Sleep restriction

This topic contains 5 replies, has 3 voices, and was last updated by Martin Reed 1 week ago.

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  • #30606

    wsh
    ✘ Not a client

    Hi,

    I’m new to this forum. Thank youth everyone involved for sharing your tips and advice on insomnia, and to Martin for setting this up. I have already read quite a few of the posts on sleep restriction which I found very helpful. I have problems (recently developed) with sleep onset insomnia. I guess my sleep has not been that great for a fair while anyway, but in August last year after a particularly bad night of sleep away from home I admitted myself to the ED in a hospital with what felt like a heart attack (and was incorrectly diagnosed as that), bit which turned out to be a bad anxiety attack. Since that time I have been on a long journey to recover from the anxiety, but in February this year I started to really struggle with sleep onset. Since then about once a week I have a night where my head hits the pillow, and I get very anxious about sleeping, and can’t fall asleep. These nights I get maybe 1 hour of sleep. On one occasion I had two of these nights back to back and the next day was one of the worst I can remember.

    So I went to a sleep clinic two weeks ago, and did the sleep study thing. Which told me I don’t have sleep apnea and not much else. How you are meant to sleep at these places with a billion wires and tubes hooked up to your head I do not know. Anyway the sleep doctor prescribed CBT and Gabapentin (Neurontin in the US). So as part of the sleep log I now need to do the sleep restriction thing, which I have started about 11 days ago. It has been very difficult to do. Anyway, I have set my sleep window to 6.5 hours, and near the end of week 2 I am averaging about 5.25 hours average sleep time with about 77% sleep efficiency. I am still having a lot of variability in this. Some nights I sleep almost the whole sleep window. Other nights maybe 2-3 hours.

    It would be great to get some stability back into my sleep again.

    #30609

    gsdmom
    ✘ Not a client

    I’m curious about the gabapentin, it is effective at all?

    #30610

    wsh
    ✘ Not a client

    I think it helps a bit. I take 300 mg about 1-2 hours before bed, which is a fairly low dose. I am no expert in finding solutions to insomnia, so I am trying quite a few things in parallel at the moment, and it is a little difficult to say which things are working and which are not. I have only taken benzodiazepines in desperation about 4 times in my life (I am 57), and they definitely put me to sleep. Once on those things I slept for 12.5 hours straight, but they are not a viable long term solution because of all the problems associated with them.

    #30631

    Martin Reed
    ★ Admin

    Hello wsh and welcome to the forum. The way your insomnia developed is not unusual so I see no reason why CBT-I techniques will not be helpful for you. You might find this short video helpful:

    How one night of poor sleep can turn into chronic insomnia

    Are you working on CBT-I with a therapist? Your sleep window sounds a bit too long compared to your current average nightly sleep duration. If you are currently getting around five-and-a-quarter hours of sleep each night, I’d suggest starting with a sleep window of around five hours and 45 minutes.

    I hope this helps!

    #30645

    wsh
    ✘ Not a client

    Hi Martin,

    Many thanks for your reply, and the video link was really helpful. I am not currently working on CBT-i with a therapist, but if you are offering I am keen so let me know whether this is something you can offer. Send me a private email on this please. Actually the sleep clinic I went to in Australia was not as helpful as I would have liked. After a rather expensive sleep study (with a very poor sleep as a result of having a large number of wires and tubes hooked up to me) they told me I didn’t have sleep apnea (which I already knew). They just gave me a prescription for Gavipentin (leaving the dosage up to me), told me to do any online course on CBT-i for insomnia and pretty much left it at that.

    Anyway, I am currently just about to finish week 2 of sleep restriction. I am using a 6.5 hour sleep window. So far in week 1 my total sleep time averaged 5.0 hours, and sleep efficiency was 73%.  In week 2, total sleep time improved to 5.6 hours, and sleep efficiency has been averaging 86%.

    On the basis of these numbers, do you still think it is a good idea to reduce my sleep window from 6.5 hours to 5.75 hours ?

    Kind Regards,

    Bill Hunter.

    #30646

    Martin Reed
    ★ Admin

    I’ll send you an email, Bill. With those sleep efficiency numbers, I’d suggest waiting until Week 2 is over before adjusting your sleep window further.

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