Sleep Restriction or ACT for Insomnia

This topic contains 188 replies, has 10 voices, and was last updated by Mac0908 11 hours, 12 minutes ago.

Viewing 15 posts - 151 through 165 (of 189 total)
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  • #28014

    Deb
    ✓ Client

    You’re welcome, Steve. You may also want to talk to Delv, whose insomnia started around the same time as yours and has been working with a local CBT-I therapist. You can ask him what’s been helpful and what’s not helped.

    #28015

    delv-x
    ✘ Not a client

    Thanks Deb. I am always willing to help others and provide suggestions to anyone on here. I honestly think everyone is different and there isn’t a cookie cutter solution. A lot is trial and error but the answer is more of doing what you did before all this. Some may find 2 hours of winding down helpful. Some may find tea helpful. Some may find a cooler room helpful. From my experience, almost everything I’ve tried worked initially and then stopped and led to disappointment.

    What is working/helping for me in general:

    – Treat every day and night as unique. If you slept well or poorly the night before it has little bearing on how you will sleep tonight.

    – If you got up at your prescribed time or earlier and can’t fall back asleep, go through your day. It is usually not as bad as you envisioned when you first woke up. The more fun you have during the day/evening, the less you will worry about sleep, the easier it will be to fall asleep and stay asleep.

    – Avoid naps. If you need to make sure it’s early morning, early afternoon and keep it short. What I do is set 30 minutes. If I sleep, I sleep, if I don’t I relax but after 30 minutes I am up. If I really needed to sleep that WAS my opportunity. Tough love.

    – Tough love. Try to wake up at the same time everyday including weekends. Once you are up, avoid napping. Your next opportunity to sleep is at bed time. It sucks but after awhile I find that I am less tired.

    – In the evenings, find things to do. Go out, socialize, play board games, bowling etc. Staying in on the couch watching Netflix in a dark room is cue for sleepyness. This will make it more difficult to stay awake and also wind you up to think about how you will sleep tonight. You will end up in the paradox of easily falling asleep on the couch but wide awake in bed.

    – Wind down. I think everyone is different and you will need to experiment. Wind down for me is it is nice to relax but too much makes it worse. If I spend an hour doing yoga, meditate, tai chi, hot bath, read, have tea I not only waste time but I am more likely to have worse sleep. Do what you did before your insomnia. If it were to read for 20 minutes, read for 20 minutes. If you like to walk the dog before bed, go for it.

    – If you get 3-4 hours of sleep or whatever that night, see above “tough love”. Staying in bed for another few hours is almost futile especially if you are no longer sleepy. Getting up and about your day is the best option. Your next opportunity to sleep is at bed time.

    – Avoid looking at the clock. Better yet remove clocks from the room. If it’s not 7am I don’t want to know. It’s bedtime.

    – Consistency. I would rather have 5 hours of sleep every night than 3 here, 7 there, maybe an 8 and then a 2. The inconsistency makes daytime functioning hard. 3 hours of sleep I feel awful. 8 hours of sleep I feel awful even if I did get 8 hours!. Getting the same amount everyday is better. Best way to stay consistent is sleep restriction. If all is well after a few weeks you may be able to sleep 7-8 hours solid. If you are older then maybe 6-7. Nothing wrong with that.

    – Finally, sleep difficulty is common. So common that it is a billion dollar+ industry of pillows, gimmicks and potions promising better sleep. I know it is very hard to do but when you do get a good night sleep, make the best of your day. Exercise, socialize, have fun. The odds are that will help for that night and spiral you upwards and not downwards. It is 99.9% guaranteed you will have poor nights again and possibly several nights in a row. Not letting it get to you and not giving it attention it wants is one of the best and quickest ticket out.

    #28016

    delv-x
    ✘ Not a client

    Oh and one more thing. (I can probably go on and on). In ACT, they say that you cannot control sleep and this is true. The more you “try” to sleep, the more difficult it becomes. For those who are controlling which is a lot of us, you can control sleep to an extent. You can control when you go to bed and when you wake up. Everything in between unfortunately is out of your control.

    So if you feel the need to control some aspect of sleep, you can decide when you go to bed and when you wake up. If you sleep in by over an hour, you’ve lost control.

    Once you consistently can sleep with 85% sleep efficiency or higher for a few weeks, you should be more confident and be able to add more slack. Maybe on weekends, sleep another 30 minutes or a bit more. Take that 30 minute power nap etc.

    If you start to slip, start sleep restriction asap.  Sleep restriction shouldn’t be a big reduction but rather consolidating sleep and getting consistency back.

    #28017

    Mac0908
    ✘ Not a client

    Really well written Delv. All very good points. The one that I took note of most was keeping active in the evenings. I absolutely have realized that is true. Whether I went to the gym kind of late, stopped by my parents house or was simply out with a friend, those nights have always seemed to end up better for all the obvious reasons. But the reality for me, at 34, most of my weeknights ARE time spent on the couch watching TV. I’ll get sleepy and then yes, you’re spot on in that once I get in bed things change a bit. I still fall asleep within 30 minutes (usually), but its very different if lets say I came home from some sort of party and its 11pm and I just crash. Really no way to avoid this though. What am I supposed to do? Sit in a chair instead of the comfy couch? Stand up watching TV? Lol. Obviously before my problems began 2.5 years ago none of this was an issue, but, you know..

    #28018

    Steve
    ✘ Not a client

    My problem is that my alarm goes off at 5:00 in the morning. That would make my sleep window 11:30 to 5:00. What am I supposed to do at 5 in the morning to 11:30 at night on a weekend? It’s too early to do anything. Sometimes I stay in bed until 7:00 and I do pick up another hour of sleep that way. And that does help me throughout the day.

    #28060

    Mac0908
    ✘ Not a client

    4 good nights in a row. Including 2 work nights of course. 4 in a row is typically more rare for me. Just an amazing feeling being awake during the day and feeling good on a consistent basis. Why do I have a feeling I’m about to jinx myself now?

    Deb how’d you do?

    #28061

    Deb
    ✓ Client

    Glad you had some good nights, Mac. I’m not doing well. My anxiety has been creeping up and as it does the insomnia has been getting worse.

    #28062

    Mac0908
    ✘ Not a client

    Can you explain what you feel led to this return of sleep anxiety ?

    #28063

    Deb
    ✓ Client

    The days of shallow sleep and wondering what’s causing them. Wondering if I’m doing things wrong and don’t know what I’m doing. Exhaustion during the day that leads to low moods that then feeds the anxiety. Bad nights leading to more anxiety and more bad nights. Wish I had a coach to help me with this other method. It’s so hard to do this on my own. I have no where to turn with questions and problems.

    I may look for someone to help me with my anxiety, which is what this is all about. I’ve got to learn how to calm myself instead of buying into the stories that my thoughts and emotions are telling me, which then feed the insomnia.

    #28065

    dragon
    ✘ Not a client

    Yeah I’m having the same issues Deb.  You are not alone.  Not sure how to address either honestly.

    #28066

    Deb
    ✓ Client

    Just have to keep practicing the skills to help me with my attitude, thoughts and emotions. Last night I realized that I was “struggling” with the insomnia again and it was just making everything worse. When I let go of the struggle and did some mindfulness to anchor myself back into the present, things got better and I finally fell asleep. But the sleep was fragmented again so of course I’m tired today again. Have to work on my attitude, thoughts and emotions during the day as well as at night to deal with the daytime tiredness better. Otherwise the negative thinking during the day contributes to the night time insomnia.

    It would be so much easier to just put an external structure into place like SR and SC to try to solve the insomnia, than to work on myself. But as we all can see here, there’s no guarantees of that getting us the results we want either.

    #28076

    Deb
    ✓ Client

    Not that SR and SC are easy. They’re far from it. None of this is easy. It’s the hardest thing I’ve been through in years.

    #28093

    Mac0908
    ✘ Not a client

    Hey. Guess who jinxed himself after all. Yup, a bad night. As per usual after putting together a good few nights in a row, its like this permanent thing that can’t allow me to go any further. I start having small subtle thoughts about how this can’t go on forever and tonight just MIGHT be the return of the bad night, and then it usually is. I really didn’t even do anything much differently at all either, last night. It was simply the thoughts and a bit of anxiety creeping up. Crashed around 11pm maybe a tad after, woke up at what I estimated to be 5am. Laid in a daze until my 6am alarm. Very tired today. Just short of feeling like a zombie. ((sighs hard))

    #28097

    Deb
    ✓ Client

    Sorry you had a bad night, Mac. I’m curious, what’s a good night for you? You said you had 4 good nights in a row. Is that 7 to 7.5 hours?

    Yesterday I was tired and by the evening was a zombie. Could not do anything but lay down on the couch. Fell asleep for an hour or more and woke up completely refreshed! Best I had felt in days. By 11:00, my bed time these days, I wasn’t ready to sleep so stayed up an extra hour till 12:00 when I was feeling tired again. Fell asleep right away and slept until 7:00. The best I’ve slept in days so am very grateful to be feeling good today.

    Hoping that I’m back on track after being derailed for several days. Using the ACT tools again of acceptance and mindfulness and most importantly, giving up the struggle. A couple nights ago I realized that I had gotten back into struggling and it was just making things worse. So let that go.

    Last night was thinking about an interesting difference between CBT and ACT. CBT is a more masculine approach while ACT is more feminine. With CBT it’s more forceful, where you grab yourself by the neck and  then push yourself to do it. You’re in control. ACT is the opposite, where you learn to surrender and give up control. Also its more feminine in that you’re very gentle with yourself like a mother with a child. Just as a mother comforts a child when he’s scared of the monsters in the bedroom, you learn to comfort, calm and reassure yourself. You stop feeling like you have to fight those monsters or barricade your bedroom so they won’t come in. Your anxious thoughts melt away when you realize that “Everything will be ok.” So when the anxiety starts rising again, you reassure the little kid within you that you’re safe and that those big, bad thoughts can’t hurt you. Then you can sleep like the child who knows he’s completely safe and secure.

    #28098

    Mac0908
    ✘ Not a client

    A “good” night I’d say is a full 6.5 hours. That is where I feel ok and at least rested. When I start lingering around 6 that’s when I’m in trouble and under 6 I’m toast. 7 or more is a great night.

    Fri night I got 7 hours for the first time in a long time but that’s only I went to bed with a migraine and insomnia was the last thing on my mind. Sat sun and mon I got 6.5

    Today i just feel flat out bad. Even have a little scratchy throat now on top of it all. “Payback” for my streak of 4 good nights perhaps

Viewing 15 posts - 151 through 165 (of 189 total)

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