[Deb]

Yeah, it’s probably just that I’m still recovering from insomnia, so the system is not completely relaxed yet. In the past I’ve had coffee at 4:00 and it was no problem.

[delv-x]

I think us in this boat are past sleep hygiene (caffeine, TV, dark room etc). Consistency is key. Trust me that if your body is exhausted you will be able to sleep with the sun shining, techno playing and no AC in the summer. It would be uncomfortable and very frustrating but we will sleep.

I remember last summer a few months before I started having issues (I may have had a bit of issues then but did not bother me to freak out) I went to visit my sister in Belgium and although I didn’t really sleep on the plane which is normal for me I landed and spent the next morning awake. That afternoon in the car with her driving I felt really tired and fell asleep. That evening sleep was difficult for a few reasons. No white noise of a fan I am used to, a different bed, new environment, hot room, sun rising early and finally roosters doing their morning yelling. It was rough but I didn’t have anxiety about sleep or the next day. I was frustrated but not anxious. I just knew that based on the circumstances sleep would be more difficult and Ill make it up which I did.

It seems like our sleep drive needs to be quite high to drop off. As a teenager I could sleep whenever and nap whenever for however long I wanted. Mind you it had its disadvantages such as grogginess from oversleeping and general procrastination because I would sleep in until noon.

Finally, the fact that I want to control sleep isn’t helping.

[Deb]

Regarding your comments, “I know I am trying to control sleep when I should let go. If I wake up at 4am, I should just be like “okay… cool ” rather than me thinking “ok I have 3 hours, how can I maximize my time to ensure I feel the best today. Should I relax with my eyes closed? should I get out of bed? Should I get a glass of water and try to go back to bed? Should I try the couch?” ACT cannot be done halfway. After all, it’s “Commitment” therapy, so an absolute commitment to the method must be made in order for it to work. You can’t hang onto even just a little bit of control, because this method requires that you give up ALL control over your sleep. I don’t believe that ACT can be combined with CBT. Maybe you can sprinkle in some elements of ACT like mindfulness, but then you’re really practicing mindfulness, not ACT.

When you give up ALL CONTROL and STOP STRUGGLING then your mind gets out of the way and your body can begin to take over and allow you to fall to sleep naturally. This is what is happening to me. But your mind will still be in the way as long as you hang onto any control or continue to struggle. SLEEP CANNOT BE CONTROLLED. The more you try to control it, think about it, worry and obsess about it, try different things to help you sleep, the more it slips away from you. You know yourself that on the nights when you “just don’t care” then you sleep well. This method will help you get to that point of not caring. Of course on a deeper level we all care and want to sleep well, but on a more conscious level we stop worrying and struggling with it and begin to have faith that it will naturally happen in its own time. We LET GO.

Now I am falling asleep naturally and it’s like I’ve remembered how to fall asleep again. But I had to get to the point where I was willing to take the plunge of having some sleepless nights along with the demons that might show up. To tell you the truth, it took about a month for me to finally be ready. When I first got the book a month ago I was still in the middle of doing CBT with Martin. I couldn’t even read the book at night because just thinking about it could wreck my night. So I only read it during the day, hours before going to bed. Finally over time I kept reading it, thinking about it and getting more comfortable with the idea (but was still scared to death!) Also I could finally read the book at night. The last step I took was to contact GM’s clinic to see if anyone there could help me with this. When that didn’t work out then I realized that I had to do it by myself. It’s definitely working.

[Deb]

There’s a huge difference between sleeplessness, which you experienced during your trip to visit your sister, and insomnia. My husband has a lot of sleeplessness due to Parkinson’s disease. Some of the symptoms are restless legs, going to the bathroom a lot and aches and pains. He can get up 2 or 3 times a night to go to the bathroom. When his leg becomes restless he gets up and sometimes stays awake an hour or more until his leg settles down. Same with the pain. If it bothers him enough he’ll get up and take something for it and then go back to bed when he feels better. He always falls back asleep right away. He does not have insomnia because he never worries about his sleep. Insomnia develops when we begin to worry about sleep and then the worry takes over and we start doing everything we can to try to “fix” it.

[Daf]

I think ACT/Mindfulness and CBT-I/SRT and SC are complementary.

The only thing I think is silly about CBT-I is getting out of bed after 15 mins if you don’t sleep. I always thought that was ludicrous. Get out of bed if you are not chilled and mindful and accepting, otherwise best stay there and just rest.

Have a regular chill out bedtime routine, try to get up roughly same time (bit don’t be a total slave to this) and keep sleep a bit restricted (but don’t be a total slave to this either), and practice ACT/mindfulness and things will come together.

I have enjoyed this debate. I think it has been very good.

[delv-x]

I do think they are complimentary. There are some differences. Of course the big ones are staying in bed vs getting out and rules on napping. CBT-I is no or not recommended. ACT is if you feel like you need one then 20 minutes max before 3pm. Also the to bed and wake up times are looser as you know.  I think a little wiggle is ok (say 30 minutes) but more importantly is consistency. All the other sleep hygiene rules are the same except that if you are mindfully doing a big routine, it will be counter productive and becoming reliant on wishful thinking say the lavender will make a difference. Both CBT-I and ACT encourage mindfulness. ACT more so.

For me I am overlapping with SC. If I wake up in the middle of the night I relax and see how things go. Sometimes within 5-30 minutes I am back to sleep and glad I stayed in bed. If I wake up alert or has been 20-30 + minutes and know sleep won’t happen. (tossing and turning and frustrated) I will get up for a bit. If I am in bed for awhile but not frustrated, Ill relax and maybe sleep will happen, maybe not. If not then not to be wound up about it.

 

 

[Daf]

Exactly the same approach as I employ Delv. Bang on the money

[Deb]

Delv – the fact that you’re getting frustrated shows that you’re still struggling. ACT is about giving up the struggle.

6th day of ACT. After I lay down last night I felt the old worrisome thoughts and feelings creeping in. I reminded myself that they are only thoughts and feelings, and that they can’t hurt me. They didn’t hang around too long. Took me awhile again to fall asleep – maybe 1 to 1 & 1/2 hours. Don’t know for sure because I don’t check the clock. I’m not worried about sleeping because I know that eventually it will come, which it did. I’m sure that over time the amount of time it takes for me to fall asleep will gradually decrease. Healing still needed for things to settle down. Slept the rest of the night and slept in this morning, making sure I got enough rest. Got up feeling a little weary, but this is from this darn cold/flu bug I’ve got, not from losing sleep. I got plenty of it – at least 8 hours.

[delv-x]

When I had a cold/flu bug a few weeks ago I managed to get in 8 hours of sleep. It was a reminder that my body does know best even if it’s stubborn. I did wake up around 4am but relaxed and eventually slept until 7:15. I just let go and try not to care about anything.

[Deb]

Great! Yes, just LET GO.

[Deb]

Day 7 of ACT. Was wiped out because of this darn cold/flu bug and fell asleep on the couch after dinner. Usually been going to bed with my husband around 10:30-11:00, but decided stay up till 11:30 even though I was already tired by 11:00. The old fear of not being tired enough crept in. When I hit the sack, a little worry was there but disappeared soon. Fell asleep within a half hour and slept solid all night – maybe 8.5 hours. Bit by bit the fear and worry is lessening and the sleep is getting better.

[Davy]

i have one question sleep restriction if you have so many sleepless night what are you going to restrict i follow cbt now from cursus in hospital our government fund its 50 percent i need to be in bed for 5.5 hours no longer it’s more than a year i slept this much how you going to restrict something if you are more awake then you sleep

[delv-x]

Hi Deb,

Hope you are feeling better. One day at a time. Sounds like you are on the right track. Remember that you will have bad nights. Treat each night as individual and just keep at it. I slept over 7 hours last night which I haven’t done in a few weeks. I accidentally slept in an hour + it’s daylight savings time which means another hour. I would like to say sleep is getting better (last 2-3 nights) but I know it will change. I just need to cope better when I do have a bad night so it doesn’t lead to subsequent bad nights.

[Deb]

This cold/flu bug isn’t too bad fortunately. Just don’t have much energy. It’s a beautiful day here in the 60s and I would take a walk if I felt better. May still do it.

I’m not afraid of having a bad night because this method has helped me look at fear directly in its face. I’ll just keep doing what I’m doing, accepting whatever happens in the night, good or bad. Then anxiety cannot get its grip on me again, spiraling into insomnia.

 

[Deb]

Had a bad night. Delv – you jinxed me! Got caught up in the struggle when I couldn’t sleep and got overwhelmed by it. Need to learn how to create some space between the struggle and myself by trying to “observe” it rather than get caught up in it. Back to mindfulness practice.

[Author]

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