[Christie77]

Hi
I have been implementing CBTi for about 4 weeks. I feel like everytime I implement an advised change (eg. shorten my sleep window, begin stimulus control) I do well for a few days and then my sleep deteriorates. I now have a 6.5 hour window and get about 4 hours sleep.

My question is about stimulus control, it seemed to work for a few days and now I feel like it is increasing my anxiety and doesn’t work at all. I’m just up and down a number of times in the night before I just get back up for the day as I don’t end up falling asleep in my bed. Could this be the case? Could SC be increasing my anxiety (especially overthinking when to get up out of bed and when to go back to bed) and therefore negatively impacting my ability fall back to sleep? I find I can lie in bed quite calmly awake, just using it as a means to relax and rest. But this can last up to 2 hours before I fall into a very light sleep again.

Any thoughts? thanks so much

[Deb]

Hi Christie – SC does seem to create more anxiety for some people. As an alternative to CBT-I you want to look into ACT, another therapy for insomnia. It’s worked for me. The best resource on this is The Sleep Book by Dr. Guy Meadows, who developed it. It’s based on learning to relax in bed so that sleep naturally comes. Check out my last post under the thread, ACT for Insomnia.

[Patrik Jalc]

Hi Christie,

When I was at week 4 I was questioning the methods also..mostly during bad nights. I was not sure it works until week 6. I spent whole nights practicing SC.. So my advice would be – just keep doing it as instructed and be patient, also when you are in bed thinking if or when to get out then just go out 😀 you are already thinking too much. Good luck

[Martin Reed]

Hello Christie77 and welcome to the forum. Are you implementing cognitive behavioral therapy for insomnia (CBT-I) with a therapist? If so, I would encourage you to raise your concerns and challenges directly with them.

If you are currently averaging around four hours of sleep each night, it sounds as though a six-and-a-half-hour sleep window might be setting you up for quite a lot of wakefulness (up to two-and-a-half hours) during the night.

Stimulus control is a long-term technique intended to help you associate your bed with sleep rather than unpleasant wakefulness. So, it probably didn’t directly “work” for those first few days since it usually takes longer to experience results and recondition yourself to see the bed as a place for sleep.

I suspect you found it easier to fall back to sleep at first because you had the belief that it was going to help you fall back to sleep — then, on the first night that you found it harder to fall back to sleep, you started to worry that the technique wasn’t working and this triggered your anxiety (which, in turn, can make sleep more difficult).

As you pointed out, it’s usually not helpful to be performing all the “mental gymnastics” at night trying to figure out when or if you should get out of bed. I would suggest that as soon as you start to feel worried or anxious, you start tossing and turning, fighting with the bedsheets or start groaning with frustration, that is your cue to get out of bed — because, under these circumstances, you’re probably not going to fall asleep any time soon.

If you are awake but feel calm and relaxed, I think it’s OK to stay in bed because the conditions are right for sleep. As soon as being in bed becomes unpleasant, that can be your cue to get out of bed.

I hope this helps.

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[Christie77]

Hi all

Thanks so much for your responses and advice. I followed some of it and have to say ACTi has been a complete game changer for me. Martin I followed your advice re staying in bed if relaxed and calm and Deb I read Guy Meadows book.

Honestly, everything (for the moment!) has shifted. Thank you so much.
Christie

[Author]

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