[Deb]

I’m with you Borgesbi. No offense to Martin either. I know he’s helped a lot of people get completely well using strict CBT-I, and I really appreciated the help he has given me. But for some of us maybe the continued strictness doesn’t help over the long run. It’s like the strictness ends up making us more uptight and worried about everything little thing we’re doing in order to get a good night’s sleep. It goes against natural sleeping, which is about completely relaxing and trusting that sleep will come instead of trying to control it and force it to happen using all these methods.

Like you I hate that with CBT-I I have to be completely exhausted in order to fall asleep. It was never like that before the insomnia. I would go to bed when I was starting to get sleepy and it would typically take me anywhere from 10 to 30 minutes to fall asleep. I never worried about it because I would always eventually fall asleep. Also, I read in bed, watched TV in bed and sometimes fell asleep in bed in the evening if I had an extra glass of wine at dinner. Later I would get up, brush my teeth and go back to bed, falling asleep with no problem. I want to get back to this place of being relaxed about my bed and sleep.

That’s why I decided to try ACT again, because it’s about relaxing and learning to trust in our ability to sleep again. I’m in my second week but so far the results have been mixed. I really wish there was a coach for this method so that I could see if what I’m experiencing is normal or not. But because there isn’t, I’m fumbling through it on my own. I don’t know if I’ll stick with it or not, or some version of it.

[Padron1926]

Deb,

Would you recommend Guy Meadow’s book?  I’ve listened to a lot of Dr. Claire Weekes talks on YT about acceptance and that is a path I’m going to down to deal with the sleep anxiety.  If you’re not familiar with her, she did a lot of work with anxiety (sensitization disorder/nervous illness) and facing the fear, accepting anxiety and not fighting it cause that just adds fuel (basically do nothing to combat anxiety), floating with the anxiety (riding the wave of anxiety because it will pass) and letting time pass (not setting expecting for when you will get better, just accepting you will get better over time).  I had the same problem eight years ago that I do now with waking up after 4.5/5 hrs of sleep and not being able to go back to sleep but it just went away after a year cause I guess I stopped caring about (learned to accept in a funny way) and decided that I just needed to go on with my life.  Went from EMA to normal sleep just like that.  No need to increase things in 15min every week or 2.  Once sleep confidence came back I was good to go.

Borgesi

The short SW (5.5 hrs), with me, caused major anxiety issues as well as some depression (more than the insomnia caused itself) too.  I would have panic attacks at least once a week; I didn’t know what was happening at first cause I never experienced them in my life before starting SRT (guess I was getting more sleep with insomnia than I thought).

I know people say to adopt a robotic mindset about these things but I’m a human and not thoughtless, I’m going to need to monitor and make sure I’m following the rules, sorry this stuff isn’t second nature and will never be to me.  If I accidentally took a nap at work, micro slept before my SW for just a few seconds, having to stay awake before my SW and being extremely sleepy from 10Pm to midnight just waiting for my SW to begin all just increased my anxiety because I felt if I didn’t follow all the rules every night that I wasn’t going to get any better and just delay/setback any progress I had made.  A couple nights a week I would basically hold onto bags of ice and march in place to stay awake and there were times I felt like I was falling asleep standing up but would make it to my sleep window, fall asleep instantly but awoke an hour or less later (didn’t clock watch, have means to know) WTF.  I never had this problem before starting SR.  Just fueling the anxiety it seems

Talking with a an insomnia expert at a leading hospital here in Connecticut, I’m going to go with a more liberal SW and focus solely on SC and going to bed and getting up at more or less the same time everyday.

[Deb]

Yes I would recommend the book. It’s easy to read and understand but not easy to implement just like CBT-I isn’t. It helps so much to have a coach like Martin or a forum like this to know that what you’re experiencing is normal and to give you the encouragement you need to keep going. But the ACT people don’t “have their act together” and there’s no support for the most part. You just have to read the book or watch their videos and then try to implement it on your own.

[Borgesbi]

Deb and Padron,

It’s really nice to know you both can relate a bit to my experience. Deb, it’s a good thing that you’re trying something different, and I’m about to join you. Padron, it was particularly helpful to know you have also experienced depression as a side effect of SR because that has been a shock to me. I googled it a ton and never found depression as a side effect of SR and also never heard of anyone else commenting on it here. This depressive state of mind is a brand new experience to me and it has been scary because suicidal thoughts crossed my mind a few times and I have quite a bubbly personality, I’m joyful, have been through a lot in my life and never had suicidal thoughts before. I have also been getting less sleep now for 10 weeks than I used to with insomnia, so things definitely need to change. Good thing I practice mindfulness because I am able to let those thoughts flow without taking them so seriously – regardless, it’s still very unpleasant and a little scary.

I kept thinking I was the odd one out for a long time until I found this forum. The sleep specialists make it sound like it works wonders for everyone and I find that to be harmful to the ones for whom CBT-I doesn’t work as well (or works slower). Also, I don’t like that the sleep specialists/research  are “turning their head” to the cases that don’t work as well. I think there is a good 20% of us out there? I think with only a little tweaking in the strictness of the program, it could work better for the remaining of us.

I think it’s going to take some time to un-do the “bad stuff” learned from CBTI (mentioned on my other post) but I’m going to start working on them soon.

 

[Deb]

Borgesbi – If I remember correctly,  you did well before with SC and after awhile you were getting up less and less and falling asleep more and more quickly. So you’ll probably do well just doing it alone without the strict SR. It’s interesting, the first book I read that ever mentioned conditioned insomnia only said to do SC. It said that doing SC should cure most cases of insomnia within 2 weeks. Ha ha! If only!

With ACT, you’re supposed to stay in bed instead of doing SC. The idea is to learn to relax in bed and accept whatever happens, and that then over time you’ll start falling asleep naturally because you’re so relaxed. In my first week I fell asleep pretty quickly most nights but now in the second week I’ve had 3 days already where I was awake most of the night. 2 of those nights I couldn’t stand it anymore and broke down and took some Ambien, which I know is a no no. If I just can’t deal with this, I’ll go back to SC. If only I had someone to tell me it’s normal to stay awake most of the night for the first one, two, or even three weeks, and that then I would start falling asleep more quickly, then I could probably hang in there better. But there’s no one to ask and no support for this method.

[jazzcat22]

Yay–this thread is getting active again, so I want to play with the cool kids  who understand how difficult this is.  Supposedly all people have a less than stellar night every once in a while, but we have really bad nights all too often (and I do know people who always sleep well–or at least they seem to spend time in bed and can’t be roused easily—some don’t seem very refreshed when they wake up or throughout the day).

I completed Martin’s course exactly a week ago.  I went from averaging about 3 hours a night, with totally sleepless nights, to 6 and no sleepless nights.  I wasn’t even really scared that the insomnia would return.  And for the the three days that followed, I was sleeping 7 hours—exactly what I did pre-insomnia.  Falling asleep right away (my problem has been sleep inset).

Happy days, or I should say, nights–until the fourth night.  Only got 4 hours of sleep.  Not sure why—I know we are not supposed to analyze stuff too much.  I had a gynecologist visit that I was dreading—but surely that couldn’t have prevented me from falling asleep by 11, as I’ve been doing—took until 1.  We’re always told that it’s hyperarousal that’s conditioned around sleep, but I had all these successful days previously, so it was definitely not hyperarousal about sleep.  If not looking forward to a doctor’s visit or other event caused sleep problems, many more people would be insomniacs!

So although I began the week with the wonderful 7 hour sleep, this week after graduation from Martin’s program I am back to an average of 3 hours a night.  One totally sleepless night, so then I was able to sleep 6.5 hours the next night.  But yesterday was only less than 2 hours, and that was after finally doing an hour of yoga, from 3 to 4 am (then slept 4 to 6 am).

I found the SR easy and wasn’t anxious about my 5.5 window (by the end of the program, it was upped to 6.5) because it’s not like I was really being restricted.  5.5 was a distant goal, like twice of what I was getting.  So technically I’m not sure how SR could have worked for me since it wasn’t restricting my sleep at all, but did keep me from trying to go to bed before 12:30.  SC is fine for me–would rather get out of bed and read or listen to a podcast than lie in bed.

By week 3 I could feel that I was less anxious about walking back to the bedroom and accepted (was grateful!) for even 4 hours sleep.  And with the progress I made I was fully committed to doing the sleep window—I ended with a sleep window of 11:30 pm, but with the buffer zone beginning at 10:30, that was fine and I was going to bed soon after the buffer zone started—and doing SC if I ever needed it.

But now I have hyperarousal and anxiety so extreme that it can feel like a panic attack (never had anything like this before and I’m 65!).  All this afternoon I was so bad, just dreading tonight, that I took my two remaining supplements that never worked for sleep, but which are supposedly calming (theanine and lemon balm)–and then had 2 ounces of wine.  I’ve been a nondrinker my entire life, but I just had to break the anxiety loop, not even so much to sleep tonight, but just not to lose my mind.

It’s crazy.  I do so much mindful stuff.  Yoga.  Meditation.  Qi gong.  Read Buddhist teachings.  And yet I can’t get past this anxiety about bed, even though I did a week ago, and the weeks before that.

It’s not that I need 8 hours sleep.  I can do well with 6 since my sleep is pretty restorative once I fall asleep.  But I just don’t feel sleepy—so how can I fall asleep when I’m not sleepy at 12 am and 2 am?  I doze off for 5 minutes around 8:30 when watching TV, and can get a couple microsleeps during the afternoon, but at night it’s not that I am wired but tired.  I don’t feel physically tired and don’t even feel perceptibly wired most of the time.

I was so excited a couple of weeks ago when I got some head nods and book drops when reading during my buffer zone, because I haven’t experienced them in the nine months of this insomnia.  But no more head nods or book drops.  Lately I haven’t even had any heaviness behind my eyes or difficulty concentrating on reading.  But my eyes pay for it come the following morning when I read all night—my eyes are dry anyway, but being open 24/7 and using them for all that reading dries them out even more.

It’s so rough!  So does CBTI work?  Jury is still out for me.  It certainly seemed that something helped, but it wasn’t sustained, even with not changing anything after graduation.

Now I’ve thoroughly depressed myself.  But hey, at least all of us are survivors.  Maybe we should have ribbons like other diseases and health issues have.  What color would you like?  🙂

[Padron1926]

Deb,

how does ACT handle sleep restriction?  I can see how ACT SC can work but I don’t know if I could use that. I’d rather accept that if I can’t sleep I’d rather be up doing something else and not try to force sleep which feeds my insomnia

[Deb]

With ACT the sleep restriction is more relaxed. He says to just decrease by a half hour on both ends the time you used to sleep before the insomnia.

[Mac0908]

@jazzcat, you haven’t had head nods or book drops because somewhere along the lines your cycle got messed up and along with it your sleep pressure. Whether this was bc of too long of a lie in, or going to bed too early, SOMETHING altered things. Take it from me who “overslept” 1.5 hours each weekend day last weekend and paid for it all of last week.

You now need to build your sleep drive back up by going back to a strict window for at least a few days and then sticking with it. That’s the key. Only after some real successful results can a recovering insomniac begin to really tamper with a sleep window IMO if he/she wants a chance at a full recovery. And even then, at the first sign of things going off track, they must revert back to the smaller window again. Best of luck.

[Daf]

Update.

I seem to be doing OK now.

In the past, had up to 9 nights of nil sleep a month.

Now it is down to just one or two nil sleep nights a month since Feb….. Very pleased. (It’s now end June)

I keep my sleep amount down to 5 to 6 hours. (Varies from 4.5 hrs to around 6.5hrs, but I don’t slavishly record it). This 5-6 hours means I have enough sleep for the day and feel refreshed but by the next evening there is plenty of sleep drive too.

Have relaxing evenings and only close eyes when really tired, usually about 1030 to 1130pm. If I sleep on couch, so what, I’m sleeping. But I don’t obsess about times slept for too much. My “older man’s bladder” means I’m up for a P three times a night, so it’s pretty easy to keep to less than 6 hours, because of the wake ups. Once I have got to sleep once and woken for a P, I’m lucky that usually I’m OK to sleep again, even if the need to have a P wakes me up. (I have a pot by couch/ bed, so I don’t have to walk to bathroom or open eyes!)

No real stressors in my life – I’m my own boss and things going well in life.

Was on mirtazapine 15mg, but now down to just 3.75mg (a quarter of a dose, very small dose!) and sometimes when I feel really sleepy I’m starting to increasingly not take it at all. When I have taken it, it’s key to take at least 45 mins before you’d ideally like to go to bed, folks.

Think my big epiphany was finally realising that my sleep was not totally broken – and if I did not sleep at all one night, I would always sleep the next night – with no need for drugs. Took me 2 and a half years to see that! Once I realised that was true, I relaxed a lot, I think. That helped massively. Plus the sleep restriction – because that gives me just enough sleep that I need, plus means I’m getting real tired by 930ish at night. Plus accepting the bad days and just carrying on and a positive attitude, CBT style, thanks to me dear wife and friends. It’s got me through.

[Steve]

Mac – Are you back on track now?

Deb – I’m really surprised you went back to ACT after you had so much trouble with it the first time. I know you want to be “normal”, but we are insomniacs and for now, have to live with that fact. Are you still having trouble in the second week of ACT?

As for me, I was in a zombie state Friday but slept well Friday night and so Saturday was in great shape. I got the oil changed on my truck, mowed my lawn, went to a local nature center and hiked 3 miles and rode my old 10 speed bicycle another mile. However, apparently, all of that didn’t do anything for me and Saturday night, I only got around 3 hours of sleep again putting me in a zombie state on Sunday. Last night, I got about 3 1/4 hours sleep so I am near zombieish today. I did do SC again last night but it didn’t help any as I couldn’t get back to sleep. Just remembering that each night is independent from other nights so I hope I have a good sleep tonight.

[delv-x]

Thanks Daf for the update and a positive one!

Sleep isn’t ever “broken”. It is something that is ingrained in us from evolution and can never be unlearned. It is like hunger, breathing and going to the bathroom. It’s just that it is harder for some and I think all of us struggle. Some more than others unfortunately. Support from family and friends does help. Also good news that you’ve reduced your dose. I’ve reduced down to 2.5mg of zopiclone which is 1/3rd a regular dose and didn’t really know the difference in terms of sleep and slept a little better actually. A few times I’ve woken up and tried to get back to sleep and take more didn’t seem to help at all so I am convinced that sleep drive itself is much more powerful than sleep aids.

 

[Daf]

Totally agree Delv,

Very very occasionally I take Zopilcone too. And like you I think small dose is better. When I take 7.5mg I only ever get 3 maybe 4 hours on it and feel slightly depressed in morning of next day. (Is that an effect of the drug or is it because I hate taking such a drug, don’t know!)

But if I cut pill up and take 3.75mg, I get same sleep and feel less down.

But as I say, I only take it on v occasional basis, when I am unable to sleep at all and it is 3am say, and I also have something on the next day that is big or I want to do really well…..

Think some people who post here would do better if they accepted / realised that sleep will come in the end, so to be patient and accepting and just push through,… also maybe stop trying to measure it to death…. and start living as best they can.

I really recommend Jon Kabat Zinn and his Seven Attitudes of Mindfulness video to everyone.

[Daf]

BTW how do you cut a pill in thirds?  I have a pill cutter, but it is hard to do other than 1/2s or 1/4s with it..

[delv-x]

@daf

In Canada they offer it in 5mg and 7.5mg so I have 5mg and split it to 2.5. I hear you about feeling lousy. I find a higher dose doesn’t really help. I would still wake up 2-4 hours later anyway. I think I slept better before I started. It only really helps with dropping off I find. So nights where I am exhausted I may take the plunge and don’t take it at all.

I still worry because during the day I sometimes feel fatigued and remember back in college/high school that I would just lay down and sleep for an hour on demand. When I felt stressed I would sleep to cope and now it’s the opposite. The arousal and self monitoring is awful at times and hope that I can overcome that and keep it at bay. (I guess keep doing CBT-I and some acceptance and doing what I used to do before all this)

A lot of things have helped me through this journey and one I can think of off the top of my head is that the first half of the night is the most restorative. So if I go to bed at midnight and wake up around 4am and from 4 to 7am I am not even sure if I slept or not, I know the more important portion of sleep I have. Some nights I can fall back asleep and others I have more trouble but try not to worry about it. I no longer have a sleep tracker watch (it broke) so I’ve moved past that. I do still keep sleep logs and have for 9 months and thinking about giving that a break and just keep my reasonable window of 7 hours and get up at 7am and hope I don’t need to resort to getting out of bed before that.

 

[Author]

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