[wsh]

Last year I went through complete hell with insomnia. In a 6 month period I had at least 12 nights of no sleep (sometimes 2 in a row), and probably at least 1 night in 6 was less than 4 hours. I know many people get it much worse than this, but this felt really horrible for me as I have always been a 7-8 hour/ night sleeper (I am 58). I tried many different things. I had lists of things to try for pre-sleep rituals (at one stage there were 26 items on this list!). At the worst times, I took Valium – in my view, a horrible drug (Google Jordan Peterson/valium), which made things worse. I tried an expensive and useless sleep doctor. Eventually I found CBT-i. A difficult undertaking, but after 8-9 weeks of perseverance (and logging the results) I could see this starting to work.

I have now returned to my former sleep pattern (7-8 hours per night), and this has been pretty regular now for the last 5 months at least. I ask myself why. Firstly, I stopped panicking about sleep. I realised that if my sleep went off the rails again, I could always re-implement CBT-i and get it back on track. WAY better than any horrible drug. Secondly (as a result) I stopped caring about whether I went to sleep or not when my head hit the pillow. By that I mean I knew I could function the next day regardless of whether or not I slept, and if it became a persistent problem again I could always bring it back under control. So even when I finished CBT-i, it has become a “safety net” for me, which seems to keep my insomnia at bay. For me, insomnia is all about fear. A fear of not sleeping. For me, reducing or eliminating that fear seems to have made it go away.

[ababak01]

I am doing CBT-I right now and finally feel like I am turning a corner..I still have a night per week that is pretty bad and it is hard to not get upset and feel like the CBT-I isn’t working…how long did it take for you to stop having the bad nights totally..also, how often did you have to do SC while you were doing CBT-I…SC is the hardest part for me as I feel like a zombie in the middle of the night and I can’t think straight.

[wsh]

Hi ababak01,
I agree with you that not sleeping is very upsetting, and sometimes the CBT-I feels like it is not working. Also the sleep control/sleep restriction is extremely challenging. Forced sleep deprivation is a traditional form of torture after all!
It took me 7 weeks before I was averaging 6.5 hours sleep per night with ~ 80% sleep efficiency. However even after 7 weeks, like you I was still getting 1 really bad night of sleep per week (eg 1 hour). That is why it is so important to keep the sleep diaries, as they give the better picture of the long term trend to improvements in average sleep hours and sleep efficiency. I totally agree with Martin that you just have to try to overlook the odd bad night.
Even after 13 weeks I went through a really bad patch (in November last year) of several weeks of very poor sleep. However I re-did the sleep restriction and everything came good again.

[Alice]

Hello wsh,

I have a few questions. What kind of insomnia did you have ? Sleep onset insomnia or sleep maintenance (or even terminal) insomnia? Before starting SRT, I had terminal insomnia, I could fall asleep easily, but after 2-3 hours I could not get back to sleep anymore. Once I started SRT, I developed sleep onset insomnia and nights with zero sleep. Was that the case for you too? I have another question if it is not too personal: Do you think your insomnia was triggered by depression?

Also, how did you manage to stay awake during the day? I even had difficulties keeping my eyes open during the day, especially waiting for my bedtime in the evening was a torture, I was REALLY tired, but once my bedtime approached all the sleepiness was gone, hence the sleep onset insomnia. I’m now starting to think that CBT-I, especially SRT, are not working for me (after trying it for almost 3 weeks).

• This reply was modified 4 years, 6 months ago by Alice.

[wsh]

Hi Alice,
Mine was almost always sleep onset insomnia. I could be super tired before going to bed, dozing off. My head would hit the pillow. I would just be about to fall asleep, then BANG. Wide awake. No more sleep.
As far as depression goes, its hard to pinpoint what came first. I had terrible anxiety (triggered by a recently diagnosed genetic heart condition). Then insomnia. Then depression. In my mind these are the holy trinity of mental health issues. (Anxiety, insomnia, depression). They all feed off one another to create a very ugly vicious circle in which you spiral down. However, conversely, when one improves (eg sleep), the anxiety and depression seem to improve in a virtuous circle and you spiral back up again. My depression and anxiety is considerably better, although I still have my not so good days every so often.
Regarding the tiredness that comes with sleep restriction. Like I said, this is like torture. But that’s how it works. Eventually, you just get so tired you do actually get some sleep, then a bit more, then a bit more, and so on.
PLEASE DONT GIVE UP. Week 3 is way too soon. I kept a sleep diary, and my sleep had not started to improve after 3 weeks at all (in fact it was probably worse). It was more like 6-7 weeks before I could see any improvement. And then more than 3 months after that I had a setback and had to start it over again (but it was much quicker the second time). However, in the last 5 months I have now been sleeping pretty well. I haven’t had a bad night at all for the last 3 months, and Im sleeping 7-8 hours each night.
I understand how tempting it is to give up. But what else is there? Drugs are not the answer. I would curl up in bed and get my lovely patient wife to hold me while I cried for hours. Depressed, sick with tiredness, and desperate for sleep. But I think CBT is the gold standard of insomnia treatment because it (eventually) works.
I give you all of my heart felt wishes and prayers for you to get your sleep back again Alice. Until recently, I have never been much of a religious person, but when I started sleeping again it has truly felt like a miracle from the heavens.

[ababak01]

I would love to hear about your experience with SC..it is the hardest part for me..I have sleep onset insomnia and the sleep restriction is challenging but hasn’t been that hard and I am even sort of use to it now..I still have such a hard time with SC..On those few bad nights I am still having, I lay there and sleep surf through the night instead of getting up for the SC part…I do not feel like I will be healed until I get this part of the therapy executed properly..can you weigh in?

[wsh]

Hi ababak01,
By SC, I assume you mean that you are having difficulty getting out of bed when you haven’t fallen asleep, and then wondering what to do. Like you, I found this difficult. The advice is to get out of bed if you haven’t fallen asleep after 20-30 minutes. Then because you haven’t fallen asleep due to sleep onset insomnia, you find yourself getting in and out of bed like a yoyo for most of the night. Worse, when you do get up, you are so tired and feel so miserable you dont feel like doing anything. If this is what you are describing then this is what I experienced as well.
Firstly, I would advise the night before to sleep to expect that you will be getting up many times, and plan out some things that might pass the time with low mental effort in the middle of the night. Also, make sure you can get out of bed and put on something warm and comfortable. Do nothing stimulating. It might be a low-key TV show. Or an easy book. Or some gentle music. Build some lego. Jigsaw puzzles. Colouring in. Go for a moonlight walk. Build a model aeroplane. Hand write a letter to a friend. Anything. Secondly, I would say it is not necessary to get out of bed every single time you can’t get to sleep. Try reading a boring book while sitting up in bed some of these times. There are even some online sites with people reading boring books to help.
If this is not the answer you were looking for, let me know.
Cheers.

[Martin Reed]

Thank you so much for sharing your transformation, @wsh. I really appreciate the fact that you don’t sugarcoat things — that you emphasize that these techniques can be challenging, especially over the short-term, but that they do end up changing the way you think about sleep and give you a set of behaviors to follow that improve sleep over the long-term.

Furthermore, since CBT-I techniques are, ultimately, a collection of skills, you know exactly what to do should sleep disruption ever return and prove difficult to shake off at any point in the future.

I have no doubt that your experience will be motivational for many people and will encourage others to implement techniques that will improve their sleep for the long-term, just as you did.

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[EddaK]

Thank you so much. This is so encouraging to read as I am just at the beginning of learning CBT-I. Nothing else has worked so far and I’ve been suffering with insomnia for four years.

[Gabriele Buonomo]

Hi Whs
I am glad you defeated insomnia I have just finished 8 sessions of CBT-I from which I have had many benefits with an 86% sleep efficiency, only now that I have concluded I am anxious to continue from alone and I’m afraid of falling back into the vortex. I wouldn’t want this anxiety to ruin all my results, I’m afraid of missing out on sleep benefits. Did you feel this way too after the treatment? Forgive my English, I write from Italy.

[Author]

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