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I could be totally wrong, but I wonder if sleep onset is a little simpler to fix and perhaps the reason why it was so quick for you, Deb. I remember you said with CBTI things were going quite well, it was only when anxiety hit that you’d have bad night, is that right? At least from my own experience, sleep onset really comes down to sleep drive and anxiety. If I have just enough sleep drive and I feel calm (no anxiety, no monitoring) I’m out like a light. Sleep maintenance seems a little more difficult – perhaps because the brain has made a stronger association between wakefulness and evening? The brain created a pattern of waking up in the middle of the night? And if that association has been made, it probably involves more anxiety, more activation of the amygdala while we’re sleeping, more conscious/unconscious monitoring?
By no means am I saying that sleep onset is not a struggle – it is, I have had it and know how incredibly hard it is, but also from my experience with CBTI and ACT I noticed it’s an easier/simpler fix than sleep maintenance since it seems to come down to enough sleep drive and total relaxation only. So for the ones of us with sleep maintenance issues, it may take longer for these associations to go away as the mind relaxes and the body takes over. As always, my own theory! 🙂So good to see we’re all improving a bit! By the way, I’m far from healed – I still have nights of little sleep (although they only happen when I work out or if I have a more concerning personal issue), and awakenings still happen on good nights of sleep, but they don’t last long. I noticed what really changed for me with ACT is my attitude towards insomnia, both during the night and day. I think I just don’t see insomnia as a problem anymore. With ACT, I also started feeling great during the day: energized, good mood, less anxious, appetite went way down which was out of balance when I was doing strict SR. Maybe a full healing of sleep system will follow, but if not, I can live fine with how things have been! I think I got to the point that I’m tired of fighting or feeling frustrated with insomnia and prefer to just let it be.
Deb, as always, I’m forever grateful to you for bringing up ACT and recommending The Sleep Book, what a life changing experience. Also, so thankful to Martin for allowing us to discuss ACT here!Hi Burn,
I’m not sure I would be able to help but I’m more than happy to try! Steve is right though – if you want to get in touch with Martin to get my email address we could then coordinate a time to talk? I don’t use Skype, so it would be a regular phone call, if that’s ok!
Hi all,
Wanted to come here to report that I’m noticing my sleep improving to great extent with ACT although I can’t be sure of how “permanent” this is. I found out that my long-lasting awakenings have been happening only on days that I do strenuous strength training (I read that it has to do with release of high levels of norepinephrine and adrenaline that can last 24-48 hours after a strenuous work out, which probably wouldn’t affect a normal sleeper as much). I still need to see what to do about this since the work outs are in the morning so there’s no much more I can change to not affect my sleep.
Besides days when I do strength training, I have to say sleep almost feels normal again. I hit my head on the pillow and sure enough I fall asleep with no problem, I don’t remember when was the last time I struggled to fall asleep in the beginning of the night. I generally wake up quite early but that’s because I go to bed early, so it doesn’t bother me.ACT has been working for me in learning to not overthink anything, relax, go with the flow, and just “not mind insomnia” either if I have to be awake for a while at night or deal with some uncomfortable symptoms the next day. I stopped worrying about insomnia in general for the most part, including “activities in bed” and sure enough I’ve slept just fine on days that I hung out in bed watching a show or reading a book. I haven’t really used any of the tools from the book anymore, except for just “noticing” and laughing it off (in a heartwarming manner) when patterns emerge – every now and then I catch myself monitoring my state of consciousness when I’m in bed and it’s so automatic that it was interesting to catch it and kind of laugh at it. I had never caught the moment in which I was monitoring how alert or how sleepy I was and it was so intriguing I told myself in the
moment “yeah, no wonder you’ve been having insomnia – this monitoring thing would make anyone really alert”, it seems to play a huge part in keeping us awake (it’s not anxiety, just a subtle monitoring). Because it’s such an automatic and ingrained pattern, I know it will still come back a few times before it dissolves completely.
So I think for me just being light hearted about the whole thing and letting it be as much as possible has been the key. Hope we all keep getting better and we can remember not to fight it when dealing with setbacks and difficult thoughts/feelings!Hi Nik! Ok to ask the sleep doctor about activities in bed? Should we restrict just a little, or for the most part?
When are you scheduled to talk to her?Steve, that’s exactly what I think is happening to us. If not that, then an automatic association of the brain with wakefulness in the evening because it has learned to do that in the past and we’re still breaking the association.
The patience required to just lie there for several hours without falling back asleep is no joke. When I get light sleep I don’t mind as much because at least time seems to go by faster. When I’m completely alert, being in quiet wakefulness for more than an hour is tough! I don’t think I have yet welcomed the frustration and struggle I feel from not falling back asleep after an awakening. I think this one will be more challenging.Thank you so much, Deb. You’re right, I’ll be careful not to start worrying about this. I feel like the same thing happens to me as it does to Steve. The longer I lay there, the less likely it becomes to fall back asleep. I haven’t felt anxiety in a while though. For example, last night I was pretty calm but just laid there for several hours awake and calm – some mild frustration did show up at times. I think sometimes we’re not necessarily anxious, but we’re consciously or unconsciously monitoring what’s happening and that keeps us awake? I remember Martin mentioning something like this. Possibly what happened to me last night; the monitoring is subtle so it’s hard to catch it but seems to bring quite a state of alertness.
Hi everyone! For the ones practicing ACT – what has been your attitude in terms of activities in bed? While practicing ACT, do you all still restrict bed only for sleep and sex or have you been flexible about it?
Since starting ACT every now and then I’ll hang out in bed to watch something on my computer or read (not in the middle of the night), which helps me see my bed as a “friend”, not as a forbidden place as it happened for me when I was practicing strict SC. However, I’m wondering if that’s promoting awakenings and difficulty of going back to sleep which have been happening more often these last few days even though sleep had been pretty decent for about 3 weeks.This association between bed and wakefulness talked about in CBTI – I can’t tell what to think of it. With ACT not much is mentioned about that. We’re practicing staying in quiet wakefulness in bed when we can’t sleep, so that would be associating bed with wakefulness as well, no? I’m getting a little confused with the 2 techniques..
Hi RonA,
It is possible, definitely. But I’ve dropped CBT-I since it wasn’t working for me and from recommendation from another person here in the forum, I started ACT for insomnia, which has been working great for me. I try to do a sleep window of 8 hours during the week and let myself relax about it over the weekend. I was still pretty sleepy and falling back asleep fast last night even though I had many awakenings so my body was definitely asking/needing more sleep 🙂
I had just been thinking to ask the same thing here in the forum. My insomnia has been so much better too and I feel like it will only get better from here and on (with small relapses perhaps), but one thing I also still experience are awakenings. Las night I slept straight from
9:30pm to 2:30am and then from 2:30 until 6:30 I had a ton of awakenings (at least 3 or 4) although I would fall back asleep pretty fast after each one. It didn’t frustrate me necessarily but it makes me wonder if these awakenings will eventually go away.One of the people here in the forum said her sleep doctor explained that in people with insomnia, the amygdala is much more active and stays active while we’re sleeping even if we’re consciously calm. So it’s almost as if our unconscious is on alert and waking us up to make sure everything is ok and we’re safe because it has gotten the message from us in the past that being in bed or anything related to sleep is stressful. The best thing in my opinion is for us to not give these awakenings much attention and let it be – if we can fall asleep rather quickly after an awakening, that’s already great 🙂
Ps: I lacked the sensation of sleepiness for more than 2 years btw! Just want to re-assure you that is not an adenosine receptor issue, as I’m feeling sleepy just fine these days!
Hi Patrick,
Have you tried Martin’s course? Or read about ACT for insomnia? I’m no expert, but I doubt that excessive caffeine for a prolonged period of time would harm your adenosine receptors. When my insomnia was really bad I too lacked sleepiness, it was a sensation I had forgotten completely. I only experienced sleepiness again for the first time when I did a more strict sleep restriction – only 5.5 hours in bed. That fixed the problem of feeling sleepy pretty quickly! I don’t need such a strict sleep window anymore to feel sleepy, but it might be helpful for you to do it for just a few weeks until you start feeling sleepy again! Always better to do this with the support of a sleep coach/doctor so I recommend getting in touch with Martin!
Syub40,
What you described sounds a lot like hypnic jerks thay are accompanied/caused by anxiety. They are super common in folks that struggle with insomnia, I used to have them a lot but since getting better from my insomnia, I don’t experience them much anymore. I recommend either CBT-I or ACT to help you move through this.
Padron 1926,
With all due respect, I find it unnecessary and unhelpful to write a post to try to point out something someone said that might not sound accurate to you. The vibe on this thread is of help and support as you may have noticed and not to try to call out on what we are saying that may or not be supported by a study – unless someone was going completely overboard and not being helpful. We are all on difficult journeys and sharing anything that may be helpful to us, being to just vent or offer support. Even if it’s a theory from the sleep doctor or from Deb herself (which I know is not the case), it’s alright, and honestly, by Deb sharing this info it helped me accept my awakenings more and feel more relaxed about them. Understanding the biological reasonings behind my insomnia help me a lot, even if it’s just a theory. Anyway, hope you can get/offer some support here too. All the best!
Steve, I’m also on a SW but I allow some flexibility with it. Do you think giving more flexibility to your SW could help you think less about sleep? For me, it has helped – my rule is “as long as I don’t go to bed a lot earlier than 10pm and don’t sleep too long past 6am, I’m allowed to be in bed and rest”. A less structured SW helps me relax about the whole thing and think less about sleep overall 🙂
I’m glad I’m not the only one who has had meltdowns, Deb. Was the emergency room incident because of a panic attack? I’ve had them in the past and felt the need to go the hospital but thankfully that’s all behind.
My insomnia started in the winter of 2017. This meltdown last week happened after I had been wide awake for 2 hours struggling trying to fall asleep without realizing I was doing it. It had been such a long time I hadn’t experienced an awakening like this, the frustration kept building. At some point I turned on the light, sat up in bed and just broke down crying out of anger, frustration and sadness. Ugh. I think I’ve had just a couple of meltdowns since insomnia started but this one was surprising since it had been probably 1.5 years since my last meltdown and it happened about a week after starting ACT. It makes me wonder if it wasn’t all of the repressed frustration I felt while practicing CBT-I that finally came to surface since I was allowing feelings to come up. What a tough journey this has been..so thankful to ACT for helping uncover and deal with all of the demons that come with insomnia.
