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The following article I found on the net in a Panic Away newsletter which also deals with anxiety. Whilst I do not suffer from panic attacks, this was a part of the information I was getting emailed to me in a newsletter. This information would be helpful to those who have trouble going to sleep. At the end of this original article there was the option to share this via many media and social websites (Facebook etc), so I would assume, it is OK to share it here.
The information came from Barry McDonagh at the PanicAway.com website at this address :
http://www.panicaway.com/newsletter/9
Getting to Sleep and Panic Attacks at Night
As most doctors will tell you, there are two things that disturb sleep: physical pain and worry.
It’s therefore understandable that many people with anxiety report frequent sleep disturbance as a major problem.
Not being able to sleep can actually be quite traumatic for many people.
The first thing you need to understand about sleep is this: it’s not the amount of sleep you get that’s important, but rather the quality of the sleep.
Quality over quantity.
I am going to give you some quick tips to help tackle any problems you are having with sleep. Firstly, to break the insomnia cycle, begin by not presuming you will sleep! That seems like the wrong attitude, but if you approach each night as just a possible opportunity to sleep, this helps remove the pressure you are placing yourself under.
In a way, some people have performance anxiety when they think about sleeping:
“Will I be able to make myself sleep tonight?”
The answer is maybe yes, maybe no. If you’re going through a period of sleeplessness, a good night’s sleep isn’t guaranteed, for whatever reason, so you have to accept that for the moment. If you get one or two hours’ sleep, that’s well and good, and if you get nothing, then accept it and move on. Each night, as you retire, say to yourself:
“I’m preparing for bed, but I won’t try to force sleep. If it comes, it comes. If not, I won’t beat myself up over it. This is a period I’m going through, but I’ll soon return to normal sleep patterns.”
Every person goes through periods of sleeplessness from time to time. It’s very natural. You may not be aware of why you experience sleeplessness, but at the very least, you can accept it.
Let me emphasize the importance of surrendering to your inability to sleep. Surrender to whatever may or may not happen during the course of a night, and you’ll put your mind under less pressure. After a certain point, it’s really the anger and frustration that keep you awake most of the night.
Naturally the best way to get a good night’s sleep is a good physical workout each evening in the outdoors. This is very effective because the mind may try to keep you awake, but the sheer physical exhaustion brings on sleep quicker. Couple that with a willingness to accept sleeplessness, and you’ll find yourself sleeping much easier.
Remember that alcohol, caffeine, and nicotine should be avoided several hours before sleep. You may be the type who finds it initially hard to get to sleep as your mind races with anxious thoughts. Should you find your mind racing and you simply can’t achieve sleep, keep a journal beside your bed. Sit upright and start to write down how you feel:
“I’m feeling quite restless. I keep turning over and over, trying to sleep, but I have worries on my mind.” Now write down all of your worries, for example:
“Tomorrow I have to do X, and I’m afraid I won’t be well rested, etc.”
Continue to write down your worries until the exercise actually becomes quite boring. Then your body and mind will slowly want to return to sleep. Writing like this is a simple tool for preparing your mind in a linear way to wind down and return to sleep (an advanced form of counting sheep).
Don’t be afraid of writing pages and pages of nothing in particular. What you’re doing is helping the conscious mind release whatever is keeping it awake so it can stop obsessing and return to sleep.
You see, one of the reasons we can’t fall asleep is that our mind feels these worries (whatever they are) are important to analyze over and over; they need urgent attention and therefore should be thought about all night long.
The more worked up you get by the worries, the more your body gets stimulated and the harder sleep is to achieve. Writing down all your worries on paper has the effect of saying to your mind:
“Okay, mind, you think these are important. I’ve written them all down in detail. They won’t be forgotten, I promise. I can come back to them tomorrow and deal with them then-but RIGHT NOW, let’s sleep.”
The mind can be like a small child who just needs reassurance that things will be dealt with and looked after. That’s all it needs to let go of these mental worries. You then discover, in the morning, that almost all of the worries or concerns aren’t big issues. Many of our worries are the workings or an overactive imagination.
Dr. Dennis Gersten of San Diego suggests an approach that is effective for particularly restless nights. You may want to experiment with it the next time you are very restless in bed.
Try the following:
-As you lie there in bed, start by remembering a time in your life when you absolutely had to stay awake! Maybe it was an important exam you were studying for and you had to keep cramming through the night.
Maybe it was staying up all night nursing your baby to sleep. Maybe it was when you were traveling through the night on a bus and needed to stay awake in case you missed your stop.
I am sure there have been many different occasions in your life where you had to force yourself to stay awake.
-Remember the weariness and the effort just to keep your eyes open. Remember how your eyelids felt like lead weights and you wished you could close them, even just for a minute. At that time, you could not give in to your urge to fall asleep; you had to fight hard to stay awake. Relive those memories and really try and remember exactly what that felt like.
-Now think about right now, and how good it feels to actually be in bed with no pressing need to stay awake. Think how much you would have given to be where you are now, lying in your bed with your head resting on the pillow and the complete freedom you have to fall asleep. It feels really good to actually have full permission to fall asleep right now.
There are no demands on you to stay awake. With your eyes closed spend a few more minutes remembering that time.
-End of exercise.
No worries Martin, I understand copyright issues. I was incorrect when I said I read them from recent 'articles'. The comments are not from 'articles' and cannot be attributed to any one person/organisation for due credit to be given. They came from other posts and other forms of social media with no reference to where they came from apart from that person who posted it, but they got it from another source not identified ….
Back on topic, to answer your question. No, I don't think my insomnia is anxiety related solely. My insomnia tends to come in fits and bouts with no known causal factors that I am aware of, and it is only when I don't sleep that the anxiety starts. “Why can't I sleep? Will I sleep tonight?” etc and so it goes. When I sleep there's no issues with the anxiety and we know anxiety feeds on itself. I really don't know how and why the insomnia/anxiety started. It just literally came one night, right out of the blue …. strange things us human beings!! But I am pleased to say, I haven't had to take a sleeping pill in a very long time! Any troubles sleeping, which I am also pleased to say are now rare, are usually treated with 1/2 an anti-anxiety tablet, which in small doses, acts as quite a good sleeping pill. And, now that I very rarely take that, as opposed to every day on medical advice, my body responds to it far greater and it does it's job! Here's to that trend continuing!!!!
For someone who is scared of heights, I have a mad pasion for aviation! When I was younger I would often go out to the airport, sit on the open verandah watching the planes comeing and going and pulling up to the gate, breathing the wonderful smell of Avgas (yes, I still love it nowadays too). I would watch the planes and think what it would be like to travel overseas to foreign lands, with different money, languages, cultures and just about everything else that I knew of here at home in Sydney. I never wanted to be a pilot – I wanted to be a flight attendant or air steward as they were called in those days! I had a go at it applying for the position after leaving school but there was major dramas in the world of air travel back then in Australia with airlines going bust, pilots striking etc. I got rejected!! Oh well, what next? I considered a career in teaching but never applied to go to university. I worked in a factory as a labourer doing sheet metal work for air conditioning. I did this for about 15 months or so but quickly realised it was not for me. I decided to join the police force and I have been there ever since – 22 years ago!! I love my job – it's just unfortunate with the terrible incidents we have to get ourselves in and investigate!! Don't see myself doing anything else with no other formal qualifications. I am in the middle management level of the organisation now and enjoy working with younger officers. I also assist the education office with presenting at lectures and training days so the teaching aspect of previous ambitions has been able to be achieved.
Wonderhussy,
Sometimes it is tough, but hang in there. It will take a while to kick in. I think the booklet says that for some people their sleeping WILL get worse for a while. Thats why it goes for a minimum of 4-6 weeks. I am past the 6 weeks stage now, but am still following the program. Be 100% dedicated to it. Remember, it is a hard situation you are trying to change and it may have taken you a long time to get to the poor sleeping situation you now find yourself in. Years of poor sleep habits are not easily broken. I had 21 years of shift work – 7 mornings, 7 afternoons, 7 night shifts, then we changed to 2 days, 2 nights, each of 12 hour duration. You can succeed. I know you will. Read my Challenging Self Defeating Thoughts post for a little encouragement too.
G'day Wonderhussy!!
Wow!! That's great news. I'm so glad you tried the CBT booklet and more importantly it IS working for you! I think for some people experimenting with what works is the key. For you it was a combination of both the booklet and isochronic tones. Others might have luck with one option or another. Anyway, I'm glad it's all working out for you wonderhussy!! Take care and all the best, Darrin.
Hello PatO,
It has been going very well thanks. I haven't taken a sleeping in absolute ages now! So long so that I can't even remember! I now go to bed later (about 10.30-11pm) and usually I have no trouble going off. If I feel an 'all nighter' coming on (i.e, my breathing is different for some reason, increased heartbeat for no reason etc) I take 1/2 an anti anxiety pill and that seems to do the trick. I have had to do that twice in the past 7 nights, so thats not too bad. Each week is getting better. Ofcourse, when you are sleeping, thoughts of not sleeping are few and far between. So with my sleeping going well, the thoughts and anxiety of not sleeping have been very much minimised. I have gone to bed occasionally not sleepy at all, but surprisingly have gone off to sleep with no problems. My mate has a similar problem, but he's manifests itself in bad dreams which makes him wake up sweating and anxious and then ofcourse has trouble going back to sleep. We have both found that it tends to come in cycles and for no apparent reason whatsoever!! We have just learnt to accept it and play the hand we get given each night. That's about all you can do. I am glad that you have been able to get some sleep PatO. I think that if you keep at it, the CBT will kick in to the subconscious mind and things will change. Your brain will associate night time with sleep. Best of luck PatO and please keep in contact.
G'day everyone, Just thought I'd update you all on my sleeping progress with the CBT self help book. Sleep has been going really well for the past 5 or so weeks. Last night was my first night of no sleep since I started this program. I think there might be a few reasons behind last nights no sleep. 1. I was away at a wedding in the country. 2. I had a bit to drink (as one would normally do at wedding!) 3. I received some bad news that my brother-in-laws' mother-in-law has been given 2 months to live with breast cancer and brain tumours and this news saddened me a great deal as my brother-in-laws wife came to the wedding and was very upset when she saw some of us and lastly, I had a disturbing dream about a very good friend of mine. My friend committed suicide in late July. I found him with another mate. Basically the dream was that my friend showed up unannounced and he was still alive and the 'suicide' was just a joke. Pretty weird dream huh?? Obviously it troubled me both in the dream because I woke from it and, I thought about it the next day. Needless to say the anxiety was well and truly back – the dry mouth, the frequent trips to the toilet, the horrible flushings of adrenaline in my guts for no reason, tossing and turning etc. I am disappointed this happened. I was SO tired on the bus coming back to the hotel too. Oh well, I guess you just have to expect setbacks from time to time and try not to let them get me down. If I have trouble going off to sleep tonight I will take 15mgs of Avanza. That normally works, though it lost it's magic when I took it nightly to fight the depression I was in initially, but the doctors told me to keep taking it to build up my reservoir of serotonin. I usually find it works well when I take it infrequently. I have also recently seen school friends on facebook posting about their regular sleep deprivation. I have contact with a very famous Australian singer/musician who only gets a few hours sleep a night because of sleep apnoea. He says the worst aspect of it is the anxiety of not being able to return to sleep after waking up. I know exactly how he feels. It's in the back of my mind now as I write this at 2.41pm in the afternoon. Funny thing, listening to the radio these days, all the modern songs have so many references to not sleeping it's absolutely unbelievable. Insomnia and sleep issues are on the rise with todays society. That's all from me for now. All the best to you ll.
Yes, i understand PatO. Well i hope you continue to try to find something that works for you. You never know, the next attempt just might bring success!! Best of luck to you. Cheers, Darrin.
OK. These are the 9 rules to go by. There is a lot more information in the booklet, but this is the 9 rules.
1. LIE DOWN TO GO TO SLEEP ONLY WHEN YOU ARE ACTUALLY SLEEPY. This may mean staying up 1 or 2 hours later than your usual bedtime. Do not go to bed until atleast 10 or 11pm.
2. DO NOT USE YOUR BED FOR ANYTHING EXCEPT SLEEPING. Do not read, watch tv, listen to the radio or eat in bed.
3. IF YOU DO NOT FALL ASLEEP IN 30 MINUTES AFTER TURNING OUT THE LIGHT get up and go to another room and do something that is not too arousing. Stay up until you feel the next wave of sleepiness coming on. The goal is to associate bed with falling asleep quickly.
4. IF YOU RETURN TO BED AND STILL CANNOT SLEEP, repeat rule 3. Do this as often as necessary until you fall asleep in about 30 minutes.
5. IF YOU WAKE UP DURING THE NIGHT AND CANNOT GO BACK TO SLEEP follow rules 3 and 4.
6. GET UP AT THE SAME TIME EVERY MORNING seven days a week regardless of how long you have slept. This will help your body to develop a consistent sleep rhythym.
7. DO NOT NAP DURING THE DAY.
8. DO SOME FORM OF PHYSICAL RELAXATION DURING THE DAY meditate, yoga, stretch etc
9. LEARN TO REDUCE THINKING AND WORRYING IN BED – see next part.
HOW TO REDUCE THINKING AND WORRYING IN BED
1. Most thinking and worrying that we do in bed needs to be done – it just does not need to be done in bed. Devote some time during the day to your thinking and worrying and not within 60mins of going to bed. Say to yourself “Stop. I thought about this today. I'll think about it again tomorrow. Now is the time for sleep.”
2. If you are wanting to fall asleep, or if you have woken up during the night and want to go back to sleep quickly, try not to let the first thought come in. Say to yourself “Don't even start.”
3. More sleep is lost through worrying about 'not sleeping' than through any other cause. Say to yourself “What is the worst thing that could happen if I don't sleep tonight? I'll be very tired tomorrow. This will be very unpleasant, but I won't die from this.In fact, I'll probably make it through the day, just as I have always made it through the day in the past. Worrying about it now will only make it worse. I'll just lie here and as long as it's peaceful rest, that will be nearly as good as restorative as sleep anyway.
Best of luck to you all. Darrin.
The book came with cassette tapes. They really just are a rehash of what is written. Its in a question and answer format. The tapes arent essential. Its the sleep hygiene / good habits that do the trick i believe. I will post the 9 golden rules asap in this thread.
Hi Martin, Thanks very much for the welcome to the site. It's great, job well done mate! In relation to CBT, when I went to see a counsellor initially I was told that I would be treated with CBT, but alas as time went on, I wasn't. Other 'issues' which weren't an issue for me were discussed. I sometimes walked away from therapy thinking what an absolute load of hogwash. We just chit chatted about stuff in general, quite often not about me. I think the counsellor may have been digging for something which as I have said before, I don't think was there in the first place. I remember one session where my counsellor discussed 'success and what it means' and read to me from a document which I was to take home anyway. I wasn't there because I considered myself a failure, quite the opposite really. I was there because I couldn't sleep. I just think at the time there was nothing they could do so just went along with the chit-chat to kill off the hour. Even though my counsellor knew my main issue was sleeping and initially a depression, the only advice I got was as previously stated, “Don't worry about it, it will happen.” Gee thanks for the scoop! Real help. I really thought she thought that it would just go away. I was sleeping on and off when I was seeing her. The good point was she kept pointing out that I had an ability to cope perfectly fine with limited sleep, so I am thankful for that. I regret not saying that I was not getting anything from the sessions and that I thought we were discussing stuff that was not pertinent to my situation. So in answer to your question Martin I don't think I really got the CBT I thought I was going to get. I got no real advice in how to deal with it. I was promised some positive scripts about sleeping to read and say to myself, but they never came, even after several reminders ….
Now this Sleep Better Without Drugs booklet I have is a complete self help CBT program full of wonderful advice, facts, exposes myths, outlines strategies, tips, success stories, sleep diaries but most importantly gives you reassurance that you'll be OK. I love the section about getting your mind OK with not sleeping, I found that like a lifeboat whilst being cast adrift in the sea of insomnia.
Hi Molly,
Thanks for the welcome. I am lucky I suppose in the fact that I can get by with the minimal of medication. I only take it if I know there's going to be a second night of no sleep. One night I can handle. Two and the anxiety gets ramped up a bit and then I might take half an anti-anxiety tablet. When I was taking them full time, they worked wonderfully well for the first 3 weeks, then they lost their sleep inducing effect. I felt better mentally, so I stopped taking them about 6 weeks or so ago after being an anti-depressant/anti anxiety medication for almost a year. The Avanza that I take apparently works better in smaller doses, so I only take 15mg when needed. When I went off them I was on 30mg per night, but as I say, I think I have come a long way from then, even just being able to handle the sleepless nights. They are less stressful and hopefully will get even more so. You know a funny thing, I sleep the best when I say “Right, stuff it, I don't care if I sleep tonight, I've had enough.” Then miraculously, I sleep. I had that for about 3 weeks and thought, you beauty, I've kicked it and then whammo, out of left field, there it was again. Another all nighter for no good rhyme or reason and then things went off the rail again. For me, I have no known stressors, so I really don't know why this is happening to me. Later, in life I'll look back and think, wow, what happened there? 😀 All the best to you Molly
