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I called them “sleep hygiene adjustments”, but I also meant that I was basically doing CBT-I (at least the behavioral end). Certainly I wasn’t lingering in bed for long when unable to sleep, and all my time in bed was confined to a fairly short window. For example a (very) typical night would be: go to bed at 10:20 (same time every night over long durations), fall asleep very soon afterwards, sleep through the night, awaken around 4:30 or so, out of bed by 5:00.
It was helpful as far as I could tell — at any rate, things were slowly improving, and I interrupted it only because of my travel. But then I hit the road, and all of a sudden I was getting 7+ hours of sleep most nights.
Yeah, I was on the stimulus control and CBT-I bandwagon already. Indeed, on the road was the first time in months that I wasn’t following the rules (for example by browsing the web from my hotel room bed).
I think the reason has to be one of the following two things: (1) psychological — I tend to deal with change better than routine; I had gotten stuck in a rut, largely as a result of the insomnia itself, and perhaps I mentally associated home with that; (2) environmental factors — for example, I think the air in my apartment is dryer than I’m used to.
Do either of these sound plausible?
Thanks.
I often get somewhat sleepy with it, although I’m not sure if it’s entirely the trazodone. With the smaller amount of sleep I’ve been getting, and my newly incorporated sleep hygiene habits, I think I’d get drowsy anyway.
75 mg of trazodone, about 30 minutes to an hour before bed.
I wouldn’t say there’s a hard barrier between 6 hours and 7, but I definitely feel better after 7!
Three hours, oooooof, good luck to you!!
The pattern I settled into was:
- Go to sleep at 11:00 pm each night, occasionally later when I was out with friends; never earlier.
- Fall asleep almost immediately, and sleep straight through the night with minimal waking up.
- Wake up around 5:00 or 5:30. I’d feel in my body that no more sleep was going to happen, and I’d get out of bed soon after and start my day.
Much better would be if I slept until 6:30 or 7:00 — but at least now, I get enough rest to have a productive day.
Simultaneously with starting this regime, I kicked a habit of eating a lot of food just before bed, or getting out of bed to eat when I was lying in bed unable to fall asleep. I was somewhat overweight when I first posted, and I’ve lost 10-15 lbs. or so.
I saw a CBT specialist, did an in-hospital sleep study, the whole works. (The sleep study confirmed that my “sleep efficiency” is quite high, although it reported very little deep sleep on the night I did the study.) I feel that by now I’ve incorporated nearly all of the advice I’ve gotten. The one thing I could do more of is various techniques for inducing relaxation, controlling worry and anxiety, etc.
In the meantime, I’m in the middle of a month of travelling — all over the place, across all kinds of time zones, and with crazy jet lag. I’ve actually been sleeping better. I’ve never been a person who enjoyed routine, and it seems not only my mood but also my sleep are better when I get out of it.
> All in all, apologies to impendia for barging in his/her thread.
No apologies necessary! It’s helpful to see what others are going through and how they’re dealing with it.
Yes — I’ve been going to bed at the same time every night. Often I feel sleepy earlier, but wait out the clock to keep things consistent.
I’ve been getting out of bed whenever I wake up — so not at the same time every night.
Thanks.
In effect, what I’m doing is equivalent to that. In practice, I’m allotting an unlimited amount of sleep — but if I wake up around 5:00, having gotten as much sleep or more than my recent average, then I’ve been getting out of bed promptly without trying to go back to sleep.
Thanks.
Hi Martin, thank you very much for your detailed reply.
To answer some of your questions — I don’t know if I snore or not (I sleep alone), but I had a home sleep study done and am making plans to have an overnight in-lab study done.
The days are sometimes a struggle, depending on how much I’ve slept the previous evening. I don’t ever feel like I’m going to fall asleep though. Only very rarely do I take naps.
Since I started the 10:30 bedtime last week, I have always felt sleepy at that time, and it has never taken me more than ten minutes to fall asleep. So that’s good. 🙂 (I’d previously been trying to compensate for lost sleep by going to bed very early, and I think this was causing more problems.)
You mention stimulus control, and I’m already essentially doing this. I spend almost no time in bed (or indeed in my bedroom at all) other than when I am sleeping. The one problem is that I keep waking up (and getting out of bed) after only six hours of sleep (I used to get eight), not feeling well rested.
I read Ehrnstrom and Brosse’s book, and the central strategies they recommend (also found on your link above) are sleep restriction and stimulus control. They suggest that these strategies are particularly recommended if your sleep efficiency is low, which mine isn’t. The only thing I am not already doing is setting an alarm. If I did so, most nights it wouldn’t change anything at all — I’d only awaken to the alarm on nights where I was getting an unusually good night of sleep. I find it difficult to imagine that this would accomplish anything. But maybe I’m not thinking about this in the right way …… ?
Thank you very much.
