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Thanks, Martin. I no longer research sleep, but I do get suggested articles on a smart news feed and the other day when the newest article was posted about the tau in younger people over one sleepless night, it gave me pause for a second. Really appreciate your thoughtful detailed analysis and critique of the research. No point in voluntarily worry and anxiety, sleep-related or nonsleep-related!
Bob, I was a little bit concerned about this latest study, too. I know every research study has some flaws, but can we really discount every single one, especially when almost all seem to indicate some future health consequences? So it is concerning—-but it just makes me double up on other aspects of healthy living, like diet and exercise, that may cancel out any potential adverse effects of insomnia.
And until recently, all studies concluded that amyloid beta was responsible for Alzheimers—now it is tau, so who knows? Look how coffee fluctuates as being unhealthy/healthy—and fat, carbs, etc.
I am just the opposite in that SC was my favorite part of CBTI! I kind of envy those of you who would prefer to stay in bed. It makes it harder for you to adhere to CBTI, but it also means that you are at least somewhat comfortable and relaxed in bed. The bed became such a stressor to me that once I had a panic attack (first one in 65 years!) walking back to the bedroom. Lying next to my husband while he sleeps is nice for about 5 minutes, but boring after that. I love mindfulness. I meditate during the day. I can do a little at night, but with what I do during the day, not a big impetus to do more, especially for hours. I truly would rather get up and read or listen to a podcast or do yoga than lie in bed. I have mostly made my peace with still-remaining challenges of falling and staying asleep, so it’s not that I need to practice more acceptance. I accept that I get bored in bed and that it just isn’t pleasing or productive for me to spend more than 5.5 hours in bed…and even less if I’m not sleeping. My problem is more that I often don’t even give myself 20 minutes before getting up to go into the sunroom and read.
But for you, Ellen, it sounds like you don’t have anxiety in bed. Possibly you can combine CBTI, like with the sleep window and other principles, with ACT, lying in bed not sleeping. But for me, I never would have made any progress without the SC because I would hate being in bed for longer than about 10 or 15 minutes without sleeping!
Hi Deb,thanks for your reply. I had insomnia for 18 months—note how I said “had” because I do recognize it’s improved—and now I look at it as sleep challenges or just short sleep and not true insomnia. May just be semantics, but it feels more positive and empowering. For months I truly was unable to sleep at all many nights and just a couple of hours some nights, so never getting less than four hours, occasionally seven, and usually 5 to 6, doesn’t seem like an inability to sleep—just an inability to sleep eight hours (which I understand is typical and not even pathological).
I always used to be in bed for seven hours, 11 to 6. But was I actually sleeping all those hours? Probably not. Before I had what was undeniably insomnia I noticed that I was unable to fall asleep for the one hour naps I used to enjoy in the afternoon. Just either wasn’t sleepy and often not even tired. I tried to do it since it was my routine but gave up because I either didn’t need them or in any case couldn’t do it. And then I noticed that if I didn’t go to bed immediately upon experiencing the first sign of sleepiness then I couldn’t fall asleep quickly.
What I had (have) was sleep onset challenges. I do wake up several times during the night, but usually associated with my bladder calling me, and falling asleep right away after, so didn’t consider that a problem.
I did read the ACT book. But relaxing in bed isn’t going to more quickly lead to sleep if the sleep drive isn’t there. It’s like Daniel Erichsen says about pills and supplements—if you took them in the middle of the day would they cause you to fall asleep? Probably not, and that’s why he says they are not causing you to fall asleep at night. I’ve never been one to just lie around. I never understand why people enjoyed lying (and often sleeping) on a beach for hours! And I don’t think boredom automatically leads to sleep, especially in someone without strong sleep pressure. I’m not bored when watching TV but still fall asleep a little. I don’t understand that sleepiness at 9 pm because I am quite sure that I would not fall asleep for the night if I was in bed at 9 (I don’t watch in bed). I’ve never seen an explanation as to why there could be such brief sleepiness at 9 as if sleep drive is building up but then not being able to fall asleep for two to four hours later. It’s almost as if the brain reacts a bit to some adenosine starting to build up, but it’s not enough to sustain sleep for hours. Similarly, why do so many people experience sleepiness from about 2 to 3 pm and then not for hours later?
I understand what you mean by “not relaxing and setting the condition where sleep will naturally come, but I do think it’s possible to relax away from bed. It’s the buffer zone that Martin describes—where people can do anything relaxing, even knitting or watching TV—and you do it to relax, not to try to get sleepy. I think just the hours of being awake set the conditions for sleep, although admittedly in my case I seem to need more hours awake than the 16 you and many people need to get there again.
It’s interesting that you don’t depend on a strong sleep drive to fall asleep. Because my understanding is that it’s a combo of Circadian rhythms and sleep pressure that makes us fall asleep. Is is just that you don’t experience typical signs of sleepiness? Except for the couple of quick head nods while watching TV, I don’t experience much signs of sleepiness any more. I honestly don’t feel any different when I try to go to sleep at 11 but can’t and then get up for about half an hour to read and then after rinsing and repeating another time, and it’s more 12:30 or 1 at that point I go to bed, not feeling sleepy, but the sleep drive now is obviously there and the hyperarousal is minimal to nonexistent, so at that point I CAN fall asleep even though I am still reading well and my eyes aren’t closing (at most a couple of yawns).
That’s too bad that you feel tired after less than 8 hours of sleep/light sleep. I did think an advantage of ACT is that the lying still and relaxing in bed would be restorative even if the whole time wasn’t spent sleeping. I’ve seen some experts who think that just lying in bed relaxed is as good as sleeping (there’s a type of yoga meditation that purports that one hour of doing it is equivalent to four hours of sleeping, which I am cynical enough to think it can’t be true since it isn’t the deepest delta wave sleep) and others who say deep sleep is needed to feel good the next day.
I don’t ever consider my sleep light. It may be short. It may be broken up by awakenings/bathroom trips. But I guess it’s restorative enough to make me eager to get the day started at 6, whether it’s 4 hours or 7, so I think I’m getting what I need…and my ACT efforts are just accepting the new normal, which really is pretty good, and not be frustrated by having some sleep pattern changes.
Hi Mac, thanks for your reply. Wonderful that you got such a good night’s sleep. And it’s so good that you just enjoyed it for what it was without worrying that it could impact the subsequent night of sleep, as I would. Let’s hope that such nights become less rare for you.
As for what caused my insomnia, my whole life I’ve never slept long or what I considered deep (like a college roommate who could sleep through fire alarms!). But it was adequate for me. Then a couple of years ago I noticed that I could no longer take my treasured afternoon nap of 30 to 60 minutes (sometimes wasn’t tired, usually not sleepy, and couldn’t fall asleep lying down) and that I had to turn out the lights the second I experienced sleepiness or that feeling would go away and I couldn’t fall asleep for another hour. But what set it off 18 months ago was being up for two nights with my husband in the ER and then worrying about his health and impending surgery (he’s fine now).
Yup, in some ways I was happy that I functioned as well as I did with nights of 0 to 2 hours sleep, but I did wonder whether I was trying my body to just accept the new normal.
I do agree that my 30 years on you makes it a little more palatable in dealing with this, as does retirement. I really feel for people who have to get up and function at work for eight hours every day! And hopefully as young as you are, the bout of insomnia will be long behind you and won’t cause any cognitive difficulties even if it’s run in your family…and that their will be treatments and preventive vaccines by the time you are my age!
The thing with ACT is that it’s actually not enjoyable for me to just lie around in bed. I understand that it is for most people. I have nothing against relaxing. I enjoy meditating—but at my level of skill, can only do it/enjoy it for 20 minutes or less. Lying around for two hours just isn’t fun for me. I’d rather get my relaxation away from bed, reading, listening to music or a podcast, doing yoga, etc. It’s like with vacations. I’ve always preferred a mountain vacation with hiking than a beach vacation where you mostly just lie around on the beach. I’ve read the book by Meadows and I can listen to some of his videos. I do incorporate acceptance/mindfulness into my days and nights. It’s very much related to secular Buddhism, which I’ve found helpful in so many ways. Dr. Hayes, who founded ACT, has a new book out—maybe I will read that.
HI everyone, I’ve been reading your posts and admiring the remarkable progress so many of you have made, but don’t post much for three reasons. The first is that I feel like a failure since I haven’t fully or nearly recovered to my original sleep patterns like so many of you do, even if it’s just for some weeks until you get a hiccup but then you get back on track. The second is that I feel my situation is so different from the majority here, although it’s pretty close to Daf’s experience. The third is that I do so poorly with ACT and actually prefer CBTI!
But your honesty, especially Mac’s, Deb’s, and Pam’s, have inspired me to tell my truth, even though it’s a little pathetic in some ways. I’m always an outlier—can’t even fit in with fellow insomniacs…but I’d appreciate your input.
I did well with Martin’s 8 week course and was falling asleep quickly between 10:30 and 11, getting up at 6 (with several awakenings, which don’t bother me, especially since it’s associated with bathroom trips. But within a week or two, the difficulties started again—sleep onset to the point where I couldn’t fall asleep until 2 am and some sleepless nights. I had not stopped the SC so continued with that and readjusted my window, but my sleep was very erratic. So I tried ACT which goes along nicely with the mindfulness, meditation, and Buddhist teachings I love—-but lying in bed does not necessarily lead to sleep for me. I find it boring. I am comfortable there, psychologically and physically, just bored. I’d rather get up and read or do yoga. Of course I think acceptance is a wonderful thing for every area of life, especially that which we have no control over/can’t change, but I work on acceptance out of bed and not just at night. To me it’s the ultimate in acceptance to admit that I’m not sleepy/can’t sleep and be okay with it. Lying in bed is almost a sleep effort for me.
I have made substantial progress in one area: no more totally sleepless nights for several months. So I always have confidence that I will sleep. But although there is the occasional night that I go to bed when my husband does at 11 and fall asleep within half an hour, in general I can’t fall asleep until 1 a.m. And I always wake up naturally at 6. Being retired I could sleep in but that wouldn’t do anything to build up my sleep drive for the next night and I know I couldn’t fall asleep because I am not sleepy.
And therein lies the problem. I know Martin and other sleep experts would say that I must still have some hyperarousal, but I’m positive I don’t. I just don’t get sleepy until 1, even though my entire life (65 years) I’ve never gone to bed later than 11. I fall asleep watching TV around 8:30 or 9, but only for 10 minutes. Obviously I am really relaxed watching TV so that enables me to fall asleep—but it’s not like I conk out for hours. So I honestly feel like I don’t have a strong sleep drive and/or need for more than 5 hours sleep.
At the beginning of all this I freaked out with five hours sleep. Now it’s just normal for me. I wake up eager to get my day started. Feel rested and clear-headed. Good mood—just some slight frustration that I am on the 5 hour plan, probably for the rest of my life. Is this a problem when I can function so well the next day, doing all the physical activity I do and chores? Of course I wince when yet another article says how people who sleep less than 7 hours will get dementia, but so far I am doing well physically and mentally. I just can’t sleep until 1 or past 6! I’m still working on making the two hours between my husband going to sleep at 11 ( I now read in bed from 10:30 to 11—I reclaimed the bed to that extent) until I try to sleep at 1 (without any actual signs of sleepiness—I’m not wired, but definitely not eyes closing, etc.—a few yawns) as fulfilling as possible.
I no longer believe my ability to sleep is completely broken, but I do think it’s possible that I have low amounts of melatonin and adenosine. Maybe not so low that I can’t sleep at all, but lower than most people’s. We get blood and other lab tests to see our chemical makeup, so why would it be impossible that some of us have low levels of neurochemicals? I think I just have to accept this and be grateful that I function as well as I do on four to five hours sleep.
Some of Martin’s recent interviews including Daf note that their sleep isn’t perfect and can be on the short side still–it’s more about your attitude with this and ensuring health in other ways than conquering sleep and demanding your fair share—I guess!Sorry about writing so much. I’ve been wanting to post but almost felt ashamed that I didn’t love ACT and wasn’t as successful as many of you. This was cathartic for me. Any input would be appreciated.
Hi Deb (and everyone), thanks for asking. It sounds like you are doing so well.
I feel that my sleep isn’t much improved. It’s my attitude that’s improved. Because of this, I feel better. I did have an improvement that I haven’t had a zero sleep night for the past couple of months. I no longer have anxiety going to bed or staying in bed. But I usually just get about five hours sleep. Occasionally six and very rarely seven. I actually now see that I can function well on only five hours as long as I don’t expend energy on being upset about it.
Regardless of whatever time I go to bed I wake naturally around 6 every morning. And while I don’t observe a sleep window formally it happens by default. My big problem is that I just don’t get sleepy, except for about 30 to 60 minutes daily from 2 to 3 pm (which happened even before the insomnia, like lots of people) and watching TV from about 8:30 to 9:30 (microsleeps, 5 to 10 minutes). I seldom experience any signs of sleepiness even at 12 and 1 am! I am now back to reading in bed to be with my husband and normalize things after 18 months of not doing so. When he turns off the light at 11, I do as well and try to sleep. I can lay there for 30 to 45 minutes without anxiety or frustration….but boredom sets in so then it’s a treat to move into the sunroom and read, play games on the iPad, or listen to a podcast. I go back to the bedroom every 30 to 60 minutes and try again…and repeat as needed until I fall asleep and then I stay asleep, averaging 5 hours.
I am absolutely positive that it’s no longer hyperarousal that diminishes my sleep drive. I’ve never been a long sleeper. All my life I did just six to seven hours. So maybe now at 65 there really is a lessening of some of the biochemicals and I just have to accept this. I can live my life as I want and have lots of energy (I live a very healthy lifestyle except for the limited sleep). It’s just that those hours between 11 and 1 and sometimes 2 aren’t always fun. I’m awake. I’m not fighting sleep. But I don’t feel quite as energetic mentally or physically then, so I’m not at my best reading or listening to a podcast. It feels more just like killing time until I can try again in bed even though I’m not experiencing sleepiness.
I do lots of meditation and like the ACT approach, but I don’t see how some of you can lie in bed for hours just observing and accepting. I run out of things to think about and watching my breath loses its fascination after doing it for 20 minutes (being honest, more like 10!).
Here’s the article about Dave Asprey:
https://www.menshealth.com/health/a29502116/dave-asprey-super-human-book-sleep/
I’ve gone just under 48 hours without sleeping multiple times in a month and not experiencing much sleepiness except for some very quick microsleeps. Fortunately I am much better. It’s possible for even us severe cases to improve…although not become perfect (which my sleep never was, even pre-insomnia—but hey, it was sufficient to get me through 64 years of functioning well during non-sleeping-time!
Daf, I have a similar issue to you in that if I sleep for 7+ hours I have extreme difficulty sleeping the next night. I also feel more groggy and less energetic, like I’ve OD’d on sleep!
I have a natural wake-up time of 6 am most mornings. I’d be happy going to bed at midnight, even though I have been going to bed earlier, 10:30 to 11 all my life. But hey, what’s an hour? The difficulty is that now the midnight bedtime seems to be moving towards 1 am—and there isn’t even many signs of sleepiness then.
I honestly feel that I don’t have a strong sleep drive. I’m not saying my “sleep mechanism” is broken, as I used to think. But I definitely don’t experience sleepiness every 16 hours. My circadian rhythms seem sluggish and I seem to be much more on a 18 to 19 hour schedule. I’m 100% sure it is no longer hyperarousal. I’m not saying I have no melatonin or adenosine in me, but at 65 I may be producing less or am just an outlier who demonstrates that there is some human variability in bodily functions. Fifty years from now there may be tests and treatment for low levels of adenosine (although I will admit that exogenuous melatonin doesn’ts eem to correct the situation/problem. What do you think?
I agree that not everyone does get/need 8 hours. But for a long time, my not being able to sleep for 8 hours made me feel unhealthy. I viewed it in both ways—that a healthy person had the sleep ability to sleep wonderfully for eight hours and that 8 hours sleep led to goo health. But recently I stumbled upon an article about Dave Asprey, the biohacking guy who views his body as a scientific experiment to tweak and prevent aging and ensure maximum functioning. I don’t agree with what he does/promotes, whether it’s freezing his body or drinking bulletproof coffee full of butter. He tried to see if he could function on only three hours sleep, doing polyphasic stuff, and wasn’t successful. Then he thought he needed to sleep 8 hours, but didn’t want to continue to devote that much time to sleep. And he saw a research study that said people who sleep 6.5 hours a night have much lower mortality than people who sleep 8+.
He concluded that: The people who lived longest required less sleep, “because they didn’t need as much time to recover from chronic illness, inflammation, and/or everyday stress. If aging is ‘death by a thousand cuts,’ sleep equals recovery from many of those ‘cuts.’ The fewer cuts you need to recover from, the less sleep you need,” he says.
Based on that realization, here’s what he did (and you can, too):
“I started using my sleep length and corresponding energy levels to measure whether I was doing things during the day that made me older. I knew that if I jumped out of bed ready to bring it after six hours of sleep, I was on the right track. But if I felt groggy after a solid eight hours of sleep, that meant I was probably doing something that made me sick and inflamed. This explains why I needed less sleep when I started following the Bulletproof Diet. I was taking fewer hits from the foods I ate, so I didn’t need as much recovery time. ”
And I have to wonder if he has a point. I strive for a healthy life in terms of exercise, stress management, and diet—so is it possible that by not having the chronic illness, inflammation, abuse to the body that others have I honestly don’t need as much sleep since there isn’t that much to repair? I do get out of bed, even after 5 hours, raring to go and yet I know people who sleep 8, 9, and 10 hours whop aren’t.
What do you think?
Kimmiek, thanks so much for this. Dr. Zhou sounds incredible—I see that he gets 5 star reviews. Did you work with him virtually or do you live in the Boston area?
What was your insomnia like at the beginning and what is your sleep like now?
I loved what you wrote about Sasha Stevens. I was focusing on her books like they were revealing the secrets of the universe or at least, sleep difficulties. If I had problems one night I would blame myself for not reading the book that day! And chastise myself for not buying everything she said 100% even though so many people do. I felt like she contradicted herself at times—that she is a fantastic sleeper, but yet it can take her an hour to fall asleep. If this is the case, seems like she would adjust her bedtime a bit. I personally would rather be doing something else for an hour than lying in bed, even if relaxed. Maybe half an hour at the most. And it just seems so disingenuous to tell yourself that you are a great sleeper when you know you aren’t. After all, great sleepers don’t have to convince themselves of this—they just sleep!
Staying away from the forums may have its merits. I do enjoy the education I get from Martin’s and Daniel Erichsen’s videos. And sometimes I feel less alone or like a failure reading about other people’s challenges—but it also can do the reverse—make me feel bad that I am not 100% improved/back to the way I was pre-insomnia (although grateful for a marked improvement).
gsdmom, this is incredibly helpful. I love the idea of emotions and past experiences taking a hike with you—and then dropping out and possibly being replaced with a positive emotion or thought. A mindfulness practice does help (I completed a free online Mindfulness Based Stress Reduction course over 8 weeks—not specifically for sleep issues, but it helped) but sometimes I have difficulty in accepting challenging thoughts and emotions. Your strategy is great. For those interested, this is the course—you can complete it at your own pace, but ideally it is done over 8 weeks—lots of meditations., readings, videos, even a yoga practice as based on Jon Kabat Zinn’s work on pain patients:
https://palousemindfulness.com/
Nick Wignall, a sleep psychologist featured on Martin’s and Daniel’s YouTube channel, had a terrific article about anxiety. His approach is quite similar to ACT—approaching the anxiety with compassion, being willing to live with it instead of pushing it away, and tasking responsibility for your worry habit (worry may seem like problem-solving, but as it is focused on something you can’t do anything about it right then or even something that’s not really a problem) and refocusing attention on something else:
JT, I’m enjoying your videos. Makes me feel less alone to see someone who is struggling and experiencing challenges.
Daf, your patterns are very much like mine. Even before the insomnia started I noticed that I would alternate one night of good sleep (like 7 hours) with a night of much less sleep, saying kiddingly “I’ll pay for last night’s good night tonight!” (but not really joking). I honestly don’t need 7 hours; if anything I feel a little sluggish and certainly no more energized or happier getting 5.5 to 6. But it makes me wonder. I know we all have the ability to sleep—but isn’t it possible that some of just have less of a sleep drive, just as some of us have less/more of an appetite for food? Just like a lab test will show that someone’s red blood cells don’t turn over as quickly as other people’s, can’t it be that some of us do have less melatonin and adenosine—not low enough to preclude sleeping but enough to make these challenges? And that some of us have longer circadian rhythms—that while the average may be that people sleep 16 or 17 hours after waking, some of us may take more like 20?
ACT has not really enabled me to sleep longer or fall asleep more quickly—but it, combined with the other mindfulness stuff I do (like yoga, meditation, reading Buddhist and Stoic stuff), helped the other night when I couldn’t fall asleep before 2 am. I got out of bed more or less happily since I had a book that I was enjoying and a podcast that I wanted to listen to—but the power went out due to a rainstorm for 2 hours—so I couldn’t do either without electricity—and yet I remained calm, so at least there was that.
Hi everyone,
I continue to struggle even after completing eight weeks of CBTI and then adhering to stimulus control. It’s frustrating because I am positive I am no longer hyperaroused. I admit that I didn’t perceive the state of hyperarousal when I started CBTI: I denied that I was hyperaroused because I outwardly appeared calm and do a lot of yoga and meditation, so I had bandaids to cover it up. When I started to get panic attacks upon going back to the bedroom (first panic attacks I ever had in 64 years of living!) I could no longer deny it. The hyperarousal stopped with the CBTI not so much because of the sleep restriction (the 5.5 hour sleep window wasn’t actually a restriction; it was doubling of the 0 to 2 hours I was getting) but because it removed the onus of trying to go to bed around 11 as my husband does and I have always done.
The stimulus control was very easy for me to do. I didn’t like lying in bed awake and I wanted to succeed, so I would be hyperalert waiting to get out of bed and worrying that I would go over 15 to 20 minutes. So in a way I think this backfired for me as I may not have given myself enough of a chance to fall asleep (even Sasha Stephens admits that it can take her 60 minutes to fall asleep). But I have avoided using the bed for anything but sleep completely during the CBTI and for months afterwards.
I did really well by the end of CBTI, experiencing sleepiness by 11 and falling asleep within minutes—and achieving 6 to 7 hours of sleep, which is all I need and al I’ve ever gotten. But then the problem started again. Tried to resume the sleep window starting at 12:30 am, but even then I was seldom sleepy—but definitely not hyperaroused as I no longer have panicky thoughts about not sleeping since I know I can survive even with minimal to no sleep some nights—and I’ve not had any medical issues because of the severe insomnia. Another reason I know I am no longer hyperaroused is that I have less nervous energy to burn off during the day and at night.
My biggest improvement is no longer having nights of nil sleep (another indicator that I am no longer hyperaroused), but I no longer experience much sleepiness except between 2 to 3 pm (I resist taking naps but get microsleeps) and watching TV around 8 pm—but then I can’t fall asleep until 2 a.m. No matter what time I go to sleep, I wake up without an alarm clock at 6 am, give or take an hour occasionally.
A smaller improvement is that I decided that if stimulus control wasn’t assuring me consistent sleep I would take back the bed as if I was fully recovered. I now read in bed from 10:30 to 11. When my husband goes to bed at 11 I leave to go into another room not to disturb him—but at least I have normalized my sleep routine to include a little of the bedtime activity I enjoyed—and I will lie in bed not worrying about 15-20 minutes, as long as I am enjoying being in bed. Usually I want to get up, not because of anxiety but just boredom. I experience no signs of sleepiness so I’d rather get up and play some word games or read or listen to a podcast.
I don’t know if I will ever be an adequate sleeper again, but I am handling the challenges much better than when they first started 18 months ago.
