[laimtoh5]

Thanks Martin, I look forward to getting back to my treatment again soon.

[laimtoh5]

Hi Martin,

Not too bad thanks, the Christmas break (I was off for 2 weeks) wasn’t so tough as I had feared, as I normally don’t sleep as much as I normally would at home, plus I didn’t have such a structure over that time. I would say my sleep quality wasn’t much below par, but my routine took a bit of a dive.

I’m back into the routine of daily exercise and sleep restriction, and I think I’m returning to where I got to before Christmas – a definite improvement in sleep quality (which has improved my energy levels, mood, memory recal and acuity quite noticeably) but not much of an improvement to the amount of sleep hours. Sleep efficiency is variable, and I am being more determined to keep to the schedule.

So I’m looking at things positively, and will continue what I’m doing and looking at my sleep diary trend line from time to time, which I keep updating daily.

[laimtoh5]

Thanks Martin, I’ve been meaning to write back.

I’m getting slightly better sleep quality, slowly but steadily increasing.

I listened to your recent podcast where you interviewed a lady nurse from the US, and it encouraged me to get started with the stimulus control (get out of bed if not feeling like sleepiness is strong enough) – to add to the success of using sleep restriction which has made a large positive difference already. I’d say my sleep overall is 15-20% better than when I began 2 months ago, and I think this next step will help more.

I think some things in ACT are good, Jonathan, I think the acceptance of insomnia in general has been really helpful. I used to waste so much energy on being angry and blaming it for all manner of problems in my life, which didn’t do any good. My way of accepting insomnia is to see it as a natural part of me, that just needs to be trained, not fought.

How I act this out, is not to let anger rise when my memory fails me and I look foolish, or some such occurance, but instead I tell myself it’s ok, nothing bad happened, and I’m allowed to make mistakes. I stop giving myself a hard time, and that’s made me more relaxed overall, and therefore I’m less anxious about sleep when I’m going to bed. A positive feedback loop.

The positive feedback loop effect is very powerful, when I can get it working in a helpful way. (And I’m mindful of how it can work against me, like the anger – blame insomnia routine I had been running most of my life, and could have been endless).

[laimtoh5]

Thanks for suggesting that Jonathan, I’ll have a look at that.

My belief is that the nightmares only affected me for a fairly short period of time, but I’m open to new ideas about it.

[laimtoh5]

Thanks for the encouraging words everyone. I’m feeling very positive about my condition now, and also about what I’d call success from the treatment I’m working through now.

In reply:

Mike, indeed it is, but I’ve only failed before by looking for quick and easy solutions, to a learned problem (circadian rhythm as mentioned before).
I felt that by giving the course of treatment a 6-week (if I recall correctly) timeframe, that put too much pressure and expectation on me, so this was the only problem.
But the small improvement and structure of keeping a regular sleep diary were useful practice, and convinced me it was worth persevering with, in my own time (so I finished the course, but without permanent results).

Jonathan, it’s interesting that I hear that a lot. I sometimes wish it were true, that perhaps it would be easier to remedy than my messed up circadian rhythm.
I think I just grew out of the nightmares, and not that much later than they arrived. But the stay-awake habit lasted much longer, and left its mark deeply.
In fact, I welcome nightmares, gratefully, which used to be rare (along with any dreams) – perhaps only once a month. It told me I’d slept more deeply than normal.

I think they’re very useful to mark how successful my CBT-I is going, and I add them to the sleep diary spreadsheet that I created after the NHS course.
Dreams/nightmares (it depends on your definition, I call a nightmare a story I wouldn’t enjoy awake) are at least twice as common, since I started CBT-I.

Martin, my productivity was always a problem, and I’ve seen that increase fairly well in the short time I’ve been on CBT-I. Another thing, is how shocked I was when I thought of all the times I’d make excuses for myself and blame insomnia, like it was a physical being, existing only to torment me.
Poor memory recal, clumsiness, difficulty in standing up for myself. Wow, I’d probably blame it 10 times a day.

Now I actively check to see if I’m doing that, as it’s almost an unconscious action, and is so inhelpful. As you say, it’s better to look at how well life goes on despite a poor night’s sleep.

One thing that’s really lifted my spirits is something I read about called positive feedback loop (and not applied to insomnia, so it’s my take on the concept).
As I gain more energy and enthusiasm, however small, from successful treatment, I will achieve slightly more in my life.
As I achieve more, I’ll feel more relaxed and contented with my days.
As I do more, I’ll be a bit more sleepy come time for bed.

I prefer visual examples and analogies, so I see it (bear with me here) as a set of old scales – I’m adding a small weight (with better sleep) with each day that passes, and my life is lifted slightly higher.

[laimtoh5]

Thanks for the welcome Martin.

My insomnia began when I was about 4 years old, and due to having an episode of particularly worrying nightmares, and no parental help, I decided the best way to avoid nightmares was to be as restless as possible, and not sleep (for as long as I could manage).

So this altered my circadian rhythm, probably at an easy time to do so.

I found it possible to live with insomnia, as it became, as it isn’t like pain or any other type of physical discomfort. You just live with it, badly and knowing it affects your life terribly, but it’s easier to go along with it.

I took stock of my life, seriously, last year, having tried most of the available self-help, medications (including temazipan for short periods) and most types of sleep hygeine, but it was really getting me down so I took serious action. Decades had passed since I was 4.

I used an online NHS funded sleep CBT-I course, which was certainly good, but my condition was too severe for this to work effectively, in the 6-week period, I felt. So I took the recommendations from it, and put them into practise in my own time.
In particular, the sleep restriction phase was too short on the course, so I’m currently 2 weeks into that (and finding it pretty hard, I must say). But I’m getting better at it, and I’m really pleased to say, I’m also finding I’ve got more energy and am getting a long to-do list shorter all the time, which as a pretty conscientious person, is crucial as it’s one of my anxiety factors.

Other than insomnia, I am remarkably lucky to have no ailments, and excellent health, along with being as physically active as I can manage.

Reading the beginning of The Sleep Book in the last few days has also been very helpful, as I didn’t realise how much I connected my life to my insomnia. In fact it’s so bad, I could accurately be called “that guy with chronic insomnia” before any other description is necessary. The author’s description of how I view insomnia was spooky, with statements like “I know tomorrow will be terrible if I don’t sleep tonight” and “it has prevented me from succeeding in finding a long term relationship” came like a shockwave. At last I heard that someone understands this condition, and that’s such a comfort.

So I begin to drop my hatred of insomnia, and accept what it is right now, and try not to attribute anything directly to it. It will lose its power of causing me anxiety that way, at least I hope so.

I’ll continue with the things I know work, like sleep restriction and keeping a sleep diary, as I’m not obsessive about them and actually find them motivational.

Hopefully I haven’t bored anyone with my story – if I have, hopefully it will have had a meditative effect on you!

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