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Sablana,
Have you tried to taper off the Ambien? CBT won’t be worth doing if you’re still taking sleep medication.
If your doctor doesn’t know how to taper you, there are websites that can help. It’s not rocket science, but it does take patience. I was on 1 mg Lorazepam for 15+ years and my doctor thought a couple of weeks of tapering would be okay. He was dead wrong. It took me three months, but during that time I never felt ill.
Right now, because of my husband’s situation, I am suffering from anxiety, of course, but the original problem really started 20 years ago, when I hit menopause. Combined with my Hashimoto’s Thyroiditis, which went undiagnosed for decades, my endocrine system is a mess and no amount of dose tweaking seems to help. Even when my thyroid numbers are optimal, I still have obvious physical symptoms. And of course nobody really knows all that much about female hormones because we aren’t tested before menopause, so our individual optimal levels are unknown.
I would say that my insomnia is about 60% medical and 40% anxiety at the moment.
A couple of years ago I worked with a therapist who had me doing 20 minutes of meditation daily. She swore it would help me sleep, but after a year of practice I gave up. It did make me feel better in the moment, but as a sleep aid it was a bust.
I went through the CBT in March/April of this year, about a month after having a night in the local sleep clinic to rule out apnea.
It was a five-week course. I kept a sleep diary on line. I had a weekly “coaching” session, which was really just a review of my on-line sleep diary plus a few pretty basic relaxation techniques
I went to bed at midnight without fail, got up at 6 without fail, I never stayed in bed if I wasn’t sleeping, and I have never been able to nap, so that wasn’t an issue for me either. As the days went by I became more and more anxious, I was constantly nauseated and dizzy, and by the end of the first week I no longer dared to drive. I had to cancel a dinner party we had planned because there was no way I could cook for eight people and sit and be sociable with them. After a week I was also loathe to go into my bedroom at all. My asthma became so pronounced I had to back on my puffer full-time after nearly a year of not needing it.
The most sleep I got on any night was three hours, but not in a three-hour block. Also, my pattern has always been to fall asleep quite quickly and then I wake up after a couple of hours. Because of the requirement that I had to get up if I wasn’t asleep within 20 minutes, I just couldn’t go to sleep at all, I was so worried about it.
The other thing is that once I get up, my heart starts racing and won’t stop. I don’t have heart disease, but I do have low blood pressure, which can do this. So every time I got out of bed, my heart would start racing and pounding, and then of course there’s no going to sleep with that going on.
In the end I think I must be one of the 20% who aren’t helped by these techniques.
gdsmom,
Thank you for your kind reply.
Yes, I am on both estrogen and progesterone and my levels are in the normal range. A high dose of oral progesterone had me sleeping like a rock for 18 months, even after my partner’s diagnosis — but one night it didn’t work, and that was that. For good.
I practise good sleep hygiene — and was overjoyed to see that the new Kindle device has a warm backlight so I can read before bed without worrying about blue/white light affecting my sleep. I have a regular bedtime and try to get up within half an hour of 7:00 am every morning.
My partner doesn’t require any special kind of care right now. My concern is that my lack of sleep leads to depression, and right now we’re focused on having as much fun as we can, so depression really gets in the way. I’m his emotional support, and that’s what’s suffering because of my insomnia.
I am two different people. When I sleep you can’t hold me back — I’m like the energizer bunny. But after a week of 2 hour nights, I can’t even get dressed.
My sleep restriction therapy (it’s euphemistically called sleep consolidation therapy here) was the basic one: don’t lie in bed awake for more than 20 minutes, keep a diary, get up at the same time each day, don’t take naps.
My initial sleep window was 6 hours; from midnight to 6 am. In the whole 5 weeks I don’t think I slept more than three hours in a night, and even then it wasn’t three contiguous hours, it was broken by an hour or two being awake. A few times I had to break down and use a sleep aid because I can’t drive on the amount of sleep I get. Most nights I got between 0-2 hours, which is about what I get now.
The only way I can survive at all is to use sleep aids a couple of times a week; otherwise I wouldn’t be able to function at all. I’m trying to stay positive for my partner, but it’s almost impossible on no sleep. My exhaustion also comes with nausea and dizziness, which means most days I’m afraid to drive.
Of course, I also fear my future. I imagine another 25 years of life like this, and frankly, it wouldn’t be worth living. That doesn’t help, I know.
(By the way, the avatar your site chose for me is very apt; it looks like I feel).
