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@Mac – glad to hear you are doing better or even good these days. May I ask you how did u arrive there? What did u do? ACT? CBT-I? Was it an anxiety-problem? Did you have also anxiety during the day? Thanks in advance for ur input. All the best.
@Chen of course I understand. I advise you to work with Martin (I think he says CBT-I works normally even with drugs, but ask him). And he always says that when working with him, stay of the forum. It only triggers you. Good luck!!
@Mac – glad to hear you are doing better or even good these days. May I ask you how did u arrive there? What did u do? ACT? CBT-I? Was it an anxiety-problem? Did you have also anxiety during the day? Thanks in advance for ur input. All the best.
@Chen CBT-I is considered to be the best treatment option for this type of insomnia: “Longitudinal studies have shown the most effective treatment for psychophysiological insomnia is cognitive behavioral therapy (CBT). This treatment helps patients eliminate the beliefs and misconceptions they have about sleep.”
I have also (sometimes) a big problem with sleep anxiety.
I am a fan of both CBT-I and ACT elements. In fact, I think the “C” part of CBT-I relates to the ACT elements. So for me, it is noth either this one or that one approach. I use elements of both.
Right now, I am working hard on the “acceptance” part.I like the DARE approach a lot. There is a great book and an excellent APP. But the principle are always the same (as in the “Sleep Book”): accpting, even embracing anxiety, non resistance aso. I work on these things a lot. But as Martin says, these things are a sort of higher skill. So SRT/Stimulus control work often better (or first) when ur not able to work in a constructive way with ur anxiety.
Good luck!
I am struggling again. Sleep anxiety is back. This constand up and down is hard.
How do you deal with the toll insomnia/anxiety/worrying takes on your mood? Didn’t u get depressive? That is my “other fear” now. My oh my.
Thanks for your input.
For me, it is a big up and down. Till Saturday, I had two great weeks. And then I had a dream about sleep anxiety (similar when ex-smokers dream about smoking 🙂 ), and it started all over again.
Anxiety during the day, and in bed, my mind is very “creative”: intrusive, frightenigh thoughts leading to the vicious cycle. Anxiety “telling” me that I am “loosing” it, that this thing will destroy me. It is basically fear of fear then. It really scares me.
I have some questions relating to ACT:
1. Since it is a process that takes some time, how do you behave in the beginning of trying “ACT”? What I mean is the following: accepting, welcoming thoughts.. is not easy to do, so what do you do when u lie in bed and the anxiety hits you and you are stell in the “learning” phase? Do u nevertheless stay in bed the whole night with the anxiety? Or, in the beginning, to you leave bed after a certain time (stimulus control) until you really “master” the techniques?
2. I have read that ACT should not be combined with CBT-I? Why not? Why can’t “accepting, welcoming, mindfulness…” (ACT) not be very helpful with implementing CBT-I?Thanks a lot for your help – all the best to all of you!!
Manfred
Mac, Deb and gsdmom – thank you very much for kind words and your advice.
With ACT or – I like it a lot: The DARE RESPONSE – it comes all down to the same thing: NOT RESISTING the fear, accept it aso. I think this IS the thing to learn.
I am a big fan of sleep restriction (SC is another thing though…). Although it adds pressure (knowing you have only 5,5 h for sleep, adds pressure); here the “not resitsing” part comes into play.
I need to work on a deeper level with this anxiety (and intrusive thoughts). As written in “DARE”, I think it is the fear of the fear, the FEAR what the FEAR could do to me, that is what keeps fueling the anxiety.
Right now, I am reading “Feel the fear.. and do it anyway”. Seems to be very good, with clear exercises to work with your anxiety (the author states the same: the deepest level (level 3) of every anxiety lies “I can’t handle it”. That’s it! She offers precise exercise (I am still reading the book), for ex. positive self-affirmations).
It is good to know not to be alone here.
Stay seafe and healthy.
Manfred
I have another setback – and my intesive sleep anxiety is back.
After sleeping for several weeks very well, I had one bad night and that brought the whole thing back.
I was triggered by me enacting my (violent) dream. I don’t know if this REM disorder, that I rarely have, is triggerd by the anti-depressant I take for years, is part of my “rhytmic movement disorder” (since a child, I roll my head/body during sleep) or – and that frightens me a lot – is a disorder on its own since it is often a precursor to Parkinson. Need to go to a sleep lab, but due to Covid-19, everything is closed here right now.
My sleep anxiety has an obsessive part. And I fear “losing it”. It is a mixture of intrusive thoughts, ruminating, adrenaline rush…
After two bad nights with lots of anxiety (also during the day), I re-started CBT-I last night. Cut my sleep window to 5,5 hours. I fell immediately asleep and slep around 5 hours.
But my anxiety keeps “hunting” me. I think it is “fear of the fear”, the fear that the anxiety is stronger than me and won’t let me sleep.
I know ACT and the Sleep Book. I have meditated in the past. The whole thing is very difficult for me.
Does anybody here know and tried the “DARE Response” (book and app). I like it alot, the principles are quite similar.
How do those of you with intensive sleep anxiety, cope? What do you do exactly when anxiety hits? How do you prevent it? Do you take a benzo to bring anxiety under control?
I could really need some advice.
Thanks in advance, stay healhy and … sleep well!
Manfred
Dab: I mostly used CBT-I. But trying also to “accept” it, but that is the hard part. I know the theory very well but struggle a lot with the practice. Tried mindfulness, medidation aso., but still can”t figure out how to accept “not sleeping” when all you wish is … to sleep.
But how do you stopp “freaking out”? That is exactly my problem, and leads to fear of the fear.
I am in the same camp. After two months of very good sleep, I thought I was recovered. But then on Sunday night, I had some trouble falling asleep and woke up early – then my sleep anxiety was back. My trigger was the fact I didn’t wind down correctly, my brain was too “excited”. The next night (Monday to Tuesday) was better, but last night my anxiety struck again and I had a rough night. Now I have intensive sleep anxiety again (also during the day – btw, I am from Europe).
It shocks me how fragile I am after two months a very good sleep. How is it possible things can derail so quickly? I feel depressed with lots of fear.
Hi David,
thanks A LOT for your reply. Helps me a lot.
Did you do the CBT-I on your own or did you work with Martin or another counselor? I am asking because Martin says not go under 5,5 hours. But I understand that with so many “nil nights”, even 4 hours is a huge progress.
Did you stay in bed during these “nil sleep nights” oder got up? I suppose, after hearing the podcast, it was anxiety/obsessive thinking that lead to these nil nights, wasn’t it?
Tonite, I am going to watch the Kabat-Zinn video you mention.
Great that you recovered!! Hats off!
Manfred
@David – I listen to the entire podcast, very interesting – thank you. Nevertheless, I would like to ask you a few questions to get even a better understanding:
1. In the podcast, you said that a big step forward was the realization how much you obsessed about sleep, that you have an obsessional personality and obsessed about other things in your life too. I am very much the same – but what I would like to know: how did this help you? Knowing that you have an obsessional personnality is not making the obsessions going away, is it?
2. You worked with very a very short sleep window. How long did you stay with a SW of under 5 hours?
3. In your last post, u mention that your sleep windows vary as to the start hour: 11 to 3.15 or 1 to 515. I thought it is important to always wake up at the same time. How did you do it exactly?
4. Wasn’t it depressing to start your day at 3:15 or 5:15, esp. on weekends? What did you do when u wake up soooo early?
5. Did you also have daytime worrying and anxiety? How did u deal with that?
Thanks a lot for help in advance
Manfred
@David May I ask you a few questions:
1. Do I understand it correctly that you had a sleep window of just 4 hours for 3 weeks?? I thought one shouldn’t go under 5,5 hours (Martin is teaching this).
2. Can u explain a bit more how you dealt with this “obsessive thing”. I am also very obsessive about my sleep. I have intensive sleep anxiety and at night also intrusive throughts.
Thanks in advance
Manfred
Thsnks Deb. I really wonder how one does lay in bed and do nothing. My anxiety and racing mind wouldn’t let me. But I gutes that this is the essence if ACT. and normal sleepers.
Well, my sleep window was 6 hours. I needed to go out of bed only 1 time per night for just a few days. I playd cards (solitaire). But I can’t really focus or relax, because my mind is ruminating.
In November, my anxiety went away after just a week or so. This round, anxiety is more intense, giving me also intrusive thoughts when I try to sleep. Not easy.
I know all the theory, but the moment I go to bed… And lots of anticipatory anxiety.
