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Sorry you guys are having such a hard time. I’m no expert on this, only on my own insomnia and recovery, but it seems to me that the most important thing for ACT to work over the long haul is consistency in getting into that acceptance state at night. This is what teaches our brain to relax and settles down our overactive nervous system. Of course it was easier for me than you guys to stay consistent because I didn’t have to practice it very long. It took me less than two weeks again to recover. You guys have had to practice this a lot longer.
Because it’s taking so much longer for you guys, I really recommend you get some help. So that’s great, Steve, that you already decided to do this. I think when you’re struggling with something as difficult as insomnia and as long as you guys have been struggling, it’s important to get help. My guess is that you haven’t been able to stay completely consistent with your acceptance and slip back into frustration, anxiety, and looking for other ways to solve the problem. Therefore, your brain cannot settle down. But with some help, you would get the “hand-holding” and encouragement you need to persist and stay consistent. And sometimes you need someone that believes in your ability to recover when you can’t. Then you can hang onto their faith in you until you begin to develop that faith in yourself.
If you contact Dr. Kat, you can set up appointments so that you see her every week for a half hour instead of an hour every two weeks. In between, you can email her with any questions or problems you may have. I think that this more regular help from an expert will give you the hope and encouragement you need, and will help you persevere more consistently towards your recovery.
Hi Whitelori – That’s great that the night before last you stopped struggling and had a decent night. What was it like? How long were you awake and how long did you sleep? Then what happened last night? What did you do when you realized that your mind was active? Did you end up sleeping at all? How much? Is this how it usually is for you?
About combining ACT and CBT-I, I don’t think it’s a good idea. The idea behind ACT is to learn to relax about sleep, so you don’t want to be worrying about anything like your sleep window. As long as it’s a reasonable length, I think you should be fine. Of course you want to be tired when you go to bed, so I suggest waiting to go to bed until you’re tired. But you don’t have to be super tired.
Since you know what it feels like now to be accepting and relaxed in bed like you were the night before last, I would aim for this state of mind. If your mind gets too active, you may want to do something to calm it like get up and reading for a little bit, journaling, or whatever settles down your mind. Then go back to bed. I find for myself that sometimes when my mind is active it settles down on it’s own after awhile although it may take an hour or so. There were times when I thought about getting up, but then I laid there and eventually my mind settled down and I fell asleep.
Just keep your focus on accepting and not struggling night by night. I think you will start have more decent nights then. If you find yourself struggling, then let go of the struggle. If your mind gets too active, find a way to calm it down or just lay there until it eventually calms down on its own. Consistency with this method is very important. You want to teach your brain that the bed is a safe place and not a place of worry and anxiety.
Hi Whitelori – glad you have a husband like mine who has a calming effect on you. We are very lucky! Just wondering what you mean when you said that with ACT you get it right one night and not the next. About your having to wake up with the alarm clock, here’s my take on that. When I practice ACT I throw out the strict sleep window and SC (getting out of bed). I go to bed at the usual time around 11 with my husband. I then let myself sleep as long as I need to, even waking up at 8:30. That’s because in the beginning of practicing ACT I may only sleep a few hours or the sleep may be light, so I need extra time to sleep. Now it’s been almost 2 weeks since I started, so my sleep is consolidating and I’m waking up earlier and closer to my usual time of 7 to 7:30. So I don’t think it’s a good idea to combine CBT-I with ACT. Dr. Kat will tell you that as well. You want to learn to relax about sleep and having the strict rules of the sleep window and SC will not help you relax.
David – I’ve also got that obsessiveness too and that wanting-to-help nature (maybe too much) and am sort of driven (I find it hard to do nothing and just relax.) I also notice that many of us go into great detail about what’s going on with us. I wonder if this is part of the obsessiveness. I’m lucky that I’m married to someone who is the total opposite of me. He’s laid back and falls asleep within 5 minutes. When he’s not working he knows how to relax and watches sports, plays video games or watches movies. He’s had Parkinson’s for 9 years, but doesn’t obsess about it, taking one day at a time. As a result he’s doing really well for someone with this condition including skiing, taking hikes and bike riding. He also does very high level intellectual work as an astrophysicist, keeping his mind sharp. If he missed some sleep, he would not worry about it. But I obsessed over it when it first happened and that was the beginning of my chronic insomnia.
David – I was lucky in that I pretty quickly figured out how to accept things and relax in bed. But it’s tricky for a lot of people. They’ll do mindfulness in bed, or focus on emptying their mind, or do relaxing exercises, or spend too much time on accepting their thoughts & feelings – whatever – but they are all forms of “doing” which keep them awake. That’s why I keep encouraging people to see Dr. Kat, to get individualized help. Otherwise, no matter how long they try, they won’t see results.
Hi Christie – SC does seem to create more anxiety for some people. As an alternative to CBT-I you want to look into ACT, another therapy for insomnia. It’s worked for me. The best resource on this is The Sleep Book by Dr. Guy Meadows, who developed it. It’s based on learning to relax in bed so that sleep naturally comes. Check out my last post under the thread, ACT for Insomnia.
Mac – that’s interesting about the high cholesterol. At my last annual physical, my doctor told me that too! I’ve never had high cholesterol before and of course the check up was during the worst of my insomnia.
David – Dr. Guy also says that about mindfulness in his book – it’s not to be used to go to sleep, but just to help calm oneself down by observing our thoughts instead of buying into them.
I didn’t use much mindfulness or acceptance of my thoughts/feelings in my recovery, except for the “Acceptance that I may or may not sleep each particular night” which is the main point of ACT – to stop struggling to sleep. And that is what led to my recovery. After making peace with the possibility of not falling asleep, I could finally relax and do nothing but lay there in bed and let my mind wander like before the insomnia. The first night I was awake most of the night, but by the 2nd night the time spent awake was already decreasing to 2-3 hours, 1-2 hours, to 1 hour and now less than a half hour. So accepting sleepiness on a nightly basis helped me completely relax and then sleep naturally came.
Sorry you had a bad weekend night, Mac. Friday night was bad for me too. I had a Saturday seminar to attend and somehow in the back of my mind was some worry about waking up on time. I ended up awake most of the night. Blah! Luckily I got back on track last night and slept well. How was the night before your special event?
ACT is tricky. That’s why some fine tuning is needed. We may think that we’re doing it right but if we’re not, it won’t work. Yes, to get to the place of acceptance takes work. That’s why many times I had to get up and write in my journal to clear out my mind. Then when I was completely accepting of whether or not I was going to sleep, I’d go back to bed.
About the mind wandering – yes that’s what needs to happen. But you said that your mind tends to be overactive when it wanders, and that is not conducive to sleep. It needs to calm down somehow. Maybe Dr. Kat will have some tips on that.
If you decide to work with Dr. Kat, please let us know here how it’s going and what you’re learning. Then others can benefit from your sessions as well. After my first hour session with her I asked if I could do half hour sessions with her once a week instead of an hour every two weeks, since appointments are available only every two weeks. She was very willing to do this.
If you want to get email notifications again of posts here, then unsubscribe and come back the next day and subscribe again. You should start getting the emails then.
Whitelori – if your mind is busy and working, I don’t think ACT will work. Also practicing the “exercise of acceptance” or staring out a window is “doing” something. They are both active and keeping your mind awake, and won’t help you fall asleep. I really encourage you to talk to Dr. Kat. I’m sure she’s worked with people with all types of situations and could help you achieve the complete relaxed state that you need in order to fall asleep. It just sounds like you need more day to day individual coaching to understand how to get to that place of relaxation. I remember in the Sleep Book, Dr. Guy talks about Carlos, who took two weeks to finally learn how to be in a relaxed state in bed. He had the advantage of individual coaching by Dr. Guy to get to that point. If you talk to Dr. Kat, you can also email her questions between sessions so that you have more day to day (or night to night) support.
Whitelori – just wondering is there any difference between now and before you started ACT? Did you have light sleep before? Are your hours awake any shorter?
Hi Mac – So it sounds like you’re not waking up as often but having light sleep instead. That’s great that you’re not waking up! Now hopefully the light sleep will begin to consolidate into good sleep. Just keep relaxing and accepting. That’s how it was for me. Instead of laying in bed awake for hours, the time it took to fall asleep shortened but the sleep was light. Eventually, the sleep consolidated. That’s what I’m going through right now. I’m falling asleep within a reasonable period of time but still just a little tired when I wake up. But I’m rating my sleep a 4.5 out of 5, which is pretty darn good!
I’ve had some realizations through this last relapse which should help me in the future and minimize any future relapses instead of taking so long to finally get around to doing the therapy (almost two months.) I realized that I’ve been avoiding doing the ACT therapy because for months I’ve been carrying around some fears in the back of my mind:
– That my quick recovery in July (less than two weeks) was due to “luck.” I’ve seen others here on the forum take so much longer to get better, so I thought maybe I just got lucky that one time and it may not be easy the next time around.
– I thought maybe I had experienced the “placebo effect” where one believes one is healed, so then they act like someone who has healed.
– Because of the above, I was afraid that this time it was going to take a lot longer to heal and it would be a lot harder, so I dreaded getting started.
– I kept comparing what I was going through now with how it was back in July. When I started ACT in July I had one long night and then quickly shifted into the stage where I fell asleep soon but the sleep was light. This time, every time I tried to start I would have a day or two of really long nights (and then I would give up and take a pill or have a drink). I dreaded the thought of 2 or 3 weeks of long nights along with zombie days.
– Of course my biggest fear of all was this: IT WON’T WORK THIS TIME!Talking to Dr. Kat really helped clear my mind. I stopped comparing and then finally settled in to do the therapy. And when I did it, lo and behold, it worked again just like before! It’s been seven nights now and I’m well on way towards total recovery. So it wasn’t just luck. It really works when you do it right and give it a chance. When I looked back over my sleep diary since the relapse began, I realized that I didn’t give it more than a night or two before I would give up. The fears were just dominating me.
Anyway, I’m very grateful to be feeling much better – both physically from decent sleep and emotionally, from relief from fears. How’s everyone else doing? Steve, Whitelori, Gdsmom? Karen – did you recover again from your recent relapse? Anybody else we haven’t heard from in awhile?
Hi Hopeful – Read the success stories of people who have recovered and that will give you hope for your own recovery. Most all of them used CBT-I techniques. I also used sleep restriction and it helped give me back my confidence that I could sleep. For myself it started to work right away – I was sleeping well 5 nights a week. But for others it takes time for it to begin to work. Keep talking to people here and you will find the support you need.
Well I’ve just finished my 5th night of ACT and it seems to be working its magic again. Of course I hope I don’t jinx myself by saying this! The first night was long – maybe I was awake 4 or 5 hours or even more. The second and third nights I was awake 2 or 3 hours. The night before it was 1 to 2 hours and last night maybe a half hour. The quality of my sleep is gradually improving too. Let’s hope this keeps up!
