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Steve – I read Sasha’s book and I agree with Nik’s assessment of it. It’s CBT without SR.
For myself, acceptance is done on a nightly basis. I accepted that I might not sleep that night. I would go to bed to “rest” with no expectations of sleeping, just accepting whatever happens. I think you’re already doing that Steve, so you’re doing just fine. Try not to overthink.
I know that people have tried ACT on their own and gotten frustrated with it and then given up on it. That’s why my main complaint about ACT was the lack of support available for it. When I first tried ACT on my own in March I couldn’t get an appointment with Dr. Kat until mid April. By then I had already given up and was going back to CBT-I. That’s what’s so great about Martin’s support for CBT-I. He’s available 24 hours, which is what you need when implementing these therapies.
Mac – I say I recovered in 2 weeks, but actually it’s more like a month and a half because it was back in March when I really learned how to practice the techniques. I had sleep onset so I could go for hours never falling asleep initially. But when I first started to get the hang of “acceptance” in March, I was amazed that I was falling asleep so quickly. Also during this time I learned how to practice mindfulness and “create some space” between ME and my negative thoughts, feelings and sensations. Then I learned how to “welcome” them, which would neutralize them. So when I started ACT again in July I just “pushed the acceptance button” as Borgesbi says, and I could get to that state of mind much more easily. I actually didn’t have to do much work at all this second time around because once I accepted whatever happened, I relaxed and fell asleep fairly quickly. I say that I’m fully recovered, but maybe it’s 95% because sometimes there are still some worries of it coming back, which I know is normal. But I’ve been sleeping well every night, for the most part going to bed at 11:00 and waking up around 7:30. I haven’t had special event anxiety, but there probably is someone else here who has.
Anyway I want to encourage you to read the posts here because they will help you learn how to practice. We don’t have a “coach” helping us on a day to day basis like Martin does with his clients, but we coach each other here. I believe this peer-coaching has been very valuable to everyone and has made a huge difference, in comparison to trying to do it all alone like I did before and you and others have.
For a specific example of using techniques to reduce anxiety check out Borgesbi’s post on page 35.
Sounds like you’re making good progress, Gdsmom, sleeping a little more, stressing about things less and using the Ambien a whole lot less. That’s great! I was just curious – is there less dread about making dinner because you’re less tired or just less stressed because of an attitude change? I know that Dr. Guy says in the book that when people got better at accepting, and just rest in bed instead of struggling, then they had more energy during the daytime.
Nik Burn – I’m sorry, but I’m not going to force myself to stay awake for a whole night! The couple nights this week when I had anxiety, I did stay up until about 1:00. When I completely accepted the fearful thought that I could possibly have some sleepless nights, then I was good and slept fine afterwards.
Mac – I don’t know if you’ve been keeping up with the posts on this thread or not. Here’s a recap in case you haven’t. I started doing SR/SC again in late April and did it for a couple months. I got frustrated with it again because I was still having 2 bad nights out of 7 just like the first time I did it back in Jan & Feb. I wanted to deal directly with the anxiety, which I felt was always there underneath the surface and which was keeping me awake those 2 nights. So I started ACT again and this time I worked with Dr. Kat from Dr. Guy’s clinic. When I finally committed myself to it, my insomnia was over in less than two weeks. That was 2 & 1/2 weeks ago.
Since then, some other folks here got interested in using it, especially those who had a hard time with SC or just weren’t completely satisfied with CBT-I. If you look over the last several pages here (maybe even 10) you will see all of our journeys and how we have tried to learn to practice ACT. It’s more “tricky” than CBT-I, which is pretty straightforward. With ACT, you have to learn how to think differently. So people have been putting their questions out here and then others offer feedback on how they practice it and how it’s working for them. You may want to look over these pages.
The most basic idea is learning to “accept” the insomnia, and to stop struggling with it. The other idea is to learn to “tame” the anxious thoughts and feelings through using techniques such as mindfulness and welcoming. The Sleep Book by Dr. Guy explains it the best and very thoroughly. Please read chapters 2 and 3.
I have to tell you honestly, Mac, that part of my motivation in going back to ACT was watching you and Delv continue to struggle even after so earnestly practicing CBT-I for several months. Something was missing. I think for some people it works great and Martin’s success here is a testimony to that. But for some other people, they need something more. Maybe these people are just a little more anxious, which I believe you are. Even in your post here, I can hear your anxiety in the things you say. In that case, it’s better to deal directly with the anxiety like ACT does.
That sounds like a great attitude to have, Nik.
Just wondering, how long have you had your insomnia?
I was going to go off them soon, but I think I’ll take them for another month or two until I’m sure that I’m completely relaxed and confident about my sleeping.
Just as I told Steve about honeymoon periods, ironically I think my own honeymoon is over. This week some fears have been creeping in. The last couple nights some worries about the insomnia returning came in when I went to bed. I figure this is normal though. I think that the last two weeks I was just so overjoyed to be free of insomnia, that any anxiety I had was pushed far away onto the back burner. But this week they’re on the front burner, at least when I go to bed. My mind was restless and I couldn’t sleep for an hour or so, and knew I had to get up to calm myself. I wrote in my journal both times which always helps. I realized that a part of me just wants to push away all the fears and forget the whole nightmare. But I knew that I had to face the fears and just accept them. When I did that, I calmed down and then went back to bed. I had no problem falling asleep and slept fine both nights.
Feathery – I let myself sleep in in the morning an hour or so a few times if I needed it and it didn’t seem to hurt my sleep that night. It sounds like you’re tired at night since you’re too sleepy to open a book, so I wouldn’t think it would be a problem. Dr. Guy recommends a consistent sleep schedule with some flexibility of plus or minus 30 minutes. I don’t use an alarm because I don’t have to, but I know a lot of folks here have to use one in order to get up on time for work.
I didn’t have any aches so don’t know about that. Sounds like a good question for the sleep doctor. I was tired also until my sleep started to deepen naturally.
Steve – I was wondering when you were using a SW of 5.5 to 6 hours. Was it before ACT? If so, I wouldn’t go back to it because you said that since you started ACT two weeks ago, your sleep has been getting better.
I wonder if your sleep is getting fragmented because there’s some anxiety about increasing your SW. So the anxiety is creating the fragmentation. When I did ACT back in March, I also worried about my light sleep which was fragmented, being in and out of sleep all night. I worried a lot and also thought that maybe I should go back to a smaller SW to deepen my sleep. I know how it is to want to go back to the “security blanket” of something that worked before, even though it’s given you limited success. My worry just fueled the insomnia and it got worse.
This also reminds me of how about when I was about about 5 weeks into CBT-I, I had a really bad week. Up to that point I had been consistently doing well with 5 good nights each week. I think that sometimes we first go through a “honeymoon” period when we start something new and we’re putting so much hope into it. Then reality sinks in and we start to lose confidence. The thing is to keep going. I kept going and then my sleep got better again after that week. So there are always ups and downs with any process. My suggestion is to keep going, doing what you’re doing and to not worry about decreasing your SW. Trust the process, relax and your sleep will start getting better again.
My meltdown was because I was desperate for sleep and couldn’t get any relief. I had gone to my doctor for sleeping pills, asking for Ambien because I had taken it years before and it worked for me. But this young whippersnapper wouldn’t give it to me because he said I was too old and could fall down. This was very frustrating because although I am older, I’m in great shape and feel a lot younger. Anyway, the sleeping pills he gave me didn’t work at all. So I could never get a break from my insomnia. I got so crazy that I just wanted someone to hit me over the head and knock me out. Finally at the emergency room they gave me a prescription for Ambien and afterwards, I found an older, more understanding nurse practitioner who gave me a ongoing prescription. I had my last meltdown right after my vacation and just a few days before recommitting myself to ACT and then finally healing. For me it was just the old stuff of struggling with “trying again” to cure my insomnia. You know how it is when you’ve tried so many times and it doesn’t work out. You get so discouraged. That was where I was at. Of course now looking back I realize it was that old devil trying to make me give up just when the victory was right around the corner.
Pam – some of us are clients and some of us aren’t, but we’ve all been going through the same struggle, so we all belong here, you included. I’m so glad you’re feeling hopeful and that it’s helping your marriage. My insomnia was hard on my husband too. He was very kind and supportive but I know it put a lot stress on him, worrying about me. On some level also, he just couldn’t really understand it. I think he just thought I had a lot of anxiety and that I was obsessing about it, so that’s why it wouldn’t go away. A couple counselors I talked to also thought this, and thought that medication for anxiety and compulsive obsession was the answer, which of course it wasn’t. I’m sorry that you felt “broken” and blamed yourself for having this problem. But it’s normal to feel like we’re defective when nobody else seems to understand what we’re going through. Only fellow insomniacs really understand what it’s like.
ACT is kind of “tricky” so please ask all your questions here because none of us are experts (except on our own insomnia and what’s worked for us), so we’re all trying to figure it out as we go along and are glad to share what we’ve learned along the way.
In broad strokes ACT works to reduce sleep anxiety so that you learn to relax in bed. You give up “struggling” to fall asleep and learn to accept and make peace with whatever happens using mindfulness and welcoming techniques. As your mind gets out of the way your body takes over and you naturally fall asleep. The best resource on this is The Sleep Book by Dr. Guy Meadows.
Borgesbi – very happy to help because I know how awful insomnia is. I had some terrible meltdowns too and once went to the emergency room because I was completely falling apart. My poor husband who had to deal with this basket case! I just feel so blessed to have recovered so quickly once I understood how ACT worked and how recovery took place, and then practiced it consistently. I wish it could be so quick for all of you, but at least everyone seems to be making progress. By the way, when did your insomnia start?
Suren – what kind of insomnia do you have – sleep onset or maintenance? Mine was onset and I could be in bed for hours never falling asleep.
