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Also, Odinsky – what did you do before to recover from your bouts? You said that you used ACT. So what exactly what did you do? And what was happening during those 8.5 hours in bed while you slept 5 hours?
I personally think that using SRT will only increase your anxiety. With ACT you learn to relax in bed. So it seems to me that you have to remember how you were finally able to relax in bed and recover from your relapses.
The purpose of imagining the worry as a creature is to help you separate “You” from the worry. It’s only part of you. When I imagined it as a creature like that then I felt sorry for it. Then it went away. But if what you’re doing with it is not helping, then try something else. Don’t just let it dominate you and take over. When my anxiety got really bad and I couldn’t think my way out of it while in bed, I usually got up and did something to calm myself like write in my journal or read a book. Then I went back to bed after I was calm. Your goal is to learn how to stay calm in bed.
Hi Mac – so glad you’re sleeping great! I am too! I also am staying away from here for the most part unless someone asks me something, like Chen. Let me know how you’re doing once you have to go back to work again. In the meantime, enjoy!
Hi Odinsky – I would recommend sleeping somewhere else until your sleep improves and you know you will be able to fall back asleep. In Guy Meadows’ book, he talks about the client who couldn’t sleep with his wife until he got better. Then he gradually transitioned into it.
Hi Chen
1) I would sleep in. I didn’t have a strict sleep window.
2) For myself, by the second night I was sleeping a few hours so it gave me hope to keep at it. Over time my sleep gradually improved, so I wasn’t tempted to take any pills.
3) I was sleeping normally by about 2 weeks after I started practicing ACT consistently every night.
4) I lay in bed all night, not worrying, just relaxing. It was a very long night of doing nothing there but laying, but because I had hope in the process, I didn’t let myself worry. When I was exhausted the next day, I took a short nap to help myself get through the day.
5) Well, ultimately we are using ACT to help us to sleep. But when we’re in bed, we accept on a night to night basis that we may not sleep that particular night, which helps calm down our mind and then may lead us to sleep. We give up the worry and then sleep starts coming naturally. The “acceptance of a sleepless night” is a TOOL to help relax our mind so that eventually we will sleep. Please re-read the chapter on Mindfulness which talks about Carlos, who finally learned to completely relax in bed after about two weeks. Then he started sleeping better after that. So the goal is to learn to relax in bed and not worry. Then eventually you will start to sleep better consistently. ACT retrains us to “let go” of all our thoughts when we go to bed like normal sleepers.Chen – if we already are able to accept our sleeplessness and lie peacefully in bed, then we don’t need to do mindfulness. For myself, I didn’t need to do mindfulness because I was able to accept whether or not I slept and lie in bed peacefully. But if aren’t able to do this yet, then mindfulness and welcoming are tools you use to help your mind settle down and relax. I also only needed to do welcoming a few times. Once I knew how to lie in bed relaxed, accepting whether or not I would sleep, then I didn’t need to practice mindfulness or welcoming. So the point is to learn to settle down your mind. If you learn how to do this and just relax in bed, then eventually you will fall asleep.
Hi Chen – It’s normal to think “I want to sleep” when you go to bed. But a normal persons knows that they will fall asleep eventually, so they don’t continue to have that thought anymore and their mind relaxes and wanders until they do fall asleep.
That’s correct that you accept whether or not you will sleep that night. But you don’t accept or allow just anything, like worrying, to take over your mind. Worrying will only keep you awake. So you’ve got to find a way to let go of the worry. This is what mindfulness and “welcoming” is helpful with. Through mindfulness, you create some “space” between “You” and your thoughts and feelings. Then they lose power. Through welcoming and making the worry not such a big deal, it loses its power and then will disappear. Once your mind is calm, then you lay there and do nothing and let your mind relax and wander, and eventually you will fall asleep. Maybe not the first night, but probably by the second night you will sleep at least a few hours, even if the sleep is light. This is the beginning of things returning to normal.
Hi Chen – welcome to our group. Sorry you’ve struggled so long with insomnia. To answer your questions:
1. Yes, ACT means that we stop struggling with our sleeplessness and accept it. By stopping the struggle and worry, then we start falling asleep naturally.
2. We let our minds wander, not thinking about anything particular.
3. When the thought of worry comes, we don’t try to distract ourselves or make it go away. We welcome it by trying to befriend it so that it loses its power. We don’t let it take over us though and remind ourselves that it’s just a thought. So for example, when I felt worried, I imagined my worry as a round, furry, red-faced little guy, all scrunched up with worry. When I thought of it in this way then I felt sorry for it and the thought lost its power and disappeared.About which method to choose, it depends. With CBT-I, you focus on actions, the 2 methods of sleep restriction and getting up when you can’t sleep. When you start having success, then naturally your anxiety starts to decrease. With ACT, you work on your thinking and learning to calm yourself down. If you think you’ll have a hard time letting go of the anxiety, then go with CBT-I. Later you can incorporate some of the elements of ACT if CBT-I is not completely healing you of the insomnia. That’s what some have done here, like Mac. Either way takes time to work. Once you start, let us know how you’re doing and we’ll support you here so that you can hang in there. Also, Martin Reed, the founder of this website is a great coach to help you with CBT-I.
About the pills, for myself I had to give them up completely. Guy Meadows says to do it gradually if you need to. So I don’t really know what the correct answer is. Maybe it depends on your situation.
Any other comments from the rest of you for Chen? How are you all doing – Mac, Delv, Steve?
Good to hear from you, Delv. Glad you’re overall doing a lot better even though you’ve had some setbacks. My sleep has been pretty good in general, but I know that I’m still prone to some anxiety and have experienced some the last couple of weeks. Like last night. I was tired when I went to bed but a little anxiety crept in. I didn’t really feel like I slept the first few hours but I probably had some light sleep during that time. I woke at 8:00 this morning and am a little groggy, but not too bad. I’ll be fine today and won’t need a nap.
In general, when I feel this anxiety I try to avoid any compensatory behaviors like getting up or taking a pill or having a drink, because it’s just making things worse by teaching my mind to be dependent on something instead of learning to just let go and relax. Overall I think I’m doing better though because in the past this could have triggered a full blown relapse. Instead, I’ll just let that go, continue to relax at night and will get back to sleeping pretty normally again.
Mac – glad you’ve had this long spell of good sleep. I’m sure as a result, you will have more confidence when you have to get up early again.
Hi Mac – I’m still sleeping well and glad that you are too except for the one bad night. I had one night where I went to bed way too late, around 1:00, and I was overtired. I tend to do this sometimes when my husband is out of town. He’s been gone for over two weeks and will continue to be gone indefinitely for awhile. His mom is in the hospital. Unfortunately he can’t visit her. Anyway, the late night messed up my mind and I didn’t sleep well that night. But by the following night I was back to normal. I think in a way that my 3 relapses helped me, because when I have a brief relapse like this one night, I have more confidence in getting back to normal because I’ve done it before.
We’ve opened up here in Alabama. I’m still not going out to restaurants or church where there will be groups of people. But I couldn’t stand it anymore after being completely alone for over two weeks and started visiting again with my two kids and grandkids. They came over and visited with me last night for a belated Mother’s Day celebration. It was very nice.
Manfred – When I had anxiety in bed, I used welcoming and then the anxiety went away. But if the anxiety was overwhelming, then I would get up and write in my journal. So I would say to do whatever works to calm yourself down. About not combing ACT with CBT: With ACT you’re not trying to build up the sleep drive – the focus is on learning to relax in bed so that you naturally fall asleep. So as long as you have a reasonable sleep window, you should do fine. Sometimes having a strict sleep window can cause more anxiety, so that’s why it’s best not to combine it with ACT. But if you just can’t get over the sleep anxiety, then maybe it’s best to do CBT alone. CBT reduces the sleep anxiety when you start sleeping consistently through using SR and SC. So if you can’t “think” yourself out of the anxiety using ACT, then do CBT where you stop thinking and just focus on the doing. Just do it like a robot, like Martin says.
Gdsmom – sorry you’re having so much pain. Hopefully you’ll find a solution to this. I had back pain for 30 years. Then I finally found a physical therapist who used a type of therapy that worked. I still have the predisposition to the back problem but I do exercises everyday which prevent it from getting painful.
Steve – glad that you’re getting better over time.
JA – That is a great achievement that you’re sleeping through the night! You are on your way to recovery! What you’re going through is normal and is what I experienced. I went from staying awake until 3 or 4 (or longer) to finally falling asleep within a reasonable amount of time on a regular basis. But I was in light sleep with lots of dreams or waking up a lot. I realized that even though consciously I was no longer worrying about falling asleep because I was falling asleep quickly, on an unconscious level, my brain was still on high alert after the months of the insomnia trauma. It took some time for that part of my brain to finally settle down and my sleep to deepen and become normal. The worse thing you can do is worry about the light sleep. That’s what I did my first go around with ACT and thus prolonged the process. When I finally talked to a sleep doctor and was reassured that light sleep was normal in the beginning of the healing process, then I just accepted it and over time it resolved itself.
Hi Mac – sorry to hear about the death in your family. Glad to hear that overall you’ve been sleeping well. I’m sure you’ve developed some sleep confidence which will help after you go back to work.
I’ve been doing well. It’s been over a month now since I recovered from my relapse. I’be been off schedule a bit the last week since my husband went out of town. That usually happens when he’s gone. I tend to stay up too late. When he’s here he keeps me on schedule. I had one morning when I was surprised to wake up at 10:00! I think I went to bed close to 1:00 the night before. But no problem sleeping the next night although I went to bed a little later than usual around 11:30. ‘Then I got back to my usual wake up time of around 7:30.
How’s everyone else doing? Ron, Manfred, Steve, Gdsmom, Delv and anyone else I haven’t mentioned?
Hi Ron. Whenever I practiced ACT I would always completely give up taking Ambien, because I knew that by doing so I was training my brain to depend on it to sleep. Martin talks about this too in one of his videos. He says that the worst time to take a sleeping pill is when you’re frustrated about not being able to sleep, because you are reinforcing the association between the pill and sleep. So I would go completely cold turkey. If I couldn’t sleep I would just accept it, and over time my sleep got better. I was determined to remember how to sleep naturally which I did.
Yes, Steve, I agree with you. Manfred, as long as you have a reasonable sleep window you should be fine. The focus is on learning to relax about sleep and not on building up your sleep drive.
Steve – How about sharing how you practiced “Welcoming” and dealt with your fears. You were good at using humor to subdue the fears and you had some good examples. For myself, when I would feel fear, my stomach on the left side would tense up. So I imagined that tension as a little guy who was a furry red ball and who was so worried. I named him Mr. Worry Wart. When I imagined him in this way, then I felt sorry for him and the fear melted away. Gdsmom, you had some good examples also of taming your fear using “Welcoming”. I think these examples would be helpful to Manfred.
