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Just some comments about getting professional help. I found out why the counseling is so limited at the Sleep School. They don’t get enough business! I asked the sleep doctor about this and she answered my question in an indirect way. I think that just as most people have never heard of CBT-I, even less people have heard of ACT.
Anyway, it turned out that getting an appointment was not that hard and Dr. Kat was willing to work with me and divide the hour into two 30 minutes sessions once a week instead of one whole hour every other week. I couldn’t afford to pay $200 every week and besides, I didn’t need a whole hour anyway. I felt more comfortable paying all this money knowing that it would just be temporary and that I wouldn’t need this therapy forever. It seemed like most people were a lot better by two months, according to the book, so I figured I’d probably be on my way towards recovery after a month and then wouldn’t need the therapy anymore. That turned out to be true. I only had 3 sessions starting in June. The last session I had nothing to talk about because I was already well on my way to recovery. We stopped at 15 minutes and whenever I want to use the other 45 minutes I can contact her.
I’m saying this to encourage you all to get expert help if this is not working well for you. I’m an expert only on my own recovery and that’s all. Dr. Kat could answer more thoroughly all your questions pertaining to your particular situation.
Steve – When I think about acceptance, I’m thinking mostly about acceptance at night – that I will relax and accept whatever sleep I get or don’t get during the night and not worry about it or try to do anything about it. This also includes not worrying at night about the effects of the insomnia the next day. It sounds like you’re doing a pretty good job at this both during the night and during the day.
I think in the beginning of doing ACT just like the beginning with SR/SC, there’s a lot of fear that it won’t work and that it’s going to be hard. Those were definitely my thoughts and that’s why I stopped and started so many times. It seemed so hard, but I really wasn’t giving myself a chance by giving up after just a few days. I thought about Carlos, whose sleep didn’t change for the first two weeks and then started getting better after that. Finally I made the commitment to do it at least two weeks and then re-evalute after that.
If I were you, Steve, I wouldn’t worry about trying to change my sleep window. In March when I did ACT the first time, because my sleep was so shallow I thought that maybe I needed to combine ACT with SR so that my sleep would deepen. But that’s when things started getting worse for me. I was all over the place adjusting this and that because of worry and it just made my sleep worse.
Gdsmom – what have your 5 days been like? If you’re having light sleep or just a few hours of sleep, that’s normal and just part of the process. Try not to get disappointed because it will take some time. The more you can relax and accept, the quicker the process. I was shocked how quickly it worked for me once I could consistently get my mind into that state. I always thought about the story in the book of Carlos, who saw no improvement in his sleep for the first two weeks, but just learned to relax more and more in bed during that time. Then he started to see improvement after that.
Thanks, Nik. When I first started ACT back in March I had mostly nights of light sleep. At the time I had no one to ask why this was happening or if it was normal. I couldn’t get an appointment with the sleep doctor until mid April. I got frustrated like you and thought it wasn’t working. I worried about it a lot, thinking that I was training my brain to have light sleep all night (those of us with insomnia can find just about anything concerning our sleep to worry about!) Anyway, because I was frustrated and worrying, I think this fed anxiety to my brain and so I continued to have light sleep.
When I started again in early June my pattern was this: the first night I would be awake all night and then the next night maybe just 1-3 hours in the early hours of the morning, or light sleep all night. Then I’d give up the next night after being awake most of the night and take a pill. Then I would start all over again. I did this several times. The longest I stuck to it was 4 days and that was twice.
Finally this last time, I made the commitment to stick with it at least 2 weeks with no pills and then make a decision to or not to continue based on whether I was getting any better. After the 8th night I had the strong sense that I was on my way to recovery. My sleep was getting deeper and I felt like it was becoming natural to fall asleep again, like I had “remembered” how to fall asleep.
So with this method it takes perseverance to get through those zero sleep/little sleep/light sleep nights. Over time the sleep will begin to deepen by itself and get better.
Thanks, Ron.
Nik – Just curious, is your insomnia sleep onset or do you wake up too early? Mine was sleep onset, so at its worst I would go hours without sleeping.
On the other hand Ron, you might be surprised. I was stunned how quickly I recovered once I put everything together. I figured it would probably take a couple months. But instead I went from no sleep nights, 1-3 hours of sleep nights and light sleep nights to sleeping 8 hours a night in less than 2 weeks! It feels like a miracle!
Steve – Glad that you’re developing a lighter relationship with those negative thoughts, feelings and urges so that you don’t take them so seriously. Also, glad that you’re getting more comfortable in bed. This is what ACT is all about – getting more comfortable, relaxed and peaceful in bed. When in this state then the body takes over and we drop off into sleep. So it sounds like you’re doing well and that you’re falling asleep more easily when you wake up. More and more your brain will relax, realizing that sleeping at night is safe. So then sleep will come more easily and eventually your brain won’t wake you up either because it no longer will have to be on the alert anymore.
Ron – I don’t think it’s the sleep drive that needs to be built up in the middle of the night when you wake up. It’s learning how to relax. For instance, last night I slept from 11:00 to 7:30 with a bathroom break in between. However, I was lazy when I woke up and dozed off again until 8:15. I had slept 8.5 hours by 7:30, so there was no sleep drive. I was just completely relaxed so I fell back asleep easily.
Nik – have you been reading the Sleep Book? It will give you the techniques that Steve, Gsdman and myself have practiced to settle down our brains. I didn’t “commit to not worry.” I just used to techniques to tame the worries both during the daytime and night. Then they would disappear by themselves.
I’ve studied Internal Family Systems (IFS) and can see how this can be applied here. In IFS, we identify the different parts of ourselves and get to know them all – the bad thoughts, the demons and the urges. We come to understand that they are all here for a reason, and that reason is that they are trying to help us! So for instance, my Mr. Worry. He has good reason to worry. I had had so many miserable nights, so he worries that this night is going to be miserable again and so he’s warning me about it (loudly!) by tensing up my stomach. His intentions are good, but unfortunately, not helpful. So that’s why we “thank them.” They’re trying to help us. So Steve if you can, try to begin to develop some compassion for those parts of yourself – the bad thoughts, the demons and urges. They’re only trying to help you.
Ron – I started taking Effexor back in April when I was having a really hard time. I plan on weaning myself from it soon. I’ve done this before and had no problems. I just did it gradually. Glad your sleep is improving every week.
Gdsmom – sounds like you live in a nice place! I see that you’re coming up with some clever names for your “friends.” I remember when my stomach would start to tense up from fear in bed, I would welcome Mr. Worry, a round, red-faced, furry little creature who was all tensed up with worry. I felt sorry for him and then he dissolved.
Nik – the thing is to accept your sleeplessness, that you might not sleep that night. The opposite is to “try to fall asleep.” You’re trying to do something about it instead of just accepting it. There are many things in life that we struggle with and try hard to change. But sometimes there are things that are beyond our control and so if we’re wise, we finally give up trying to change them and instead accept them as they are. Then we can have more peace in our life. Same thing with insomnia. Dr. Guy says acceptance is not resignation, as in resigning ourselves to a lifetime of insomnia. Acceptance means accepting this temporary condition of insomnia for the night and not struggling with it by trying to find a way to fall asleep that night. Does this make sense? Happy to answer any questions.
Hi Nik – I’m not exactly sure what paradoxical intention is but all I know is that in the book Dr. Guy talks a lot about how we have to do the opposite of what comes naturally to us. Our natural tendency is to try to “fix” our sleep problem, but the more we try to fix it – using sleeping pills, listening to soft music, darkening the room, etc., the further we get away from our goal. Instead, we need to do what is counterintuitive by leaning into it and accepting it.
I don’t do anything in bed but lie there and relax. Then my mind starts wandering, thinking random thoughts just like it did before the insomnia. And then I fall asleep.
Steve – That was you who asked the question about light sleep, not Ron.
Just some thoughts regarding ACT vs SC. They take different approaches to addressing the same issue of the bed being associated with anxiety and wakefulness. With SC you get out of bed to break that association. With ACT you break the association by learning to relax in bed. Sometimes I did both. If I could relax, then I stayed in bed. But occasionally my mind was just too anxious and I wasn’t getting anywhere trying to use the techniques. So there was no point in just laying there in bed all night like that. So then I would get up and calm myself down by writing in my journal or reading. Usually I would realize that I was “struggling” and then I could calm myself down. Dr. Guy talks about how we need to “catch ourselves in the act” of struggling. It takes awhile to acquire this awareness of ourselves and our thoughts but this is what mindfulness is all about.
Ron & Steve – My husband has a Honda 750, and I’ve enjoyed riding on the back of it with him. One day he tried to teach me to ride it by myself but that was a disaster. Within a minute it had toppled over on top of me! I gave up that venture.
Ron – I have had different types of light sleep. I’ve been in and out of sleep all night, I’ve had lots of dreaming, I’ve woken up too early in the morning, and I’ve laid in bed thinking I’ve been awake all night but it’s probably a combination of wakefulness and light sleep. The next day my husband will tell me he heard me snoring!
Steve – I didn’t ask Dr. Kat about combining ACT with SR. I was doing fine with my 8-9 hours of sleep. Actually, because I was having light sleep all night, that extra sleep in the morning helped me from being a zombie the next day. After several days my light sleep deepened and went back to normal. So it’s just a matter of time before the brain finally realizes that the bed is safe and it doesn’t have to be on constant alert all night.
Gdsmom – like you, my default when I was having a bad night was to take an Ambien. I stopped and started ACT many times starting in June, going one or two nights without the pill and then giving up and taking it. I knew I was sabotaging my progress. Dr. Kat said that taking a sleeping pill needs to be a “decision” not something we do out of frustration. Martin also talks about how taking sleeping pills when frustrated sabotages our progress. A few weeks ago I finally made the commitment to stop taking them when having a bad night. I went 5 days without taking them. But then we went on vacation for 8 days so I “decided” to take them during that time so I wouldn’t be tired my whole vacation. After the vacation I made the commitment again. That was 2 weeks ago. Now I don’t need them because I’m sleeping well. Anyway, I’m just saying this to let you know that I understand what you’re going through. This process is like a yo-yo. But once we stick to it consistently, we start getting better.
Sounds like you’re doing better, Steve. So when you say you slept 4 hours, then 5 hours and then 5.75 hours, is that one solid chunk of sleep starting at your sleep window? When does your sleep window begin again? Or do you fall asleep a few hours, wake up and then fall asleep again and it adds up to that number of hours?
Is the welcoming helping you? I hope so.
I’m very happy to share what I’ve learned from Dr. Kat. I know how miserable insomnia is so I have a heart to help others with it.
Glad you’re living your life and dating. Maybe your date would like to ride your motorcycle sometime too!
I actually started ACT back in June. The first week was like a honeymoon period where I felt a lot of hope and had some really good nights. Then in the second week, reality hit and it got difficult again. So I think when we first start something, our hopes are up and we sleep well. Then the fears kick in after that and we go back to having some difficult nights.
Just a suggestion – don’t “try hard” but instead just accept whatever happens and relax. I told myself I was going to bed to “rest” instead of “sleep” so that I wouldn’t get my expectations up and could accept whatever happens more easily. This was especially helpful when I was very tired. I realized that “resting” felt good even if I didn’t sleep that night.
Also, when you’re tired during the day, try not to let it get to you because then it will feed the anxiety that night. In my first week (this time starting 13 days ago) the first night I didn’t sleep at all and the others I only slept a few hours (1-3) or slept lightly all night. I would wake up tired but “ok” and say to myself that my sleep wasn’t “too bad” and that I could deal with it.
Good luck!
Last night was the ultimate test of whether or not I’m back to sleeping normally. We went out for dinner and I had a glass of wine. Around 8:15 I was feeling sleepy from the wine and laid down in bed and dozed off and on for a while. At 10:30 my husband woke me up, telling me it was time to go to bed. I got up, brushed my teeth and went back to bed. There was a tiny bit of fear that I might not sleep because of the nap. But I fell back to sleep right away. Woke up today at 7:00 well rested.
It’s hard to believe how quickly ACT worked for me this time, once I decided to stick with it and not fall back onto sleeping pills. I figured it might take me a couple months, but today is my 13th day. I asked Dr. Kat how long it normally takes people to recover and she said there is a lot of variation. She said that the hardest thing for people is learning how to “accept.” Once they get that, then they start getting better. I got the hang of that back in March when I did ACT the first time, so I think that’s why it went so quickly this time.
