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I agree it’s like a phobia. And the way phobias are treated are through exposure therapy. You expose yourself over and over to the feared thing until the fear loses its power and dissipates. You realize over time that it’s is nothing to be afraid of. That’s another reason I like ACT, because you basically just expose yourself over and over to the original fear of not falling asleep by going to bed without any props, pills or anything and look the devil straight in the eye. Then you realize that all it really was just a paper tiger and the fear goes away over time.
Thanks, Martin. Interesting but a little hard to follow. He seems to be getting better using CBT. I wonder why some people get stuck and seem to remain on a plateau without much improvement. Any ideas, Martin?
As for ACT, last night was my second night. Went to bed very, very tired. Was in and out of sleep again all night. Not consciously aware of any particular thoughts or struggle, so didn’t really need to practice any mindfulness. Just slipped in and out of sleep. As a result, am tired again this morning. Will use mindfulness during the day to keep positive. Hopefully over time, my sleep will begin to settle down. Need to be patient. Am reminded of Carlos from the book, whose sleep did not improve for at least two weeks, but by two months was sleeping normally. At least I’m feeling less apprehension about going to bed at night because I won’t be struggling. May not sleep well, but won’t be consciously aware of it.
Barb – FYI, ACT is no piece of cake. Doing either ACT or CBT-I requires commitment, perseverance, patience and the willingness to endure discomfort over time for the greater purpose of getting well.
Hi Barb – check out the book, The Sleep Book, by Dr. Guy Meadows. He tells you exactly and in detail how to practice ACT to overcome insomnia.
Yes, it’s hard to let go. But then again, think about how much you struggled last night, trying so many different things and still not getting a good rest! That was a lot of hard work! I guess what helps me is that I’ve taken so many leaps of faith in my life that for me, this is just another one. When I went to bed I imagined myself jumping off a cliff, not knowing what would happen, but then the wind picks me up and carries me. For me this is God, my Higher Power, or whatever you want to call it that is carrying me. It has been there for me so many times, that I just have to try again to put my trust in that.
You say that eventually the insomnia resolves itself after a few days. But you know that it will strike back again in the near future, so it’s never completely healed doing what you’re doing. I need a permanent solution. So that’s why I’m going to go all out to do this. But you’re not ready to make that commitment right now, and that’s ok. It’s where you’re at right now. Remember Carlos in the book? It took him six months before he was ready.
I’m already feeling hopeful. Last night was completely different than what usually happens. Usually when I can’t fall asleep within 15 minutes or so then I’m up half the night. But not last night. I was in and out of sleep all night, albeit not deep sleep. But still, I was sleeping a good part of the night.
Practiced ACT during the day as well as last night. Started by trying to let go of the frustration and worry during the day because of the previous night’s lack of sleep and because my string of 6 good nights in a row was over. Used mindfulness to “observe” myself in a bad state of mind and then let it go.
Last night was interesting. Practiced ACT in earnest. Observed myself “struggling” with sleep and then let go of the struggling. Stayed in bed. As a result, I was in and out of sleep all night. I remember dreaming 3 times. Woke up tired this morning, but not too bad. The night was not easy, but much better than the previous night of fretting, frustration, being wide awake and not being able to sleep at all until I finally got up and settled myself down.
The goal is to give up the struggle, both during the day and the night. It takes a leap of faith to jump into the night, no knowing how it’s going to be and giving up all control. And accepting the fact that one could be up all night. The hope is that over time one learns to relax both in bed at night and during the day (regarding sleep worries) and then sleep comes more and more naturally. Makes sense to me. Definitely worth a try.
I catastrophise also. Hoping to use mindfulness to settle myself down during the day as well as during the night.
I had a bad night, so I’m certainly no expert at ACT. I lay in bed until 3:30 and finally gave up and got up. Slept just a few hours so am tired today. I’m feeling discouraged. I have no idea how to really practice ACT. But I just can’t stomach the thought of going back to SR and staying up until midnight when I’m totally exhausted.
Was this last 6 days just a good phase? And now it’s back to the same old struggle again? So discouraging.
But maybe with the foundation of all the work you’ve already done with CBT, it will go quicker for you like it’s going for me.
Yes, easier said than done. In the book it took the client Carlos 2 weeks just to finally relax in bed, and 2 months before he was sleeping normally. And that was with direct coaching by Guy Meadows where he could give him a phone call the next day if he was struggling or had questions.
If it helps, remind yourself of the times when you just didn’t care, and then you were able to have a good night’s sleep. That’s your goal, to not worry anymore about it.
Delv – since CBT isn’t giving you the results you want I really want to encourage you to try ACT all out. You had a taste of it last night when you calmed down after welcoming everything. But then you got frustrated, thus were “struggling” with the insomnia. The goal is to stop struggling. I’ve reread the sections on ACCEPT over and over to really try to understand deeply what he’s getting at and it makes a lot of sense. On page 72 he says “stop the physical tossing and turning, emotional fretting, over-thinking or excessive energy expenditure, all of which keep your brain awake and prevent your entry into peaceful slumber.” On page 75 he says, “it is only when you can accept wakefulness that you can sleep.” And on page 85 he says, “the first step to accepting your insomnia is to be able to notice yourself struggling in the first place. What you don’t see, you can’t begin to let go of.” As in mindfulness, we become an observer of our thoughts. So when you catch yourself being frustrated again, just observe it and then let it go.
If you really give this a good shot, Delv, you might have some sleepless nights like I did while facing your fears directly for the first time. But sleepless nights are nothing new to you, so you can handle that. The goal is to give up the fight and learn to be ok with not sleeping. Then paradoxically, you’ll start sleeping because your body will take over and do what it naturally does, instead of the mind trying to control things through struggling to fix the insomnia.
Hi Martin
Since last Saturday night I’ve slept every night including last night and have had 6 good nights of sleep in a row. I’ve been going to bed with my husband between 10:30 and 11:00 and waking up around 7:00. This was my old pattern of sleep before the insomnia.
Every evening I’ve felt some apprehension and heaviness about going to bed. I don’t expect this to disappear overnight though because I’ve had insomnia almost 5 months now and have been traumatized by it. But day by day the fear is decreasing. When I go to bed I’m not as exhausted as when I was going to bed at 12:00, but it hasn’t been a problem. Just the usual amount of tiredness I used to feel at bedtime before the insomnia struck. When I’m in bed, I’ll feel the fears come in, but somehow they haven’t been strong enough to keep me awake. I’ve been falling asleep after maybe 15 minutes or so.
So, so far, so good.
Delv – just a thought. I wonder if when you relax and have a good week and then relapse, if you’re just keeping the fear at bay during the good times and then it catches up with you when you relapse. That’s what I felt about myself. During most of the weeks of SR I would either fall asleep right away and then sleep all night or stay awake half the night. On average, 5 days I would fall asleep right away and the other 2 I wouldn’t fall asleep right away and then would stay awake for hours. I always felt that on the 5 days I fell asleep right away I was keeping the fear at bay, just barely escaping it with the help of a night cap to knock me out. The other 2 days the fears managed to creep in despite my best efforts to keep them out. When I finally decided to stop having the night cap, the fears came back in full force. I had 4 bad nights in a row. That’s when I decided it was time to face the fears directly. Anyway, just a thought.
Thanks, Delv. I like how you mention “For others, a too strict SRT may make things worse because the act of overthinking, overdoing, overwinding for bed can make things worse.” I was tired of being afraid of and worrying about having a bad night if I didn’t do everything perfectly (going to bed 15 minutes early, eating a cookie, winding down only 1/2 hour, etc). As Guy says, when you’re doing that you’re trying to “control” sleep instead of just letting it happen naturally. So that’s why I decided to throw out all the constraints for now. Of course I will still practice good sleep hygiene such as getting up and going to bed at the same time, not sleeping till noon on the weekends, etc.
Yes, Dragon, I looked into Guy Meadows’ method of dealing directly with the anxiety. You can read about it in his book, The Sleep Book. So last Saturday night I faced directly those fears and as a result was awake all night. He said that this is common, because for the first time you’re facing your original fear directly. Since then I’ve slept through the night for the last 5 nights.
I actually took a radical approach and went back to my normal sleeping pattern of going to bed with my husband between 10:30 and 11:00 and then getting up at 7:00. I just decided to relax all the constraints like SR and just deal with the fear directly. So far so good. I had a couple nights where the fears crept in, but it didn’t keep me awake more than 15-30 minutes.
I’m thinking that probably the SR that I did for 7 weeks actually reduced a big portion of my anxiety, so that now I’m just dealing with the little bit that is left over, and that’s why it’s going pretty easily. Also, all that reconditioning of associated the bed with sleep is paying off, making it easier to fall asleep. Let’s hope this keeps up. Will keep you posted.
