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Hi Steve. Glad you have had no problem riding. For me it is the best therapy. Takes my mind off of everything but the road. My Harley is 1,750 cc. Big bike but all you do is cruise. Not as nimble as your bikes.
I am not really doing ACT. I do mindfulness mediation when I wake up in the middle of the night which seems to help get me back to sleep quicker when I have difficulty. My main problem with insomnia is sleep anxiety and I starting taking a SSRI 2 months ago which has helped me to be more relaxed about sleep. I am now getting 5 hours every night which I am very happy with. For me light sleep is when I do not even know I have slept. Last night I woke up and 3am and struggled to get back to sleep. I started tossing and turning thinking I needed to get up for SC and then I looked at the clock and it was 4:30am. I clearly slept almost an hour. That made me feel good and I rolled over and went back to sleep.
I am a firm believer that sleep is all about anxiety and first and foremost you need to get that under control, even with medications if necessary. SC is a great tool if you are getting frustrated lying in bed. If you are calm and relaxed (using ACT tools) then there is no reason to get out of bed. Sleep restriction is all about sleep drive and if you are consistent, it will help you sleep and most importantly it will consolidate your sleep. Of all the tools we have for overcoming insomnia, Sleep restriction is the most valuable, at least for me.
I think you can cure insomnia using only sleep restriction, but it would require using a sleep window that is much shorter than 5.5 hours when the person is getting 2-3 hours of sleep. It is really really hard to do, and I think that is part of the reason many of us have struggled.
Hi Steve. A little off topic but what do you ride? I live in AZ and have a Harley Road king. One of my big problems with insomnia has been not being able to ride. I just don’t feel safe riding with less than 5 hours sleep over several nights. I have slept better this week so was able to ride this morning. It was great!!!
Sorry to hear the consolidate sleep went away. I think ACT is great, especially the mindful practices to help accept our current reality and hopefully reduce anxiety. I believe it makes sense to stay in bed if your are calm and not tossing and turning. I would just question if it makes sense to have a longer SW when your sleep is now more fragmented. I think SR is the most important tool in CBT-I and we need to be 100% consistent on the wakeup time and not moving the window until we have 85% efficiency. While SC is important, I believe you can cure insomnia with SR alone. Does Martin agree with the longer sleep window?
Either way good luck. This is quite a journey!
Hi Steve, would you rather have 4 hours of consolidated sleep or 6 hours of fragmented sleep? On week 2 of my SR, I got a few nights of 6 hours very light sleep. I psychologically felt great because I thought I was going to quickly beat this thing. The following week I returned to 2-4 hour pattern but my sleep was somewhat more consolidated. I am now getting 4-5 hours of consolidated sleep but I have not to be able to sleep past the 5 hour mark again since my early SR success.
The funny thing is I feel pretty good with the 4-5 consolidated sleep, certainly as good as I did with 6 hours fragmented. I feel good enough that if you told me I had gotten 6-7 hours sleep last night, I would think I did not have an insomnia problem. It feels like my body has (at least for the time being) adjusted to 4-5 hours as all that I need.
So, psychologically, I would prefer to get 6-7 hours but I am not sure my body is agreeing, at least right now. I am trying to tell myself, that this is just my sleep cycle right now and it is ok because it is consistent, consolidated, and I feel pretty good during the day. I hope that over time it will elongate back to where it previously was but I am trying to celebrate the success I have right now and hopefully not stress about what it is not.
This is the third major bout of insomnia in my life and I am finding that it is a MUCH SLOWER process this time too. I think small part of the problem is I am older now and probably do not require as much sleep as I did when I was younger. My sleep is lighter and more broken up today than 10 years ago, so I think it is just harder to correct. I also know I have not been as consistent as I was the first time I completed Sleep restriction. The first time, I was sleeping 2-3 hours a night so I did a sleep window of only 3.5 hours and I never went to bed early and got right up out of bed. It was very tough but I think it accelerated progress.
This time I am using a 5.5 hour sleep window which is easier but is probably too long. I can see the same slow progress as you, but I think if I had used a tighter window, the improvement would be faster. I have also been a little lazy some nights which I did not do the first time. Consistency is the key to progress and I have not been as good as I was the first time.
It took 7 weeks the first time to sleep well again. I think 4 months sounds about right for me this time too.
Hi SleeplessinHB. I am on week 4 of doing the standard SR. My current sleep window is from 11:30 to 5:30 which may be too long. I always fall asleep right away and sleep from from 2.5-3.5 hours. Then I have a very hard time falling back to sleep. Last night I slept till 3am and then did not fall back to sleep at all. That is why my friends approach was interesting. Does it work better for my type of sleep maintenance insomnia since I have a very hard time getting to the end of my sleep window?
Do you know anyone that has tried my friends approach or did you get in from my post??? Either way, good luck and would love to hear your progress. I am going to give the standard SR some more time, but if I continue to struggle and you make some progress, I will probably try my friends approach too.
Ok update. I watched Martin’s videos and one recommendation that I have taken is to try to go to bed a little later. So I moved my sleep time back from 11pm to 12pm and my new sleep window is 12-5am. The last two nights, I have been exhausted but managed to stay awake till midnight and I fell asleep immediately. The good news is I slept both nights till 3am so I got 3 hours of contiguous sleep each night. The bad news is once I woke up, it has been impossible to fall back asleep.
I feel pretty calm when I wake up, but I just am unable to drift back to sleep. I try relaxation exercise but they make no difference. After 20 minutes or so, I get up to read but never feel drowsy again. I am writing this again at 4:30am waiting for the sun to come up.
I feel like no matter what time I wake up, I have lost the ability to fall back asleep once i wake up. Is this just another bad pattern that will sort itself out or do I need to shorten the sleep window even further and stay awake even later to build up more sleep drive?
Thank you Martin for the encouragement and video links. Very helpful.
Another question. I see in GSDMoms response that she is taking sleeping pills on an as needed basis while also implementing components of CBT-I. What are your thoughts on taking a sleeping pill on a one-off basis during streaks of bad sleep. Would it be helpful to get one night of good rest from a pill to gather strength before returning back to CBT-I and Sleep Restriction?
Martin, good points. I always need to remind myself that I am sleeping because of me.
I was recommending this counting process as more of a distraction, than a relaxation technique. It feels to me that if you remain focused on counting your breathes, your brain will be less likely to be self monitoring for sleep. The last three nights I have tried this, in less than 5 minutes I start losing track of my counting and I have drifted back to sleep.
Hi Gsdmom. Like you, I was slightly tempted last night to take an ambien to get a full nights sleep. But only slightly tempted. I desperately do not want to rely on pills and am glad I have been off for 6 nights. However, I do not know how long I can go with 3 hours sleep. I wonder if taking the ambien 1-2 nights a week is hurting your recovery because you are not building a consistent sleep debt?
I am planning to stay the course for a bit and keep my 12-5am sleep window but I still wonder if tightening the window to 3.5 hours will speed my recovery?
Hi Steve. Thanks for the response.
My current sleep window is 5 hours, but honestly it could be 10 hours and it would not matter. I am only getting about 3 hours straight in the beginning of the night. I suppose this may consolidate over a period time, but I am wondering if my body has adapted to 3 hours sleep because I do not feel too bad during the day. I am however totally exhausted before midnight and fall asleep quickly.
Has anyone else had this problem? How have you resolved it and might a shorter SR help speed the process?
Ok, I started SR last Saturday night and have completed 6 nights. The good news is I have been Ambien free and I did not experience any rebound symptoms. In fact I slept 3 light hours the first night. The frustrating part is I have slept only 3 hours every night this week.
My sleep window is 12-5pm and I have taken no naps during the day. I have been exhausted at bedtime and have fallen asleep every night almost immediately. I am waking up between 2:15- 3-15 and I cannot get back to sleep. After 20 minutes or so, I am getting up and reading and then going back to bed when I get tired. I have fallen back asleep for maybe 30 min when I initially slept less than 3 hours. When I have slept 3 hours, I cannot get back to sleep.
Now that I am going into week 2 and my efficiency is 60%, do I need to shorten my sleep window to 3.5 hours?
Tank you Martin. My prescribing physician was very cavalier responding to my question about ambien. I asked him if he had any concerns about long term use of Ambien. He said not at all. It is just a personal choice. He had several patients using sleep meds for many years with no problem. That made me shudder! When I told him that I wanted to taper, he said no need at all and that CR 6.5MG over 1 month was a very low dose and should not be a problem to just stop. It is comforting to hear that your sleep physician contact also does not know of any problems with “cold turkey”. I did not get much comfort from my physician!
Hi Gill999. Sorry to hear about your problems. You say that you have had bouts of insomnia in the past. Have you tried sleep restriction before and did it work for you? I have a little different experience than you in that I find the sleeping pills do work for me. I found the first few days I only got a couple of hours sleep on the ambien but my body must have adapted because I now get a steady 5-6 hours contiguous. I understand how people get addicted to sleeping pills. When they work they are great.
I have only been taking the pills for one month and my doctor says there should be no rebound insomnia. He was making no predictions but it is likely I will just return back to the state I was in when I started the pills. So cold turkey it is for me and I will start sleep restriction immediately next week. I am waiting till next week because I will have more family support available which I think I will need.
Good luck to you!!!
Hi GDSmom. I did speak to my doctor about a tapering plan and he just recommended stopping cold turkey. He said the Ambien CR 6,5 is the lowest dose anyhow and because it is timed release you are effectively only getting 3.5 mg to start. Cutting a small regular in half would not make much of a difference. Or so he told me.
I took Ambien last night and got 6 hours of great sleep. I also don’t see how I can do sleep restriction with the Ambien since I am getting GREAT sleep while using pills and would have an unnaturally long sleep window.
You say you are getting 3 hours of night without the Ambien. While 3 hours is no picnic, that sounds like a good starting point for Sleep restriction without Ambien. I understand the first week is tough, but if you can avoid the Ambien for more than 1 week, perhaps the sleep will improve, at least it should with CBT-I. I hope so, because that is my plan. I expect a bad 1-2 weeks but have no desire to keep on with the Ambien as a failsafe.
