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Steve, sorry yo hear about your bad night. I have had the exact same type of cycle in the past.
I think most of us here are worriers and obviously in a very fragile state around sleep. It is not a normal state to get up and then spend most of the morning ruminating about the previous night and already starting to think about the upcoming night. I think part of the problem is we set ourselves up for a bad night by overthinking. For me, I SO BADLY want to be over this sleep issue that when I have a great night I am even MORE worried the next night because I so badly want to keep it going and not fall back to square one. I am also acutely aware that my sleep drive might not be as strong after a good night which is also setting myself up for a bad night.
Easier said than done, but the only answer is to relax about the whole thing. We have very little control other than what time we go to bed and wake up. My theory is the stronger the Type A person, the longer it takes SR to work because we are always evaluating and trying to control the process. It will eventually work for strong type A’s too because at some point your mind just wears down and gives in, it just may take a little longer.
Steve wrote: “You know Padron, Martin asked me a very interesting question about how do I feel when I get out of bed at 3:00 in the morning to do SC. I told him I was half awake and half groggy. He asked since I was still groggy, if I didn’t think I should stay in bed and try to fall asleep. I thought about it and our discussions on SC and I thought maybe I was just getting up a lot of times out of habit and didn’t need to. I will have to think about it more next time I need to do SC at that time.”
Steve, is it possible that you are sleeping and not even realizing it? If you are getting up while you are groggy, I think it is very possible that you are! My rule of thumb is to get up and do SC when I am frustrated. Sometimes I perceive that I have been tossing and turning for a long time but then when I check myself, I am relaxed. Every time that happens it means I have been sleeping more than I thought. Besides if I am relaxed, it probably means I am keeping a good association with the bed and there is no reason to get up. However, even if you are sleeping and wake up frustrated, getting up is a good idea until you are relaxed as you will probably not get to sleep that way anyhow.
“I would recommend that you get back onto sleep restriction again and stick with it until these go away. I think that if you’ve just relaxed and are trying to just sleep like a “normal person” and like you used to, it won’t work. I saw this happen with another person on this forum. He relaxed too soon because he was having mostly good nights but then the bad nights came crashing back in again. Now he’s back on the program and doing better. We need to stick with the program until we are COMPLETELY HEALED. ”
Deb, I agree and have made this mistake for each of my bouts with Insomnia. After a few decent nights of sleep, I am always tempted and have succumbed to going to bed too early and expanding my sleep window too soon. The result is usually a fragmented night of sleep. However maybe an even bigger mistake I make is revolving my entire life around setting up for a good nights sleep. I think it is very important to try and live life like a normal person, while always maintaining the sleep window no matter what. Difficult to do but maybe more important that Stimulus control.
Hi John. So sorry to hear about your situation. I was in a very similar place about 10 years ago and it was scary. I truly thought I had lost my ability to sleep and saw no end in sight. I tried all the meds including Ambian and had worse results than you. I remember lying in bed waiting for the Ambian to kick in and nothing happened. In the state I was in at the time, nothing worked and I also could not nap. I was doing everything wrong. I was so desperate for sleep that I would come home from work, eat a small dinner and go right to bed at 7pm and watch TV in bed until I fell asleep. The problem was I would wake up 30 minutes later and then be awake all night. I found CBT 3 months into my ordeal and worked. Very very well actually.
You have come to the right place. There is an end to this and you have not forgotten how to sleep. You have just lost the ability for awhile. In the state you are in, I would recommend immediately engaging in the full CBT program. Martin knows his stuff. Be prepared, the core of the program is sleep restriction therapy and it is not easy but it was less difficult than what I was going through 10 years ago. I imagine the you are in the same place what you described. I also found the personal coaching invaluable as well as a good support system at home while you are going through the program (if you are lucky).
Thanks Martin. I do consider that my sleep is still very fragile and while alcohol has never been a sleep problem for my in the past, I may need to just avoid it entirely until my sleep confidence returns.
I was pretty sleepy when I went to bed last night, but not as sleepy as I have been sine I started SR if that makes sense. I did get out of bed once but this is one part of CBT-I that I do not consistently follow. I have found that it is often more effective for me to stay in bed and work on relaxation techniques rather than get up until I am sleepy. I have jumped out of bed in frustration more than once to implement stimulus controls only to find out that I actually was sleeping and just did not realize it.
Martin, thank you for your response.
The reason why this is an issue for me is I can control the time I go to sleep but I cannot control the time I wake up. I had initially setup a sleep window of 11pm-4:45am but while i was generally falling asleep right away, no matter what I was waking up just before 4am. Part of the reason is I have a dog living with me part time that is conditioned bark at that time. I don’t want to be up that early! 🙂
Anyhow, because I held to the sleep window about 10 days into SR, I finally slept all the way up to the alarm at 4:45am. That was great! However the next night I had some difficulty falling asleep and I was wondering if it was because I had effectively slept 45 minutes past my conditioned wake up time. I have always been told to set a wake up time and don’t move it. While my set wakeup time was 4:45am, in realty it was 4am for the first 10 days of SR.
I personally think a 5.5 hour SAW maybe to generous and should be shorter for many just starting SR. I think while the longer window is “gentler” it also may lead to the therapy taking longer. I think this was one of my mistakes the 2nd go round because I was wildly successful with the 3 hour window 10 years ago.
There was no magic answer for managing to stay up until bedtime. It is miserable. I just try and stay on my feet and take lots of walks. I actually fell asleep standing several times. But in the end it was worth it.
Keep at it. SR works!!!
Hi Steve, this is my second go round with SR. My first time was almost 10 years ago when I had a bout of insomnia following a trip to India where I slept an average of 2-3 hours for 4 months. I was at my wits end when I went to sleep therapist who introduced me to SR. After completing my sleep diary, my initial sleep window was 3 hours from 2:30-5:30 am. It was torture, especially since I went to work everyday! But I fairly quickly improved and was sleeping normally after about 6 weeks. It probably took another 3 months for my sleep confidence to fully come bac but I have slept normally for more than 9 years up until my current relapse.
My insomnia returned about 6 weeks ago after some medical procedure complications and taking muscle relaxants. I started with a sleep window of 6.5 hours despite initially only getting 0-4 hours of sleep a night. My sleep window was way too generous resulting in erratic sleep performance during the first 4 weeks that included a 10 day trip to NY. When I returned home, I tightened my window up to 5 hours and saw much improvement up until my major slip last night.
One problem for taking a pill for anxiety right before bedtime is creating an association that you can only sleep with the aid of the pill. I have found that it is almost as important to alleviate your anxiety during the run-up to bedtime as it is right during bedtime. What has worked for me in the past is to take a Xanax for sleep anxiety at 4pm or so in the afternoon. This helps calm the anxiety throughout the evening and allows me to fall asleep easier without directly associating the pill to bedtime.
I experience this often too. I think it mostly happens during very light sleep for short durations, under an hour. Longer sleeps I will usually recognize as sleep. I will often fall asleep but think I have been awake the whole time and feel the need to jump out of bed as part of stimulus control. I sometimes figure out that I was dreaming and realize I have actually slept part of the time. I think this happens more often than not during “sleepless” nights. I think it happens so much that I have eliminated getting out of bed when I think I have not slept for more than 20 min, I now tell myself that I probably have slept and that seems to ease my frustration a bit and I stay in bed.
