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How Gretchen went from believing she was the world’s worst sleeper to someone who sleeps well and has confidence in her own natural ability to sleep (#16)

Listen to the podcast episode (audio only)

Gretchen is a pediatrician and the mother of three children. Her sleep was regularly disrupted as she worked shifts during college and was on call during her pediatric residency. After having children and then entering early menopause, Gretchen started to spend hours awake during the night. This led to sleep-related worry and anxiety that combined with work stress to make sleep more frustrating and more difficult.

In this episode, Gretchen talks about how changing the way she thinks about sleep and implementing constructive sleep-related behaviors helped her improve her sleep significantly — and how setbacks along the way didn’t lead to insomnia working its way back into her life.

Gretchen went from believing she was the world’s worst sleeper to looking forward to going to bed at night! Gretchen did it — and you can, too!

Click here for a full transcript of this episode.

Martin Reed:
Welcome to the Insomnia Coach Podcast. My name is Martin Reed. I believe that nobody needs to live with chronic insomnia and that evidence-based cognitive and behavioral techniques can help you enjoy better sleep for the rest of your life.

Martin Reed:
The content of this podcast is provided for informational and educational purposes only. It is not medical advice and is not intended to diagnose, treat, cure, or prevent any disease, disorder, or medical condition. It should never replace any advice given to you by your physician or any other licensed healthcare provider. Insomnia Coach LLC offers coaching services only and does not provide therapy, counseling, medical advice, or medical treatment. The statements and opinions expressed by guests are their own and are not necessarily endorsed by Insomnia Coach LLC. All content is provided “as is” and without warranties, either express or implied.

Martin Reed:
Okay. So Gretchen, thank you so much for coming onto the podcast today.

Gretchen Volk:
Oh my pleasure. Thanks for having me.

Martin Reed:
So can we start right from the beginning and can you just tell us when your sleep issues began and in what ways were you struggling with sleep?

Gretchen Volk:
So, I struggled with sleep for many, many years. Things got noticeably worse probably seven years ago when I entered early menopause. So for the past seven years I’ve just been struggling more nights than not.

Martin Reed:
Mm-hmm (affirmative). So, did you tend to struggle with falling asleep at the start of the night or was it more to do with waking and then finding it hard to fall back to sleep or maybe both?

Gretchen Volk:
Yeah, for me it was both, so it would take me a long time to fall asleep, and then I would pop up multiple times during the night and just stay awake thinking in my brain way too hard and wishing I could go back to sleep.

Martin Reed:
I think you touched upon it there, but why do you think you were struggling with sleep, what do you think was the barrier that was making sleep more difficult for you?

Gretchen Volk:
I think ultimately the issue was the anxiety that I developed around sleep. So I think initially there were maybe some hormonal issues that switched in my body and then issues just related to family conflict and worries about that and work stress, all the normal things. But then, I think why this became such a huge problem for me is that at the slightest sign of sleep trouble, my brain would just launch into this full fledged attack like, this is going to be terrible. Oh my gosh, here goes another bad night. Oh, you’ve only got six hours left to get a good sleep. You better fall asleep right now, and so that would just make things a hundred times worse.

Martin Reed:
Yeah. I think you touched upon this right at the start of our discussion, but I think you mentioned that you tended to always feel that sleep was a little bit of a struggle for you, more than just when it become a major issue. Do you feel upon reflection that it’s always been something that’s been in the background for most of your life?

Gretchen Volk:
I really do. And when I was reflecting on what we might talk about, I think from a very young age, I always neglected sleep or neglected to recognize sleep was important or just always treated it as something that could be put on the back burner and fixed later. So, through high school and college, I would always stay up late either because of part time jobs I had or just getting through my studies. And then in medical school and training to be a pediatrician, it was required to either stay up all night working or you might be allowed to sleep at the hospital, but then woken up several times during the night by nurses that needed help. And so that just became normal getting a poor night’s sleep was normal.

Gretchen Volk:
And then my first real job as a pediatrician, I worked in the emergency room and I worked all the different shifts. So I worked a day shift. I worked an evening shift that would end at midnight, and then I worked an overnight shift that would end at 7:30 in the morning. And so I don’t think my body ever really knew what is a sleep routine. And then I started having kids and my kids, some of them, one particular was just a terrible sleeper, so I fully expected to go to bed each night and be woken up six times during the night due to his needs. And so, it just became normal to sleep poorly and function on poor sleep, so that it just smoldered along and didn’t really question it. But then, I think it just became unbelievable that it could worse than from that terrible point and got even worse.

Martin Reed:
Yeah. I think a lot of people will identify with that, just being able to recognize that. There’s not so much struggle, but recognize that sleep maybe is a bit more of an issue in their lives than it is for other people, but it’s never really been a big deal. But then something switches after a time and then it becomes more of an issue. And I think that the reason that is, is because some of us are just more predisposed to sleep disruption, whether it’s just genetic or if we have a more stressful life, we’re more reactive to stress, things like that. But, we don’t implement behaviors to try and fix that. We’re just really not paying attention to it. So we have some sleep disruption but we can get through it after a couple of days, our sleep gets back on track.

Martin Reed:
And then, so for example, if you’re working shifts, it’s natural for your sleep to be disrupted, but then it’ll typically get back on track and people can go on like this probably indefinitely. But then when it becomes a bigger issue, that’s typically because we see these perpetuating factors, which is when we start to modify our behaviors with the specific intention to improve our sleep, and these can include things like going to bed earlier often before we’re sleepy, spending more time in bed, staying in bed later, modifying our days, maybe even calling in sick after bad nights of sleep. And then just the way we think about sleep changes, we tend to spend more time researching sleep, reading about sleep, thinking, worrying about sleep and all of these things turn what would just be this acute sleep disruption to short term a few days here, a few days there into this more chronic issue that makes it really hard for our sleep to get back on track. Do you think that that might help explain that progression?

Gretchen Volk:
Yeah. I mean, for a while I was convinced I could fix it and so I would make this huge chart to try to determine why one day was better. Okay, I went jogging this day, and then how did I sleep? Okay, I had a beer within, how did I sleep? Okay I meditated. Ad so I would spend all day charting what I was doing with the intent that that would then create a better night, but I think it just added to this mounting obsession. If I just study this hard enough, I can crack this and make it better. And then that just made bedtime loaded this lots of anxiety about it.

Martin Reed:
Yeah, definitely. I think a lot of people listening will identify with that, just really paying attention to everything you do during the day to evaluate if it’s going to have an effect on your sleep. And ultimately, really all that does is it just distracts you and makes sleep more difficult. Besides, it just making you just always focus and think about sleep nonstop, it can give you the impression that you can somehow control sleep. So, for example, you can get this impression that if I do a two hour workout at 6:23 PM I know I’ll sleep well that night. But the problem is, is then you go to bed and you’re just monitoring for sleep. Okay, did this work, did this work, didn’t it work? And let’s say you do sleep all that night, you can believe that it was because you took that two hour workout at 6:23 PM, so when it doesn’t work the next night it never did work. But then when you feel it didn’t work, then you’re even more worried because that’s just another thing that “didn’t work.”

Gretchen Volk:
Right, yeah. Yeah. It was funny last night because knowing we were going to be talking today, there’s still a lot of old habits ingrained in my brain. And I said to myself, oh, wouldn’t it just be ironic if I couldn’t sleep the night before I’m supposed to talk to Martin? And I was like, nope, I’m not doing that. I’m not going to go into that whole, what if? And if it’s a bad night and I was able to nip it in the bud. But it was just funny, I’m so used to thinking too hard about it.

Martin Reed:
Yeah. Yeah absolutely. That’s a good point. I think when you’ve lived with insomnia for so long, your confidence, your sleep confidence is just so low. Even when you start to implement these techniques and you see improvements and your sleep improves, for quite some time I think it’s natural that your confidence is still going to be quite fragile, so you do experience that night of difficulty. It’s easy to think, oh no, my insomnia is back. I’m back to square one when in fact most of the time we can identify any potential cause, so if there’s like a doctor’s appointment the next day or a deadline at work, something like that, it’s natural for sleep to be disrupted and it’s just a key, it is just a process of just looking ahead and just believing that these techniques that have worked for you before, they’re going to work again. You just have to stick with them, and it is a journey just getting that confidence, but every good night reinforces that confidence.

Gretchen Volk:
Yeah, yeah.

Martin Reed:
All right. So you’ve described how you were struggling with sleep. You had the double-edged difficulty falling asleep and staying asleep. Did you find that that was affecting your daytime routine? Did you try and modify your life as we were talking about earlier or compensate for the loss sleep during the day in any way?

Gretchen Volk:
I think it just led to an incredible coffee habit. So, that’s basically it. I would expect bad nights and then have bad nights and in the morning I would drink yesterday’s coffee while waiting for today’s coffee to brew. I just needed it. But, I just always had to go to work and still be a mom and just keep going, but what is notable now that I’m sleeping so well is life is just easier. My thoughts, they’re clearer. I just have better energy. I didn’t realize I didn’t have good energy, but my energy is so much better now and I’m not a slave to coffee, so I can wait for today’s coffee to brew before drinking yesterday’s. So, yeah, I think that’s the main way that that played out was just pushing through persevering, trying to keep a happy face on things, but inside just feeling really I mean, despondent’s too strong of a word, but pretty upset every morning. Oh, here we go again.

Martin Reed:
Yeah. I think you mentioned a really important point, that because you had that job because you had your kids, it forced you to adapt to stick to a certain degree of routine. Many people find it really overwhelmingly tempting to either call in sick or even quit their job when they’ve been dealing with really severe chronic insomnia. Typically, that’s not helpful because then you don’t have that routine, so you tend to spend way more time in bed. You won’t be getting out of bed at a consistent time. There’s no real impetus or reason for you to be out of the house engaging in life and being active. So you end up just being a lot more sedentary. And when we’re sedentary that’s when the mind wanders and it can focus on all these distractions and obsess about sleep. So I think that’s an important thing to emphasize. The fact that I think you recognize that yourself, the fact you had that job that you’ve got your kids probably helped minimize to some extent the effect the insomnia was having on your days.

Gretchen Volk:
Yeah. I mean I was very surprised in your course to learn not to go to bed earlier after a bad night. That just seemed backwards to me until I thought it through and then realized, oh that makes so much sense. Because I definitely, once I would get the kids squared away at the end of the night, I would go up to bed as soon as socially acceptable. Okay, not 7:30 but okay let’s see if I can sneak in there at eight or 8:15 or 8:30 and it was always a disaster, but I never really connected the dots as to why. So I’d go to bed and be like, oh good, I’ve got two extra hours I can catch up from last night, and it would just lead to all that non sleep time in bed and then mounting anxiety that here comes another bad night.

Martin Reed:
Yeah, it can seem really counter intuitive to when I want to go to bed now, why can’t I go to bed now? Why do I have to wait a couple more hours? Maybe I’m not going to be sleepy in a couple more hours or something like that. But ultimately, what we’re doing is just using the body’s own mechanisms in our favor. We’re building up that sleep drive to make sleep more likely to really help it, especially if we have a high level of anxiety and worry about sleep. The more sleepiness we can build, it ends up overpowering to a certain extent that worry and anxiety because we’re always going to sleep if we’re awake for long enough. Our goal in the short term is to just build that sleepiness and give you that early win, so you can recognize that sleepiness and get those first few nights under you belt where it starts to get a bit easier to fall asleep and then that really can give you the confidence and the motivation to keep moving forward.

Gretchen Volk:
Yeah. I thought you were really bossy the first time you gave me a bedtime. I was really not happy. You gave me many choices, but I’m like, these are all terrible, but it really did work.

Martin Reed:
Yeah. So, it can be difficult to hear those suggested initial sleep routines. But, I like to say, they can look a little bit off putting when you first see them especially if you’ve been used to spending so much time in bed. But sometimes a good way of thinking about it is why not just try it, just do an experiment for let’s say two weeks. If after two weeks you’ve not noticed any improvement, then come back to me, I’ll quite happily have that egg on my face, but let’s do that two week experiment first just to try it out. Because invariably, even within just a couple of weeks, you’ll notice some kind of change, even if it’s just a little bit more sleepiness when you go to bed at night, and that can just give you that motivation to keep going forward.

Gretchen Volk:
Yeah, definitely.

Martin Reed:
So before you started on the course, what kind of things had you done or tried previously to improve your sleep? I just think this is a good question, because people with insomnia typically have this huge long list, I’m expecting people to recognize some of the things you’re-

Gretchen Volk:
Right. I did a lot of different things. So, there was a time I had a recipe that was two Benadryl, two Aleve and two beers. I did that for a while with plus and minus success. I tried a fair number of sleeping pills from my doctor who was very good and said these are not a longterm solution. And I’m like, I just need a pill, knock me out. I tried just regular counseling thinking that maybe if I just work on the problems that are rattling around in my head at night, maybe then I can get some peace. I tried exercise, I tried some whiskey, and I think the thing where I finally discovered your course was so my husband’s also a physician and he said, you’re the worst one I’ve ever heard of.

Gretchen Volk:
And I said, well, what would you do if I was your patient? And he said he’d refer me to this particular specialty place in town. So I Googled them to see what they had, which was CPAP, and I knew I didn’t need that. But what they offer for insomnia is this machine that you wrap around your forehead and it cools your head temperature down and you wear it all night long and it costs $700. And I said, that is crazy. But, I felt so desperate that I was like, well, maybe I should wear a machine around my head all night. But it just seemed wrong. And then when I found your course and was like, actually what I need is a skill, I don’t want to be traveling with this machine my whole life and tied down to this thing. So it just finally made sense. I really need to learn a skill.

Gretchen Volk:
I think the very first email you sent me was, these pills don’t help. Oh and I had tried vitamins and herbs and lavender and anything anyone would ever suggest to me, I would go to the vitamin store and buy. And I’m like, all right, this is actually, I’m losing a fair bit of money on all this garbage at the end of the day. So, yeah, when you suggested weening off, I just stopped that day because I knew it really doesn’t help at all. So.

Martin Reed:
Yeah, that’s the thing with … There’s only one thing that generates sleep and that’s just our own biological sleep drive. We can have pills, supplements, hardware, technology, sometimes they might help distract us and just lower that initial barrier that’s in the way of sleep typically like this high level of worry or anxiety. And that might then help us sleep, but even then to sleep is only being generated by our own body. Nothing else can generate sleep. There are things out there that can generate sedation that can make us anxious, right? But that’s not the same as sleep.

Gretchen Volk:
Yeah. I’ve been thinking about Michael Jackson and his issue and I was like, yeah, if I could have an anesthesiologist in my home that knocked me out every night, that would be fantastic but not a good solution.

Martin Reed:
Yeah, exactly. If any of these truly worked then insomnia wouldn’t exist, because the solution would be out there. It would be this medical device or this magic pill or something like that and no one would ever have insomnia. So, that’s further evidence that these things just don’t work. And like you say, sleep is this ability that we never lose and it’s with us forever. We can get in the way of it and make sleep more difficult, but ultimately if we’re awake for long enough, we’ll always sleep. We harness that knowledge and give you the skills and help you change the certain behaviors and the certain thought processes that are getting in the way of sleep and making it more difficult, these cognitive and behavioral techniques and that’s why they’re so effective that you touched upon because they’re skills, they’ve been there with you for life.

Martin Reed:
You can recognize the beliefs that you had that weren’t helping, the behaviors that you were implementing that weren’t helping, you can address them, your sleep starts to improve and then those skills are with you for life. So, if ever you struggle again in the future, you don’t have to take out this new subscription, buy something else. You’ve already got these skills, you just reimplement what you know from experience works and that’s just why this is such a great solution and they ultimately are a really effective longterm solution, these cognitive behavioral therapy for insomnia techniques.

Gretchen Volk:
Yes. Thank you.

Martin Reed:
I think some people might be a little bit curious listening to this, that why are there two doctors here, that hopefully that were a bit confused about insomnia and struggling to know what the best solution is for insomnia. Why do you think that is? I know, I’m friends with a sleep physician and he told me that during his MD training he got maybe 10 minutes education-

Gretchen Volk:
Oh none. None, I would say. Yeah. And it is funny because being a pediatrician, I talk to parents all day long about good sleep habits for their kids, and I really from four months onward have pretty explicit advice like, hey, you need to get on this project because you need to teach your child some independence. So, it is totally ironic that I can share information all day long about this and yet come home at the end of the day and I’m just a person struggling. But yeah, I wouldn’t say when I went to medical school, which was back in the 90s that there was really any information at all about that, either that I remember I did fall asleep a fair bit in lectures, I’ll confess. But yeah, not a big part. And I think the whole sleep medicine arena has really blossomed, but I feel like the emphasis right now for that is really on machines like CPAP and giving people a quick fix rather than helping them.

Martin Reed:
Yeah, I think, yeah. I think when it comes to sleep, I think the emphasis is typically to more towards sleep apnea. And in terms of the overall messaging that’s out there, it’s all really focused on the importance of sleep and good sleep hygiene. The issue with that is the only people really reading those messages about the importance of sleep are people who are struggling with sleep. And this is really unhelpful messaging because it puts more pressure on you to try and get more sleep, and it makes you worry about the potential consequences of poor sleep. And even to this day, we don’t have one study that finds insomnia causes any health problems. We have studies that find associations, but we don’t have anything. We have no concrete evidence that chronic insomnia causes any health problems. As soon as a new study comes out with these association, out go with the headlines, some creative writing in the media, and everyone just thinks, if I don’t fix this, I’m going to have Alzheimer, I’m going to get cancer, or I’m going to have Parkinson’s. And that just heightens the worry.

Martin Reed:
And then you read about sleep hygiene, which we know doesn’t work for people with chronic insomnia because it’s more of a preventative set of techniques than an actual intervention, and people will try that. It doesn’t work. And that leads to more worry because then you think, well, everyone’s telling me to do sleep hygiene and I’ve done it. It didn’t work. I must be this really unusual case, I’m doomed. I’m destined for, I don’t know, very bad things. There’s no hope for me, and it’s a real shame that that is the current situation.

Gretchen Volk:
I think that’s why I got really for a while fixated on just finding the right sleeping pill because I thought, I’m so abnormal, I just need a chemical to shut my brain off. And yeah, and then that just led to more of a wild goose chase for a while.

Martin Reed:
Yeah. The problem I see with sleeping pills is that they can just give you this mistaken belief that they’re generating sleep or that you need them to sleep, which I guess is fine as a temporary measure for a couple of days. But then they’re not longterm solution because really you need to regain that belief and that confidence in your own ability to sleep in order to sleep well for the long term. And as long as you have this external crutch, this thing that you feel you need to have in your life to generate sleep for you, I think there’s always going to be a struggle. You’re always going to have that higher than normal level of worry and arousal about sleep. You’ll never really get into the root problem, or as changing the way you think about sleep and changing these unhelpful behaviors. That really is key, because then you’re just removing all the obstacles and all the barriers to sleep and giving it the best chance possible.

Gretchen Volk:
Yup.

Martin Reed:
So you enrolled in my online coaching course for about four months ago, almost to the day now. And my coaching course just focuses exclusively on evidence-based, cognitive and behavioral techniques. So in other words, we look to change the way you think about sleep, address all these inaccurate beliefs that many people have about sleep and just help you implement behaviors that give you the best chance possible of sleep and address, again, these dysfunctional, inappropriate sleep-related behaviors such as spending too much time in bed. So, when you were going through the course, I think you touched upon this earlier talking about the sleep scheduling, but what techniques did you find especially hard or challenging to implement? Were there any techniques that you were really struggling with?

Gretchen Volk:
So initially the later bedtime was challenging more mentally than physically. It was just so objectionable. And especially because my husband was going to bed at what I consider to be a normal time and I’m stuck alone downstairs. What am I supposed to do by myself? But actually, that paid off pretty quickly so I could see that that was good, so once I got through that, I never grew fond of the 30, 30 rule at all, that was just a big stickler for me. So I feel really happy that I don’t need it very often, and I don’t know if it’s just here in New York it’s cold at night, so getting out of bed at two in the morning and wandering around like, ah, and I just never really had a great itinerary for well, what am I going to do for that time period while I’m waiting to fall asleep other than watch TV or something like that. So, that really never … I understand it, I get it, but to actually implement it has not been good for me. That one’s tough.

Martin Reed:
Yeah. So just for people that are unfamiliar with these techniques, so the sleep scheduling is just to do with allotting an appropriate amount of time for sleep. So typically what we do is we look at what an average night your sleep duration is over the course of one or two weeks and we’ll add around half an hour to that just to account for time it takes to fall asleep some time awake during the night. And then you have this overall duration. So let’s say your average night your sleep duration is five hours we’ll add say half an hour to that. And we’ll say, okay, moving forward, try allotting no more than five and a half hours to sleep. So figure out what your final out of bedtime will be. Let’s say 5:30 just to make the math easy, count back five and a half hours and then you have an earliest bedtime of midnight.

Martin Reed:
So what this does is because we’re still allotting more time for sleep than you actually spend asleep, we’re not looking to reduce the actual amount of sleep you get, but we’re just looking to reduce the amount of time you spend awake during the night, because that really feeds into this sleep related worry and anxiety, and we’re also trying to give you that consistent morning out of bedtime, which is helpful to make sure we’ve got enough time to build sleep drive during the day and to give your body clock that really strong warning anchor so that it’s going to be sending, allowing these sleepiness signals to be taking over at night rather than you get out of bed really late and your body clock could still be sending these weak signals at the time when you want to be going to bed.

Martin Reed:
And then the 30, 30 rule, this half hour, half hour rule is to do with stimulus control. So, what we want to do is many people have just learned that the bed is an unpleasant place to be, because they’ve struggled night after night. So, just thinking about that or getting into bed just immediately activates the arousal system, almost like this fight or flight mode and your mind just becomes reactive. You get worried, anxious, and that makes sleep difficult. And it’s understandable because you’ve experienced so many difficult nights in bed. You’ve associated the bed with difficulty and wakefulness and frustration, and ultimately the way we address that is by making sure the only thing you do in bed is sleep or your relaxed and sleepy and you’ll fall asleep when you’re in bed.

Martin Reed:
And so the only way we can do that ultimately is by saying if you’re awake, you’re frustrated, you’re anxious, you’re alert, all those negative emotions when you’re in bed, that’s your cue to just get out of bed. And it really doesn’t matter what you do when you get out of bed that much. If you like watching TV, that’s fine, reading a book, that’s fine. It’s just we say, just to get out of bed, just so you’re not reinforcing the idea that the bed is a place for wakefulness, for frustration, for worry and anxiety.

Martin Reed:
But if you are in bed, during your sleep window and you’re feeling calm and relaxed, there’s no need to jump out of bed because the conditions are right for sleep. It’s just when it starts to become unpleasant, that’s when it’s often a good idea to get out of bed. So, you’re not reinforcing that association. And in addition, getting out of bed is often a bit more appealing than staying in bed when you’re really struggling. And just the process of getting out of bed and doing something else can distract the mind, so it doesn’t just obsess about sleep and worry and frustration. And it often helps you feel a bit calmer, a lot more quickly compared to just staying in bed in the dark alone with your thoughts.

Gretchen Volk:
Right, right. Yeah.

Martin Reed:
So, okay. So I just wanted to cover that because not everyone that’s listening may be familiar with all the techniques. So was there any particular moment, you mentioned that when you first saw this new sleep window, you were a little bit reluctant to try it, but you did try it, but was there any particular moment when you realized that these techniques you are implementing were working and that your sleep was starting to respond positively?

Gretchen Volk:
I really feel like a couple of weeks and maybe three weeks in or maybe four, I actually was looking forward to going to bed. The negative cycle definitely broke, which was incredible for me because yeah, I had so much dread around bedtime, laying down, is my husband going to fall asleep before me and then I’m just left alone laying there rattling around in my brain? And then success just brought more success, so the more I looked forward to going to bed that made the next night’s bedtime better, and then, oh my gosh, two good nights in a row, could I do it a third night? Yeah, I think one thing just built on the other was very helpful.

Gretchen Volk:
And then, I can’t remember what week this is, but where you introduce the exercises we should do during the day to calm our thoughts. I still wake up at night and I just acknowledge that as, oh, I’ve completed a sleep cycle. I’m just in between sleep cycles and I just in my mind, run through. I feel peaceful. I feel content just a couple of times and almost all the time I just go right back down into sleep and it doesn’t evolve into a big deal in the middle of the night. So, I think you had said the word confidence. I think that’s the biggest improvement I have is I just feel confident like I can pretty much handle it. Not 100%, I’ve had some setbacks, but they don’t rattle me like, oh, here we go, here goes five more bad years. I’ll be like, one bad night, okay, I know what I need to do.

Gretchen Volk:
So that was really helpful when those exercises got added and I think that helped me not need to do the 30, 30 rule because I had something I could do when I was awake in the middle of the night just to keep my brain occupied in a more positive thing rather than getting anxious again.

Martin Reed:
Yeah. Yeah. I thought that was great that you said that you started to look forward to going to bed because I think many people listening to this who have struggled with it they think, no that’s the part of my day, that’s the part of my life even that I dread is going to bed just because I know that it’s going to be really difficult and just changing that mindset, right?

Gretchen Volk:
It’s funny, just talking with you about it now I’m like, oh, can’t wait till bedtime tonight. That’s new for me.

Martin Reed:
Yeah. And, you described this as well where you get those few early wins, so you start to feel a little bit more confident and you worry a little bit less about sleep. So then your sleep typically responds and sleep becomes a little bit more easier and then you worry a little bit less, sleep becomes easier. So, it really turns that vicious cycle of more worry, making sleep more difficult, leading to more worry completely on its head. And it turns this vicious cycle into a positive cycle, and it really just becomes self-reinforcing. There’s the more good nights, the more wins you recognize, the less you worry and then the more you’ll see responds and becomes better ultimately.

Martin Reed:
So, what’s my next question going to be? Let me just look through here. So how did your sleep improve as a result of all the techniques you learned about and you implemented? You mentioned earlier on that how difficult it really was falling asleep and staying asleep. What are things like now? How would you describe a typical night now?

Gretchen Volk:
I can pretty much fall asleep within 10 minutes of deciding to turn the lights out. A long standing problem I have is if I do fall asleep, and get awoken by something within the first 15 or 20 minutes, whether it’s my husband or a kid or a phone call, I get this just full fight or flight, just I’m super jazzed up if I get that early awakening. And in the past I would just be like, forget it, this whole night is shot. And now even when that happens, because it still does, I can say, okay, I can just start fresh from the top and maybe I’ll go back and read a little bit or maybe I’ll do one of those exercises, but I can pretty much put myself to sleep pretty quickly.

Gretchen Volk:
What I used to think of as like the Holy grail of sleep would just be eight continuous hours, and now I see that that’s … I’ve had that a few times, but more I just recognize I will pop up a couple of times in the night, but it is not a big deal, and then I can just put myself right back to sleep like I did at bed time, typically within five minutes I would guess for the middle of the night pop ups. And then I wake up in the morning just feeling really happy about what just happened rather than super upset about how the night went.

Martin Reed:
I wrote some notes here from when we first started working together and then eight weeks later when you finished the course, and I think it was when you first enrolled, you were saying it would take you up to an hour to fall asleep at the start of the night. By the end of that eight weeks we were looking at sleep onset for around about 10 minutes. What a really funny thing that you put in your initial questionnaire that I get people to fill out upon enrollment was how many times do you wake up during the night, roughly and you put a million.

Gretchen Volk:
I stand by that.

Martin Reed:
And then in your sleep diaries by the end it was, I think an average of once per night. And I think with those nighttime awakenings, it’s important to recognize that they’re normal. It’s a normal part of sleep is waking during the night, and the difference when you have chronic insomnia is you’re just far more alert to them. So, as soon as you wake up, you immediately worry that you’ve woken up, and that in itself just makes it more difficult to fall back to sleep. Whereas someone that pays no attention to their sleep, they wake up, they fall right back to sleep again, and then they probably don’t even remember waking.

Martin Reed:
So we can get this really distorted belief when we have chronic insomnia that there’s a problem there because we’re waking. But really the waking itself isn’t the problem, it’s that activation of the arousal system once we wake that is the problem, and that’s what we look to address with these CBT-I techniques. Yeah, and then I think your time awake during the night to lead on from that I think when you filled out that sleep history questionnaire, you were saying it was over an hour and a half. It was just time spent awake during the night, tossing and turning. And I think at the end of the eight weeks we were looking at around about 15 minutes during the night.

Martin Reed:
And then your average nightly sleep duration when you enrolled, you said it was about five hours. At the end of the eight weeks you were looking at over six and a half hours. In terms of sleep duration now, do you think that has progressed anymore? You still think you’re probably around about six and a half hours?

Gretchen Volk:
Probably better because I consistently get up at 6:30 in the morning. I make myself stay away from the bedroom till about 10:00 PM, that I’ve gotten much more strict about. Honestly, I used to try to sneak up there early, 8:39, 9:30, but now I’m like, I don’t want to enter that bedroom till 10, and I might read for 15 minutes or so, so possibly lights out by 10:30. So it’s possible I’m getting much closer to eight hours, which feels incredible.

Martin Reed:
Yeah. Yeah. That’s something that I do typically see as well, because like you mentioned earlier where you’re ultimately just learning new skills that’s what these cognitive and behavioral techniques ultimately are this is just a new skill set. And so, as long as you just stay consistent with them, even when you stop working with me or with whoever you’re working with, your sleep would typically continue to improve until you get to that point when you’ve found your own individual sleep requirement.

Gretchen Volk:
Yeah.

Martin Reed:
So yeah, that’s not all that surprising, the after eight weeks we stopped working together you were around six and a half hours, but now you’re probably maybe seven and a half hours closer to your individual sleep requirement. So that’s not surprising and I think that should be further encouragement, that you can do this on your own as well. You don’t need someone by your side all the time. Once you’ve learned these skills, it’s just the case of consistent implementation and practice.

Martin Reed:
So, one thing that I did want to talk to you about was setbacks, relapses when you go through bad patches. So, we stopped working together after eight weeks and we’ve already touched upon how since then you’re actually sleeping even better than the end of the eight weeks. But in between that time, were there any setbacks along the way? Any struggles?

Gretchen Volk:
Yeah. So, my father died maybe two weeks after the course ended and it almost seemed like everything went away. I was back to just total alertness at night and I was so upset. But, the last session you gave during the course was on setbacks, so it was so helpful to just acknowledge, hey, this isn’t just one person going through this. This is a known thing. But, it’s such a blur now, but I just went right back to being alert at night and my brain thinking too hard about things. And I remember I emailed you and you just said something calm and reassuring, and I went back to doing some of the mindfulness exercises during the day to remind my brain what to do at night when I woke back up. And just went back to the skills you taught me. And so it sorted itself out within a couple of weeks and then it has improved.

Gretchen Volk:
But yeah, that was really devastating like, oh my gosh, all this hard work and there we go. But also just to acknowledge this would be normal for anybody to have a sleep disruption with something so big like that.

Martin Reed:
Yeah, absolutely. I think the recognition that it would be abnormal for you to sleep well during a time like that, so it’s to be expected that you’re going to experience sleep disruption, and I think the key is to just recognize that and also to just go back to implementing what you know from experience has worked for you in the past. It can just be so easy to experience a setback and then think, oh, that’s evidence that these techniques don’t work, that I’m somehow different, that these techniques aren’t going to work for me, that I’m beyond help.

Martin Reed:
But, if you are able to take a step back and think about the progress you’ve made, what was the reason why you made that progress? It was because of these techniques you implemented. So therefore, by reason of logic, if you implement them again, then you should expect your sleep to get back on track. And I almost see it as this test, it’s like your insomnia testing you. It’s like, is this person really ready to truly let go of me yet? Let me see if I can get back into their life.

Gretchen Volk:
Actually, it’s a full confession I called my doctor, I’m like, well, my dad died so I need sleeping pills now. And she gave me the prescription and I took one and it didn’t help. And I’m like, I’m not doing this. These don’t help. And so, yeah, it was like this little inner battle comeback. Yeah. So a more lighthearted setback that I’m not struggling with, but coping with right now, because I know I’ll be okay. But on Wednesday nights I play in a band now.

Martin Reed:
Oh nice.

Gretchen Volk:
It’s a two month thing, and it’s so fun. So, it’s once a year, every January through March. And so the rehearsal is from seven to nine. So at nine o’clock I’m pretty jazzed up, and so historically when I try to go to sleep after band practice, I’m just da, da, da, and so I’ve just been much more deliberate. I come home and I just need an hour to mind. I just can’t expect to pop into bed and fall right back asleep. So I just really trying to be deliberate about unwinding maybe a glass of wine, read a boring book, watch a very boring TV show and not just going right from one thing to another. So anyway.

Martin Reed:
Yeah, that’s really encouraging. There’s this example that I like to use is as parents, we know that we don’t put our kids to bed when they’ve just finished running laps around the house, right? Because they’re too hyperactive, their minds active, their body’s active, they’re not going to go to sleep. We know that give them a bath, read some books, have some unwind time. But that knowledge, we just don’t really apply it to ourselves as adults. We somehow expect to just come home from work all stressed out, get into bed and expect that our body is just going to send us straight to sleep or we come home from an enjoyable activity even but we’re still hyped up and we’ll then go straight to bed and then be frustrated that we didn’t fall asleep, not recognizing the parenting strategies we use in our kids are just as applicable to ourselves when it comes to sleep.

Gretchen Volk:
Yeah. Yeah.

Martin Reed:
All right. So, I’ve taken a lot of your time and I really appreciate the time that you’ve given up. I think there’s a lot of information here that people are going to find helpful and reassuring. I do like to always end with this one question and so I’m going to pose it to you too. If someone with chronic insomnia is listening and feels as though they’ve tried everything that they’re beyond help, they can’t do anything to improve their sleep, what would you tell them?

Gretchen Volk:
I would beg them to try this, because I think I was the worst sleeper ever. I mean maybe someone’s worse than I was, but I really think I had just terrible, terrible sleep and these methods really worked, and saw me through some bad times and got me right back on my feet and now my quality of life is just so much better, and there’s nothing harmful about these methods. So, unlike taking sleeping pills or alcohol or other things that we can try, there’s really no downside to these methods. So, I would just really, really encourage somebody to give this a try.

Martin Reed:
That’s great. Thank you so much for your time, Gretchen. Really appreciate it.

Gretchen Volk:
My pleasure. Thank you.

Martin Reed:
Thanks.

Martin Reed:
Thanks for listening to The Insomnia Coach Podcast. If you’re ready to implement evidence-based cognitive and behavioral techniques to improve your sleep but think you might need some additional support and guidance, I would love to help. There are two ways we can work together. First, you can get my online coaching course. This is the most popular option. My course combines sleep education with individualized coaching and is guaranteed to improve your sleep. You will learn new ways of thinking about sleep and implement better sleep habits over a period of eight weeks. This gives you time to build sleep confidence and notice results without feeling overwhelmed. You can get the course and start right now at insomniacoach.com/online.

Martin Reed:
I also offer a phone coaching package where we start with a one hour call. This can be voice only or video, your choice, and we come up with an initial two-week plan that will have you implementing cognitive and behavioral techniques that will lead to long term improvements in your sleep. You get unlimited email-based support and guidance for two weeks after the call along with a half-hour follow-up call at the end of the two weeks. You can book the phone coaching package at insomniacoach.com/phone.

Martin Reed:
I hope you enjoyed this episode of the Insomnia Coach Podcast. I’m Martin Reed, and as always, I’d like to leave you with this important reminder — you can sleep.

I want you to be the next insomnia success story I share! If you’re ready to improve your sleep using evidence-based cognitive behavioral therapy for insomnia (CBT-I) techniques, click here to get my online insomnia coaching course. We can get started right now.

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5 thoughts on “How Gretchen went from believing she was the world’s worst sleeper to someone who sleeps well and has confidence in her own natural ability to sleep (#16)”

  1. I’ve been struggling with insomnia for 5 years. I have been implementing the sleep restriction protocol since returning from my vacation. As I’m retired now I no longer have the added stress of work. I go to bed now at 12:30 am and I am awake by 6:30 am. I get out of bed and I use a 10,000 lumen lamp for 45 minutes while eating breakfast. For the first week or so, I was only getting maybe 2-3 hrs sleep but for the past 3 nights I have felt really tired and I fall asleep after maybe 15-20 minutes. I wake up maybe 1 time but am able to fall asleep again. I am planning to add another 15 minutes to my total bed time in another week providing I have continued success. I have never slept more than 6.5 to 7 hrs at night so that is my goal.

    Reply
    • If you suffer extreme anxiety you need to see a physician then possibly a therapist. No shame in that. The anxiety most associated with insomnia comes about from lying in bed worrying about not being able to sleep. It is a conditioned response. To extinguish that response requires action. Get out of bed and do something relaxing, read a book, watch TV, listen to some soothing music in a nice ambient setting with the lights dimmed a bit. Yo can also try meditation. It takes practice but even just a few minutes in a state of mind where you aren’t thinking of anything at all does wonders. I personally have used a Muse headband. You can Google it. With some practice you’ll be able to relax when you crawl into bed. But sticking with Martin’s advice really does work but for some of us we may need a little more in order to implement them fully.

      Reply
      • So glad to hear that you persevered with sleep restriction — imagine if you had given up after a week of getting two to three hours of sleep? You would have missed out on all the benefits you are now enjoying!

        You are so right to point out the conditioned arousal/anxiety that influences sleep disruption. Getting out of bed when you are struggling with sleep can be so helpful as can taking time to relax (however that might be for you — we are all different).

        Glad to hear you are doing well, Michael!

        Reply
  2. I had insomnia myself in the last year, but since I got rid of anxiety during the day, my sleep improved a lot and now I sleep for 7,5 or 8 hours. I would join Martin’s course to teach me to sleep for 9 hours like I used to before I got anxiety 🙂 I’m kidding.

    If your job is only cognitive (working on the computer) then you need more sleep than someone who lives at the countryside and does farming. We need to sleep more not for the muscles (we don’t use them) but for the brain.

    I did the “getting out of bed when not sleepy anymore” and it’s the hardest technique but it does help.
    My question is: what to do when you have severe anxiety during the day (like stomach pain, trembling etc) and that doesn’t even allow you to fall asleep. I’ve been through that, I had 2 nights with no sleep, I was shaking like crazy, heart palpitations etc. I don’t think the CBT-I helps with that. To get rid of anxiety takes weeks and you can’t stay without sleep for weeks. So I would say in those cases when it’s so severe, you do have to take few pills to calm down and get some sleep and then you can start this therapy.
    One has to be quite relaxed to fall asleep.

    I sleep better now because I don’t have anxiety anymore during the day (or if I have it lasts a few minutes).

    My biggest fear was that I wouldn’t be able to sleep anymore because I’ve read of a guy who did not sleep for 30 days and he died.

    Wonderful podcasts, all of them! They are helpful.

    Reply
    • First of all, if you are still awake after 30 days of no sleep whatsoever you will have broken a world record (which I think currently stands at around 11 days — and that was someone doing everything they could to force themselves to remain awake) and there is likely something wrong other than insomnia.

      The simple fact of the matter is that, with enough time spent awake, sleep will always happen. When we have a lot of sleep-related worry/anxiety then we might need more sleep drive (which builds with every minute of wakefulness) to make sleep happen. However, sleep will always happen because sleep drive always wins in the end.

      You made a great point that, since we all live different lives, we all need different amounts of sleep. Sleep is not the same from person to person because no two people are the same!

      I think that one of the best things you can do when you have a lot of anxiety during the day is to do as many things as you can that you find enjoyable, enriching, and rewarding. This helps you recognize that you have far more control over the quality of your day (and life!) than sleep, it helps distract the mind from thinking and worrying about sleep all day long, and it improves the overall quality of your life.

      I hope this helps!

      Reply

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