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How Jennifer got through setbacks and relapses while implementing techniques that transformed her sleep after 25 years of insomnia (#23)

Listen to the podcast episode (audio only)

Jennifer’s insomnia was deeply entrenched. After working with me for four weeks, she felt as though it was becoming more difficult to get through the day, her sleep had not improved, and she was understandably feeling discouraged.

However, Jennifer kept going and four weeks later she was happier with her progress. She was experiencing less daytime fatigue and getting more sleep but she was still finding it hard to fall back to sleep when she woke during the night.

Again, Jennifer kept going — she continued to implement techniques that build sleep drive, strengthen the body clock, and lower arousal. She began to notice that the quality of her days wasn’t completely dependent on how much sleep she got. She stopped striving for sleep, she stopped putting effort into sleep, and she stopped worrying about sleep.

In this episode, Jennifer explains how changing her sleep-related thoughts and behaviors not only improved her sleep, but also her quality of life. She shares how she coped with setbacks by focussing on the process rather than progress and tells us about the moment she realized that she knew exactly how to respond to sleep disruption and understood that she was now armed with life-long skills that would enable her to enjoy better sleep for the rest of her life.

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:
Thank you so much for taking the time out of your day to come on to the podcast today, Jennifer.

Jennifer Ellison:
Well, you’re welcome. Good to be here.

Martin Reed:
It’s great to have you on. I’m going to just start right at the beginning. Can you just tell us how your sleep problems began, and what you think initially triggered that sleep disruption?

Jennifer Ellison:
Well, I believe that sleep has always been a bit of a challenge for me. I know even as a child, my parents would talk about that I wasn’t a great sleeper. I’m a bit of a worrier by nature. So I know that just being over-focused on sleep or lack of sleep even very early on, was always there for me. I think one of the precipitating events was the birth of my kids and I love my kids, but kids are a challenge when they’re little and when you’re a young mom and you have to get up three or four times in the night to attend to a child, that throws any mother, any parent’s sleep into disarray.

Jennifer Ellison:
So that certainly happened for me. Then I have two children who are very close in age. So for a while, I had two little children getting up most nights. So it became sort of this ongoing battle with just trying to get any sleep at all with little kids. Then as they became better sleepers, I noticed that I really wasn’t becoming a better sleeper again, but again, life is busy and you’re a full time working mother and you just sort of muddle through, you make it work, because you have to, and that was my story, but it’s always been a struggle for me, falling asleep and staying asleep.

Jennifer Ellison:
That sort of followed me through my life and there were periods of time where sleep got better, and then it would get worse and there were some events in my life as I aged. I had a friend die some years ago and that was traumatic for me and sure enough, my sleep got worse after that. Then most recently, and really when I kind of came to, I really need to, once and for all, try to find a way to solve this problem, my father passed away last year.

Jennifer Ellison:
Once again, that threw me into another period of particularly difficult sleep. So there are definitely events I can point to in life, but I also think there’s this underlying, just being a really light sleeper, bit of a worrier, that kind of personality.

Martin Reed:
Yeah, absolutely. I thought it was really interesting how you used that word, precipitating is something that I picked up on straightaway because we use that as part of the model for chronic insomnia, this 3P model, whereby we say some people are just naturally predisposed, the first P, to some sleep disruption. So from what you’ve said, we can see that maybe you were just someone who was predisposed to more sleep disruption.

Martin Reed:
You mentioned that your parents always described you as someone that wasn’t the best sleeper in the world. Then you had these clear precipitating events, motherhood, bereavement, big life changes, things like that, and it’s completely normal and understandable that sleep would be disrupted at those times. Normally sleep just recovers by itself as we adapt, but then we have that final P in the model for chronic insomnia, which is the perpetuating factors and these are generally all the things we do in response to that sleep disruption, quite understandably because we want to fix the problem.

Martin Reed:
The problem is that all those things we do typically make it harder for us to recover and they perpetuate the problem hence, we’ve got that third P. So on that third P, these perpetuating factors, what kind of things do you recognize from your own experience that you tried to do in a bid to improve your sleep?

Jennifer Ellison:
Well, yes, when I found you back in December, I actually made a list for myself because I had to do an inventory of what got me to this place and when I said to you that I’d tried everything, I actually, looking at the list, pretty much had. So everything from, a very active person so I’m physically active. I’m very lucky, I live in a place where the foothills are right behind me and I’m a big hiker.

Jennifer Ellison:
So I get up very early in the morning, I hike. It’s kind of been my thing for many, many years. I travel a lot and so I stay very fit and active, biking, hiking, lots of different sports over time. So, I certainly tried exercise as one of the ways, in doing a lot of reading years ago, to improve sleep because everybody knows if you’re tired, physically tired, you sleep well, unless you don’t.

Jennifer Ellison:
So that was the beginning. I sought out medical help from, first my primary care doctor who gave me sort of the usual advice. Try some yoga, some meditation, which I certainly did and still do and it absolutely does help and improve things. I learned what sleep hygiene was and so I tried to control my bedroom environment to the protocol of sleep hygiene but really kind of little or no impact for me. I used some supplements.

Jennifer Ellison:
If you go online, there are hundreds and hundreds of supplements that claim to help you with sleep. I tried acupuncture, massage. I did cognitive therapy with a therapist for a while. Then finally, I resorted to medication and sought out help from a psychiatrist who prescribed various medications over time, which I have been off and on as I have relayed to you for about 20 years.

Jennifer Ellison:
They would help for some period of time and then pretty much failed, and then a different medication would be tried and sometimes it would help, sometimes it wouldn’t. So, I’m not sure if I left anything out that other people would say they tried but that’s a pretty significant list.

Martin Reed:
Yeah, it is a significant list and I think a lot of people listening to this will identify with it probably have equalled you there, maybe even exceeded that list. I’m still yet to come across someone with insomnia that hasn’t tried many, many, many different things in a bid to improve their sleep and it’s just a shame that they didn’t have access, or were aware of the best way of addressing these sleep issues, which is these cognitive and behavioral techniques just because they address those perpetuating thoughts and behaviors that make it harder for sleep to get back on track.

Martin Reed:
Like you touched upon it, especially when it comes to medication and supplements, everything kind of works until it doesn’t work and then that just leaves you scrambling to look for the next thing to try and then the next thing to try and the next thing to try. So it’s almost like you’re just kind of treading water, you don’t feel as though you’re really making that progress. That’s beside the fact that what’s going to happen when you stop taking that supplement or what’s going to happen when you stop taking that medication because ultimately, you’ve not addressed those thoughts and behaviors that are perpetuating sleep disruption.

Jennifer Ellison:
That’s a real confidence eroder too, when, if there’s a belief that, and for me, there certainly was, I can’t sleep without this or that. Then you prove yourself to be correct when you’re sleep erodes which it eventually does. So your confidence just really is impacted by that.

Martin Reed:
Yeah, exactly. When I work with clients who are taking medication or supplements, ultimately I just leave the decision to them in terms of what they want to do, whether you want to just quit them or keep taking them, doesn’t really matter because they’re not generating sleep, they’re really not having that much influence on sleep in the bigger picture of things. The time that they can cause a problem that you just touched upon in terms of eroding that sleep confidence, is if you choose to take things contingently.

Martin Reed:
So let’s say you have a few bad nights in a row, then you reach for something and then you sleep, you can just develop that mistaken belief that you’ve only slept because you took x, whatever that thing was, and that can really erode your sleep confidence because the fact is you slept because your sleep drive was strong enough to generate sleep for you. Every night of difficult or disrupted sleep increases that sleep drive.

Martin Reed:
So natural sleep is becoming more and more likely, but then when you’ve just kind of had enough, when you reach for that pill or that supplement or whatever, and then you sleep because your sleep drive reached that critically intense level where wakefulness was impossible to sustain, instead of recognizing your own ability to sleep, you can just reinforce this idea that you only slept because of that, whatever you took.

Jennifer Ellison:
You’re absolutely right.

Martin Reed:
So I think you touched upon this a little bit earlier, but in what ways were you struggling to sleep? What was an average night like back when you were struggling?

Jennifer Ellison:
Well, as I said, I had both trouble falling asleep and sustaining sleep throughout the night. So everybody wakes up in the night but for a lot of people going back to sleep is not a struggle. For me, it always was a struggle. So when I would wake up, so falling asleep would be like an hour, two hours some nights, some nights I wouldn’t sleep at all.

Jennifer Ellison:
Those were not that frequent, but they certainly did happen. So when I did wake up in the middle of the night, I often woke up sort of in this panic, because I recognized I was awake. For me, that meant likely either not going back to sit at all for the rest of the night, or it being many hours before I went back to sleep.

Jennifer Ellison:
Of course, the moment you panic, as we all know, even people who sleep well know that it makes it difficult if you’re panicking to go back to sleep. So a lot of my nights kind of looked like that, and maybe it was three to four hours on average, something like that a night. That would be a kind of an average night sleep for me.

Martin Reed:
Something that people who haven’t experienced long term chronic insomnia probably don’t recognize is the impact this can have like on your day. It’s not just a problem in terms of struggling through the night, it can make it harder to struggle through the day as well, right? For you, what were your days like back then? How do you feel that that struggle with sleep influenced your days?

Jennifer Ellison:
If I look back on it now, given the quality of my life is so much better now. It’s remarkable that I got through as well as I did, and what I really see is how resilient the body is and that I was really able to quite efficiently get through my day, most days, even with three or four hours of sleep. It’s not that I ever gotten used to it, I always felt poorly.

Jennifer Ellison:
I could take care of my kids and hold down a full time job that was oftentimes a stressful job. As I said, I’m active so I always exercise every day, even if I didn’t feel well, because I knew it would make me feel better. So I just think the human body is remarkable that way, but I would say the quality of life was certainly diminished from what I’m experiencing now.

Martin Reed:
That’s an excellent point that you made that we are remarkably resilient, the body is really good at just naturally compensating for sleep disruption, and getting us through the day. As you’re able to now reflect upon, you can see that there’s that definite difference in terms of the quality of your days, but you’ve also got that perspective of being able to recognize, wow, I did get through all that. I successfully raised kids, I successfully had a career and got through my days at work, even when I was really struggling.

Martin Reed:
I was able to still be active, and when I was active, that helped me feel a little bit better. It just goes to show that although insomnia can have a very real negative impact on our lives, we are remarkably resilient in the face of insomnia and we are able to get through the day.

Jennifer Ellison:
Right, right. Sometimes the scariest part is what you believe, not really what happens. You read so much online about all the bad things that can happen to you if you don’t get enough sleep, and of course, that just again perpetuates, there’s that word, the problem and I knew from all the things I had read that getting three or four hours of sleep could eventually cause major health problems for me, because everybody knows that. You read it everywhere. To the degree, you actually believe that, just you dig your hole deeper.

Martin Reed:
Yeah, absolutely. This is where education can just play such an important role. That’s why when clients start working with me, one of the things that we go through, as I’m sure you remember, is this sleep education component. Before we talk about anything to do with behavioral changes, it’s just learning more about what normal sleep is just because, whether we have insomnia or not, there’s a lot of incorrect beliefs about sleep.

Martin Reed:
One of them is this idea that we need to get, say, eight hours of sleep and that’s something we should all strive for. When you were going through this kind of educational component of the course, did you have like any aha moments, or anything that you’ve really identified with that helped change the way you think about sleep or maybe reduced that worry or that arousal?

Jennifer Ellison:
One of the things I recall is being really relieved to find out from you that eight hours of sleep was really not necessary. For me, in only getting three or four hours of sleep, I can’t imagine eight hours.

Jennifer Ellison:
To me, that was so out of the realm of possibility. Now it isn’t, but then it certainly was, that there was such a relief in being educated and knowing that this mythology of everyone needs eight hours of sleep or else, is really debilitating for a lot of us and just not true.

Martin Reed:
Yeah, exactly. There probably are a really, really small number of people out there that maybe, their individual requirement is eight hours, but they would definitely be the exception rather than the norm. I think most people it’s probably closer to five and a half, six hours, probably about six ish hours, but we’re all different. Just like we wear different shoe size, we all have our own individual sleep requirement and just as, let’s say we wear a size five shoe, but we want to wear a size eight shoe, not much we can do about that.

Martin Reed:
It’s the same for sleep, if our individual sleep requirement that the body is capable, and all it needs is, say six hours, striving to get eight hours is, first of all, not going to produce more sleep, and second of all that very process of trying, striving and putting the effort into sleep is completely counterproductive and will probably end up making sleep more difficult.

Jennifer Ellison:
One of the great assignments you give that was really useful throughout in the beginning as I was learning more about behavioral changes is a sleep diary. In the very beginning, I focused a lot on the number of hours because certainly I was recording that, the number of hours of sleep I was getting and yet as time passed, and I began to understand more deeply about sleep, I really focused more on the quality of the sleep I was getting instead of the time that I felt I was actually asleep.

Jennifer Ellison:
What I noticed is that if I assessed how I felt during the day, as a result of asleep the night before, that was a better barometer for me, then, did I get four hours or six hours or three hours or zero hours or how did I feel?

Martin Reed:
Yeah, and really, that’s all that matters, right? Because the numbers don’t matter. All that matters is, if we wake up in the morning, we feel refreshed from sleep, we feel as though we’ve got enough energy to get through the day, then ultimately, that means that our sleep is probably fine. The numbers really don’t matter that much, it’s just how we feel. Sleep is really, really subjective.

Jennifer Ellison:
For me, it took the pressure off too, and not striving for the number of hours, removing that pressure of, oh my gosh, I didn’t get five or six or whatever the number is. When I really shifted my attention to the quality of how I felt, then suddenly the worry about did I get enough in terms of time, it’s disappeared.

Martin Reed:
Yeah, absolutely. Another thing that’s interesting is, we can’t really control sleep duration. I mean, we could deliberately deprive ourselves of sleep by only spending an hour in bed, but we can’t do the opposite. There’s no way that we can make ourselves sleep for, say, seven hours, or to sleep for, say, eight hours. We have no control over that, but we do have control over sleep quality to a certain extent.

Martin Reed:
So we can more closely align the amount of time we allot for sleep with how much sleep we generally get to reduce nighttime wakefulness, build sleep drive, that makes it easier for us to fall asleep, leads to more consolidated sleep. It’s just one example. So we can control that sleep quality and ultimately, it’s sleep quality that influences how we feel during the day and how refreshing we feel that our sleep was.

Jennifer Ellison:
Yeah, that’s true. I remember in the very beginning, like week one through four or something like that, understanding sleep drive was key for me because it was the beginning of me getting confidence back about sleep. The reason for that was that before because I relied on other things other than myself to fall asleep, I didn’t really understand sleep drive. I think I said to you in my initial interview, I don’t really understand what it is to feel sleepy, like sleepy. People say I feel sleepy, I’m going to bed, I feel sleepy. That wasn’t the usual occurrence for me. In building sleep drive, such that you’re not going to sleep until, for me, my sleep window was quite condensed.

Jennifer Ellison:
So I really got to feel what it felt like to be very, very not just tired but sleepy and ready to fall asleep. The minute I learned that, I started to feel confident that I could fall asleep because there’s no way I could have not. The sleep drive was so strong at that point that falling asleep was quite easy.

Martin Reed:
I really like starting with that sleep window as kind of like the first behavioral change that I talk about with clients, just because it really helps you get that early win, helps you get that sense of sleepiness back where it may have previously been lost. A lot of us can mistake fatigue with sleepiness. So we might go to bed when we’re feeling kind of worn out and exhausted, which might not mean that we’re actually sleepy enough for sleep.

Martin Reed:
So by allotting an appropriate amount of time for sleep, not only do we, by default, spend less time awake during the night, but we’ve got a lot more time for sleep drive to build during the day. With every minute that we’re building up that sleep drive, it makes sleep more and more likely to happen, and you do get that intense feeling of sleepiness. Because that wakefulness that you’re saying, awake for longer, you’re out of bed for longer and that can just be so reassuring, because you can recognize that my sleep drive is there.

Martin Reed:
It’s not broken. There is nothing, from a medical standpoint, there’s nothing wrong with me. That sleep drive is there and it could just be so reassuring, and it goes from one way you kind of, sometimes you can be dreading the approach of bedtime. Bedtime in an hour, bedtime in half an hour, and it completely switches it around. So like, come on, I’ve still got to wait one more hour before I can go to bed, now I’ve got what 30 minutes before going to bed and you’ve actually already looked forward to that relief of getting into bed and that can just be so transformative as an experience.

Jennifer Ellison:
That time shifts a lot too. I remember in the early part of working with you, I would get just incredibly sleepy too early in the night, like six o’clock, seven o’clock, eight o’clock, and have to just really do everything I could to hang on. Sometimes I would actually leave my house and go for a walk just to wake myself up enough to make it to my sleep window.

Jennifer Ellison:
Then the arousal system would kick in as I got closer to the sleep window and suddenly I would be more awake, closer to the sleep window. It took a little while to adjust that so that I was actually sleeping closer to the sleep window instead of too far from it. This therapy works tremendously well, but it’s not an overnight thing. It does take time, and the body doesn’t adjust quickly, but I was really willing and committed to give it all the time it needed to make it work.

Martin Reed:
You just touched upon it. It is a process. It’s not necessarily a quick fix. It can take weeks, maybe even a few months, but in my experience, everyone that is committed and consistent will experience improvements in their sleep just because, like we touched upon, sleep drive always wins in the end. If you’re awake for long enough, you’re always going to sleep. So if we can kind of harness the power of that sleep drive, and if we can harness the natural power of our body clocks by doing things like getting out of bed at a consistent time every morning, being active during the day, if we can try to reduce arousal, worry and anxiety and thinking about sleep throughout the day and at night, conditioned arousal, all those aspects, if we can work on addressing them, get involved in the process of addressing them, sleep is always going to improve because they are the perpetuating factors behind chronic insomnia.

Jennifer Ellison:
I remember you coaching me, saying to me a number of times when I was having a rough spot, don’t worry, Jennifer. Sleep will always win. I just kind of held on to that always, sleep will always win, even when it doesn’t seem like it right now and you were right. It always did. It always did win.

Martin Reed:
I think we should talk about this a little bit more because I think we were about halfway through my online course, you were like four weeks in. It’s eight weeks long, and at that point, you weren’t seeing significant improvements in your sleep, but you said that you were actually feeling more fatigued. It was even getting more difficult to get through the day, and quite understandably, this made you feel discouraged.

Martin Reed:
Am I doing things right? What’s going on? What’s wrong? Is there something unique with my insomnia, that means it can’t be fixed? Things like this. Especially because you were implementing the techniques, you were doing things like getting out of bed when being in bed didn’t feel good to help address that conditioned arousal. You were working really hard on that consistent out of bed time in the morning and following the sleep window. So, how did you manage to keep going like during that point, because you were putting all this effort in, you actually may be feeling worse than before you started implementing these techniques. How did you motivate yourself to keep going at that point?

Jennifer Ellison:
A couple of things. One, as I said, from the start, I feel like I have tried everything and this was my, in my mind, this was my last shot at something that seemed like the right road. It wasn’t a medication, or some sort of potion or something else. It was something that I could do on my own that my body could generate, and I desperately wanted a solution that was, “natural.”

Jennifer Ellison:
So there was that, and I just believed that, I can’t tell you exactly how I just believed that this would work. In spite of the fact there were points when it was discouraging, and difficult. You’re right, getting up multiple times a night and staying up and then going back to bed to hopefully fall back asleep. There were times when I felt bad, but I always told myself that even the worst night, my days, the next day, were still better than most days on medication, and what it feels like to wake up with a medication hangover, and not sleeping only three or four hours a night.

Jennifer Ellison:
So when I reminded myself that, one, I could get through the day, no matter what, even if I didn’t sleep at all. I knew I had experience getting through the day, and that even the worst days through this program, were better than many days I had experienced in the past. That sort of kept me going.

Martin Reed:
I remember you made a comment to me that this whole process of getting in and out of there, that sometimes it felt a little bit like a cruel trick because you would find that you would fall asleep, maybe like five minutes before the alarm went off to signal the end of your sleep window. So you’d gone through this whole process throughout the night of every time being in bed didn’t feel good, you got out of bed, which is really good so that you’re not reinforcing this idea that the bed is an unpleasant place to be.

Martin Reed:
So you’d be getting in and out, in and out and then that final time you’d just fall asleep, alarm goes off, end of the sleep window, but you still stayed committed and you’ve got out of there by the end of the sleep window. How did you manage to do that? That’s something that so many people struggle with and my clients are always asking me for tips and suggestions on how they can stay committed to that consistent hour of bedtime. Do you have any tips or guidance you can offer there?

Jennifer Ellison:
Well, I did have a routine I developed for, so my out of bed time was 5AM. So when my alarm would go off at 5AM, first of all, I devised a really sweet little alarm with bird sounds and not some blaring alarm and I will say that seems like a, is that really a tip, but it really was lovely to wake up to that sound and not just some blaring alarm. So there’s that.

Jennifer Ellison:
The routine that I developed is I like to drink tea, so I would use it and when I was doing this with you, it was the winter, so it was very dark at 5AM. Now it’s kind of getting light already. So I would make some tea and I would watch some television for one hour, just because it’s fairly mindless, and I’d get into a series and I’d watch something that I really enjoyed, but that was not very anxiety provoking, something simple.

Jennifer Ellison:
I would just let myself kind of wake up for the day between 5AM and 6AM. So I’m awake, but I’m not really doing anything and then I would begin my day. Strangely, I began to look forward to that 5AM wake time because, the time between five and 6AM, I created a lovely kind of moment before my day began.

Martin Reed:
I really like that. It’s almost like how we talk about taking time to unwind before bed, maybe like an hour before your bedtime you just relax, do whatever you want, as long as you find it enjoyable. You kind of flip that around, and also use it in the morning, which is great, because I always tell people, you don’t have to be like jump out of bed, as soon as the sleep window ends and go for a run, or jump in the shower, have a cold shower or anything like this.

Martin Reed:
All we’re saying is, it’s a good idea to just get out of bed and not fall back to sleep at a consistent time in the morning. So if it helps, grab your blanket, drag it to the couch, have a cup of tea on the couch or a cup of coffee on the couch, watch some TV. Start your day as slowly as you’re ending the day. That can be really helpful too, because it’s a bit more appealing than this whole idea that you’ve got to jump out of bed and get your day started. Just start it slowly and gently. That’s a really powerful insight. I think that’s going to help a lot of people.

Jennifer Ellison:
Good.

Martin Reed:
So we were talking about how you’re kind of halfway through the course, got a little bit discouraged but doing really well implementing these techniques. I think it was shortly after that you kind of experienced this breakthrough moment. I think that every client I work with that has this one memorable breakthrough moment and it’s typically either something like, for the first time, I recognize that I can have a good day after a bad night of sleep.

Martin Reed:
For other people, it’s I had this great night of sleep, the best night of sleep I can ever remember. I think that was what you experienced and it helps you recognize that you do have that natural ability to sleep and sleep well all by yourself. No medication needed, no supplements needed, no external sleep crutches needed. Then a couple of weeks later, you’d string some of those great nights together in a row and you were doing so much better at that point. I think, correct me if I’m wrong, I think that by that point, you weren’t even taking medication anymore.

Jennifer Ellison:
No, I actually stopped the medication, I think the last time I took it was maybe week three, and I only was taking it once or twice a week, even between week one and three. So I stopped it very early. I was very committed to exiting that medication very early on. I needed to prove to myself I could do this.

Martin Reed:
So the benefit of that is all those improvements, that breakthrough night then that string of good nights, you got to recognize that it was all down to you and just your natural ability to sleep.

Jennifer Ellison:
It’s 20 years of learned behavior that has to be unlearned, and something else has to replace it. I think what I would say to other people is that this is a process. This does take time, particularly if you’ve been at the insomnia thing for many years, the way I had been. I think it took me a little longer probably than most folks because I did have to quit the medication as well as learn the techniques and implement them, but yeah, worth every minute of struggle.

Martin Reed:
So fast forward now, where you’re finishing the course. We’ve been working together for eight weeks. I think you reported that you were generally feeling happy with your progress, you said that you felt your quality of life was better. Didn’t feel quite as much fatigue as you used to, but you did give me a side note that you were still often struggling to get back to sleep hen you woke during the night.

Martin Reed:
Then I think you got back in touch with me a few days later and said, this is starting to get worse. I’m starting to really struggle to fall back to sleep when I wake during the night. Can you tell us a little bit more about that? What happened and what do you think was the cause of that setback?

Jennifer Ellison:
So as I said, I did really well with sleep drive and generating sleepiness in order to fall asleep. So that became something that I got good at quickly, but this whole arousal system and what happens when you wake up in the middle of the night and then not being able to fall back to sleep, that was more of a challenge for me, and it just took longer.

Jennifer Ellison:
So that was the source of my frustration and that I would fall asleep, let’s say my sleep window was at 11 o’clock, I’d fall asleep within 10 minutes, but then I’d be awake in three hours. Then many nights, it took me time, well, a lot of time to go back to sleep. That was close to the end of my eight week time with you.

Jennifer Ellison:
Again, it kind of comes back to confidence. You touched on, I did have a breakthrough kind of aha moment when I got a really great night’s sleep about week five or six or something like that. So I knew I could do it, but then once you do it, the question is, well, how do I get back to that place? I think for a lot of us that suffer from insomnia, and I do have other friends that I’ve consulted with over time, it’s really easy to think a lot about sleep when you have insomnia, more than is really good for you.

Jennifer Ellison:
You could say obsessed about it, that when you have insomnia, there’s a tendency to research everything to try to find a solution to spend your days thinking about your last night’s sleep or what will your next night sleep be like. The struggle to fall back to sleep, you actually summed it up in an email to me one day, when I wrote you a long email about how, Martin, I don’t know what else to do. I’m doing everything I’m supposed to be doing.

Jennifer Ellison:
I follow all the directions and I’m struggling, what should I do? You, in a very kind way said to me, well, what do you think you should do? It really hit me that, I felt like you were kind of saying to me, I’ve given you all the tools, Jennifer. What’s next for you? What came to me was, I just need to let this go now. I need to stop trying to do anything about it, and remarkably, that was the key.

Jennifer Ellison:
So when I took all of the energy out of trying to figure out why or how to fix it, it resolved itself and not overnight, but I began to see that, oh, when I woke up and everybody wakes up. It’s not like, I’m just going to now sleep for eight hours and not ever wake up. I suppose there are folks that do that, but I think most people do wake up in the night, I began to see that I could wake up and fall back to sleep relatively quickly. The other thing that I do now, when that happens is I just tell myself, it’s okay. If I go back to sleep now, it’s fine. If I don’t go back to sleep now, it’s okay too. It doesn’t matter.

Martin Reed:
I think that’s a fantastic insight, because all these thoughts, this ongoing research, experimentation, the rumination is one of these perpetuating factors of insomnia. It’s, is this on the arousal side, this cognitive arousal. I’m just always thinking and worrying about sleep. I’m putting effort into sleep, trying to troubleshoot why every single difficult night happens, exploring the past and worrying about the future.

Martin Reed:
It can just be so helpful to focus all attention simply on the process, just implementing behaviors that help set the stage for sleep, and just trying to abandon all control. Because ultimately, sleep works best when we don’t get involved in it. As soon as we try to sleep, or even just spend a lot of time researching sleep and experimenting, this by itself implies that we can control sleep when we can’t. That in itself just increases this cognitive arousal and can make sleep more difficult.

Martin Reed:
So like you said, that was kind of your breakthrough moment when I kind of prompted you, what do you think your response should be to this. It kind of sent you on this mental path of self discovery that just maybe focus on the process. Recognize that I have no control over, certainly I have no control of what already happened last night, because that’s in the past. Really, I don’t have any control over sleep tonight, but what I can do is give it the best chance possible of happening by implementing these techniques that really just help set the stage for sleep.

Jennifer Ellison:
I chose at that point to let go of the sleep diary because I felt like I already knew now after keeping a diary a really long time, I knew the pattern. I knew what I was supposed to do, I knew the results, I didn’t need to chart it anymore. I felt like that just perpetuated again, the focus. Instead, I decided to do an extra yoga class day or ride my bike for an hour, where I would have normally focused on sleep.

Jennifer Ellison:
So when your mind focuses on other things that are relaxing and enjoyable, you don’t really have time to focus on the things that cause you anxiety or stress, like am I going to get a good night’s sleep?

Martin Reed:
Yeah, exactly. I think the sleep diary can be really helpful in the short term just to help you identify where there are behaviors that are perhaps not helpful for sleep, like those inconsistent out of bed times, going to bed too early, for example, things like that. Once you get to that point where and maybe even hold yourself accountable to the changes as well. When you get to that point where you recognize that putting effort into sleep or spending time analyzing sleep just isn’t helpful, there’s really no need to be keeping a sleep journal or paying any attention to sleep from that point.

Martin Reed:
I love the fact that you kind of use that time that would have been spent filling out a sleep diary and thought, I’ll use that time to add enjoyment to my life, to enrich the quality of my days. That’s so helpful and that’s something that I encourage everyone to do. Whether it’s connected to keeping a sleep diary or not, just because it’s so easy if we have insomnia to withdraw enjoyable activities in our life.

Martin Reed:
I don’t feel like I’ve got the energy to do this anymore or I can’t go to the movie theater and watch a late night movie anymore. I can’t do this. I can’t do that. So you’re guaranteeing that sleep has a negative influence in your life. You can just kind of make that effort. Often getting started is the hardest part, but if you can just make that effort to do things you enjoy.

Martin Reed:
These don’t all have to be physical activities, just things you enjoy that you get a sense of reward, enrichment, things that add quality to your day. The more you can do that, the more you can disconnect to this idea that the quality of your day and the quality of your life is 100% dependent on how you sleep, because that’s not true. We ultimately have the most control over the quality of our day and the more opportunity we give ourselves to prove that to ourselves, the more helpful that is, the less pressure we might be tempted to put on ourselves to sleep, the less worrisome it might be when we wake during the night.

Martin Reed:
We also just give ourselves the opportunity to just recognize that even after a difficult night, we can still have some okay moments, maybe some good moments. It can just really just lift that pressure off of ourselves because it’s so easy to just put an overwhelming amount of pressure on ourselves to sleep and see it as something that’s critically important to our lives.

Jennifer Ellison:
Absolutely. Yeah, stop worrying about it.

Martin Reed:
Yeah. So here we are, we’ve gone through the whole coronavirus, the whole pandemic and outbreak. Most people would maybe be expecting you to experience some setbacks at this time and just like people have never experienced insomnia before are finding themselves grappling with sleep problems at the current time. What’s sleep like for you now? What’s a typical night like?

Jennifer Ellison:
For the most part, I’ll just use hours because people relate to that even though I don’t really look at it that way anymore, but I get about six to seven or even more hours of sleep a night, most nights, but like all people, that’s not every night. Some nights I get less but I consider that all normal now and last night for example, I got less.

Jennifer Ellison:
My dog is sick and she was up during the night so I was up with her and people who have sick dogs get up in the middle of the night and they don’t get a great night’s sleep. So I feel, as I said before, the quality of my life has greatly improved because I feel so much better, and part of that is a great night’s sleep and part of it is no medication. Part of is I take great care of myself.

Jennifer Ellison:
So coronavirus is a challenge for everybody. I’m sure there are people suffering with sleep troubles right now that didn’t happen before. Remarkably, I continue to improve through this. Maybe being sequestered at home is relaxing also, on a certain level. I don’t know, but it’s going really well.

Martin Reed:
That’s great. I think it’s amazing how our perspective changes. When we’re at that point where we don’t really think or worry or pay any attention to sleep, our reaction to any difficult nights is completely different, isn’t it? It’s just like, you go back to perhaps, how you were in the past whereby you have a bad night, but you don’t think about it, you don’t talk about it, you just accept it that you had a difficult night and then you see the next night it’s a fresh start.

Martin Reed:
You can recognize obvious external causes of sleep disruption, like if your pet is unwell, for example. It would be more unusual, I think, for you to sleep well in those circumstances. It’s your whole perspective changes and once you get to this point where you’re not thinking about sleep, you just don’t have that worry, that pressure on yourself to sleep. As a result, you don’t think about it. It’s just a complete transformation.

Jennifer Ellison:
Even like today, I’m a little bit out of sorts today from taking care of the dog last night, but I’m having a fine day and it’s great being here with you and I’m not at all concerned about tonight. That would not have been true six months ago.

Martin Reed:
Yeah, absolutely. It’s so easy when your confidence is still fragile or non existent that you can put those string of better nights together, but it’s so easy for more challenging or one difficult night to kind of set you back and then lead to a number of nights of sleep disruption because then you worry. You worry about that one night, and that arousal in response is what can then disrupt sleep, but if you can just try and see each night as a fresh start. What happened in the past is not really relevant. There’s no way of predicting the future, the less concerned you can be, the easier sleep becomes.

Jennifer Ellison:
I haven’t thrown the entire program out the window just because I feel better. There are still things about the program that you taught me that I still implement daily. So it’s not to say that I just sort of go about my life not thinking about sleep, everybody thinks about sleep. In particular, I noticed that having a buffer zone, which you taught me, so that hour before bedtime, or before you get sleepy that I do something that is relaxing, I still do that every night.

Jennifer Ellison:
Because I find that to be really useful for me, just because I work a lot during the day and just to kind of unwind and just be in that space of relaxation. Whether relaxation brings sleep or not is irrelevant to me, but just to be relaxed in that hour before bed is useful. Then the other thing is the clock watching. I recognized that I was a huge clock watcher, when I had insomnia that I would look at the clock when I was awake and I’d look at it again and again and again and again.

Jennifer Ellison:
Of course every time you look, it just makes things worse. I avoid looking at the clock. Now I know that whether it’s one in the morning or four in the morning, it doesn’t really matter, I’ll either go back to sleep or I won’t. So why bother looking at the clock? So those are some things that I still do that’s part of the program but in terms of like the sleep window, I go to sleep when I’m sleepy and I wake up when I wake up. So it’s much more, I guess, people would think of it as natural than derived from a prescription or a program.

Martin Reed:
Yeah, exactly. I’m really glad that you talked about that, because some people can believe this, let’s say, the sleep window, for example, that the sleep window is going to be something they’re going to have to follow for the rest of their lives. Especially when you first start out, that sleep window is often quite short and the idea, what, I can only spend, say six hours in bed for the rest of my life, I can’t go to bed before this time for the rest of my life. I have to be out of bed by this time for the rest of my life.

Martin Reed:
Well, no, that’s just a short term behavioral change just because this change is a really good way of helping you recognize, in terms of sleep window, sleep drive in the quickest time possible. So it’s just to help you get those early wins under your belt and address these thoughts and behaviors that perpetuate insomnia until you get to that point where you feel more confident in your natural ability to sleep.

Martin Reed:
You spend less time thinking and worrying about sleep, and when you got to that point, you don’t really need those behavioral interventions so much anymore because those perpetuating factors behind insomnia aren’t present or they’re far less of an issue in terms of your sleep.

Jennifer Ellison:
I know that if I should ever relapse into having real troubles, ongoing troubles, not just the occasional I didn’t sleep well, I have all the tools now. I’ve been through this with you. You’ve supplied me with all the materials I can review again if I had to, I know how to implement all the techniques. So that part of my confidence is so much greater as well because I literally know now this will stick with me the rest of my life, even if I have to go back and use it again. I’m 100% confident that I can do this forever.

Martin Reed:
Yeah, exactly. That’s why I’m just such a big believer in these techniques, because not only did they just help you at the time you’re first implementing them, but because they’re skills based, they’re with you for life. So you were implementing these techniques for the original eight weeks of the course. We ended up working together for an additional eight weeks just so you got to that point where you felt confident enough to kind of go it alone.

Martin Reed:
Now moving forward, you know that should you ever need help again, in the future, you don’t need me anymore. You’ve got those skills and they are with you for the rest of your life. So anytime you experience prolonged sleep disruption, you individually know exactly what you need to do to get your sleep right back on track all by yourself.

Jennifer Ellison:
Yes, very much so.

Martin Reed:
So I have one last question for you. I really appreciate the time that you’ve spared us today, but I do like to end every episode with this one question. So I’m going to pose it to you now, Jennifer. If someone with chronic insomnia is listening, 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?

Jennifer Ellison:
They don’t know Martin Reed. That’s what I would tell them. I mean, seriously, I am that person you just described. I had tried everything and I had very limited success with trying everything for 20 years. I would say, you have nothing to lose if you think you’ve tried everything, in trying this and that the key I think, to being successful is really your own commitment to this.

Jennifer Ellison:
I’m not one of those extremely driven people where I set my mind to something and I always, I’m not really that person. So it’s not like, I’m just a crazy achiever, but I really knew that this needed to change for me and I really wanted it to be this natural program that was behavioral change that would make the difference. So I would say to people, if you really have tried everything, and I wouldn’t get to a place where I tried everything. I would try this first.

Jennifer Ellison:
This is the way to go, and if you try it for eight weeks, and I don’t know, remarkably, it doesn’t work for you, what have you really lost? I don’t think that’ll be true because it does work.

Martin Reed:
I completely agree with you. I hear from a lot of people who tell me they’ve tried everything. Often it doesn’t involve these cognitive behavioral techniques through no fault of their own. It’s just they’re too difficult to discover. It’s too hard to find out about them-

Jennifer Ellison:
And doctors don’t know about them either.

Martin Reed:
Exactly. Or people who have tried them maybe struggled and then not had that support system in place to help them get through those challenges. So have withdrawn from it, and then moved on to trying something different.

Jennifer Ellison:
I don’t think this is something you read in a book. Honestly, it isn’t and I would not have a time to do this without support. It is challenging enough that you need a coach now.

Martin Reed:
All right. Well, I really appreciate you taking the time to come on today, Jennifer. I think that your story is going to resonate with a lot of people, especially with those ups and downs. How to respond to the setbacks, how to keep yourself moving forward and if anyone can identify even a little bit with your experience, I’m hoping that our conversation will give them the motivation to do exactly what you did and get their sleep back on track. Because if you are successful, there’s no reason why anyone else can’t be successful too.

Jennifer Ellison:
Exactly. Yes, I wish everyone well.

Martin Reed:
Thank you, Jennifer.

Jennifer Ellison:
Thank you.

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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8 thoughts on “How Jennifer got through setbacks and relapses while implementing techniques that transformed her sleep after 25 years of insomnia (#23)”

  1. This episode really spoke to me. I can relate to so much of her CBTI experience.
    2 questions:
    How did you figure out how to translate the sleep pressure you were experiencing evenings into sleep. The same thing is happening to me.

    Ryan

    Reply
    • Hello Ryan and thanks for your comment — if you can relate to what Jennifer went through, you can be successful, just as Jennifer was! I am not sure I understand your question. Typically, the more intense our sleep drive when we go to bed, the easier it is for sleep to happen. Our arousal system can temporarily overpower sleep drive in the short-term, but sleep drive always wins in the end!

      Reply
      • I am getting sleepy at like 6 instead of 11 when I need to go to bed. Jennifer indicated she was able to direct her sleep pressure more towards the in bed hours when this happened to her. How did she do this?

        Reply
        • Usually we use sleep pressure to our advantage by maintaining an appropriate and consistent sleep window and avoiding daytime naps or remaining inactive during the day. This was, sleep drive is strong when we go to bed.

          If you can tell me roughly where in the episode Jennifer talks about this, I might be able to help clarify, Ryan!

          Reply
          • Hi Martin! I’m also curious about this! I believe Jennifer begins speaking about this around 24:18.

          • I believe that Jennifer was saying that when she started the sleep window she would find that she’d be really sleepy before it began, but then found it hard to fall asleep when getting into bed (due to the arousal system).

            However, by remaining consistent and continuing to observe the sleep window and other techniques (such as getting out of bed when being in bed didn’t feel good), she started to find that she was able to maintain sleepiness upon getting into bed since she was continuing to build sleep drive while lowering arousal.

  2. I am trying to follow sleep restriction from 12-6. I just started 2 days ago. I find it very hard to keep my eyes open or even think about anything around 7-8. I have young kids so I put them to bed and stay there for a few minutes. I find that sometimes I doze for a few seconds and come back awake. Also I watch TV and drink tea around 9 and have found myself dozing towards the end of the show. Not like a long doze maybe a min or two. The first night I was able to fall asleep in 20 mins but woke up in an hour or so and couldn’t sleep. I would get up from bed only if I was feeling anxious. When I get up from bed too tired to do anything but still read a book even though not able to focus fully until the anxiety is gone. Then I go back to bed whether its in 5 mins or 15 mins as long as I am feeling calm and relaxed. But sometimes I am able to go back to sleep sometimes I am relaxed and resting. I did get up 3-4 times both days. But get up at 6 promptly. I noticed that towards the end I am getting some light sleep and feel somewhat relaxed. I will continue on this path and will probably contact you in 2 weeks. My main issue is tackling these micro sleep I am getting before my sleep window. Does that reduce the sleep drive even though the total duration is only like 3 or 4 mins.

    Reply

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