Insomnia Support Group
Insomnia is a symptom, rather than a disease, and is characterized by inadequate quantity or quality of sleep. People with insomnia complain of difficulty falling or staying asleep, which results in significant impairment of daytime functioning. Insomnia is categorized as transient (shorter than one week), short-term (one to three weeks) or chronic (longer than three...
I had been doing pretty well when I started sleep restriction. But then I got cocky, going to bed earlier, staying in bed later, taking 2 hour naps during the day. Which was great at first.... It felt like this insomnia had passed. How wrong I was.
I'm going back on tonight.... Doing it for my wife and son. Ive become much less of a husband and father since struggling with this.
I feel very low right now...helpless.
I look at my wife and son and it cuts through me that I'm not "there" for them.
So this time it's for them and me.
12 in bed.
6 out of bed.
No napping during the day.
Out of bed if not asleep in30 minutes.
Who's with me?
I'm going back on tonight.... Doing it for my wife and son. Ive become much less of a husband and father since struggling with this.
I feel very low right now...helpless.
I look at my wife and son and it cuts through me that I'm not "there" for them.
So this time it's for them and me.
12 in bed.
6 out of bed.
No napping during the day.
Out of bed if not asleep in30 minutes.
Who's with me?
Yes, this is a process of strengthening, and it works different ways for different people. It's not like flicking a light switch on or off.
The basic idea is to sustain a high sleep drive level, which will help produce more robust sleep. In addition, keeping regular sleep-wake hours will help synchronize your biological clock and circadian rhythm. These are two of the key processes regulating sleep.
Some people experience fairly rapid results with this method. Not me. For me it was slow but reasonably steady progress over a period of many months. Fortunately, slow and steady progress tends to be lasting.
Wishing you well with this, keep us posted.
Saturday night I tried to go to bed at 10:30. That day I also took a 2 hour nap.
But that night I only slept for about 2 to 3 hours of crappy sleep.
However, Sunday night I fell asleep on the couch at 7pm and slept until about 6am.
I know this is very bad and not helpful to developing a good sleep rhythm, but it does show that sleep drive is a very real thing.
During the last 10 days my average nighttime sleep was 5 hours and 58 minutes. Typically 6 hours would be a good starting point for restriction, but because of the anxiety she suggested 8 and see how I do.
My first night I slept 5.9 hours in one block with 8 hours of bed time. The second night was 5.5 hours with 7.1 hours of bedtime (I woke up one hour early and decided to just get out of bed...I had some hayfever allergies and figured I likely wouldn't get back to sleep).
The lack of sleep is one thing (ironically a month ago I would have been joyous at a average of 5-6 hours sleep, but now I'm quite tired on that amount...a good sign I guess). However, the days after a poor sleep I tend to feel very depressed and hopeless, which makes me think the depression (or a large part of it) is a result of the lack of sleep and not the other way around.
If my sleep amount doesn't improve I'll carefully reduce my time in bed, but I'm sleeping solidly in 5.5 hour (or better chunks), in a bed these days. One month ago I could only sleep on a couch, I'd wakeup about 3 times per night and even touching a bed would result in a panic attack.
It's good to focus on the little improvements...
Great improvements, Ohio!!
I'm probably getting 5 hours and 20 minutes the nights I've been doing sleep restriction.
I get some anxiety during the day which makes me think I'm headed for a bad night. But I'm trying my best to change those thoughts.
Last night I had two blocks of sleep. One was 2 hours and 48 minutes and the other was alittle over 2 hours. Which for me is pretty good.
My progression seems to have gone from anxiety to sleeplessness to depression.
The anxiety came from my very poor methods of dealing with work stress that was building up for several months.
But now it seems like I have conditional insomnia. Weeks of tossing and turning in bed, unable to fall asleep or even nap during the day. A psychiatrist that was throwing so many meds at me that failed and only seemed to make me feel more anxious the following day. I truly believed I was going mad.
I wish that she would have mentioned cbt and sleep restriction.... But such wasn't my luck. I'm coming away from all of this being very skeptical of the psychopharmacological industry.
When I sleep restrict for that short of time It takes me longer to go to sleep and my total sleep time gets reduced. The depression and anxiety come back and unfortunately I can't (literally can't as I feel I'm on my way to a breakdown). Even with a increased sleep drive the restriction seems to do exactly the opposite of it's intent.
So...I think I'm done with sleep restriction. Seems to help people who like to sleep in and can have constant schedules. Doesn't seem to help me, a lark who has trouble falling to sleep and has a variable work schedule.
I must say, I'm also disappointed in some of the CBT-I's that are offered online. Specifcally, SHUTi:
http://shuti.me/
This site is more expensive than the others and unfortunately they don't offer a refund (even when asked, twice!). My sleep therapist suggested that most people can not just do online CBT and expect results. Perhaps SHUTi skews their success rates to increase their revenue? In any event, their guidance made my insomnia worse and their support over e-mail didn't resolve the issues I had with their site and program.
I'm disappointed there are a lot of "cures" online which seem to be ineffective and sometimes destructive, yet I ( and other insomniacs) are likely taken advantage of because we'll pay any amount to reduce our suffering.
I do believe I will overcome the insomnia, but the online one-sized fits all approach seems inappropriate for many and unfortunately caused me to get worse and struggle more.
I am glad I have a sleep therapist nearby that can give me good advice.
Do you mind me asking how long you were doing the sleep restriction for?
I had two good nights.... then two bad nights.... and then last night was a very good night for me. I think I was at 92% sleep efficiency.
Those two bad nights threw me for a huge loop though. I was considering stopping the sleep restriction.... but every place I read I keep coming across that the first 3 weeks can be very rough. Some people it seems like the first month can be very rough.... but then the start to get more consistent with their sleep.
Also,
like what SleepTraining says: have you tried the cognitive portion along with the behavioral portion?
Being more accepting with the insomnia, more patient with yourself, not running from the bad sleep thoughts, but also not obsessing over them. Tell yourself: "so what if I have a bad night, I know there will be good nights. If tonight is a bad night then fine, I'll get out of bed, find something to do and occupy my time; but I'm not going to let this ruin my life."
Right on Jorge, that's the way to take control. I think your advice is excellent. Having a positive attitude is a key part of improving sleep.
That said, I agree that self-help is not for everyone, whether it's online, from a book, video, recording, whatever. In that case, most definitely see a sleep doctor, counselor, therapist, or other healthcare professional who can examine you, understand your unique medical history, and so forth. That's the right thing to do.
It's important to understand that CBT methods alone will not address underlying medical issues that are disrupting sleep, whether physical or psychiatric. Those issues must be addressed with a healthcare professional.
On the other hand, self-help for insomnia can work for some people, and I speak from personal experience on that.
We are all unique individuals, and I think going through an incremental process is a good way to do it. Check things out, try different approaches, see what works, what doesn't.
Jorge, you are right about the first few weeks typically being the toughest. Hang in there and be confident you are strengthening your ability to sleep, but be sure you are also using the other CBT methods, including sleep hygiene, stress management, and cognitive restructuring. These all combine to make the journey to better sleep a little easier.
Do you mind me asking how long you were doing the sleep restriction for?
I had two good nights.... then two bad nights.... and then last night was a very good night for me. I think I was at 92% sleep efficiency.
Those two bad nights threw me for a huge loop though. I was considering stopping the sleep restriction.... but every place I read I keep coming across that the first 3 weeks can be very rough. Some people it seems like the first month can be very rough.... but then the start to get more consistent with their sleep.
Also,
like what SleepTraining says: have you tried the cognitive portion along with the behavioral portion?
Being more accepting with the insomnia, more patient with yourself, not running from the bad sleep thoughts, but also not obsessing over them. Tell yourself: "so what if I have a bad night, I know there will be good nights. If tonight is a bad night then fine, I'll get out of bed, find something to do and occupy my time; but I'm not going to let this ruin my life."
Hello,
I only tried sleep restriction for 3 days at most. Not sure how I can best describe what happens when I do sleep restriction, but I'll try...on the first night of sleep restriction I don't sleep well. Let's say my sleep drive increases by 1 unit (if it could be measured, I'm trying to make a point here), but my anxiety about sleep increases by 2 units since I didn't sleep well. On the second night, my sleep drive will increase another unit, but the anxiety will increase another 2-3 units because I'm really tired and start to notice much more depression. By the third night, let's say my sleep drive is at 5 units, I'm very tired, but my anxiety is 9 units, and thus even though I'm more tired I'm also much, much more anxious and depressed so I don't seem to be sleeping more...in fact I'm sleeping much less. How long do I continue to do this and cause myself to continue a psychological slide? It's scary...
Also, unfortunately my job frequently causes scheduling shifts, so the same wake up time everyday is not going to happen (unfortunately). I'm in the transportation business so I can't be very tired while working nor can I expect to wake up the same time everyday.
I've love for sleep restriction to work, trust me, I really would...but so far I haven't gotten the knack of it that is for sure. I wish I wouldn't get so depressed when I don't sleep well for 2-3 nights in a row. It seems to be a real impediment to get better and get control over my sleep.
Yes, I have been seeing a psychologist (in addition to just starting to see a sleep therapist) regarding the cognitive portion. When this began I could only get adequate sleep on a sleeping bag on a couch, I could get into a bed without having a panic attack and feeling like I would vomit. It was horrible.
The good news is a lot of the cognitive stuff has helped. I can sleep in a bed now, I don't have too much anxiety about it and certainly don't have panic attacks. I know if I don't sleep well tonight or tomorrow night eventually I will sleep well, and it is very rare when I have a very bad day because of sleep.
With all that said, my sleep is still erratic. Most days my sleep is "fair", while some are poor and some are good. I'd certainly like to get more control and continuity over it, but like I said, sleep restriction is a scary struggle...especially with my shifty schedule.
My sleep also was somewhat erratic when I started a CBT. It seemed to go in cycles. My progress was slow, not linear, but overall steady.
Eventually, I reached a point where there was real consistency and sleep became more or less a nonissue. For me that took upwards of a year. Using CBT some people have much faster results than this. Your experience will be unique, as it is for us all.
Even though sleep was no longer an issue I did not stop using CBT methods. My sleep continued to slowly improve as more years passed.
Through practice I think most people can learn to quickly recognize and disregard negative sleep thoughts. As you cut them off these thoughts begin to lose their power over you and your sleep.
From time to time negative sleep thoughts recur to me, as they can for any of us. So practicing CBT is somewhat like good oral hygiene. You don't stop brushing your teeth just because you get a good checkup. These CBT methods become part of your lifestyle, almost like second nature.
Managing stress and anxiety are in this sense lifelong pursuits, as is prioritizing the kind of lifestyle that enables good sleep.
That said, insomnia is often correlated with depression. And anxiety for that matter. The 3 are often tightly linked. And it can be very difficult even for a medical professional to unwind the direction of causality.
Are we depressed because we can't sleep? Or do we have insomnia because we are depressed?
And there's no question that uncontrolled anxiety can potentially expand and lead to depression.
The good news is all of these conditions can be successfully addressed.
For normal levels of stress and anxiety, CBT can be very effective.
But if anyone ever feels overwhelmed by anxiety and/or stress, I would encourage you to seek professional help. There is help out there and these conditions are treatable. Addressing excessive anxiety and depression will often result in better sleep, as Ohio mentions.
The good news is that I was sleeping approximately 6.5 hours on my own without medication for a couple weeks without any restriction. Although my time in bed was about 9 hours so my sleep efficiency was a bit low, I didn't care.
I had a couple rough nights in a hotel for work (a hotel that I dislike), so I started sleep restriction. As with the previous times, my sleep became less and less for 5 nights. Even as my sleep drive increased my anxiety and depression levels became severe at night.
Sleep restriction isn't for me. I read the original Spielman study from 1987, and it didn't work for 30% of his patients...apparently I'm in that group. I've tried it 5 times now and each time seemed like toxic torture. It certainly made my sleep much worse.
I hope psychologists come up with a alternative. As of now, treating the underlying anxiety and depression has helped the most. I can't say good things for CBT-I, that's just the way it is for me.
I'm beginning to think my insomnia is a product of depression and anxiety too.
I haven't been sticking to sleep restriction but my sleep has been improving. ...as the depression anxiety episode passes.
Last night was a hard night for me though. Seems like I'm having one really bad night at least once a week. Then the following night I typically crash pretty hard.
You and I seem to be in the same boat.