Sleep Restriction Therapy for Insomnia

[[al...]]

Has anyone out there gone through, thinking about going through or actually starting going through Sleep Restriction Therapy for their insomnia? I have been having a good chat with Longdistancerunner about this in another thread about REM sleep and thought that this topic should have its own thread.

 

I just started the therapy last night and boy is it going to be difficult at first! Not a single wink of sleep and I am not allowed to attempt sleep again until 1 am. Each attempt is limited to 30 minutes in bed then I must get out of bed and return again when I am more sleepy. The whole process must stop by 6 am. As hard as it will be, it sounds like the therapy has a pretty high success rate.

 

I would like to hear from people with experience in this and would be happy to share my experiences.

[[MT...]]

Hi Aloha. I did the whole CBT-i with sleep restriction. Parts of it were very difficult. I wasn't allowed to go to bed until 2:30 am. It did help to consolidate my sleep and the techniques overall have helped me. A couple of weeks after I jumped nothing helped me sleep but the techniques I learned were quite helpful for my attitude and not panicking or catastrophizing.

 

I'm a big believer in this stuff and it's great you're doing it. I wish you the best of luck.

[[al...]]

Thanks for the encouragement MTfan.

 

I am sending out good thoughts your way in the hopes that you can shake your sleep issues. I think that you have to be an extreme insomniac to fully understand what a big deal it really is. Others are always asking me why I get so upset at night. They do not have a clue.

[[MT...]]

So right, Aloha. I have a friend who has had extreme insomnia for about 20 years. I never appreciated how difficult that was even though I had some insomnia. I think it was so terrible I couldn't absorb it. I'm not sure how much of her problem is the benzos or z-drugs at this point. Prior to all of this I wouldn't have believed someone could survive with this little sleep. Now I totally get it.

 

People who can sleep so take it for granted.Just like we probably once did. Insomnia is a big freaking deal. Fortunately it's going to get better at some point.

[[al...]]

I did not realize just how hard this sleep restriction therapy was going to be. I thought that it would just be a matter of trying to stay awake. Night 1 was 0 sleep since I had to abort trying to sleep every time 30 minutes passed.

 

Night 2 was so hard to stay awake until my prescribed 1 am bedtime that I was giddy with excitement. If I kept dozing every few minutes in front of the TV then sleep was bound to come once in bed. It did, but only for a short time and I was back awake having to deal with the 30 minute time allowance to get more. Night 2 saw about 2 hours of broken sleep and that was only obtained because exhaustion forced me to cheat on my therapy rules a bit.

 

Being so sleep deprived and disappointed with my early sleep performance during this therapy brought back the anxiety that I had been battling. It got so bad that I started to fear for my safety. I'm glad that we do not keep a firearm in the house. I feel kind of trapped since the therapy is looking like it is going to be very hard on me, but giving up and returning to my regular insomnia pattern is not an option because I was not getting enough sleep.

 

I'm not sure how I will get through this day and stay awake until 1 am. Luckily for me, I have a very supportive wife who helped talk me down all night long without complaint every time I started freaking out. Can't wait to see even a little progress, but the anxiety is going to slow that down.

[[MT...]]

Aloha, I really feel for you. I figured out pretty quickly that I needed to take a couple of weeks off of work (I work two days/week) to do the program. I was having the same problems as you but I also felt some hopefulness because the treatment made sense to me. I've accumulated a lot of mindless activities I can do when I'm brain dead from not sleeping, and that's most of the time:

--I record a lot of distracting TV.

--books when I can concentrate enough (at times I read young adult fiction because it's easier to follow and has fewer characters), magazines for other times.

--I'm a Huffington Post fan. Every day they send me an email with different kinds of news. On bad days I go to the "good news" section, read uplifting stories, and watch lots of cat, dog and other animal videos.

--zentangle.

--I force myself to get some exercise even on most of the days after zero sleep. Sometimes I can make it an hour, sometimes it's 15-20 minutes but it makes a difference in terms of how restless I am at night. At the least I try to do some push-ups and sit-ups but some days I'm just too weak.

--coming on BB, reading different sections, especially success stories.

--emailing.

--writing in a journal.

 

I find going back and forth between activities makes the time pass better. I hope you see progress soon!

 

Katie

[[al...]]

Thanks Katie,

 

After last night, I am declaring war on my anxiety since it is the one thing most holding me back from sleep. Today I asked my acupuncturist to mix me up an oriental medicine herbal treatment to help combat stress and anxiety. I also downloaded several anxiety talk-down sessions from YouTube. I plan on listening to these daily to get back into the grove. In addition, I am reading about acceptance, minfullness and living in the here and now to better help me live with my situation.

 

I would really rather be offering up words of encouragement to others in this forum, but I guess that sometimes I need them myself.

 

Aloha,

Kurt

[[Si...]]

I'm right there with you Aloha. I had terrible sleep for s few months after coming off Lorazepam. The I got better and slept great between months 5-10. I got the flu in March and it has crippled me since then. I slept great last Friday and Saturday night. Last night I had really light sleep for only a few hours. Hoping tonight is good for us all. I have an appointment with a sleep specialist in two weeks.

[[MT...]]

Aloha, it sounds like you have a great plan there.

 

Siggy, I'm sorry your sleep is still so bad. Let us know how things go with the sleep specialist. I hope it helps.

[[al...]]

Siggy,

 

I'm glad that you have been having some good nights of sleep mixed in with the bad. That will help keep your body and mind going. I'm trying not to focus on wanting something that I do not have right now, but boy would I love a night or two of good sleep again. I can sort of handle the physical effects of sleep deprivation, but I am finding that the emotional effects are a lot harder for me to deal with. Last night the concept of suicide kept creeping into my thoughts. Never in my life has that happened. This morning I feel a lot stronger and have totally rejected that option and will discuss last night with a therapist that I am seeing.

 

Hopefully you will find relief with a sleep specialist. Sometimes we just need to put our problems in the hands of experts who are trained to deal with them. Good luck!

[[Si...]]

Thanks, I actually slept lqst night too. I'm hoping it keeps up. I'm still going to the sleep specialist. He's also a pulmonologist. The doctor is part of only two accredited sleep centers in Atlanta. Found out the other day my younger brother went to a sleep specialist too. They are testing him for sleep apnea.

 

I've had the suicidal thoughts too, which is really not like me at all. It's mostly in the middle of the night when I'm wide awake and feeling hopeless.

 

Hope y'all have some better nights (and therefore days)

 

[[jo...]]

It works for some people but not others. Insomnia was what got Me into this mess in the first place. My insomnia was caused by My life long depression and it got really bad, went one week without sleeping . Only micro sleep and I almost  died, sleep is job one and so important. I was put on low dose K and it drugged Me up but felt like I was hit by a truck after it wore off.

 

In the end I regained around 61% of My sleep on My own through natural ways suppliments etc and getting Myself tired kinda like this therapy however My sleep is still broken and light. Hope it works for You. I can tell You to avoid any stimulants especially caffeine if You suffer from insomnia also alcohol is no good either.  Research the web for natural ways to regain sleep, all medications only work temporarily and You soon end up back to square one except worst off than when You started. Drug commercials on TV by themselves are enough to keep a person awake and anxious.

[[al...]]

Thanks, I actually slept lqst night too. I'm hoping it keeps up. I'm still going to the sleep specialist. He's also a pulmonologist. The doctor is part of only two accredited sleep centers in Atlanta. Found out the other day my younger brother went to a sleep specialist too. They are testing him for sleep apnea.

 

I've had the suicidal thoughts too, which is really not like me at all. It's mostly in the middle of the night when I'm wide awake and feeling hopeless.

 

Hope y'all have some better nights (and therefore days)

 

 

Siggy,

 

I went to a sleep specialist and spent a night in a sleep lab. Pretty interesting stuff. You might find it to be kind of fun. I was diagnosed as having light sleep apnea and was prescribed CPAP therapy. I tried it for awhile, but it was at a time when my insomnia was really setting in and getting used to sleeping with the device did not make things any easier. I returned it, but may consider trying again once my insomnia lightens up.

[[al...]]

Wow, just had two consecutive nights of 0 sleep following 2 nights of badly broken sleep totaling about 3 hours per night, preceded by a third night of 0 sleep during this week. Everyone says that sleep will come sooner or later, but it is getting harder and harder to believe. This sleep restriction stuff has temporarily (I hope) made my insomnia much worse.

 

The hardest part is staying awake to my prescribed sleep time long after I kissed my family good night. My neck really hurts from all the times I nod off in front of the TV and jerk myself awake. Oddly, when I do go to bed, the nodding-off stops completely. I could perhaps just sleep in my chair in front of the TV, but the goal is to recondition myself to sleep well in my own bed.

 

Unfortunately, getting through this sleep therapy requires mental and emotional strength, but lack of sleep saps this strength away at an alarming rate. I am a basked case now and wonder what I will be like following a couple more sleepless nights.

[[MT...]]

Aloha, I hear how exhausted you are. I understand how your internal resources for strength get depleted from the insomnia and that the sleep therapy requires that strength. I found I had to get up and move around frequently, get a drink of water, even doing something on my computer, and so on. As soon as I started to get sleepy when it wasn't time I'd do something. This is very hard to do when you're already tired. Is there anyone in your family that could help you for part of the time? I did that some too--stayed up with family for part of it.

 

So that the computer doesn't mess you up with the blue light (like TV and anything backlit) there is a free program called Flux you can download that filters out all blue light on your computer (and phone if you wish) so the light won't disrupt your sleep like it usually does by interfering with the release of melatonin. I find it helpful. When I'm not sleeping there are so many hours to kill and having something besides TV and reading to do, and something that won't disrupt sleep, is super important.

[[al...]]

MTFan,

 

Thanks for the info about Flux. I just downloaded it.

[[al...]]

After several nights of very little or no sleep at all, I was finally able to fall asleep within the allowed 30 minute time period and sleep through most of the 5 hour prescribed sleep window. This Cognitive Behavior Therapy for insomnia and sleep restriction stuff might just do what was promised after all (fall asleep every night soon after head hits the pillow).

 

Strangely, my body began to get used to not sleeping. I was able to attend my yoga class and get in long cardio workouts at the gym without crashing. In fact, yesterday I reached a point of calmness and alertness that I rarely was able to obtain in the past. I think that the trick is to take real good care of yourself during the sleep restriction to help reduce anxiety and conserve energy. The yoga, gym workouts, acupuncture treatments, herbal medicine and daily meditation (stuff I would never think of doing before) really seems to work hand-in-hand with the sleep therapy.

 

Hopefully the improvement will continue.

[[MT...]]

Hooray, Aloha. So glad to hear that you're feeling stronger and that you got some sleep. I hope it continues. You're going to make it through this

[[...]]

If you need sleep then sleep, the rule is go back to bed when you feel SLEEPY, not stay up lying in bed, there are no hard and fast rules to this!

 

I think your schedule is too extreme, yes moving your sleep time forward helps with sleep onset but 30mins is too much of a gap, 10-15mins or until you feel SLEEPY

 

And again, if your body is ready for sleep (on the sofa noddy off) go to SLEEP! You have a short window where your body puts you in the correct state for sleep (body temperature, hormones etc) also the time of day (circadian rhythm)

 

If you need 8 hours sleep then go to bed at 12am and sleep until 8am if you wake, go to the toilet, make a drink, then go back to bed.

 

Also you should hire a professional to work with you through the process, a lot of people on here and everywhere else "have the cure" or know something which may or may not be medically correct.

 

 

[[al...]]

Hi Zuko,

 

Actually I am doing the sleep restriction as part of a broader cognitive behavior therapy for insomnia approach through a licensed therapist working with a sleep center overseen by a M.D. I was told that they are following a pre-established treatment approach with decades of experience behind it. I was advised to follow the program without making up my own rules in order to have the greatest chance for success.

 

The rules are very big on limiting attempts to fall asleep to 30 minutes or less, but there is no set time as to when I can return to bed to try again. If I start dozing on the couch in 10 minutes then I can return to bed for another attempt of up to 30 minutes. My body is to be my guide. Restricting my sleep window to 5 hours gives me a chance at a minimal level of sleep to retain my health while helping ensure an adequate sleepiness each night at bedtime. The goal is to overcome negative conditioning that connects bed with past stress from the insomnia. Oh yeah, I am allowed one 45 minute nap a day as long as it is done by 3pm.

 

I am told that it is not uncommon to go up to a week with little or no sleep with this treatment. Eventually your body will give up the fight and fall asleep and you will be conditioned to fall asleep quickly every night.

 

So far it has been easier to get through the days than I though (I did take a leave of absence from work), but the final couple of hours before my 1 am bedtime is hell. My neck is sore from all the times my head pitched forward or sideways then snapped back as I caught myself starting to doze.

 

Progress appears to be in fits and starts. Many nights saw no sleep at all while one night I was blessed with falling asleep fast and using up most of my 5 hour sleep window. Yesterday I fell asleep napping for the first time since my insomnia started, but last night I only had 1 hour of sleep. It is hard not to feel some pressure due to the 30 minute sleep attempt window.

 

Since I do not have a plan B that will allow me to see the start of another summer, I am going to stick with this program and beat this insomnia into the ground.

[[MT...]]

Aloha, I think you're going to find this helps a lot given time.

[[lo...]]

Awesome job Aloha. I know this is hard as all hell, but you got this! My body is getting more and more conditioned to my protocol. I stayed at my parents place this weekend and was worried about this screwing things up, but I did totally fine. I slept much better at their place than I did 1.5 months ago when I wasn't doing this. Also, my sleep doc had me purchase Blue Blocking sunglasses, so I can keep watching TV before going to sleep without being bothered by blue light.

 

 

[[al...]]

Hi Longdistancerunner,

 

Good to hear that everything is working well for you with the therapy. I looked into getting blue light blocking glasses, but could not find any that blocked out a good portion of the blue light. What brand did you get, or is Blue Blocking the brand?

 

[[lo...]]

Hi Longdistancerunner,

 

Good to hear that everything is working well for you with the therapy. I looked into getting blue light blocking glasses, but could not find any that blocked out a good portion of the blue light. What brand did you get, or is Blue Blocking the brand?

 

It's the official BluBlocker brand. How are you doing today?

[[al...]]

Hi Runner,

 

Thanks for asking. It is 5 am at my place. Had a very bad night and I'm not doing so well. My initial gains with the sleep restriction therapy have reversed. Last 2 nights saw only a couple hours of sleep and I gave up trying for tonight. Lack of sleep is sapping away my positive spirit, at least for now.

 

I worry about not having a plan B to try if for some reason this therapy does not work. I'm not sure how I can possibly live with this severe insomnia if it can't be defeated. This causes me to have some pretty unpleasant thoughts when I start to get worked up at night. I actually feel as if my life is on the line at times. Something to talk to my therapist about.

 

What makes thing worse for me is that my wife is starting to loose too much sleep since I keep having to get in and out of bed and often am in need of help in calming down. Our family needs to have someone able to keep things going. I can only hope that something good happens soon.