Sleep Restriction therapy saved my life. An update from jittery18.

[[ch...]]

Firstly..very sorry for the really long post  ..and also very sorry for kind of hijacking jittery's thread.

 

Chantillie, I was writing to you while you were posting. I am over a year off the benzo and ambien so this should be a good time to try the sleep restriction. I can't believe you tried it so early in withdrawal. I can't imagine you being able to sleep at all. I had to use benadryl and unison for a long time.

What other CBT practices have you used successfully? Are you working with a sleep psychologist like Jittery? I want to make this work and want to get as much information as possible to make it successful. I need some sleep.

I wonder if the small chocolate bar I had at 2pm could be why didn't sleep? I am very sensitive to caffeine.

 

I was under the impression that since I was a short-term user, I would be okay to jump off and deal with mild tolerable sx (I was wrong  the sx was horrific for some time. But I'm getting through it!). I thought some of the most uncomfortable feelings were due to prolonged exhaustion, and not so much from interdose wd. I remember feeling very angry about having to take this "poison" for something that I was supposed to be able to do naturally, and I guess the anger caused me to CT and jump onto CBT as a challenge to myself right away. 

 

My experience in the first week was sleeping well one night, then not sleeping at all the next, back to sleep well one night, then to not sleeping at all for two nights, then broken unsettling sleep for a few more..it was very hard, and really confusing. I understand now that I was also going through rough wd at the time.

 

Other CBT practices basically meant changing my entire lifestyle. In the beginning of sleep restriction, I sometimes found that by the end of the night I was actually too exhausted to easily fall asleep..strange right? As though I had some adrenal fatigue occurring. Then I learned that as I started going outside a lot more in order to get sunlight in the day, and to keep my body active to generate more energy, I stopped having my perceived "adrenal fatigue".

 

anyway...to list:

- reduced stress and daytime anxiety as much as I could, where ever I could. (avoided all arguments, even certain people!  )

- cleaned up my diet (no more junk food, less sugar, less food high in fat, more vegetables)

- cut out all caffeine and tried to consume food that was good for GABA (spinach, potato, almonds, walnuts, whole grains)

- drinking a lot of water

- regular exercise (around 3-4 times a week, mostly taking long walks outside)

- gave myself an allocated time in the day where I let myself worry and think about doubts regarding my sleep situation, and then restricted the rest of the time to being positive, or casting out those thoughts.

- keeping a sleeping diary in order to document my progress. it allows me to see what might be working or not working to help my sleep, what to change, etc.

- relaxation techniques...started doing mild yoga almost daily, positive affirmations, breathing/meditational exercises

- simply staying away from the bed all day until the moment I am supposed to sleep, keeping my bedroom a clean and comforting environment

- using f.lux(http://stereopsis.com/flux/) on my laptop screen in order to reduce blue glare if I'm on the computer at night

- stop using the computer 2-3 hours prior to sleep

- eventually, stop thinking about sleep/sleep issues throughout my day and stay present in the moment

 

I started researching and learning more about the science of sleep, and the impact of sleep deprivation in order to correct dysfunctional beliefs I had regarding my problem. For example, having poor sleep or no sleep one night does not necessarily mean the next day is completely ruined, or that we will be absolute wrecks. We may feel pretty bad but our day is typically ruined largely due to our catastrophizing attitude towards how the night didn't work out, and not so much how we didn't sleep. I used to be very paranoid and worried over what insomnia was doing to me, I thought that I was going to die and that my brain simply went wrong somewhere and that I'd never be able to sleep properly again. Both untrue, and I realized it more and more as I learned about sleeping.

 

Also..no, I am not working with a sleep psych. I did get a few weeks of assistance from two lovely individuals who encouraged me to do CBT though, but other than that it has been a self-guided experience. The other people I know who are working with CBT tell me that going to a sleep psych is not vital. And in my own experience, I think that having a sleep psych would have been helpful, but is not necessary to make it work. There is enough information on the internet as well as in books for people to become aware of cbt practice.

 

Thanks Chantillie. I really need the details. It helps a lot. So when you get up after about 20 min. do you stay up until you feel really sleepy or go back to bed after about 20 min anyway? What if you never feel sleepy? Do you just stay up all nite? that is how I was last nite. Never sleepy except at 10pm. I was yawning and tired but somehow never clicked into sleep. Just listened to the rain cd and never went to sleep. Then I passed my sleep window and was wide awake. The melatonin did nothing or the Rescue Sleep. I'm just afraid I'll have other nites like this where I'm just awake. So what do you do then....just stay up or go back to bed and try again?

Also, can you read in bed and listen to cds or no?

Thanks

 

When I get up after 20 minutes, I don't go back to bed 20 minutes later if I don't feel sleepy..I tend to distract myself and not think about when to sleep until I simply start 'feeling ready' to go back. This might even mean simply sitting on the couch in low light and not doing anything at all sometimes..it clears my mind and allows me to become relaxed. Other times I might read in another room, or listen to music on low volume. I may do a little bit of stretching. I know that it's encouraged to stay away from high stimulation during this time, but if I am unable to sleep due to anxiety and racing thoughts, I find that a good comedy show (30 minutes) allows me to feel better. I've done that a couple of times. To be honest, I have never stayed out of bed for longer than probably 1 1/2 hours when doing these things. Although it may appear that I was losing sleep by getting out of bed, the truth is in the end, I am probably sleeping for as long as I would have if I were in bed during those moments.

 

When you start on your sleep restriction, how you cope will depend on your own individual preference and what makes you feel relaxed, so you may find yourself tweaking some things to work out best for yourself.

 

What were you doing while you were up last night after you couldn't sleep? I'm not sure if it's true but perhaps the reason why you didn't feel tired again was because you were wired from your frustration. The best thing to do is to not catastrophize whenever you cannot sleep, so that stress and anxiety can be reduced. Our minds have a huge power over what happens to us. There's this anticipation of failing in being able to sleep that creates a self fulfilling prophecy. You acknowledge that you are a person who is struggling to sleep, and that is why sleep becomes a bigger struggle than it was supposed to be. All of that is true for why I couldn't sleep..maybe it will ring true for you too.

 

CBT mentions that you should not read or do anything in bed apart from sleeping..but I have listened to my hypnosis tracks in bed before drifting off to sleep, and has worked out fine for me. If I don't sleep within 20 minutes though, I always get out of my bed.

 

Chantillie

 

 

[[ma...]]

Great information Chantillie. I appreciate all the help I can get. This whole sleep thing is so hard to understand. Sometimes you can just go to sleep easily and others like last nite, not at all. I have to say I was not stressing about sleep till  about 3am. I just laid in bed listening to various cds. My favorite is Insight which is rain sounds. Sometimes I do sleep tracks but at times I don't want to hear talking. I think sometimes it keeps me awake, other times it puts me to sleep. I also got a few ambient sleep music downloads. I really only like one, which is ocean sounds. They don't put me to sleep, but do help to relax. Sometimes reading relaxes me but other times I get to into the story and wake up. I really haven't been stressing about sleep. That's why I'm frustrated today. I really was relaxed so I don't know why I didn't sleep??

I  try to do many of the things on your list tho I did have some chocolate yesterday. It was a small amount but maybe that is why I didn't sleep. Possibly an additive in the marinated artichokes in my pasta. Sometimes those things really impact your sleep. Now I'll be eating in restaurants for 5 days so who knows what's in the food. I'm taking my unisom but will try the sleep restriction when I return. Jittery's success has really motivated me to try it.

thanks so much for the detailed e-mail. It really does help!

[[do...]]

Thank you so much for your post.  My sleeping problems are not as severe as yours were.  But your information (especially about getting up for 20 minutes, no lights, try again) is valuable.  I have been just giving up after just two or three hours and spending another exhausted day for weeks. Life just isn't worth living like this.  Thank you.

[[Kl...]]

Dear jittery,

 

I am thrilled for you!!!!  Lots of love and hugs, KL

[[ma...]]

Jittery,

 

What fantastic news, what an accomplishment!  I'm so happy for you--congratulations!

 

Your post has given me hope for my relentless insomnia of going on 8 months now. 

 

Of course I have some questions for you.  When you say "bright light" I take that to mean computers, but does this also include television?  I know this isn't the best habit in the world, but it's allowing me to get some sleep.  I've been watching TV on the couch until the sleepy feeling comes, usually by 2 am, and sleep about 3-4 hours.  On a good night I get 5-6 hours.  I don't go on the computer, but watching TV helps take my mind off the sleep anxiety. 

 

I'm also curious--you said your husband snores.  My boyfriend snores too and I'm beginning to think this has been contributing more to my sleep anxiety than I realized.  He doesn't always start snoring right after he falls asleep, but I think I have in the back of my mind that once he falls asleep I better fall asleep soon or I'm out of luck--once he starts snoring, forget it!  He also uses Breathe Right strips and still snores.  I know he can't help it, but it's still awful.  He had a sleep study done too, but there doesn't seem to be anything that can be done about it.  How much do you think your husband's snoring contributed to your sleep problems?

 

Mal

 

 

[[ji...]]

Hi Mal,

 

My sleep psych told me no TV or anything with bright lights. Bright lights disrupt the melatonin production in the brain and make your brain think it's time to wake up. I really suggest doing this method. You may still have bad nights but they are less frequent and the good nights are really good.

 

I dirupted my pattern on a trip we took and I had to back up my bedtime again, but last night I slept really well from 12-6am without waking up even once so hopefully I'm back on track. Tonight I can move my bedtime back to 1130. I always feel like I could sleep in more too if I were allowed

 

My husband wears a CPAP machine, so his snoring isn't as bad anymore. But he rolls around and fiddles with his mask all night.

 

Snoring can arouse you from sleep when you don't even know it. It can affect you "waking up" after being asleep and I definitely think it can prevent you from falling asleep. Is there a guest room you can sleep in, or maybe even on the couch for awhile while you get your sleep pattern reestablished?

 

 

[[ma...]]

Hi Jittery,

 

I just came across this article that could take some of the pressure off for you, and a lot of us.  I just created a new topic with the article. Turns out that maybe we don't really need to sleep in that elusive uninterrupted chunk of time that we think we do.  Let me know what you think.

 

http://www.bbc.co.uk/news/magazine-16964783

 

I seem to want to sleep in two phases naturally.  Where I've been going wrong is that I get anxious because I've been so programmed to think I should sleep in one 8-hour stretch.

 

I am sleeping on the couch these days and have been for the last few months.  As for CPAP machines, I know a lot of people who do the same thing your husband does.  I'm assuming he has to wear it for sleep apnea--is that true?  I know for some people that condition can be somewhat dangerous. 

 

Mal

 

 

[[...]]

I had to put a bed in my downstairs guest room.  My husband is a snorer and a constant mover.  After I slept a full 4 1/2 hours in a sleep lab and had no physical affects keeping me from sleep I knew it was him.  I sleep in 3-4 hour windows.  I posted an article in the insomnia thread about the 8 hour sleep myth.  The bad thing for me was that when I woke up after 3 or 4 hours I would hear him snore and it would stress me out that I couldn't go back to sleep.  Now, that I sleep alone when I wake up I have no stress.  I just lay there and relax and I generally fall back asleep within the hour.  I do wake up multiple times though.  White noise helps me a lot.  When we have to sleep in the same room, a loud box fan helps me.  Reading that article did put my mind a little more at ease because I feel like my body does that same thing. 

[[Sa...]]

Jittery

 

I am so thrilled for your progress. This is great and inspiring information for everyone, me included. I really am beginning to believe in the anxiety spiral that can disrupt sleep. Case in point, I've been sleeping quite well but my husband went away for two days and it threw off my routine.

Apparently I underestimated how much my bedtime ritual depends on my husband and I watching a show and then going to bed at the same time, (that routine 'triggers' me to fall asleep) plus knowing he was gone----all of that led me to get about 4 hours of sleep in the space of 72 hours. As soon as the "What if I dont' sleep?" seed was planted in my head, it was all over. I couldn't sleep. When he got back home, I got fell right back into my sleep schedule as if nothing had happened. I do believe that anxiety (I didn't FEEL anxious, but there was apparently enough adrenalyn there to keep me awake) can be extremely insidious and even subtle. My heart wasn't pounding. I felt tired. I just couldn't sleep. My body's alert system was keeping me from sleeping.

Next time I have my routine thrown off I'm going to try some CBT methods to see if they help. You've given me reason to believe!

 

-Sarah

 

[[Gl...]]

to do this right, do you have to go to bed and wake up at the exact same time every night or can it vary a couple of hours?  Lately I've been sleeping from 4-6 AM and waking up at 2-4 AM, but I had some insomnia and only slept from 5-10 AM last night.  Now I'm really tired and not sure if I can make it to 4 or 6 AM..not sure what to do.  I was able to keep the 4-6 AM schedule for 4 days or so.

[[mc...]]

Jittery - congrats on your success with the beast...  quick question... my issues isn't falling asleep - it's adrenaline waking me up - super vivid dreams - early morning awakening - it all seems to be related to Benzo w/d - my nervous system is amped up.  Do you think the cbt sleep restriction would -help - I know you said insomnia is 99% psychological - but couldn't it be physical also?  - I don't have a ton of sleep anxiety ( I fall asleep like a child ) but it's my body wanting to wake me up and adrenaline surges  - you mentioned you had them - but my adrenaline doesn't seem like it's from anxiety but rather from my body with it's wounded cns  - It seems like cbt sleep restriction works real well with sleep onset insomnia - but not sure if it would work for the type I deal with - you mentioned being adrenalized all the time - what's your take?

 

thanks!

 

mcDuck

[[Ti...]]

McDu k the sale thing happens to me and I am still on the benzos and trying to stabilize before resuming taper. Oh my goodness you are stop gettImg awOken by adrenalin surges 18

Months later? I am so sorry.  This really scares me too!  Has it improved at all for you?

[[Me...]]

I echo Tina - 18 months out and still getting awoken by adrenalin Rushes? - that is scary.  I am so sorry - just a thought wouldn't a Pur Bloka or Beta Bloka help.  I was prescribed one by my GP - not that I have any BP problems but he said it would help with the adrenalin surges and pulpitations.  I got the medication but did not use it?

[[Ti...]]

Meee I see you are up tonight like me. I am so tire just can't drift off. SlePt from 9:30-12:30 and have been up since. I added Valium several weeks ago which seemed to helP but as soon as tOok away Ativan insomnIa came back. So added mOre Valium and this time didn't helP at all. This Was Doctors recommendation. I am so discOuraged. How are you doing?  Has tapering made the insomnIa worse for you? Ate you taking anything else? Hugs to you, Tina

[[ji...]]

Hi guys...

 

Glyn.. No the bedtime can't vary at all, even by fifteen minutes...that's how sensitive the circadian rhythm is.

 

Mcduck.. It helps with any insomnia. Everyone wakes up 8-9 times a night. With insomniacs, we wake up and immediately the panic starts. What may be happening is your body wakes up like it should before a next sleep cycle, and your mind immediately realizes you are awake and you go into fight or flight.

 

Try the method...It has worked wonders for me. My adrenaline at night and morning is gone.

[[ji...]]

Hi Glyn....why are you sleeping from 4-6am? You should allow yourself at least five hours in bed.

[[je...]]

To those with the adrenaline wakeup problems please check out thread below on very low dose silenor

( doxepin).  I suffered TERRIBLY for months before I was even open to trying it so I understand the resistance. Ashton mentions doxepin for sleep, as well.

 

http://www.benzobuddies.org/forum/index.php?topic=49326.msg665210#msg665210

[[ma...]]

Hi Jittery. How are you doing? I just got back from 5 days in Palm Springs and my sleep was awful without Unisom. One nite I had to take a full pill which I haven't done in ages. Went to sleep ok, thanks to some wine and woke up and never went back to sleep. I'm going to give my body a couple days to detox from the wine I had on the trip and then try the sleep restriction.

Since I sleep 5-6hrs when lucky I guess I will try the 12-6. Do you set your alarm to wake up at 6? When you get up if you can't sleep in about 20min, do you stay up till sleepy(what if that doesn't happen) or try again in 20 min? Do you just keep getting up all nite if you can't sleep?

How long before you started sleeping fairly well? I'm scared but feel I have to try it. You've had such good results it is motivating me to try too.... Only because you were struggling so much and are now so much better.

Any further hints for success?

Thanks so much. Kathi

[[ji...]]

Hey Kathi...def stay away from the wine! I try again after 20 min. And yes, many nights I was up and down all night. It took me about two weeks to start sleeping 5.5 hours. Lately the baby's been waking me up at 5am and by the time I get back to sleep I about have to get up..grr. But last night I slept like a log from 11-5:15 when the baby woke up. I was just dozing when my alarm went off. So yeah, I set the alarm but put a towel over the clock!!! Not looking at the clock is so so imp. I have to ask my husband what time the baby got up bc I don't know what time it was.

[[ma...]]

Thanks Jittery. I'm so glad to hear you are sleeping. All things are possible....even sleep for us insomniacs I guess. I'm anxious to get started but also apprehensive about not sleeping and feeling lousy.

Will probably start next week.

Thanks again, Kathi

[[...]]

Jittery, does this help you get deep sleep? Sometimes my sleep is broken and I don't have deep sleep, only very light if not "half-sleep," where I'm not even really sleeping just like sort of the stage b/w sleep and consciousness. This is starting to wear me down, and I'm a little scared.

[[Gl...]]

I meant my bedtime is between 4-6 AM and then I sleep from then till 2-4 PM but I made a typo and said AM twice..lol.  If the circadian rhythm is that sensitive, how does it work for insomniacs?  Sometimes it takes an hour for me to go to sleep and sometimes only 10 minutes, so how would the rhythm be even if you're getting to sleep at different times?  Like say you pick 4 for your bedtime but go to sleep at 4 one day, then the next day you can't sleep till 6 or 7?  How does this work?

 

I kept a schedule of 4-6 AM to 2-4 PM for 5 or 6 days and then yesterday I could not sleep at all.  Now I've been up for over 30 hours and I can't sleep at all.  What do you do in this case?  Suffer and wait till your regular bedtime or go to sleep early?

[[ma...]]

Hi Jittery...the new sleep expert! I don't know what has happened to me but I had another nite that would have been zero sleep but after 3.5hrs in bed I took a 1/2 unisom. Had already taken tryptophan and 2.5 melatonin which did nothing. I was sleepy at 9:30, yawning and definitely having the sleepy feeling. Thought I would go right to sleep. Never did. I've been having this lately. I feel tired, sleepy feeling even, and then I don't go to sleep. Then I'm wired and can't sleep at all. One year and almost 2mos off. Does my body not remember how to sleep? The nite before I had 2.5glasses of wine and slept pretty well. Nite before that, wine, but wide awake in the middle of the nite with no more sleep.

I seem to be worse than I was in Dec. Don't know what I am doing wrong. Any ideas?

[[Ti...]]

Maltesemom--

 

I am going to be really blunt.  I really think a big part of the problem with your insomnia is the wine.  I don't blame you for going to it as a crutch for your insomnia, b/c it acts on GABA and is a quick fix.  But I truly believe that it is not allowing your brain and receptors to heal completely.  I am in no way suggesting you have an alcohol abuse problem, but at the same time I think you should look at the reasons why you are drinking wine.  Personally I have always LOVED wine and drank a glass a few times a week (prior to benzos w/d).  I know we live in the same hometown and there are AA meetins EVERYWHERE.  They are literally right in our neighborhood every single night.  Maybe you should consider going to a meeting just to see where you fit in.  I know alcoholics also have problems sleeping, so the two go hand in hand and you may find sympathy there and support.  Let me know if you want to the link of the website of where to find meetings--some are just for women!  Of course, you can always just "stop drinking" on your own, but you have to ask youself if that is really possible?  I hope to resume drinking wine someday but after what I've been through, I am going wait at least one full year after I fully heal before I even touch the stuff.  Not worth it.

 

Many hugs!!!!

Tina

[[ma...]]

Hi Tina. I have several friends in AA and none think I have a problem with alcohol. The problem is, is it affecting my sleeping, which would make it a problem...so in that case maybe it is. I have been a social drinker since college(San Diego State) and associate wine with fun, and friends. It is just festive and relaxing. Have I stopped for periods of time, yes. I have several non drinking friends who also have sleep problems and never took benzos and can't sleep without benadryl. I don't want to be hooked on unisom or benadryl but sometimes you just have to sleep.

I've had sleep problems all my life and am post menopausal so I hope this isn't just who I am, a non sleeper. Jittery has given me hope, to try the sleep restriction. I know I have to totally stop the wine and also unisom and melatonin which is very scary.

Are you in Yorba Linda too? That is amazing. I got my melatonin and tryptophan from Heritage Compounding Pharmacy in Brea and they are the ones that told me to go slowly in the taper. They helped several people get off sleeping pills by using their melatonin and tryptophan. It really helped me during the taper and I actually slept fairly well. It is just after being off everything that I couldn't sleep.

So, starting today, I'm off the wine again. We are going to Scottsdale to see friends for a week in March so I know it will be very hard not to have wine. They are big wine drinkers and lots of fun. See, there it is again...wine and fun. They just seem to go together...but not if you don't sleep.

Don't mean to sound defensive, because I did consider whether I had a problem with wine, but as I said, several AA members felt I did not. I never abused alcohol but probably use it more frequently that I should....especially for breast health.

Thanks for your comments. You never know when just the right information may be what you need to hear.

Kathi