INSOMNIA: Done EVERYTHING right, but still relapsed?
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- Опубликовано: 27 сен 2024
- Insomnia relapses happen to everybody - but when you are in them, they can create an awful lot of suffering. Not just because you are worried you may go back, but because they just feel really unfair.
But are they unfair, or are they just a normal part of normal sleep?
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About
Joseph Pannell is a former chronic insomniac of 20 years who overcame it with CBT-I. After training in the field he now works with the Sleep Charity, mans a national sleep helpline and runs an online sleep consultancy business. He has worked with some of the largest organisations in Britain including Network Rail, The Ministry of Justice and NHS Health Education England and the MOD.
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INSOMNIA TALKS and the information provided by Joseph Pannell are solely intended for informational and entertainment purposes and are not a substitute for advice, diagnosis, or treatment regarding medical or mental health conditions. The views expressed on this site, or any related content should not be taken for medical or psychiatric advice. Always consult your physician before making any decisions related to your physical or mental health and do not make any behavioural changes before doing so.
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Omg I’m cured! I found your videos one morning and binge listened to your book on audible that day. Slept great that night and have for 3 days since then. The anxiety disappeared overnight and I’m creating a sleep drive now. I’m sure I will have bad nights sometimes but this literally worked in 24 hours!
And not only that but it gave me new insight into my other anxieties and I have made a huge leap in my mental health in 3 days! Crazy! Thank you for doing the videos here so people can find you! I would never have stumbled across it otherwise.
Crazy. I’m just floored by the transformation
To be fair it’s only been a year of insomnia for me but still!
Hi, I'm really happy how much much book has helped you!
(for everyone else I have two - 'You Can Sleep Too! - and Your 2 in 1 CBTi book" which contain my first and second - all on Amazon!)
I think often people get very fast results as they just learn very very quickly - it's now OK to stop looking, it's Ok to stop the struggle, finally I know what to do and what not to do, so I can stop all the 1001 nonsense hacks, tips and tricks and just simplify.
Imagine being lost in a forest for days walking around in circles and then you stumble across a sign post and a tarmac path saying 'THIS WAY' to the car park. Even before you reach the end you are 100% more relaxed than before because you know the way out.
It is not the first time I have heard this about other mental health disorders. I had a client who I didn't know at the time had an eating disorder they were very restrictive / obsessive around food. They stopped fighting everything and on the call said not only is she sleeping well, they had a chocolate bar and ate junk food in the same week! I didn't know the significance of this but it turned out they had limited there diet to only 10 healthy items and this was the first time in a decade that they allowed themself to do this - and not only did they not catch fire, they felt great!
But yes, i'm really happy for you! And I'm very pleased that you are applying the same teachings to other areas of your life and already seeing results, health and happiness - wonderful!
Would you mind doing me a massive favour and leaving me a review on Audible? Literally just copying and pasting what you wrote here would mean the world to me as especially on audible I don't have that many reviews yet so something like this will make a massive difference.
Any help you need, just comment on any of my videos and i'll get back to you!
I think one bad night is tolerable (more or less) but two feels like a horrible relapse. Thanks for the video. It was reassuring to hear.
Yes, a good term for this is tolerance threshold. I can cope with 1 bad night but 2 is completely unacceptable to me.
The problem is, if two are unacceptable - that increases the chance that you throw everything out and go back to the warm baths, the kiwis, the restricting of your life etc.
It comes with the confidence, this works, I have proven to my self it does, there are 1001 variables that affect sleep and I cannot control them all and I don't won't them to happen but I know 2 nights of poor sleep for whatever reason, or no reason at all are possible. But as long as I don't change anything and I just stay the course, eventually this will pass and the lion that was right in front of my face will no longer be there.
It's easier said than done, and you don't have to be happy about it, but not being happy about it and not completely panicking are two very different things.
@@InsomniaTalks thanks for the detailed response!
Insomnia will happen or relapse if you set sleep as a goal.
This is 100% spot on. It is however virtually impossible for someone with insomnia to truly take on board.
You need to prove to them first that they can sleep (through the right behaviour changes that physiologically rebuild their pattern of sleep / body clock and sleep drive ) and lead them down the path of leaning into rather than running away from their fears around sleep (exposure therapy - to take away the power of insomnia) and take away the anxiety around sleep, and then eventually it clicks that forcing sleep is literally impossible, it is just a natural physiological process and the less you do to sleep in the given moment, and the less you do to control sleep during the day, and the less obsession, the better you sleep.
99% of what I do is to get people to do far far less until eventually they do nothing and realise what you just said - but it's a very very hard concept - but yes it's the end goal! it just takes quite a few stepping stones in the middle, but if if people can get there with as few stepping stones as possible, perfect.
What’s your take on when people say “sleep debt” and that you need to catch up on lost sleep?
Also do you think that there is an optimal ballpark window for your sleep cycle? There are some who say that sleeping earlier (like before 11-10pm) and waking earlier is associated with great recovery and boost health. Love to hear you take thank you!
Hi, sleep debt doesn't work like people think it does.
IE long term sleep debt - I've slept poorly for 10 years so I need to sleep extra for another 10 years - nonsense, you can get it back in literally 1 night.
Also, in terms of short term sleep debt, that also doesn;t work like people think it does.
IE if you 'lose' 3 hours of sleep on the Monday night you need to catch up 3 hours extra on the Tuesday - no.
There was a study by Colin Espie that shows you only need to catch up on 1 third of the hours lost. This video here explains why:
ruclips.net/video/y1xLU3cPk88/видео.html (warning this was one of my first videos in front of the camera and I wasn't used to it yet, it looks like i've had 20 cofees as I was a little nervous!)
As for the timing of the sleep window, it doesn't really matter. It's helpful to align with the rest of the world and yes getting up earlier will mean you get more daylight overall so it's certainly my preference, but say you're someone who likes to go to gigs / do lots of things in the evening, setting it later will align better with your lifestyle.
Always balance and the middle way with my teachings - some people like to get up at 5am with the sun - amazing.
Some people like to go to open mics and have a fixed bedtime of 8am instead - good stuff. Neither of these are too extreme and horses for courses.
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Hi Joseph, i have an interesting sleep problem. I sleep around 6,5-7 hours per day, without any external disturbances. But quality is unstable: one day I have really a lot of dreams, after this i will be tired all day long. Not like exhaustion after insomnia relapse, but far from being energised. Next night I will have little to no dreams, and feel perfectly at the day. It’s like some imbalance between sleep stages, one night more nrem, next rem, and this cycle continues. Do you have some advice about this shit?
Hi, I wouldn't say that this is actually that unusual but there is a few things going on to explore why it's happening.
First off the poor night of sleep.
Few things going on here. It's after a good night of sleep - so the sleep drive is down, so the quality is not as high.
Secondly, very vivid dreams are a sign of disturbed REM sleep. There is something in the brain called a startle response which is a safety mechanism where the brain will wake you briefly (but unconsciously) when you here a noise - analyse that noise to see if you need to pay attention to it, wake you properly if you do (someone checking your door handle for instance - even if the volume was very low, this would definitely wake you!)
Lorry driving past, even if the volume is much much higher than someone checking your door handle, in most instances you wouldn't fully awake.
You become aware of dreams during the brief awakening's - people who say they never dream is not true, everyone does - they just have very good quality REM sleep.
Hyperawareness / anxiety can also make for lighter REM sleep.
It's also probably become a learn't behaviour / pattern - oh no, I know this - this is the night I ALWAYS get the poor night of sleep - anxiety increase, more worry --- poor night of sleep.
So that's the poor night.
On the good night of sleep your body prioritises on getting better quality sleep to compensate.
People become obsessed with sleep duration and think that if they slept poorly the previous night they have to sleep more the next night to catch up.
That's not how it works, there was a study by Colin Espie that shows that duration wise you only need to catch up on 1 third of the hours lost- however what does happen is the quality of your sleep will improve. So the quality of all your sleep stages, including REM will be improved so you will have less awareness of your dreams the following night. You will also likely have improved quality.
So your sleep drive is up and the body is prioritising better sleep quality.
Also, the learnt behaviour is now working in your favour - I know this, this is the night I always get a good night sleep, you relax, less anxiety - better sleep!
So what to do.
I'd look at better quality sleep overall - so fixing that wake time, light first thing / exercise during the day / going to bed when sleepy. As you don't have chronic insomnia anymore, you really don't need to go back to anything more extreme to fix this but tightening the behaviours is good. Also i'm sure you are doing this already but ear plugs dampens down the startle response.
There is also the the pattern 1 night good 1 night bad you'd like to break .
So you want to stabilise it to break it - you said you sleep between 6.5 - 7 hours ---- am I right in assuming on the 'good night' the sleep duration can be higher? so you are going from poor quality, to catch up, to poor quality - rinse and repeat.
Perhaps set a gentle 7 hour window for 1 - 2 weeks - this will improve the sleep quality on the poorer night and will break this pattern.
This will help physiologically, and psychologically as well as once you have seen this pattern no longer plays out you want be fixated on it.
Hope this helps, glad your insomnia is behind you (apart from perhaps a relapse) please celebrate how far you have come as well with that! you overcame insomnia through thought pattern and behavipur changes and a good understanding of sleep, fixing this is nothing compared to that!