Doesn't CBTi just create more SLEEP obsession?
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- Опубликовано: 27 сен 2024
- To be free of insomnia you need to stop focusing on sleep. Therefore, want doing a programme where you are asked to focus loads on sleep make your insomnia worse?
No! and if it does, you're doing it wrong! CBT-I is not the end goal, it's just a stepping stone towards it!
The only thing you can go is put the right behavioural changes in place to increase the likelihood of sleep happening and then just stay out of it's way!
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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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I've had to put the stabilisers back on 😂. Was doing well for 2 months then started getting greedy more time in bed earlier bed times etc trying to let go and it back fired putting me in a big speed bump. Hope I can fully let go one day
Hi, yes progress is never linear - I had lots of speed bumps throughout my recovery and when I thought i'd let go fully, here comes another!
But the more you cycle through them, the more you understand that they are just temporary and the more you have confidence that you can get out of them.
When this happens you stop fearing them, so they happen less frequently slowly over time and with less intensity, and eventually they fade.
Not that you'll get perfect sleep for the rest of your life however, as I always say even good sleepers only sleep well 80% of the time, but after a poor night or two you won't be happy about it, no one is! but you will see it for what it is, just a poor night of two that if you just keep on keeping on and not change your now good behaviours and thought patterns it will right itself.
After you have been doing well, It's the meaning you put on a poor night - week of poor sleep / set back that is the problem, not the poor night itself.
There are 1001 variables that effect your sleep, but you know you are truly free when after you sleep poorly you don't obsess, you don't data analyse, you don't try and work out what you did wrong, you accept (as before acceptance is not the same as being happy about it!) and move on.
But yes, don't worry, you'll get through this like you did the last time and eventually with enough water under the bridge all this will fade and you'll realise it's been months since you obsessed about your sleep.
It’s 4:08 am here. Think my sleep window being 3 am - 5 am.
However, just as I heard a ONE SINGLE SOUND from the wall, probably from my upstairs neighbor I don’t know, it triggered me into no-sleep mode. I literally felt sleepy and dizzy seconds ago!
Yes, just one single sound, it’s all it takes. I think this may be some type of misophonia situation going on as my body physically doesn’t allow sound or noises to happen as I fall asleep.
It’s that stringent and demanding. But what can I do? The symptom just gets worse over the years… Every time when I move and hunting for a new apartment it’s like a coin toss. I pray to god that I can get a place that’s quiet enough when I fall asleep.
What do you make of it doctor?
Hi for everything I mentioned in this video / first steps - take a look here: www.youtube.com/@InsomniaTalks/playlists
Hi. I have found SBTI very helpful. But aomehow I am wailing up 2-3 times every night. And every time I have been out and not asleep for until 3, I always wake up early. The thing is that I am tired and super sleepy when I wake up in the morning, but I just can’t seem to get back to sleep. It feels like some evil person is telling me “you just can’t sleep”. I just don’t know what to do because why would I want to go out having fun with friends late at night if I wake up super early and feeling sleepy.😭
Hi, so this is due to now having a regulated body clock which you've achieved through your behavioural changes (which is a good thing! - it's what you want) -- the body clock controls the timings of your sleep so whilst the sleep drive will be strong, as the body clock is set for an early waketime, then it is hard to sleep past this.
Think about when people fly to a new country and move between say the UK and Australia, it takes a while for the body clock to adjust to the new time zone.
As to what to do, I suppose it's about balance, if you now and again you are partying to 3am and perhaps only sleeping for a few hours, then perhaps it's worth it to have a good time with your friends? You'll just sleep well the next night because the drive will be stronger, yes you'll be super sleepy in the day -- but this is not insomnia!
If however you're doing this regularly then it's about looking at it and deciding if it's helpful to you and scaling back.
Just like a healthy diet is about good healthy food most of the time and cakes and desserts some of the time, a healthy sleep pattern allows for partying with your friends.
But the middle way! Never going out with your friends --- Controlling, limiting life, making you miserable - BAD
Regularly partying to 3am and it hugely impacting your life and sleep - Also bad.
So the middle way is what I'd suggest.
@@InsomniaTalksthank you. But what about the wake ups in the middle of the night. I actually can’t remember the last time I got 8 hours straight sleep, which I did all the time before. I am so exhausted😭
@@Sunkal18 Hi Sunakal, so this is the purpose of putting a sleep window in place and fixing that wake time, it is to reduce the amount of night time awakenings / reduce the amount of time spent in bed awake when they do occur.
This video here goes more into night time awakenings:
ruclips.net/video/4lFJnFIndqs/видео.html
And this video here explains the sleep window:
ruclips.net/video/V_e3n2DBbjM/видео.html
I would also recommend either counter control or stimulus control to teach your brain that being awake in the night is not a threat -- when the anxiey / fear / worry around this comes down so to will the frequency:
ruclips.net/video/pJ8hkgJJAgE/видео.html
I'd recommend however taking a binge watch of the entire channel just to get that real deep understanding of insomnia and how to overcome it, it's all here and it will be helpful, but it's not a matter of a few tips I can tell you that will fix a long term chronic problem.
I'd also ask - how old were you when you thought you used to sleep for 8 hours? if you were a lot younger than now and you fet like you needed this amount of sleep as a teenager, adults require less sleep, so it could simply be a case that by trying to get 8 hours of sleep you are asking too much from your body as actually you may need less.
Focus on quality rather than quantity through the right behavioural changes and once you get the right quality in place, the body will naturally tell you the quantity of sleep it generally needs (IE if you wake up at 7am and you notice you generally start to feel sleepy consistently around midnight, you need 6.5 - 7 hours of sleep on average)
But yes I would really advise taking a long watch of all my videos to get the understanding.
Thanks,
Joe
@@InsomniaTalks thank you so much. I Also really love working out. But I feel like I am destroying myself when I do because of the lack of sleep. Is it dangerous to work out when you don’t sleep? I feel like it’s the main reason I can’t sleep. Because I am scared that I can’t work out and get process.
But thank you so much again!
Hi doc , i want to ask what is it that i am actually dreaming while closed eyes n was sleeping but I always feel like that i wasn't sleeping even my mother told me that i was snoring . What's it
Hi, yes it's very very common for people with insomnia to think they are awake when they are actually sleeping.
You can still have conscious thoughts and still be sleeping.
This is due to the brain taking on a very active pattern of sleep.
I made a video on this very common, but confusing phenomenon here... ruclips.net/video/EbAeCyOc0Fo/видео.html
Hi doc , i want to ask what is it that i am actually dreaming while closed eyes n was sleeping but I always feel like that i wasn't sleeping even my mother told me that i was snoring . What's it
Hi, yes it's very very common for people with insomnia to think they are awake when they are actually sleeping.
You can still have conscious thoughts and still be sleeping.
This is due to the brain taking on a very active pattern of sleep.
I made a video on this very common, but confusing phenomenon here... ruclips.net/video/EbAeCyOc0Fo/видео.html
Hey man, thanks for your video!
What is your take on falling asleep afraid of noise?
I’m incredibly sensitive to noises WHEN I FALL ASLEEP. During the falling asleep process, I literally can not hear ANY noise or sound, anything like that will make me awake instantly. Especially the low-frequency noise - vibrations through structure.
However, once I’ve fallen asleep, there is no way for me to wake up until next day morning. I usually sleep pretty deep once I’ve fallen asleep, and I’ll only wake up after my body feels like it.
What do you make of this? I just can’t hear any noises when I fall asleep. Now… not that I really wanna mention it but I’m mentioning again, making my brain conscious about it, is that my apartment that I live in currently isn’t exactly very quiet during the falling asleep period 9 pm - 12 am. Many people come home at the time and they slam door, so you can hear pretty clearly that your walls are vibrating and the low-frequency bass, like fuckkkkkkk.
So after a while, I think my body has subconsciously registered my apartment unit as a place of worry and wakefulness and every time I walk into my unit I feel like my spine getting stiffened and my state becomes more anxious subtly. Because I’ll have back pain a little later due to being hyper-aware in the environment.
Currently I’m thinking to get out of this apartment, which I just rented, and move to somewhere else that is quieter. However, I think this apartment is kind of quiet, or at least quiet for average people, but not quiet enough for me.
What do you make of this?
Thank you!
Hi,
So I would say that this boils down to wanting to escape and run away from wakefullness and wanting to force sleep to come and is in essence a sleep anxiety.
It could have just as easily been something else, my room needs to be 100% dark, if I didn't stop drinking caffeine at exactly 2pm then... if I don't have a warm bath before bed...
This video here, whilst not exactly to do with noise explains the mindset:
ruclips.net/video/EmEA5KSM3F0/видео.html
A lot of my work is about taking away the anxiety around sleep and helping to be people more accepting of it, it comes when people get that real deep deep understanding that there is nothing you can do to force themselves to sleep, and the belief that you can is like forcing your hair to turn blue:
ruclips.net/video/iJvEwyA2QYw/видео.html
I'd start with taking a good look at many of my videos especially this one:
ruclips.net/video/Groqv7-p2lk/видео.html
Just to take the fear out of it.
For a more structured way to deal with the fear take a look at "cognitive restructuring - Nick Wignall" just do a websearch.
This is a written exercise you can start doing to really face up to the fear of why noises before sleep cause so much anxiety to you and it will help re wire the brain to take away the anxiety.
Alot of this comes with a good understanding of sleep IE if I don't sleep so well tonight, I know tommorow night, as long as I more or less continue with my day as normal my sleep drive will just be stronger so I will sleep well the night night etc etc
As for moving apartment -- what if the new apartment is also noisy? or what you're if it's quiet and then the brain, as it wants to be anxious about sleep latches onto something else to be anxious about?
Naturally if your apartment is excessively loud then it is wise to deal with (noise cancelling headphones / masks etc can help) but from your description at the end you didn't say it was excessively loud, so moving may not fix the issue.
Joe
@@InsomniaTalks Hey Joe, thanks for the detailed and thoughtful responses.
After some rigorous testings, I’ve found out that my apartment has a bass noise problem. Basically base noise that is less than 200 hertz is penetrating the apartment room whenever a tenant on my floor slams his/her door. (Inconsiderate tenants, I know.) If they slam the door, the base just ups like a sudden jump. Structural noise is kind of problematic as it is very hard to block out, unless renovation of the walls, ceilings and floors can be done. (Some kind of suspension devices need to be installed between the existing wall and the new wall to cut the transmission of bass noise.)
Anyway, that’s all that soundproof stuff from the web.
I actually watched ruclips.net/video/EmEA5KSM3F0/видео.html&ab_channel=InsomniaTalks this video before commenting on your channel. It’s a great video honestly. I suspect the reason why I have so much sleep anxiety around sleep is very likely due to past traumas around sleep when I was young. And I have no idea how much money I need to spend to get enough counseling/therapies to completely excavate it out of my system. However, I do find other people who also suffer from noise problems falling asleep. I think it’s a combination of genetics and traumas that are in work here. I have ADHD (unofficially diagnosed, but I just know I have - short attention spans), and falling asleep has been pretty difficult for me for the past 15 years or so. I just CAN NOT stand any noises during the falling asleep phase. Some people don’t have this problem when they fall asleep. But I did find other people with ADHD seem to share my problem as well - similar kind of response towards noise when falling asleep, sensitive to sounds and insomniac.
I wonder if all of this has something to do with misophonia? But I seem to only have “misophonia” during the falling asleep phase, I don’t particularly dislike sounds when I’m awake and function normally during the day. Definitely crazy sensitive to noises when falling asleep.
I like what you have talked about in your video. Sleep window, also behavior changes lead to mindset changes. Does CBTi help with coping with noises when falling asleep? I think I’m just physically susceptible towards sounds…
Also bedtime restrictions and sleep window - trying to sleep at a certain time, or try to not lie on bed for too long if you don’t feel sleepy. These are manageable. However, for “stimulant control,” it’s just out of my reach. During 9 pm - 12 am, tenants inside the building are coming home and most of them slam doors when they come back. Every time when I hear a slamming door sound, it kicks up my stimulation system. I’m extremely awake if I hear something like that because I know I’m not gonna sleep well hearing those sounds. Living noises (slamming door sound in this case) serve as strong stimulants especially if they are physically close to me, within 5 or 10 meters. So, even though I feel sleepy on the bed, my brain can be fully awake just by hearing a strong and loud sound in my vicinity. It instantly sends the brain into overdrive mode.
I’m reading Cognitive Restructuring by Nick Wignall on his blog right now, hopefully I can find some solutions from this as well.
“what you're if it's quiet and then the brain, as it wants to be anxious about sleep latches onto something else to be anxious about?” It does sometimes work that way, but once the sleep comes in, the anxiety just gone. Also, I just don’t function pretty well when I don’t get enough sleep - strange physiological problems will come out and during the day you aren’t as sharp as fully-slept, and just basically really slow and low-energy.
Anyways man, I’ve subscribed to your channel and I’d like to hear more about CBTi for sleep. Maybe this can help me deal with noise problems when falling asleep. I’m not sure if I can get the N1-N2-N3-REM, all phases in a sleep cycle, if I hear too much noises before going to sleep, or during falling asleep. Anyways, thanks for the detailed response!
Is there any task that I can do before bed to fall asleep faster to reschedule my sleep pattern?
Hi, in a word , unfortunately no. There is literally nothing you can do that will create more sleep drive and thinking there is some magical short term hack that will increase it is what sends people downs the rabbit hole of more force, effort, control (kiwi, warm baths, meditation, not drinking caffeine after 3pm, not eating late in a restaurant etc)
This entire industry is premised on the false belief that it is possible to manufacturer something that can only be created internally - the only thing that create sleep drive is wakefulness.
The longer you are awake, the sleepier you feel.
This video here is a bit of a silly one but an important one when it comes to this topic
ruclips.net/video/iJvEwyA2QYw/видео.html
Does that mean you shouldn't do relaxation techniques / meditation / relaxing things in the evening? No, but do them with the right intention, just to help you feel relaxed, not with the intention of forcing sleep as the opposite will happen -- you will try really really hard to relax and then get cross and angry with yourself when it doesn't produce sleep.
What can you do however, the longer, more consistent behavioural changes that require slowly rebuilding your sleep pattern and doing more in the day.
Take a look at my playlist here: www.youtube.com/@InsomniaTalks/playlists
Work through this and then have a binge watch on the channel and start putting these behavioural changes in place,. This will help you. Thanks for you question! Joe
Thank you for the advice doctor