Archive for the ‘Health’ category

Desperate for sleep and need help

September 11, 2018

Q:  I’ve now gone almost 5 days without sleep.  I’ve tried everything and nothing works:  benadryl, weed, alcohol.  Melatonin and exercise have no effect.  I’m desperate for sleep and just want to know what’s wrong.

A:  What’s wrong is probably at least in part your attitude that you in fact “can’t sleep” — and need drugs to do it.

What’s wrong is likely your belief that you’ve really gone almost 5 straight days without any sleep whatsoever.  Are you saying you never even once laid down with your eyes closed during that time?  How do you know you didn’t sleep — did you use a sleep tracking device or some sort of written log?

Far more likely: you slept, but don’t realize it.  Or dismiss what sleep you did get as meaningless.

If you’re like millions of others with primary insomnia, your solution at least in part includes changing your beliefs and attitudes about the idea of sleep.  This is something you can control.

Suggest you first see a doctor to either treat or rule out an underlying medical or psychiatric condition causing this.  If you have none, then look to nonmedical solutions.

The best are contained in CBT sleep training programs.  These have a component called cognitive restructuring to reality test your beliefs and correct them to something better and more accurate.  Using this method, you can stop these negative thoughts from fueling and perpetuating your insomnia.  As part of a complete CBT solution, you can literally think your way to better sleep.

CBT sleep training also includes sleep hygiene.  Using this method you’ll learn how to lead a healthy sleep-supportive lifestyle, including how the use of drugs and alcohol are no answer for insomnia, only treat the symptom, and may actually worsen the problem.

 It’s highly likely your permanent solution will not come from drugs or any other substance to artificially force sleep.  Ask your doctor about using CBT sleep training methods.  You’ll find real help there to address the true underlying root of the problem.

Can I die from lack of sleep?

July 6, 2018

Q:  I haven’t slept now for 8 straight days.  I don’t know why and no meds work.  What will help me?

A:  Start with the idea that you’ve actually gone 8 straight days without sleep.

Did you not even lay down one time with your eyes closed during those 8 days?  How do you know you didn’t sleep?  Did you keep a log, or use a sleep tracking device?

Sleep state misperception is rampant among insomniacs.  Studies in sleep labs consistently show insomniacs underestimate how much actual sleep they get by at least an hour or more per night.  This happens when we are in fact asleep but don’t realize it because we are, well, sleeping.  All we remember is the aggravation of tossing and turning in bed, frustrated at our inability to sleep.

If you honestly examine your belief that you’ve gone 8 straight days without sleep you’ll likely find that it is false and inaccurate. An overblown exaggeration.

What you probably mean is you haven’t slept as well as you’d like over the past 8 days.  And if so, welcome to the club.  You’re no different than literally millions of others who struggle with sleep.

This is key for you to understand:  your false belief about the reality of sleep, the excessive negativity you are buying into, is probably fueling your insomnia to at least some degree.  And you are hardly alone in this.  Many if not most insomniacs do the exact same thing, and it becomes a vicious self-perpetuating cycle that can be difficult to break.

Fortunately, there is a way out.  There is a proven way to derail inaccurate and negative sleep thoughts, and replace them with something better, more accurate, and more supportive of good sleep.  It’s called cognitive restructuring.  Using this method you can literally think your way to better sleep.

Cognitive restructuring is one of the core tools in CBT sleep training.  What a good CBT sleep training program will do is give you a positive, supportive structure for implementing cognitive restructuring, as well as provide many other proven methods to help yourself sleep — and all without drugs.

As always, you should check with your doctor to either treat or rule out any underlying medical issues disrupting your sleep.  But be confident you can fix this, permanently.

Is it better to awaken quickly or slowly in the morning?

March 27, 2018

 

Q:  When waking up in the morning, I usually take my time as I still feel sleepy.  Is it generally better to awaken slowly and sort of ease into the day, or get out of bed as soon as possible?

A:  Part of the answer depends on whether or not you allowing enough time for proper sleep.

If you are allowing enough time in bed for your last sleep cycle to complete, sleep inertia — that feeling of sleepiness you described — is reduced.  In this case, most people are in a fully awakened state within about 15 minutes or so.

But if you did not allow enough time to complete that last cycle, and you awaken in the midst of a deeper NREM sleep stage, you can expect significantly more sleep inertia.  In that case it might take far longer than 15 minutes to feel fully alert.

For those who do complete that final sleep cycle, some hop right out of bed and get going immediately.  But most are probably like you and take some time to get going.

If your preference is to lie in bed awhile and frame your day, that can be constructive.  Doing so enables you to visualize your goals for the day, prepare mentally for your challenges, and generally feel more ready with a positive attitude.

Taking some time in bed may also be useful to challenge some of your negative thinking and reality check your self-doubts.  These kinds of pessimistic thoughts are something we all experience from time to time, and they often occur first thing in the morning as well as just before nodding off at night.  When they do, making the effort to put them in proper perspective — safely letting them go — can be time very well spent.

So there’s nothing wrong with taking your time to start your day.  Just be sure to schedule for it so you don’t get stressed about running late.

Why can’t I sleep Sunday nights?

March 6, 2018

Q:  I suspect part of this has to do with thinking about the upcoming work week, but I have no problem sleeping on any other nights.  Any suggestions?

A:  What you are experiencing is fairly common.   It likely is a conditioned negative response in anticipation of the upcoming work week, as you’ve already identified.  In other words, stress and worry are keeping you awake.

If that’s the case, welcome to the club.  Every one of us also deals with this in one form or another.  Most of us just accept it and get on the best we can.

But even without sleeping all that great, you may have noticed your performance isn’t adversely affected.  This is in fact what human performance studies consistently show.  We adapt to sleep deprivation and perform reasonably well even after a restless night.

Some people actually perform better with increased stress about an upcoming event, especially if there’s an anticipated positive outcome or expectation.

This is something you probably can and should try to control.  On Sunday nights you might try an extended wind-down period of relaxation to prepare for sleep, an hour or more might be reasonable.  A relaxing bath or soak, getting your clothes ready for the morning, some herbal tea, whatever helps you relax.  No stimulants, and avoid stress during this time, which can take you the other way.

You might also try writing down some of your concerns or worries about the upcoming week, and listing some solutions or constructive ways to approach those concerns.  In other words, you can restructure your expectation about the upcoming work week.  That might help you feel more positive and more prepared; and could assist in releasing some of that negative stress.

If and when awakened during the night, try some deep breathing and progressive muscle relaxation to drift back to a drowsy state more conducive to falling asleep.

Then just let go the worry.  Worry only feeds this.  It’s OK to let it go and know you’ll be just fine the next day.

Combine CBT methods for best results

October 19, 2017

Q:  After dealing with insomnia for months, I am looking for solutions without drugs.  Some experts say if you don’t fall asleep within about 20 minutes, get up and out of bed.  Others say stay in bed and try to relax.  Which is better?

A:  You are wise to seek non-drug solutions to insomnia.   Primary insomnia is not some sort of a disease you can treat with drugs like sleeping pills.  Insomnia is a complaint.  Sleep, or rather the lack thereof, is only the symptom.

Your first step should be to see a doctor to either treat or rule out an underlying medical basis.  But don’t be surprised if you have none.  Most insomniacs don’t.  In that case, look at the much more common nonmedical reasons for your sleep issues.

Most primary insomnia is typically caused by some combination of bad sleep habits and excessive worry about the idea of sleep.  Identifying and treating the true underlying basis can lead to a permanent solution.

You’ve described getting up and out of bed when you can’t sleep, which is part of what’s known as stimulus control.  This is one core method of CBT sleep training. The idea is to begin to undo the negative conditioning you have likely acquired between your bed and the idea of sleep.

The second method you’ve described is in-bed relaxation, also one of the core CBT sleep training tools.

Which should you use?  Both are important components of a permanent insomnia solution.  The answer will be unique to you, and a judgement call only you can make.

If you are lying in bed, tense and worried, not in the least bit drowsy, then that’s the time to get up and out of bed and do something sedentary and relaxing until you feel drowsy.  Then try sleep again.

But if you are lying in bed with eyes closed, drowsy but persistently awake, you can help yourself fall back asleep more quickly by practicing some in-bed relaxation methods.

Importantly, these are only two of many effective CBT methods you can and should use to help restore normal sleep.  Another essential one is cognitive restructuring, which allows you to get a handle on the negative sleep thoughts that are likely fueling your insomnia to some degree.  Another is sleep timing, a behavioral method which enables you to set and keep a sleep-supportive schedule specific for your needs.  Yet another is sleep hygiene.

All these methods reinforce one another and combine very effectively.  They work best when used simultaneously.

To do this, consider using a full and comprehensive CBT sleep training program.  This will give you the structure and support to deploy all these methods at once.  By doing so, be confident you will improve your sleep permanently, and without drugs.

 

Use positive emotions to supercharge cognitive restructuring

July 24, 2017

Those practicing cognitive restructuring to improve sleep know how effectively it can counter and control negative sleep thoughts.  These persistent negative thoughts are often the raw fuel that prolongs and perpetuates insomnia.  But did you know you can in effect supercharge cognitive restructuring by adding a positive emotional trigger?

Cognitive restructuring — one of the core components of CBT sleep training — uses reason, rationality, and understanding to correct inaccurate and distorted thoughts about insomnia to something better, more realistic, and more supportive of better sleep.

But reason and rationality by themselves — while essential and important — don’t necessarily counteract the underlying feeling or emotion behind those inaccurate thoughts.

By intentionally adding a positive emotional component to the practice of cognitive restructuring, you may find your old negative and entrenched attitudes and beliefs about sleep begin lose their grip more quickly — to be replaced by positive and supportive beliefs that you create and control.   In the practice of CBT sleep training, this is one of many ways to take better control over your sleep performance.

The method we suggest in the Sleep Training System takes the normal CBT route of restructuring distorted sleep thoughts into better, more rational thoughts, but importantly adds a meaningful emotional trigger to that thought — specifically a feeling, but not just any feeling.

By associating a concept that triggers for you a good and positive emotion along with the restructured positive sleep thought, the benefit is enlarged and magnified.  The new and more complete positive thought can now more effectively counteract all the incessant negativity and stress insomniacs tend to associate with the idea of sleep.

As part of a comprehensive sleep improvement program, thinking your way to better sleep works naturally — and without drugs or side effects.  This process enables you to constructively address the true underlying root issue of insomnia that afflicts so many people — that seemingly nonstop barrage of worry and persistently negative thoughts about sleep.

Tired of not being able to sleep

May 24, 2017

 

Q:  I’m tired of not being able to sleep.  Seems I stay awake for days at a time, this is gets really old after awhile.  Any advice?

A:  You might be surprised to learn you’re already on the right track to making this better.  Tired is really what you want — because tired is what helps you sleep!

In other words, if you make a concerted effort every day to tire yourself out — both physically and mentally — that most definitely will help you sleep better at night.

For many of us though, tired sometimes isn’t enough.  One of the most frustrating aspects of insomnia is the “tired but wired” syndrome — the awful feeling of absolute exhaustion combined with the inability to sleep.

The tired-but-wired syndrome can result when distorted thoughts and beliefs get mixed into insomnia, thoughts such as “I stay awake for days at a time”.

Do you really?  Do you not even lie down for a little while in the middle of the night with your eyes closed?

If you examine that idea closely, it’s highly likely you’ll realize this is in fact an exaggeration, a false and inaccurate belief that may in fact be fueling your insomnia.   This actually is very common among insomniacs.

Most of us experience what’s known as sleep state misperception, meaning we actually are asleep for a significant amount of time but don’t know it.  This is because we are, well, asleep, and just don’t realize it.  Somehow all we remember from the previous night are all the negatives.  The frustration and aggravation of tossing and turning for what seems like hours at a time can be a potent fuel for insomnia.

Yet we often give no credit at all to whatever actual shuteye we do get.

If you were turn that belief around and view this more objectively and accurately, if you were to credit yourself for whatever actual sleep you did get, your more realistic and accurate attitude might work to help reduce some of the stress you likely associate with the idea of sleep.

Taking more of a realistic view is an excellent way to help reduce the self-imposed pressure we often inadvertently put on ourselves.  And doing so turns out to be one of the very best ways to achieve better sleep permanently.