Posted tagged ‘primary insomnia’

How long does CBT sleep training take to work?

December 19, 2018

Q:  I’m now on week 2 of CBT sleep training, using sleep restriction therapy, and find myself lying on the couch at night unable to sleep.  I’m stressed about using the methods because they don’t seem to be working and feel worse off than I was before.  How long before I can expect some improvement?

A:  First be sure you are using the full CBT sleep training program From your description, you may not be doing it right.

As part of the stimulus control method, you sleep only in your bed, never on the couch.

The idea is to reduce frustration by getting up and out of bed when you are too awake to sleep.  Watching TV or reading while sitting on the couch is OK, but you risk falling asleep if you let yourself lie down.  That then results in an unhealthy association of your couch as the only place you can fall asleep.

It’s very important you head back to bed when you begin to feel drowsy.  You may need to remind yourself of what drowsiness feels like — yawning, droopy eyelids, wandering thoughts, head nodding are all sure signs.  When you feel that, head back to bed and try sleep again.  Stimulus control supports and improves what you’re doing with sleep restriction.

Also be assured as you continue learning all the CBT methods, you’ll soon have the tools needed to effectively counter these negative, stressful thoughts.  These negative sleep thoughts are like the raw fuel that prolongs and perpetuates insomnia, so countering them is actually one of the most important keys to a permanent solution.

To answer your question, results are very individual.  Some people respond very quickly, within a week or two of first starting the methods.  For others it is slow but steady progress that can take months.  The good news is CBT sleep training methods help most people and the benefits tend to be lasting.

Bottom line is it’s very important to use all the CBT methods simultaneously within a structure. That’s the support a full CBT sleep training program gives you.

What is the process of falling asleep like?

June 18, 2018

Q:  Please describe what the process of falling asleep is like for a normal person.  I’m having trouble lately.  It’s almost like I’ve forgotten how to fall asleep.

A:  Great question.  There are some consistencies, but it’s also probably safe to say the process is very individual.  There is no absolute right or wrong way to do it, just what works for you.

The commonalities include progressive relaxation of the muscles of the body, and a decoupling of the mind from sensing and perceiving environmental stimuli.  The process is whole person, meaning mind and body working in concert together.  When it comes to sleep, the two are really inseparable.

Worth emphasizing falling asleep is a natural and autonomic process, like breathing, something we really don’t have to think about or try to force.

In fact trying to force sleep can and often does result in taking you in the opposite direction.  Instead of drowsiness, forcing can lead to arousal, including increased heart and respiration rates.

For those with chronic insomnia, the idea of relearning how to fall asleep has some merit.  A significant body of research has shown that intensive sleep retraining (ISR) works, and quickly.

With ISR, patients are hooked up to an electroencephalograph, which accurately determines when sleep onset occurs.  Individuals are immediately awakened after 3 consecutive minutes of any stage of sleep activity.  Over an extended period of time, sometimes 24 hours or more, this understandably builds up an acute level of sleep deprivation.  Even the most chronic insomniacs will generally experience dozens of sleep onsets in an extended session.  By repeatedly experiencing many sleep onsets in a compressed time frame, the recipient by association quickly relearns what the experience of falling asleep feels like.

The results show ISR rapidly improves the ability of insomniacs to fall asleep quickly and also helps increase total sleep time.

Most of us who won’t undergo a full ISR session and just want to sleep better can learn something valuable from this.  ISR suggests thinking back on what the experience was like last time you fell asleep quickly.  That is the good feeling to dwell on.  You don’t need to necessarily try to recreate that exact same routine or experience night after night; rather just let yourself go in the same way you did when you slept well.

Because that’s what falling asleep really is — a process of letting go.  When you find that place in your mind, and over time you will, stay with it and your sleep system will eventually grow stronger.

For more drug-free ways to help yourself sleep, check out the Sleep Training System.


Can I reboot my system for better sleep?

November 13, 2013

Q:  I’ve had insomnia off and on for several years now.  Is there a way for me to “reboot” my sleep system so I can consistently sleep better and awaken more refreshed?

A:  Yes, there are effective ways to in effect reboot your sleep system and get a fresh new start.  But first, it’s a good idea to get a checkup from your doctor if you haven’t had one recently.  That way you can either treat or rule out a medical problem causing your insomnia.

But don’t be surprised if your doctor finds no identifiable medical problem.  In that case, you likely have what’s known as primary insomnia, the most common type, which has no true medical basis.  Primary insomnia is typically caused by some nonmedical combination of bad sleep habits and excessive worry about the idea of sleep.

With primary insomnia, there are ways to “reboot” your sleep system that are effective.  Just don’t expect them to work as fast as you can reboot your computer.

The best nonmedical methods to restore and recover better sleep are contained in CBT (cognitive behavioral therapy) specifically designed for insomnia.  CBT is the standard of care recommended by the American Academy of  Sleep Medicine.  These methods are drug-free.  CBT enables you to practice better sleep habits and constructively deal with the negative thought patterns that typically fuel insomnia.

CBT methods generally take several weeks to learn and produce results, but the benefits tend to be permanent.  These methods help most people who try them, and many become normal sleepers again.

You can learn CBT from a number of sources, including sleep doctors, counselors, psychologists, and other healthcare professionals.

If you are the self-help type, you will find many CBT resources, ranging from books to online programs that are interactive and affordable.

So yes, by using CBT methods be confident you can help yourself sleep better permanently, and without the need for sleeping pills.