Sleep Update: My Discovery of CBT-I

in Natural Medicine2 months ago (edited)

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A few months ago, I shared some sleep struggles I was having in a post, and asked other people for ideas on how they were able to overcome their individual sleep struggles.

https://peakd.com/hive-120078/@joshman/insomnia-sucks-or-what-have-you-done-to-fight-it

In response to this post, I received many great suggestions. Some of them were even in line with my own research.


Insomnia Coach?

During my research, I stumbled upon the YouTube channel of Martin Reed, called Insomnia Coach. I had no idea sleep coaches even existed, but apparently they are a thing. So much so that there are even industry certifications for it. Google never told me. It wanted me buy sleep hygiene products (more on sleep hygiene later). My doctor never told me. He wanted to give me sleep drugs like Ambien and anti-anxiety meds. Why didn't he suggest I talk to a sleep coach, instead of pharmaceuticals? What Mr. Reed offered was something I had never heard of before called Cognitive-Based Behavioral Therapy for Insomnia, or CBT-I.


CBT-I

Mr. Reed describes CBT-I in the following video.

The five elements of CBT-I are:

  1. Sleep Education
  2. Sleep Restriction
  3. Stimulus Control
  4. Relaxation Techniques
  5. Sleep Hygiene

I have included a description and a short video from Insomnia Coach describing them.


Chronic Insomnia is a Systemic Issue

Chronic insomnia is telling you that your sleep system is out of whack. It's telling you your sleep drive is being suppressed some how. Chronic insomnia starts with a single night of bad sleep, which can multiply into months and sometimes years of bad sleep. During this time you can develop bad habits, such as spending extended periods in bed trying to catch some Zs, or taking prolonged naps during the day. Both of these bad habits mess with your sleep drive and contribute to continued insomnia. If you combine this with a racing mind or frequent anxiety, getting a good night's sleep can seem impossible.


1. Sleep Education

This one is a bit self-explanatory, but understanding your 'sleep system' can go a long way in helping you fix it when it is malfunctioning. This is less about searching for gimmicks, and more about understanding the core processes involved with sleep. You can learn a ton, just by seeking out public experts and consuming their content. Mr. Reed's YouTube channel (https://www.youtube.com/c/InsomniaCoach/videos) is a great example.


2. Sleep Restriction

Sleep restriction doesn't have the goal of restricting the amount of sleep you get, it restricts your time in bed to sleeping only. @justinparke actually alluded to this in his reply to my post.

20210101 10_54_41Insomnia Sucks! _ What Have You Done To Fight It_ _ PeakD  Brave.png

As part of sleep restriction, creating a fixed sleep window was the most powerful technique for me. It involves choosing a specific time to wake up every morning seven days per week, and working my way back from there. No matter what occurs during the night, you must stick with your sleep window. The time that you wake up in particular must be set in stone. This has the effect of building your sleep drive over time. Conventional wisdom suggests that if you sleep poorly, you should stay in bed or take an extended nap later on, which can really mess with your sleep drive. Even the prevailing wisdom with having a newborn baby, is to 'sleep when your baby sleeps'. If you have insomnia, this is terrible advice. I learned that the hard way.


3. Stimulus Control

CBT-I actually takes restricting sleep one step further. It suggests if you cannot sleep, to get out of bed and do something relaxing like reading a book, meditation, or stretching/yoga until you feel sleepy again. This technique enforces the subconscious notion that the bed is for sleep only.


4. Relaxation Techniques

@justinparke also linked me to an article by @nainaztengra called Yoga for Better Sleep (https://peakd.com/yoga/@nainaztengra/yoga-for-better-sleep). Relaxation techniques, such as yoga and meditation can help prepare you for sleep. The idea is to relax and not do anything that is overly stimulating for a couple hours before bed, to help prevent your mind from racing when your head hits the pillow.


5. Sleep Hygiene

When you search for sleep aids or sleep disorders on Google, what you get is a bunch of ideas to improve sleep. These could consist of manipulating your environment, or taking medications and supplements. These actions are referred to by experts as sleep hygiene. Let's compare sleep hygiene to something most everyone is knowledgeable about, dental hygiene. With dental hygiene, you brush and floss, and take other measures to maintain the current health of your teeth. Dental hygiene DOES NOT however, fix systemic issues with your teeth, such as cavities. No matter how hard you try, you cannot brush away a cavity! Now let's contrast that with sleep disorders such as insomnia. Sleep hygiene measures DO NOT fix systemic issues with sleep, but you shouldn't discount them altogether, because they can make the sleep you're already getting better. Quite a few replies to my post suggested some great sleep hygiene techniques.


In Conclusion

CBT-I has really helped me get back on track with my sleep. I recently purchased an Oura Ring, which does a great job of tracking my sleep patterns. They are still far from perfect, but I've come a long way by simply recognizing the systemic issues. I still have a ways to go ahead of me, but my progress has been reassuring.

If you regularly experience insomnia, I highly recommend Insomnia Coach/Martin Reed. He has plenty of free resources, and if you require a little extra help, he also offers direct coaching for a fee.

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Oh a friend of mine recently got an Oura ring, as she's been going through forced menopause due to cancer drugs to lower oestrogen. I have 'bouts' of lack of sleep when my oestrogen drops in my cycle, which I imagine will get worse the closer I get to menopause - fun and games.

I have known for YEARS that bed is for sleep only - no tv, no bright lights. A fresh made bed, a clean room, and going to bed at 9.30 works for me. I often do a yoga nidra, which are fabuluos - have you tried them? There's a few on Insight Timer but you have to find the right one - Jennifer Piercy or Richard Miller (I think, but i might have to confirm the name) work for me.

I've also started taking 5HTP which helps produce serontonin, which we both have found fabulous, and tons of magnesium. We both THINK a lot, and get very wired with any kind of stress, so that works for us.

I'm glad you are making progress - good news indeed. It's funny how sleep can be so elusive.

Oh the other thing is this: when you wake up (same time every day, as you said, and no day sleeping to screw with cycle), go sit in the sun if you can for 5 -10 minutes, or at least in full daylight. And always tell yourself you have had 'enough' sleep, which literally stops you feeling so tired. For the life of me I can't find the study, but I tell the kids at school this all the time when they are moaning about being tired, and those smart enough to at least test my advice swear by it. They did a study by where a group of people just carried on saying/moaning about how tired they were, and the other group just carried on and told themselves they'd had ENOUGH sleep for the day they had to get through. Those in the second group felt less tired during the day. It unfailingly works for me! Sure, I havethose 'omg i'm so tired i'm going to die' days, but mos tof the time, I suprise myself by functioning reasonably well.

Gah, not looking forward to going back to work after a year off - I am dreading the change to my sleep cycles!


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I often do a yoga nidra, which are fabuluos - have you tried them?

Not yet, but I'll check it out and your other suggestions as well!

Sleep is definitely something that is taken for granted, and it's so easy to get thrown off track.

Great comments!

Thankyou! Yes, have a read online about yoga nidra. You have to have one that doesn't wake you up at the end though, that's why this one is great

https://insighttimer.com/thestillpoint/guided-meditations/yoga-nidra-for-sleep-and-rest

or this one

https://insighttimer.com/jenniferpiercy/guided-meditations/yoga-nidra-for-sleep

or a male voice

https://insighttimer.com/richardmiller/guided-meditations/irest-yoga-nidra-for-deep-and-restful-sleep

Do let me know what you think of them.

Cool, thanks for the resources!

No worries, I ended up writing a longer post that I tagged you in - been meaning to write about yoga nidra for ages, so thanks for the push.

I am pleased to see you are finding some success in dealing with your insomnia. I don't always follow the rules I set for myself, but when I am in dire need some good ZZZ's, I obey the rules. My biggest troubles are caffeine after noon and not being physically exhausted enough to rest well.

When I worked on the ganja farms in Oregon a few years back, I used to be so destroyed after 14 hours of consecutive work, I would shower and hit my air mattress like a pile of bricks.

Our new apartment has a field behind, around 1/4 of an acre, so I hope to use this space as a tool to help me get exhausted every day and ready for bed.

Looking forward to more blog posts @joshman.


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Yeah, I should be on a farm and not behind a desk! Between work and sunlight, I'd probably sleep better.

I'm really happy to see you feeling better and find the solution to your insomnia episodes. I just subscribed to the Insomnia Coach because you never know when insomnia will be back and just want to be ready for anything this year..

Glad it could be potentially helpful. I found that some simple measures can make a big difference.

I'm used to see everything being controlled by small things, but we always tend focusing on bigger ones and forget what great impact have the others

I am gonna pass this on to my Mom. I swear that lady never sleeps and can be cause knitting or crafting with her eyes closed. Thanks for sharing this info!!

No problem, I hope it helps!

@joshman, One thing is, in my opinion nowadays this Sleeplessness Symptom is becoming common, i may be wrong but in most of the cases Rapid Change in Lifestyle is one issue. My good wishes are with you and stay blessed.

Thanks, much appreciated. If there was one thing that happened last year, it was rapid change!

Welcome. "Rapid Change", that's true.

Hey @joshman,
Sorry to jump in with something a bit off-topic.
I'm are very grateful for the support you provided to HiveBuzz but its proposal expired when we left 2020.
Do you mind casting your vote for the new proposal we made for 2021 so that our team can continue with its work of gamifying Hive and motivating users?
https://peakd.com/me/proposals/147

Have a Happy New Year ✨🥂✨