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EVERYTHING wrong with CBTi for INSOMNIA
Рет қаралды 844
Күн бұрынWhat if CBT-I doesn't work and stimulus control and very strict sleep restriction actually makes insomnia far worse?
Well this could be the reality! anything that creates more obsession, more force more control around sleep actually back fires and can cause insomnia.
Treatment should never be rigid and it should NEVER be strict!
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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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@user-kd3xt4kn7w 2 ай бұрын
So we have to wake up at the same time every single day for the rest of our lives....
@InsomniaTalks 2 ай бұрын
No you don't need to be perfect, just good enough. But in the early stages of fixing it it's best to be reasonably tight around it and then you can soften it. A general awareness of why it's helpful is good, and a balance. 1 hour lie in now and again - who cares, won't make a difference. Constantly trying to get as much sleep as you possibly can in the short term and not making any long term habit and behaviour changes so the body clock and sleep drive never knows where it stands and always hoping the next kiwi fruit, warm bath or supplement will get to the root cause of a long term chronic problem.... Well people can carry on with that if they want, it's tempting to especially when you don't know and have never proven to yourself how well the alternative works ( I did the old way for 20 years - I got worse and worse) but if you want to fix your insomnia long term, it may be helpful to make some long term changes. Or not - people don't HAVE to do anything. But if you read the comments from the people who have CHOSEN to make the hard,long term changes until they became habits and then easier to do than not, they're glad they did.
@user-kd3xt4kn7w Ай бұрын
@@InsomniaTalks so my question I guess is, once you cured your insomnia you now sleep in and sleep whenever you want? You're allowed to nap again? You got rid of that fear entirely? Or is it still always there somewhat even if you're sleeping better
@InsomniaTalks Ай бұрын
@@user-kd3xt4kn7w Hi, now I just do the habits and behaviours of a normal sleeper. Which is more or less wake up at the same time but now and again have the occasional lie in. And most days I don't nap but occasionally I do. On either of these occasions i don't catch fire! The difference is balance - in Buddhism the middle way! When I had insomnia I would try to nap to compensate for poor quality sleep all the time. When I had a lie in it wasn't a lie in, it was - I must try to get as much sleep as I possibly can, so sometimes I'd wake at 7 if I had to work - sometimes it would be 3pm after spending 17 hours in bed! that's insomnia - that's very different from now where I tend to wake up at 6am and occasionally wake up 7-7.30 and relax in bed with a book. Yes now it has been 4 years on from my insomnia and I no longer worry about sleep at all. If this wasn't the case I wouldn't be able to do the work I do. But it was a gradual process. I got 90% of my way there in the first 3 months - but the last 10% of fully complete detachment just came after time and repetition and slowly letting go more and more. It wasn't a conscious action. Think about starting a new job. The first few months is a steep learning curve where you improve really rapidly. Full comfort and relaxation in the job however happens gradually overtime not through deliberate action, just through water under the bridge.
@stephenkingsley7539 5 ай бұрын
I had horrific insomnia 24 years ago for about a year and a half. Because of that, I ended up with anxiety/depression. Finally got over it. Now then, about four years ago I started having to get up to pee many, many times (12+) at night because of prostate issues, but could always go back to sleep each time. Then, I started to work on fixing the problem with sleep meds, thinking that something might help me sleep through the urges and that made the need to pee even greater (likely because of anxiety) and brought me back into insomnia. I think I've done the same thing with trying to fix my blood pressure issues, which has only made that worse too. I will buy your book today. Thank you.
@InsomniaTalks 5 ай бұрын
Hi Stephen, yes underlying health concerns can certainly impact sleep - however, as you say when it then takes ages to fall back to sleep that is when it turns into insomnia. And yes certainly, even with prostate issues , increase in anxiety (insomnia is very anxiety driven, the anxiety about sleep itself that is the issue) can increase the desire to want to vist the toilet in the night. But yes, the first step will be to increase sleep quality through behavioural changes to reduce these night time awakenings. All of this is covered in the book! hope you find it helpful, I'm certain you will. I appreciate you buying it. Joe
@lacasitoleica 5 ай бұрын
I got your book that is really helping me understand what Insomnia is all about. I actually followed a few of your recommendations. I was always going running in the morning because.... well you know..... I stopped caffeine (love coffee) and of course... I started supplements. I had good and bad days but in general things were not moving forward. I am in my third week kind doing baby steps and I see better results: I stopped checking my garmin , the other day I took a second coffee at 15PM and I went for a run after work (I didn't do everything at the same time)... and guess what.... I could sleep. I was always a good sleeper but 2 years ago I got pretty hard COVID I took a medicine and I couldn't fall sleep that night.... the rest.... you can imagine. After I finish your book I will continue with your second one.... Thank you!
@InsomniaTalks 5 ай бұрын
Really happy to help! Yes look at that, the 2nd cup of coffee didn't make anything go wrong! - the obsession and control around sleep is far far worse. Insomnia is very closely linked with OCD and it's amazing how people twist themselves into knots trying to force sleep / protect it. Sounds like you're doing really well! keep it up!
@lacasitoleica 5 ай бұрын
It makes so much sense!! Why I didn't realize before! Yesterday for example I couldn't fall asleep. I simply didn't feel sleepy and I got a light anxiety. But I took it very easy. I went to the sofa reading (your book). I needed a couple of attempts and at some point, I went to bed and could fall asleep. I didn't sleep much but I woke up at the same time I always do. I know now I will have bad days... but who doesn't. I need to be patient and take it a bit easier.@@InsomniaTalks
@thomasfeathers 5 ай бұрын
I’m having a rough third week with implementing CBT-I. Gone from a huge improvement in the second week, to going back to 1-3 hours a night. I notice my rumination has gotten much worse, and resiliency has gone down unfortunately. Sleep window and tracking sleep/always seeing improvement has hurt my mental health and positivity. Really enjoyed this video. Any tips on sleep restriction implementation that I’m currently doing? (6 hour sleep window) and how to stay positive through the muck? Thank you!
@InsomniaTalks 5 ай бұрын
Hi Thomas, this is so common I have a name for this - success regress! to further show how common this is i've probably got 3 - 4 videos on this very topic: kzfaq.info/get/bejne/eJ2UjMJy2Ja4lGg.html kzfaq.info/get/bejne/p-B0iM6ovqu1dac.html kzfaq.info/get/bejne/obR4iJR-0dW0qKs.html I can't remember but are you currently working through the step-by-step programme? If not it's on sleepze.com - this will be a good guide to follow to help you navigate the ups and downs as I do a lot of thought pattern change work on this. But yes focus on that good week and the fact that you have finally stopped insomnia pushing you around, always focus on the wins and this will keep you motivated. And remember, good enough, not perfection when it comes to the approach. Joe
@thomasfeathers 5 ай бұрын
Thank you so much Joe! I’m following the Stellar Sleep app, which seems to get to the core principles on CBT-I. I’ve looked at your site, and would love some coaching when the going gets tough. Thanks for your videos, as they’ve helped me tremendously through the 5 or so months which I’ve been going through insomnia. I know there’s not an easy fix, but staying positive through it all and seeing a light at the end of the tunnel can be so challenging when your going through the thick of it, especially when there’s a setback. Cognitive restructuring around rumination is tough. I can get through it and will eventually. ❤
@InsomniaTalks 5 ай бұрын
Happy to help, yes i'd say my course whilst CBTi based has started to move so far away from traditional CBTi I would hesitate to still call it that, but yes - not personally a fan of too much tracking and monitoring as this can feed into the condition.@@thomasfeathers
@thomasfeathers 5 ай бұрын
Thank you again Joe. I’ll reach out
@senaarman188 5 ай бұрын
Hello. When ı have to wake up early, this makes me feel lots of stress and those nights ı live insomnia. Do u have an advice for that?
@InsomniaTalks 5 ай бұрын
Hi, so yes this is situational insomnia. IE worrying what will happen if you can't sleep because you have to get up early. So firstly, you can't tell your body when to sleep, just because you need to get up early your body doesn't care. So you can't therefore go to bed 2 hours earlier than normal just because you have to wake 2 hours earlier than normal. If you do, you will just lie in bed awake, whoch will then lead to fight or flight which will make it worse. So even on the nights you have to get up early, still only go to bed when sleepy regardless of how long that will leave you for sleep - sleep cannot be forced / pushed around. Then follow the advice regarding counter / stimulus control here if you find yourself in bed awake and not sleeping: kzfaq.info/get/bejne/prBom86Yr7Cll3k.html You may also want to do a lot of thought work to reduce the anxiety around this - my sliver programme on sleepze.com has lots of written thought record exercises on it that will help with getting rid of persistent anxious thought patterns. Joe
@sawkrandom23 5 ай бұрын
I listened to your advice about not going to bed unless tired. I ended up going to bed at 5:53am and waking up at 2:47pm. I realised my body clock is just set to the day time, and I'm nocturnal basically. Would going to sleep like 15 mins earlier each day reset my body clock to a normal bed time?
@InsomniaTalks 5 ай бұрын
Hi, so you don't move your body clock and sleep drive by your bedtime. You move your body clock by your wake time. Similar between moving between time zones. Pick your wake time. IE 7.30am and then try to stick to it no matter what. (and still only go to bed when sleepy) You will find in the first few days you sleep far less, however after only a few days you will start feeling sleepier much earlier. So yes overcoming insomnia is about shifting your focus away from trying to get as much sleep as you possibly can in the short term to building new behaviours and habits so you sleep well over the long run. So fix that wake time, and go to bed when sleepy and get up at the same time. I can guarantee within a week, 2 weeks max your body clock and sleep drive will have shifted. However in the short term it will be hard, but far better than living with insomnia long term!
@sawkrandom23 5 ай бұрын
@InsomniaTalks So would it be okay to sleep from 6am to 7:30am (1/2 hour)? I want to eventually wake at 4am. Will I naturally start feeling sleepy earlier by following the 7:30am wake time or would I need to gradually reduce it over time?
@InsomniaTalks 5 ай бұрын
Hi, if you want to wake at 4am then set your wake time to 4am and stick to it. Now. Do it all at once if you can. You WILL sleep far far less the first few days, however eventually your body clock and sleep drive will make you feel sleepier much earlier - so yes the same as moving between time zones - less less in the short term, but eventually everything shiftsto the new time zone.@@sawkrandom23
@sawkrandom23 5 ай бұрын
@InsomniaTalks Hi, thanks for responding. I just want some reassurance. I physically cannot sleep till around 6am (like the point where I can't keep my eyes open). If I want to wake at 4am, I won't have slept at all. Should I not sleep at all for the first few days? Or should I go to bed earlier when I'm not tired?
@benrobben8906 5 ай бұрын
Is it really possible to lose sleep drive or lose the ability to sleep at all? I have seen people claim this for decades, such as the famous Vietnamese man, and many others. This is really confusing. Could I become like them?
@InsomniaTalks 5 ай бұрын
Hi this is impossible, it's like loosing the ability to feel hungry or thirsty. What happens instead is sleep becomes very unregulated / unpredictable and the pattern of sleep can change where it is very fragmented where you interpret sleep as wakefulness. These videos here will help: kzfaq.info/get/bejne/iKeVm9SLmZ3OeaM.html kzfaq.info/get/bejne/i5qIorhknZbbf40.html
@benrobben8906 4 ай бұрын
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@benrobben8906 4 ай бұрын
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@benrobben8906 4 ай бұрын
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@reneelanier3475 5 ай бұрын
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