Listen to the podcast episode (audio only)
Like many of us, Hannah began experiencing sleep disruption during the COVID pandemic. When it became clear that lockdowns were likely to be extended, Hannah started to find it harder to fall asleep. Before long, she also found it hard to stay asleep, too.
After trying different types of medication and finding they weren’t helping much (and came with some unpleasant side-effects), she found a website that shared insomnia tips and advice.
After trying a do-it-yourself approach, Hannah realized she would benefit from working with a coach so she could receive personalized support and guidance and so she enrolled in my online coaching course.
In this episode, Hannah talks about the new sleep habits she developed and how she changed her relationship with sleep-related thoughts, and tested the sleep-related beliefs that made sleep more difficult.
Ultimately, Hannah found that abandoning all attempts to control sleep, accepting difficult nights of sleep and sleep-related worry, committing to new sleep habits, and going about her days as normally as possible really helped her get her sleep back on track.
Today, Hannah’s sleep is back to normal — she typically averages around seven-and-a-half hours of sleep and is far more resilient to any one-off nights of sleep disruption because she was able to tackle the sleep-related thoughts and behaviors that perpetuate insomnia.
Click here for a full transcript of this episode.
Transcript
Welcome to the Insomnia Coach Podcast. My name is Martin Reed. I believe that nobody needs to live with chronic insomnia and that evidence-based cognitive and behavioral techniques can help you enjoy better sleep for the rest of your life.
The content of this podcast is provided for informational and educational purposes only. It is not medical advice and is not intended to diagnose, treat, cure, or prevent any disease, disorder, or medical condition. It should never replace any advice given to you by your physician or any other licensed healthcare provider. Insomnia Coach LLC offers coaching services only and does not provide therapy, counseling, medical advice, or medical treatment. The statements and opinions expressed by guests are their own and are not necessarily endorsed by Insomnia Coach LLC. All content is provided “as is” and without warranties, either express or implied.
Hello, Hannah, thank you so much for taking the time out of your day to come on the podcast.
It’s great to have you on. I always like to start right at the very beginning. So you’re going to be no different. I’d love to know if you can remember when your issues with sleep began? And do you have any recollection of what triggered that initial sleep disruption?
Yeah, I do, actually. It happened about, I would say five or six weeks after the initial lockdown in March, when Coronavirus was really a serious thing and people were being told to stay home. My family and I have lived overseas in developing countries and we homeschooled for years with our kids. So, we actually felt initially like, “Alright, we got this, no problem. We know how to handle chaotic environments, water shortages, et cetera.” But I think it was probably after Easter.
So, worshiping with our church family is a huge deal for us. And we had to do Easter at home. And up until that point, I was like, “I’m doing fine, we’re all good.” We were healthy, nobody had lost their job. And so we felt good. But then, it was like that was a mark for me. After Easter, I think it just sort of settled in my mind like, “This is not a short term thing. This is going to be a long term thing, possibly.” And so initially I felt, okay. I’ve worked from home for years. So I know how to structure my day. But I noticed that it was taking me longer and longer to fall asleep at night. And I just was like, “Well, whatever. Maybe I need to exercise more or something.”
But it just kept going. It got harder to fall asleep. And then that sort of morphed into waking up in the night. And I thought, “What is this?” I don’t normally wake up. I’m not one of those people that even needs to get up and go to the bathroom typically. So I was like, “Okay, this is really uncool.” And then I would wake up, and I would be waking up with a panicky feeling. So it would be like, rapid heartbeat, becoming aware and having this dread feeling of like, “Oh, no, I’m aware, I can’t go back to sleep.”
So, I tried some over-the-counter stuff, but just like melatonin. I don’t like to use medicine unless I just feel like I have no other resort. So initially, I was trying things that were OTC but more in the melatonin herbal kind of stuff. But that did not work. I’m a driven person and it has to do with my background. I remember thinking like, “Okay, I need to find a solution. What I’ve done so far is not working. So I need to find something else. And I need to get on this because I had a lot of anxiety around not sleeping.” Everybody was jokingly saying, “During Coronavirus, I put on so much weight, and I don’t feel good.”
And I’m thinking to myself, “That is not going to be me.” But I had read that there’s a correlation between not getting enough sleep and being sluggish and putting on weight, whatever. And at 42 I was like, “I am not putting on weight and then having to work super duper hard to get it off. I’m not going to do that.”
So I ended up eventually, after nothing worked, calling my GP. She’s actually a personal friend of mine. And I trust her. And I said to her, “Look, I think I need to have a sleeping pill because I cannot sleep now. It’s actually snowballed, and I cannot sleep.” To her credit, she was like, “urgh” about it because she knows that people get hooked on them and in some cases they don’t work but she was going with … But I was like, “I’m anxious now in the day. It’s not even just at night. I actually have hyper arousal all day long.”
I’m a person of faith. I pray, I have many, many ways to deal with anxiety in my life. So this was very distressing to me because I almost felt like it was an out of body thing where I’m like, “My body is betraying me. I know it has to be in my mind somewhere. But now it feels physical to me. And I don’t know how to get beyond this.” So she did, she prescribed me Ambien. And she was like, “I would just take a half and only take it maybe every other day and just see how you do because people do crazy things on Ambien. So I took it and I didn’t sleep walk or have conversations with my husband where I was not in my right mind, although I know some people do that.
But it would help me fall asleep. But it did not help me stay asleep. And I told her, I was like, “This isn’t for me, sleep maintenance is an issue now. I’m glad that I can fall asleep. Lord knows I’m glad I can fall asleep, but, I can’t stay asleep.” So then she was like, “Well, okay.” So we tried a few different things. Finally, I started taking an antihistamine. It’s a hydroxyzine. It is a strong antihistamine that you can’t get except for by prescription. And I started taking that. And it’s true, it knocked me out. And I had no consciousness in the night. If I did wake up, I couldn’t stay awake because it was being drugged.
Initially, I was like, “I don’t really like how long it takes me to wake up in the morning because I really feel drunk in the morning.” But on the other hand, I had it in my head of like, “But this is making me sleep through the night. So far, I can’t find another solution.” Maybe I should just stop and let you ask another question. I don’t know. But-
No, you can keep going. This is great.
Okay. Meanwhile, I’ve got three teenagers at home, multiple animals, and I’m in charge of just running things at home. But I just am like, “Oh my gosh, I’m so tired in the morning.” And I found that all I wanted was sugar, which I don’t eat a lot of sugar. Normally I eat healthfully and I exercise. I have all these things that I do, but I was like, “All I want is Nutella.” It who was crazy. And I think it was because my body was like you’re sluggish or, I don’t know, drugged.
So I always told myself, “This is going to be temporary. I am not going to be on a sleeping pill for the rest of my life.” I saw where some antihistamines, there’s been some studies that suggest that they’re linked to Alzheimer’s and dementia long term use. I don’t know if that’s true or not. But I was like, “I’m not going to be on this forever.” My grandpa had Alzheimer’s, my grandma had dementia. I’m like, “I’m not going to do this.” But I had grown psychologically dependent. The beautiful thing, I guess, if there is one about hydroxyzine is, you don’t develop a physical dependence.
I knew that it wasn’t like benzos or trazodone, or some of these other heavy duty sleep meds that actually do create dependence. So that was the only reason I took hydroxyzine, is I was like, “I don’t want to get hooked.” But what happened is I developed a psychological dependence on these pills. And I became convinced that if I don’t take them right now in my life, I’m not going to be able to sleep. So on a few occasions, I would be like, “I am going to stop. I’m not going to do this anymore.” And the few times that I tried, it was like a self fulfilling prophecy. I didn’t sleep and I was like, “See, I can’t do it.”
So fast forward about four months or five months. And by this point, I’m like, “This is starting to just feel like a life thing, I just have to have these sleeping pills and I feel so bad about that just because, I don’t know.” It’s probably pride on my part, but I just didn’t want to … I’m very healthy and I just did not want this. So I got on the scale and this is pure vanity. I do know that. But I got on the scale and I had in the last four or five months, I had put on something like nine pounds. And for me because I’m petite, I was like, “Since I was pregnant. I have never put on that weight.”
And I was like, “Oh my gosh.” I can’t blame it all on meds, but I don’t remember eating more, I really do feel that it’s because everything was just sluggish. There’s such a long half life for hydroxyzine, that it’s never fully … It gets out of your system about six hours by the time you take it again. So you’re just always in the state of like, depressed everything. And that is what it took, I was like, “I’m done. I am not taking these.” My husband saw me go to the medicine cabinet and be like, “I don’t care if I never sleep again, I am not having this.” So, that’s what it took for me, and then I had an awful, awful week, a week of just not sleeping.
I found then, and this was sometime in maybe like, late summer, I found a website that was so a labor of love. A woman who had insomnia for three years. And she chronicled her journey, but then also talked about CBT-I and how she was free from it. And so she was trying to help people DIY some CBT-I techniques, but I will say, including very detailed journals, different journals, there were lots of things. And so I read through that whole website. And I was like, “All right, I’m a classically trained musician, and this idea that you have a plan, you implement it, and you practice the heck out of it, and you just do it and you basically stick the landing, right, if you just practice enough.” So this is my background.” So I’m like, “I guess I’m just going to do it. I’m just going to try to do this.”
But somewhere along the line, I didn’t have any support. And I would have questions that would come up like, “Well, what should I do in this case?” And of course, there’s nobody there to ask, and everybody that I know is sleeping fine. So eventually, I just couldn’t really stick with it, I couldn’t really implement it. I never did do sleep restriction, because I was actually very, very … That was almost like a phobia for me, the sleep restriction. So I tried to do all the addressing your worries, get sunlight in the morning, exercise, limit caffeine and alcohol, do all these things. I tried to do all of those things. And those were easy, because it’s like, check. I spent 20 minutes in the sun today, check. But when it came to like really dealing with my schedule, my sleep schedule, I just was half hearted about that.
So I got to the point where I was like, “I don’t know what the next step is, for me.” I had been praying about it as a person of faith. And so often, in my experience, I pray for something and the answer is not immediately there, but it does come. So I was just like, “Well, I don’t know what’s going on with me.” And people were telling me, messaging me and being like, “This could be perimenopause because some women really go through this early and you’re 42 and you don’t have any other symptoms, but it could be that.” And I’m like, “Well.” But they would say it in a way, like so sucks. Like, “There’s nothing you can do about it. You just have to join the party.” So I just had this defeated feeling. And I called my sister who is a therapist, I called her and was like, “Hey, I’m really struggling. I’m sad. I just don’t have time for this. You know, I’ve got a million other things to be doing.”
And she was like, “Well, I don’t have experience dealing with insomnia, but I have a dear friend who just went through a course of CBT-I with a therapist, and I’m going to call her and I’m going to ask her what she did and I’m going to get back to you.” And I said, “Okay.” So, she did. And she called me back and she was like, “Okay, so Aaron said that the number one thing that she thinks set her on track was sleep restriction.” And I was like, “I can’t do sleep restriction. I’m just not, I can’t. I’m already getting such little sleep. I can’t get less sleep than I’m already getting.” And my sister, I’m an oldest and she’s the baby, and she’s very soft spoken. And she’s like, “Well, okay.”
She didn’t want to argue with me. But she was like, “That’s what my friends said. And I don’t know what else to tell you.” So I was like, “Well, I can’t.” Well, what I said is, “Oh, I’ll think about it.” But what I was really thinking is, no. I can’t. Maybe two or three weeks passed, and I was online, just dinging around. I don’t even know what I was doing. And I happened upon an interview that you did with someone else and I listened to the whole thing.
And I was like, “I’m going to look more into this Martin Reed and just see what … It didn’t ever occur to me that I could maybe get support in an online way. I figured I’d have to go to a therapist. That’s what I thought I’d have to do. So I started looking into it, which for people whose minds are not in this place, maybe they’ll think this is woo woo. But I honestly was like, “I think this might be my answer to prayer. I don’t know. I know, it’s going to involve sleep restriction. And I’m going to have to get over it. I know it will, but I need the support.” So I signed up.
And that takes us to whatever other question you want to ask, that was my history up until … I will add this, I’m a very sensitive person. Just like loud sounds, horror movies I can’t do. I’m a writer, just a creative, and I sort of … Even strong perfume smells or anything, just my senses are very sensitive. I’m sensitive to the world, outside world, I don’t watch news. And this has been the way it has been my whole life. And I can remember two other times in my life, but I didn’t have really a word for it. But two other times in my life when I was a young person that I had a season of difficulty sleeping.
I remember High School was hard for me. Towards the end of high school, I was, for a variety of reasons, I remember looking back on it when I was trying to think about my life related to sleep. I thought, “It took me a long time to fall asleep at night in high school. And I was exhausted every day.” I was an orchestra. I was taking private lessons, and traveling and doing all that stuff. I was exhausted. But it took me a long time and I’d have to listen to music to go to sleep.
And then in college, again, driven, double major, and I remember there being a season in college, where, once again, it took me forever to fall asleep. I didn’t wake up ever. I don’t ever remember the waking up thing, except for if I had a nightmare. But I do remember it taking me a long time to fall asleep. And once again, I listened to music. And that did seem to be something that would help me probably because I’m a musician and I don’t know, it just did help me.
When we moved overseas, my family, my husband and I took three little kids, our youngest was four. We were in Asia, and our living conditions were unstable. It was a beautiful experience. We lived there for three years. I don’t regret any of it. I would go back tomorrow. But it was very different. It was a very big adjustment for us and for our kids. And I remember having six months or more of being like, “Wow, this is not jet lag. This is me unable. I cannot go to sleep until two or three in the morning.” In that case, I could sleep in in the morning so it didn’t strike me as like this horrible thing because I was coping. But I don’t like to stay up till two in the morning because usually if that’s happening, it’s because my mind is racing.
So I knew that I’m stressed, this is what it is, I am stressed in my new environment, I’ll get over it. And eventually I did get over it. The difference between those times and now, I’m not really sure, except for this pandemic has gone on and on and on. It’s just such a prolonged thing that I felt this time something was different. And I’m like, “I can’t get over it. I can’t get over it.” And then also just some little fears like bars that had attached themselves to the whole issue of sleep. And also thinking like, “Is this my hormones, am I doomed?” I had kids young. So for me, I’m looking forward to these years. I know menopause is coming at some point, but I’m like, “I don’t want to just live for the next eight to 10 years being like oh, I’m in a hormonal nightmare every day, and I can’t sleep.” Okay, now I’m going to be quiet, you can ask me whatever, or say, whatever.
All of that was great. That’s why I didn’t want to interrupt you. Because I think so many people, although they might not have the same circumstances as you, I think they’ll identify with a lot of what you’ve shared. And that’s because, really, your insomnia or anyone’s insomnia, it shares, far more similarities, it has much more in common from person to person than differences. And just listening to you describe it, it’s like you fit that model that we have that describes how chronic insomnia develops perfectly. This three p model whereby we have the first p being predisposed. Some of us are just predisposed to sleep disruption whether that’s … Like you just described, we can be more sensitive to sounds, we can be really driven, really ambitious, always wanting to advance ourselves in terms of our career, and that can maybe just predispose us to more frequent sleep disruption.
And then we have this the second p, the precipitating event, you identified that as one time when you were traveling, and everything was really different. And more recently, the development of everything related to COVID. So, now we’re over the threshold and we’re experiencing sleep disruption.
Normally, sleep will just get back on track by itself sooner or later, as it did when you were done with that traveling experience, once you had adjusted to that, but sometimes it doesn’t. Like more recently before we started working together, and that’s down to the final p, the perpetuating factors. And these are all the things we do and all the things we think about completely understandably, in response to that sleep disruption, that instead of improving our sleep, perpetuate the problem.
So things like, we might start going to bed earlier than normal, or staying in bed later than normal, maybe trying to nap during the day, modifying our days in response to how we sleep, calling in sick, deciding we can’t meet friends, experimenting with pills, and supplements, all these different things. And they can perpetuate sleep disruption because they end up weakening our natural sleep drive, they can disrupt our body clock, and they can increase arousal.
All of these things are exactly what you described. And you became so tantalizingly close to addressing all those perpetuating issues. But you quite understandably, balked at this idea of spending less time in bed and went down the path of sleep hygiene, which I think is, again, important to mention or to just emphasize, because, unfortunately, for people with chronic insomnia, that’s their first stop that’s the thing that they’re recommended, or that’s the thing they find when they go online.
But we know, well, let me rephrase that. People who work with people with chronic insomnia know that sleep hygiene is not effective for people with chronic insomnia. Sleep hygiene is more to do with prevention, rather than addressing the problem. The reason that can be problematic is because, then, when we try sleep hygiene, it doesn’t work, then we can become even more worried that there’s something unique with our insomnia. We’re beyond help, and that something is seriously wrong. But in reality, the fact that our sleep is the same even after implementing sleep hygiene is to be expected.
So then you went on to, you were looking at the medication. And I think the ironic thing with that is just as you described, you felt like you were getting a little bit better sleep or you were falling asleep faster, but the way you were feeling during the day, it doesn’t sound very appealing just the way you were describing it. And when we consider that, so much of our concern, as it relates to chronic insomnia is how it’s going to impact our day. When we then take a pill, and we associate that pill with not having a great day, we get to this point where we have to ask ourselves, “Well, what is this actually offering me?” Because it seems to be that the solution is maybe even making the worst possible outcome even worse, so to speak.
And one thing that I always like to say, regardless of if someone is taking medication or not, is, sleep is only ever generated by the body. Medication can generate sedation, it can lower arousal, worry or anxiety about sleep, but any sleep we get, any true sleep we get is always being generated by the body. So, I always like to emphasize that because sometimes we can develop this belief that we’re only sleeping because we’re taking medication, especially when we get to that point where we’ve decided or we try and experiment to come off of it. And we find that we’re struggling with sleep again. And then we can really think, “Oh, I must need this to sleep.” But the reality is, anytime we make a change, especially when we already have a heightened level of arousal around sleep, more monitoring for it, the brain wants to see what the consequences. So we don’t take a pill, then the brain has to stay a little bit more active just to see what the outcome is.
And because our brain is more active, because the arousal is a little bit higher, we then need more sleep drive to overpower that arousal and make sleep happen. So, if we’re able to stick with it, eventually sleep drive will make sleep happen. But what can be so easy to happen when we’ve lost all of our confidence around sleep is, that night, we don’t take a pill or we take less of the medication and we have a difficult night, it can reinforce this mistake and belief that we can only sleep with the pills and with the medication.
Yeah, absolutely. And that’s exactly what happened to me. And then the sense of, almost weird sense of failure. Like, I’m trying to get off this medicine, but I can’t. Or I can but maybe it’s going to mean sleep is a thing of the past. It’s really sad. It’s an emotional thing too, it was for me. I felt just defeated, really. So-
Yeah. Just because I know a lot of people are going to be curious, what was that website when you first learned about sleep restriction and sleep hygiene, etc.etera, do you remember?
Okay, I think it’s insomnia-free.com. And I think there’s a dash. I’m trying to visualize it. I have bookmarked it. Because the woman is funny too. It’s funny, and after going through your course, going back and rereading now with having been through it, I’m like, “Oh, she’s she’s saying stuff that is absolutely true. It’s consistent. It’s not like she’s offering wacky advice.” It’s just that she’s asking people to do things that I think are often difficult to do without a human being on the other end being like, “Here’s how you need to do this, or, what do you think about this?” It’s support.
Yeah, I think that’s the main downside of trying to DIY it. I’ll DIY any number of things. But this was something where I was like, “I can’t do it without help.”
Yeah. And that is a theme that comes up a lot just in these podcast discussions because the techniques themselves, and we’ll definitely talk about them a little bit more in a moment, the techniques themselves on paper, they sound pretty straightforward. Really, they are pretty straightforward. But they’re not easy to implement, especially in the short term. And if we’re already at that stage where we have a lot of worry or concern or anxiety about sleep, this idea that maybe our sleep is even going to get worse than it is right now, it’s going to get worse before it gets better if we do this, that alone, it can be hard enough to get started, let alone to keep going before you actually start to get the results, because the results rarely occur immediately. You have to put yourself through this, staying consistent before the results happen. And it can be hard.
And so I think it is helpful to have, whether it’s a coach, whether it’s a therapist, whether it’s some other expert, who’s really familiar with the techniques, to help just reassure you, that everything you’re going through everything you’re experiencing is normal. And if you just keep going there is that light at the end of the tunnel.
Yeah, absolutely. I wish I could have been chilled out about it. I mean, the truth is, if I could have been chilled, which I’m never chill about anything, but if I could somehow be just like, “Yeah it’s okay.” I probably could have implemented some of the things, or most of the things, maybe all the things that I found on that that website, because it’s very wonderful. It’s a wonderful resource. But by the time I was reading that website, I was desperate. And so I didn’t feel objective at all. I felt the way a person feels like they’re slipping under the waves will grab anyone who’s near them, and try to drown them too inadvertently. Because you just have that sense of, I’m desperate. And so yeah, especially, like you said, when you’re in a situation where you already feel big emotions about not sleeping, and maybe in some cases, even full on anxiety, then you need a human being. I just really do believe that.
Yeah. So let’s move on to the techniques that you are implementing, because I remember when we first started working together and you showed me that first sleep log, that first sleep diary that you submitted, again, just like many people with insomnia, you were spending a lot of time in bed each night, definitely a lot longer compared to the amount of sleep you were typically getting on an average night. And this is one of those perpetuating factors. Because, it can weaken sleep drive when we spend a lot of time in bed, going to bed before we’re sleepy enough for sleep, and it can increase arousal as well, because we just set ourselves up for prolonged nighttime wakefulness.
So I believe we came up with an initial plan. And we said, “Well, how about just giving yourself six hours in bed each night. Allotting six hours for sleep each night?” So when you first heard that, what were your initial thoughts? Was it something you were expecting and prepared for and feeling enthusiastic about? What were your thoughts about it and how did you then progress on to actually implementing that?
Well, my entire life, had instructors or mentors, or in many cases music teachers, and I’ve related one-on-one to them. If I consider them to be the expert, I’m like, “You told me to do it, I’ll do it.” The time for even thinking about it and feeling anything about it, is done. I am in it. And I’m going to do it. I think initially, I felt a little sorry for myself, because my husband is an early to bed early to rise guy. And so I knew that what this was going to mean is that I was going to be out in the living room. My kids are night owls, teenagers are, they’re just night owls.
So I knew that what that was really going to mean, because we don’t have a huge house, is that I was going to be spending time in the main area, which was not going to be relaxing, per se. It’s just life. So, it wasn’t like I could go to a den somewhere and just chill and be like, “Okay, I’m just relaxing.” No. It was like, “Oh, I can’t go to bed. I have to stay up till midnight, and kids are going to be up.” They’re wonderful. I love them so much, but I’m an introvert and I would have ideally liked to just be by myself for that time read or whatever. But that’s not typically what happened. Although they were really good. They knew I did not want to be awake.
So, at one point, I literally sat in a chair, and I put headphones on, I wasn’t even listening to anything. I was like, “This is me, creating a wall around me. I can’t have any heartfelt conversations. I can’t do any of that right now. I am just going to be sitting here and trying to allow my body to just relax.” And I will say that, it wasn’t the staying up that was so terrible, although I did get tired, so super tired at like eight or nine. And I would often have to fight falling asleep. It wasn’t the staying up that was so terrible, it was waking up at 6:00 every morning, regardless of if I slept or not. That hurt.
And for my husband, it’s fine, because he’s already getting up. But the kids were sleeping, I just was dragging myself out of bed and being like, “Oh, man, this is … But I had this feeling of, this is going to work. I had already looked up before I even approached you. Just from the NIH and other studies that said that sleep restriction was extremely effective in many, many cases. So I already went in with this idea that this is like eating your broccoli. Like, “I know that this is going to work. So I’m just going to do it.” So yeah.
That’s great. Yeah, I think it’s an awful phrase sleep restriction, isn’t it? Because it implies that we’re restricting sleep itself, but we’re not, we’re just restricting the amount of time we spend in bed to more closely match the amount of time we typically spend asleep. Not the amount of sleep we want to get, but just the amount of sleep we’re currently getting. So really, I think it should be called wakefulness restriction. I think that’s a more appropriate and approachable phrase as well. Because when you hear sleep restriction, when you already have insomnia, you’re like, “I’m already restricting my sleep. Why would I want to restrict it anymore?”
Right, yeah. That’s a good idea.
Maybe you’re going to give me the same answer, but, how did you stick to that consistent out of bed time? Because that is something that people do often struggle with, especially when, I don’t know, it’s almost like someone’s working against you, and you can be up all night, and then you fall asleep an hour before the sleep window ends, then your alarm goes off. And you think to yourself, “If I just shut that alarm off, I know, I’ll get like three or four hours of sleep. But the rules say, I’ve got to get out of bed.” How do you deal with that challenge? How do you just force yourself to get out of bed?
Well, it’s probably different for everyone, what gives you the motivation to do that. For me in my particular personality, it doesn’t matter if I’m training for a race, because I run or whether it’s weight training, or whether it’s performing or writing finishing a novel, if it’s a program, and I’m like “I have a plan.” Then I’m going to do the plan. That’s how I am, I’m maybe a little tiny bit Taipei. But really, I’m like, “That’s what the plan says I’m doing it.”
And I think the reason I do that, the way I shift to, that’s the plan, just work the plan, is because if I actually try to check inside, and be like, “Do I feel like doing this? How am I feeling today?” I don’t get good feedback, because I’m actually feeling bad. I’m feeling bad, because it’s not fun to do something that feels like a struggle, right? We don’t want to struggle in life at all, we would never choose it. But that’s where growth is often. So I think rather than looking inside and trying to take my internal temperature, I just was like, “This is the plan. I’m working the plan. That’s all there is to it.” So I just did, I just did.
I think that can be helpful. I like to use the phrase set it and forget it, were you just have this list of rules, and you’re just going to follow it no matter what. And you also raised a really good point about if we’re just always evaluating every day, well, was getting up at 6:00 in the morning helpful? Was not going to bed until midnight helpful? How was my sleep last night? And then thinking about what’s my sleep going to be like tonight? Obviously, it’s completely natural, that’s where your mind wants to go. But when we’re just doing this ongoing evaluation and exploration, all we’re really doing unfortunately, is just increasing that arousal. We’re just bringing more focus and attention to sleep and like you touched upon, when we look for things we tend to find them.
So if we look for, let’s say we have a couple of hours, we have a really bad night, we have a couple of hours of sleep, maybe no sleep, whether it’s subconsciously or consciously we’ll probably scan our bodies for all the effects and when we scan our body looking for something we probably going to find it. So we might notice like aches and pains and niggles and anything negative that happens during the day, we’re just going to immediately by default, blame that on our sleep, which it might be connected, but it might not be. And this is another one of those things that can then perpetuate the sleep disruption because it just feeds into this arousal system and just makes us more worried about sleep. So I think that was some really good insights there that you just took the set it and forget it approach. And instead of putting effort into evaluation, it was all focused on implementation.
Yes. And lest I sound like I just did everything great, as you know, I had real moments of low points of being like, yes, I do see improvement, but I’m seeing improvement in to the tune of like, 20 minutes of more sleep stretched over many days. And I think I got to the point where I was starting to lose my nerve of just like, “It isn’t even that I feel bad.” Because when I really filled out the sleep diaries, I was like, “You know what, every single day, I’m I’m doing pretty well, like every day.” There were some days where I felt low energy towards the end of the day, and you encouraged me, “Why don’t you just work out anyways? Or why don’t you just try, test your limits a little bit to see if maybe you’re capable of a lot more even on less sleep. And I’m glad that you said that I did do it. And I did find that I was totally okay.
So that was good to test some of those beliefs that I had. I think the biggest hurdle for me was an emotional one. Again, I’m pretty strong. And I’m pretty strong mentally. But sleep has always been like … I was that mom that I had postpartum depression every single time and I had three kids in a very short amount of time. So I was very, very tired. And I remember being like, “I would have 10 kids, except for, I cannot stand the waking up multiple times in the night with the baby that lasts forever.” So sleep has always been for me, I think an emotional, not getting sleep, because I want to actually lose consciousness. And I want to have a break from my own brain.
And so, about halfway through our time with doing this course, I was seeing progress. But I also was having bad nights still, on occasion. And when I would have those bad nights, I would be like, “I cannot believe how much this is setting me back emotionally. I really feel like I need to call my therapist sister because I’m so upset about it.” And I’m just going to say this, because I think a lot of people fall into this category, I would guess, maybe it’s just me. You said this, and you were very gentle about it. But the bottom line is, sleep is not something you can control. And with so much in my life that felt like it was out of my control because of the pandemic, and because I liked to just be an achiever, I really did have this mindset of like, “I know it’s not something I can control, yes, but actually I really can. Because if I just do everything correctly, I will be able to control it.”
And then when I would have a bad night, it felt like getting an F on an algebra test. I’m like, “I am doing everything and this is the result that I get.” So honestly, I think there were two levels going on here. We don’t have to go in this direction. But there was one level where you were dealing with the sleep. But there’s another level where I think God was dealing with me because I want to control things. I know it’s human. I know, we all want to control our environment as much as possible. But there are some things that ultimately you and I have no control over. We can do positive things. I’m not saying that we’re robots, we can make meaningful choices, but there are things that are beyond our ability to control.
For instance, I’m in this stage right now, where two of the three of my kids have driver’s license, they work, they are still able to work even through the pandemic and they work at night, which means they’re on the road at night. They get home at 10:00. But I actually have to fight imagining, what if they get in a car accident? What if something happens to them? Because I cannot control that. So this is meta, but sleep for me, was actually more than just sleep. It was about letting go of control of the things that I can’t control.
Yeah. I think that’s a great point. And going back to the core of it again, it’s completely understandable why we would want to control it. Pretty much everything in our life responds positively to effort. Maybe sleep might be the only exception to that. But it’s understandable why we want to put effort into sleep, why we want to control sleep, but we cannot. But that doesn’t mean that we’re beyond help. Because what we can do is we can control how we react to difficult nights, we can control our sleep related behaviors, there are things we can control that increase the likelihood of better sleep, that create good conditions for sleep. And so I think that’s really helpful.
And also exploring this idea of, well, why do I want to control sleep? And then we can go down this route. “Well, I want to control sleep, because I know that if I have a difficult night, for example, I can’t go out and eat, I won’t be able to go to the movies, I won’t be able to go to a restaurant, I won’t be able to work out as well. I won’t be able to exercise as well.”
So how about now we test that belief? So instead of, lets just use working out, instead of not working out because I had a difficult night, how about we just try it and just test that belief. Test it. Just an experiment, because it might be true. But we don’t know unless we try it out. And sometimes when we do that, maybe we can’t work out as intensely or it doesn’t feel as good, but often we can be surprised by how capable we can be even after a really difficult night, maybe even after no sleep, maybe even after a few nights of little to no sleep.
And then we can think, “Maybe I don’t have to worry quite so much about sleep, maybe I don’t have to try and control sleep quite as much.” And then that in turn can help just lower all that sleep related arousal one of these things that perpetuates insomnia, and really keep us on that path towards better sleep.
Yes, absolutely. And that’s been the case for me. I’ve had to confront a lot of sleep fears or fears that are associated with not sleeping, and then combat those with more rational and true thoughts. And in the last month, my sleep has only continued to improve. This last week was crazy, because we had plumbing issues in our house. And we had a technician in our house till almost midnight.
So there were a couple of nights that were wacky, not because of insomnia, but because of extenuating circumstances, which is life. I did have the night before last, we think that my son has COVID it’s very mild, but he has some symptoms and lost all sense of taste and so we were like, “Man.” He’s okay, and we’re all okay, but it meant that we were all quarantined. The day that that happened, which was a couple of days ago, the day that that happened, I was like, “No, not again.” And that night, I fell asleep fine as normal. But woke up in the night, laid there tried to go back to sleep. And for the first time in many, many days, I was like, “I got to get up. I got to get up and get out of bed. Got to go do something else.” Then I eventually came back in, did not look at the clock. My clocks are all in my bedroom. They’re turned away. I never look at them.
Didn’t even look at it on the microwave where I was when I got up and then laid back down eventually, slept through the night and when I calculated my sleep, it was a decent amount. It was like six hours. But that’s such a huge change because even having a difficult night. I bounced back, I exercised to the next day, and the day after which was last night I slept eight hours. And now for me at week 12, I’m routinely sleeping between seven and eight hours. And seven hours is on the skimpy side like typically seven and a half. But sometimes eight. That’s pretty much how much sleep I got before all of this happened.
The reason I share that story about even this week is because I still, some nights, will lay there and have this residual, fluttery heart, little bit of rapid heartbeat, falling asleep almost like my body wants to not do it. But I’m like, “I’m just accepting this feeling, it’s okay, this is not going to keep me from sleeping.” And then I do fall asleep within about 10 to 15 minutes. And this is a huge change for me. But I want to say this to give hope to anyone who may be the anxiety lingers a bit longer than … It’s not something that for me has just gone away. I don’t have anxiety in the day, like it is 100% better. Because in a lot of ways, life is still crazy around here. It’s crazy town in the US.
So we’re still all living through some very big things, very momentous things in our history, and that does get under your skin. And so I would be lying if I said that I don’t still have to be mindful of like, “Okay, I’m feeling a little ramped up.” Wait an extra 15 minutes before trying to go to bed or.” And yet, I’m still sleeping between seven and eight hours a night and I don’t wake up that often. If I do, it’s probably one or two nights a week and I wake up for like, 30 seconds, and I’m right back asleep.
So I say all that to say that, like the techniques work, they work better than I could have hoped. And even though I felt very low a couple of times during that eight weeks. And I still sometimes struggle with feeling like, “Why am I feeling so performance oriented with sleep? It’s stupid. Why is this so much part of my DNA that I can’t let go of that tendency?” But those habits die hard. It took me a while to get insomnia and I think it’s just taking me a while to deprogram from that way of seeing it, I guess.
Yeah, I think that’s a great way of looking at it. It took a while for the insomnia to develop. So it makes sense, it’s going to take time for you to move past it. And it’s not just this magic on off switch, there is going to be ups and downs along the way. And if you have worry or anxiety about sleep, that’s really something that is tackled over the longer term, through just repeatedly experiencing better nights. Those thoughts that once generated really intense worry or anxiety lose their power. That’s not to say they go away, but they lose their power. And we react in a different way to them.
One reason why I love all these behavioral change techniques, and just changing the way we think about sleep is, and I think you touched upon this, is they build resilience. It’s almost like we come out of it a much stronger person than before the insomnia ever affected us. Because we know how to react, we’ve gone through this, we’ve come out of it. So we feel stronger. We are then armed with all these skills and techniques. So we know exactly how to respond to difficult nights. And we know that should insomnia every return, we just do exactly what we did in the past that worked for us, we just do it again. And there’s no reason to believe it won’t work again.
Yes. And in fact, I printed out that encouragement checklist that you have where you talk about don’t panic if you experience a couple of bad nights in a row, you beat insomnia before you can beat it again. And it is a reminder of what are some of the techniques that worked last time. And I have this full length mirror in my bedroom, and I just taped it to the top of my mirror. It’s almost like when a baby has a blankie or a pasty because I just have it there. And I’m like, “I don’t need it right now because I am consistently getting better. But there’s my list. And if I do need it, there it is.” So yeah, that was really helpful.
That’s great. And another point you touched upon is how you’ve just continued to make progress, even though we’re not working together anymore. And that’s another reason why I love these techniques. Because they’re skills based, and it’s almost just like learning new habits. And so once we’ve implemented them, got some results from them, we’re confident in our effectiveness, we become our own coach, we become our own therapist, we become our own counselor, we become our own cheerleader, and we can just go ahead and just carry on by ourselves. And that experience that you just touched upon of, my sleep is still doing well, still getting better, still having better nights. Even though the training wheels are off, I’m doing this by myself now. And that’s another reason why I’m just so enthusiastic about just behavioral change and exploring thoughts that perpetuate insomnia as a way of moving past insomnia, because it’s just so helpful for the long term.
Yeah, absolutely. And so I’m just very pleased. I’m very thankful for the way that this has turned out. And I’m very thankful for the way that you were super quick to respond, answer questions. Basically, it helped me breathe into a paper bag a couple of times, I was like, “I’m not okay.” That has helped me and I … Yeah, you can’t really put a price on that. So, I just want to thank you publicly for that.
Well, I appreciate that. Talking about the techniques themselves we’ve covered how you allotted a more appropriate amount of time for sleep restriction, the official phrase for it, we briefly touched upon this technique of just getting out of bed, whenever being in bed doesn’t feel good during the night. Just to try and make that wakefulness a bit more pleasant, to eliminate any temptation to put effort into sleep and to prevent you from reinforcing any negative association between your bed and just unpleasant emotions, unpleasant wakefulness.
And you touched upon exploring the beliefs that you may have had, that you may have developed about sleep that may have been encouraging you to put pressure on yourself to sleep to try and control sleep, what the next day will be like, or I can’t do this if I have a difficult night. So I know that we’ve covered those, was there anything else that we might be missing? Was there anything else that you picked up that you found particularly helpful that you think anyone listening to this might find useful?
Well, I will just say that I liked how, when it came to relaxation techniques that you were very open ended with that, and encouraged us to pick something that we resonated with, or something that seemed like it worked, but not to feel tied to one method or another. For me, what has been most successful, I would say, in dealing with sleep, anxiety, even that hyper arousal that your body wants to do, even when you didn’t have it five seconds before you laid down and then you lie down and you’re like.
For me, what was ultimately more effective is to simply sit with that feeling and not try to fight it in any way. Not that relaxation techniques are fighting it. I know those are there to help your body and also to help distract your mind basically, from focusing on your anxiety. But for me, it was more effective to just let it pass. I think the more attention that I give to those feelings, and maybe because I am so performance driven, it feels like even relaxing can be, am I good? Am I doing a good job relaxing? Sometimes it’s better for me to just be like, “This is a bad feeling. And it’s okay, it’s not actually going to kill me.” Just like weightlifting. Sometimes when you’re squatting with a barbell on your back, it feels bad. You feel like you’re going to, I don’t know, explode. But it’s okay. It’ll be okay.
And so I think that kind of self talk actually, has been more effective for me. And one more thing, I did implement the getting out of bed sometimes in the early stages multiple times a night. I found that to be the most difficult thing of any of it. That was extremely hard for me. I’ve looked on your forum and seen some other, and it may be hard for both men and women, but what I’ve seen, it seems especially hard for women. I think it’s because we’re cold at night, a lot of us, and getting out of bed feels like murder.
So, I did do it, but about halfway through, I tweaked it and I was so glad, you confirmed this and said that this was okay. If I’m not feeling bad in bed, if I’m not feeling anxious, if it’s not a negative, then I can just be comfortable and lay there. And I don’t necessarily have to leave bed, if being in bed is okay and it seems like the conditions would, as you said, would be right for sleep. That was helpful for me because, again, the getting out of bed, it was good initially. I think it did really break that connection that being in bed is to struggle. But long term, man, especially in the winter, I was like, “Oh, this is the worst.” So, that actually was the hardest technique for me. It might be for somebody else too. But it can be really helpful.
Yeah. It is definitely a challenging technique, especially when, again, it comes down to this, we’re striving for sleep, we want sleep to happen. So the last thing we want to do is get out of bed. But, at the end of the day, if we’re awake anyway, if that wakefulness feels unpleasant, we might as well do something that’s going to make that wakefulness a little bit more pleasant. So I think it can be helpful to reframe it, instead of thinking, “Oh, I’ve been awake for 20 minutes, half an hour, I have to get out of bed.” How about well, does it feel good? And if it feels good to be in bed, then why get out of bed? Because it feels good, you’re in your sleep window, conditions feel right for sleep, maybe sleep will happen.
And that can make it a lot more approachable, and I think just as effective, because all we’re really trying to do is make sure that nighttime wakefulness isn’t unpleasant. And we’re trying to avoid reinforcing this negative association between the bed and unpleasant wakefulness. And I think it was also really important what you said about, I know we’ve touched upon our temptation to control sleep, but your temptation to control your thoughts about sleep, trying to suppress thoughts, trying to push them away from your mind, trying to convince yourself that those thoughts aren’t there or that they’re true or that they’re false.
All of this can be really unhelpful. Just recognizing that thoughts are just thoughts can be helpful, that they’re not always accurate, that they’re not necessarily facts, and that we don’t have to respond to them. But I think that is a higher level skill that can take a lot of practice, and it can take time to get to that point. But I just think it was helpful the way you mentioned that because so much of it can come down to control. And with your permission, I know, I emailed you this before our chat, I would love to just quickly read that excerpts that you emailed me when we were working together about this apparent conflict between, well, you’re telling me not to control sleep or put effort into sleep. So therefore, why am I staying out of bed until midnight? Why am I getting out of bed at three in the morning? Why am I doing all these things? Surely that’s effort, but the way you phrased it was just brilliant. So I’d love to read that if that’s okay with you.
It’s all right, go ahead.
All right, so this is what you said. “I guess the problem as I see it, is, we sign up for the course because we know something’s wrong and needs correcting. We want sleep. But in order for it to work, we have to convince ourselves that we don’t care if we sleep, thus lowering our anxiety. But deep down, we know we do care. So the game then becomes, how can I trick myself into a state of not caring? That’s probably crudely put, but that’s how it seems to me. I know I want more sleep, or I wouldn’t be doing what I’m doing. But I’m finding it really hard not to care about sleeping. I’m trying to follow all of the suggestions religiously, but it seems like my sleep anxiety wants to metastasize with every effort I make, and that’s what I want to overcome.” So looking back on that now, what would you say your answer is to that apparently conflict between not caring, but caring enough to make changes.
I wish I could remember or put my finger on the point at which it started to shift for me, because I wrote that and was like, seriously, this is what I consider to be the Achilles heel mentally of all of this, is like, how do you reconcile this? But I have to say over time, and I do not remember when it happened, I did start caring a little bit less about sleeping. And I think the reason that I started caring less, is that I was like, “The truth is, I’m actually doing okay whether I sleep or not.”
So it’s like when you’re watching what you eat, and you’re trying to eat more healthfully, you cannot literally control metabolically what your body system is doing, how it burns the calories, what it does with the nutrients, that’s beyond you. But what you can do is be like, “You know what, part of who I want to be as a person that does what I can do to take care of my body. So I’m going to enact these things. I’m going to eat a green salad, because I know, it’s good, and I want to do it.” But as far as being obsessive about like, “Okay, so then what does that mean? What nutrients went where?” It’s like, that doesn’t matter.
So, I’ll be honest with you, it’s like, I don’t remember. But I was thinking about it the other day when you sent me that email, and I was like, “I didn’t do any tricking of my mind. It just over time, it just happened. I just started realizing.” Actually what I think it is, is it’s time, you have to just prove it to yourself that you’re going to continue to be okay. And I think when that shift happens, it’s like, “Oh, okay. Okay. You know what, it’s going to be fine.” On the night that the plumber was here, I’m looking at my look at my watch and like, “I cannot believe this.” I was like, “But you know what, who cares? It’s okay.”
I think the one thing that still does get me is, if I wake up in the night, and I feel anxiety, which is rare, it’s actually becoming extremely rare. But if it does happen, that is still the thing that I’m like, “I have to actively practice self talk.” Literally like, “It’s okay, everyone wakes up in the night. That’s normal. I can lay here if it feels good. And if it doesn’t, I can get up.” I have to sometimes. It’s like Sesame Street, I have to tell myself this little thing. It happened the night before last, as I said, but I think the issue was, our son was like, “I don’t feel good. And I can’t taste.” And I was like, “uhhhhhhhh!”.
I wasn’t worried for his, really, he’s fine. But I just was more like, “Oh, life has changed again, we cannot go out. Oh my gosh, for 14 days.” So I think that I still am in that fragile state where sometimes I have to practice this self talk. But in general, I just do care about sleep less.
Yeah. And I think you make a good point there that, we’re always going to experience temporary sleep disruption from time to time, it’s just a normal part of life. And I think it would be more unusual not to experience sleep disruption if we’re concerned that our child, for example, may have COVID. I think it would be more unusual to sleep well after receiving such news or worrying about that. But the beauty of it, the change now is that you have a plan in place, like you just touched upon. You know that if you wake during the night, you can just remind yourself that, “Look, waking during the night is normal.” And you know that if being a bed doesn’t feel good, you’ve got something else to do instead.
And I think that it really comes down to just controlling what we can control. These techniques, they’re not intended to convince us, you should not care about sleep, just pretend you don’t care about sleep, because sleep is important. But we do sleep even people with chronic insomnia, we do sleep, just typically less sleep than we want to get. And our body will always give us at the very least the bare minimum amount of sleep we need. So really, our intention is just to direct our attention towards things that we can control like exploring, evaluating the thoughts about sleep that might not be accurate, but generate a lot of worry and sleep disruption.
If we can lower that arousal system, while building the sleep drive, strengthening the body clock, we’re going to create better conditions for sleep to occur. So I think, really the summary is to just put our effort and attention into controlling things or exerting effort constructively on things that we can control where it’s worth putting the effort in, and put it into sleep directly itself isn’t helpful because we cannot control sleep.
Right. One of the most helpful things I think that I clung to, that you said is the body … Well I’ve said it to myself, the body will always give the bare minimum of what you need. It will always at least do that. It made sense to me, it clicked, I told myself that a million times, I will just say, also to listeners, just briefly, you don’t have to wait to start this course, when you feel like you’ve got just the ideal space and time to do it. I started a new job coinciding with starting this course. I had a total life change. And so, that could have produced a lot of anxiety like, “Well, I have to get up and I’ve got all the stuff to do. And I’m balancing home life and also I’m trying to … But actually what it did is, it allowed me to be distracted in the day from thinking about sleep, and then just working the plan at night.
And yes, there were some times where I’m like, especially in the late afternoon or early evening, if I tried to watch TV while I was doing sleep restriction. My kids would be like, “Mom, mom, you’re falling asleep.” So I did have some moments like that. But what I want to say to anybody is, you can actually do this at any time. I mean, tomorrow is a good time to start it, today. You can do it at any time, you don’t have to wait for the perfect time. Like when you have a break or something like that. You really can do this and go on with normal life.
Yeah. I think with anything, it’s always hard to find that perfect time, isn’t it?
What springs to my mind is having children. When should we have children? There’s never a perfect time to have children.
If that’s your plan, then you’ll probably never end up having children. But yeah, that’s what sprung to my mind when you mentioned that is, there is never a perfect time. So sooner rather than later is often the best approach, if that’s something that you want to do. And so, in terms of insomnia, or if you’re keen to start implementing techniques to improve sleep, then why wait, you’ve probably tried a million things already that haven’t proven to be helpful, why not try something else that will probably be more difficult, more challenging, but is proven to get results.
But anyway, Hannah, I know I’ve taken a lot of your time. And I really appreciate you coming on and giving up your time to talk about your transformation, I like to call it, it is a transformation. But I always like to end with the same question in all of these episodes. So I’d like to ask it to you as well, so as one last question. If someone with chronic insomnia is listening, and feels as though they’ve tried everything, that they are beyond help, and that they can’t do anything to improve their sleep, what would you tell them?
Well, I would tell them that you really can. I have three kids, we’re living through a pandemic, there’s all kinds of stuff going on, stress levels are high, my hormones are starting to shift, there are all of these reasons why I shouldn’t be able to experience much improvement. My anxiety had reached such a level before I started this, that I was on medication. And we were even possibly talking about getting on an anti anxiety med, which some people legitimately need, but in hindsight, I realize would have created more problems for me than solving them, because my anxiety was related to sleep.
So I say all that to say, if I can experience improvement, you can too. It is absolutely possible. And it’s a gift you should give yourself. It might be harder in the short term, but almost everything good and worth it is hard in the short term for long term gain.
That’s great. I think that’s a fantastic note to end on. So thank you again, Hannah for coming on and sharing your time and sharing your experience and your transformation.
It was my pleasure. Thank you.
Thanks for listening to The Insomnia Coach Podcast. If you’re ready to implement evidence-based cognitive and behavioral techniques to improve your sleep but think you might need some additional support and guidance, I would love to help. There are two ways we can work together. First, you can get my online coaching course. This is the most popular option. My course combines sleep education with individualized coaching and is guaranteed to improve your sleep. You will learn new ways of thinking about sleep and implement better sleep habits over a period of eight weeks. This gives you time to build sleep confidence and notice results without feeling overwhelmed. You can get the course and start right now at insomniacoach.com/online.
I also offer a phone coaching package where we start with a one hour call. This can be voice only or video, your choice, and we come up with an initial two-week plan that will have you implementing cognitive and behavioral techniques that will lead to long term improvements in your sleep. You get unlimited email-based support and guidance for two weeks after the call along with a half-hour follow-up call at the end of the two weeks. You can book the phone coaching package at insomniacoach.com/phone.
I hope you enjoyed this episode of the Insomnia Coach Podcast. I’m Martin Reed, and as always, I’d like to leave you with this important reminder — you can sleep.
Mentioned in this episode:
I want you to be the next insomnia success story I share! If you're ready to stop struggling with sleep and get your life back from insomnia, you can start my insomnia coaching course at insomniacoach.com.
