Insomnia Coach® Podcast

Michael Schwartz is the founder of MicroSleep, LLC, and the program director for the Clinical Sleep Health Program at the Oregon Institute of Technology. Michael has over 30 years of experience in sleep. He's a registered and licensed sleep technologist, and he's certified in clinical sleep health. Michael can be found at SleeponQ.com and on Twitter. His Sleep on Cue app is available for iOS devices and Android devices. In this episode, I talk to Michael about cognitive behavioral therapy for insomnia (CBT-I) and intensive sleep retraining.

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Transcript

Martin Reed: Welcome to The Insomnia Coach Podcast. My name is Martin Reed. I believe that nobody needs to live with chronic insomnia and that cognitive behavioral therapy for insomnia (CBT-I) techniques can help you enjoy better sleep for the rest of your life.

Martin Reed: All right. I'm here with Michael Schwartz. He's the founder of MicroSleep, LLC, and the program director for the Clinical Sleep Health Program at the Oregon Institute of Technology. Michael has over 30 years or experience in sleep. He's a registered and licensed sleep technologist, and he's certified in clinical sleep health.

Martin Reed: First of all, you do have a lot of experience in the field of sleep. How did you get involved in sleep?

Michael Schwartz: Let's see. I came out of college with a degree in psychology, and I do remember them talking a little bit about sleep in a couple psychology classes. Which I think is interesting, because we always hear in medical school that they don't really talk much about sleep. I remembered a little bit of it, and thought it was really interesting, and then didn't think much of it after that.

Michael Schwartz: Then I got out of college and was doing odd jobs in the summer, and I was actually painting a house. The person whose house I was painting was the best friend of a manager of a local sleep lab. The lady stuck her head out the window and said, "Hey, Mike, are you a night person?" I said, "What do you mean?" She said, "There's a job as a sleep technician down the road. Are you interested?"

Michael Schwartz: One thing led to another, and I was hired on to work nights in a sleep lab. Then I was running the big stainless steel polygraph machine with the Z-fold paper. Then that was in the mid to late '80s, and started off down in Southern California, and then just went on from there.

Martin Reed: Great. Now you do a lot of work, especially ... You still do a lot of the sleep apnea work, but you also do a lot of work with insomnia, as well, right? How did you branch out from doing this sleep lab work into insomnia?

Michael Schwartz: With a background in psychology, I was familiar with some of the aspects of insomnia. It was just always a bit of an interest of mine. When I eventually made my way up to Oregon in the 1990s, there was a medical director of the sleep lab where I was in who was a pulmonologist, and was actually quite interested in chronic insomnia. We started talking, and one thing led to another, and he worked it out where I could educate patients. I would provide sleep education.

Michael Schwartz: That's really how I started working with patients in a hospital setting who had, primarily, chronic insomnia. A large number of them had comorbid sleep apnea, so it was a combination type patient that I was educating. It was mostly sleep hygiene, but there was some of the other components that are a little more helpful for chronic insomnia that I was allowed to phrase in my own way with t...

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Ann is a college professor from New York City who had been struggling with sleep for over 30 years and got great results using cognitive behavioral therapy for insomnia (CBT-I) techniques.

In this episode, Ann describes how her sleep issues began, all the ways she tried to improve her sleep without success, and how she finally managed to get her sleep back on track. I think many people with chronic insomnia will recognize Ann's struggles with sleep — and the good news is, of course, that since CBT-I techniques worked for Ann, it's very likely they'll work for you, too.

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Martin Reed: Welcome to The Insomnia Coach Podcast. My name is Martin Reed. I believe that nobody needs to live with chronic insomnia and that cognitive behavioral therapy for insomnia (CBT-I) techniques can help you enjoy better sleep for the rest of your life.

Martin Reed: Okay, so I'm here with Ann Vigo who went through my online coaching course, I think it was around seven months ago now. Ann is a college professor in New York City, I believe. So thanks for for joining me today, Ann.

Ann Vigo: Of course, thanks for having me on.

Martin Reed: So, this is great to have you. Can you tell me a little bit more about like the start of your sleep issues? When did it start and how did it start for you?

Ann Vigo: For me, it started with gaining independence. I never went through sleep issues in college, I was kind of happy in my scholastic world and my ivory tower. And then when it came time to finding a real job, dealing with independence, those were like big issues for me, finding a career I really liked because my studies really didn't translate to really a practical job. I don't think I was very practical. So I had to deal with a lot of reality facing and growing up really, growing up becoming an adult. And these were like struggles for me.

Ann Vigo: And another part of my struggle was a social phobia, where I had kind of isolated myself for a lot of my growing up years, like really formative years, and I didn't have the social connections I should have. So then when it came time to really be out there and to function in life, to function in a career, you need to have a network to have friends, and all this which was natural to most people for me wasn't really like something I was so comfortable with. I had to learn it. So I would have sometimes, I would have this anticipatory anxiety the night before, like before I would meet someone, a friend even. And then I would start obsessing about sleep. So, that was also part of it. So it was quite significant for me, a big obstacle.

Martin Reed: And so, did you did you tend to find that it would start off as you just have one or two bad nights or was it kind of like, bam, it just hit you, you just suddenly have this string of bad nights all in a row?

Ann Vigo: I think it would kind of hit me now and then when I would realize like I'm not happy, I don't have a career path, I feel a little loss, I don't feel comfortable being independent. I would try to forget about it and just kind of go about doing my job. But then now and then I would step back and look at the bigger picture like as a young adult in my 20s and I'd say like, where am I going, I feel very lost. And then I would kind of panic and then that would sort of trigger my anxieties. And then I would fall into negative sleep patterns. My thinking, of course, would affect my sleep, you know, when you feel really hopeless, then I think I would fall into a depression.

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I talk a lot about cognitive behavioral therapy for insomnia (CBT-I) in this podcast. This episode will explain exactly what CBT-I is and how it helps improve sleep. The audio from this episode was taken from a Facebook Live, originally recorded in May 2019. You can find the Insomnia Coach Facebook page at facebook.com/insomniacoach.

Click here for a full transcript of this episode.Click here to hide the transcript.

Welcome to the Insomnia Coach podcast. My name is Martin Reed. I believe that nobody needs to live with chronic insomnia and that cognitive behavioral therapy for insomnia (CBT-I) techniques can help you enjoy better sleep for the rest of your life.

I just want to talk a little bit about CBT-I, what it is, why it's the best treatment, certainly the best long-term treatment for chronic insomnia, just because I think that we're still really struggling with getting the awareness of CBT-I out there and what it is, what it means. I just want to say this right from the start, that CBT is not CBD. It's not a marijuana product or cannabis product. CBT-I is a collection of skills. Anyway, with that out of the way, let's get going.

CBT stands for cognitive behavioral therapy for insomnia. Now it's not therapy in the traditional sense of the word. It probably gives you these ideas that you're lying on a couch with your hand on head, eyes closed, just recounting all your fears and worries. It's not really therapy in that traditional kind of stereotypical idea that we have around therapy.

What CBT-I is, is a collection of techniques or skills that you can implement that effectively retrain you to trust your sleep system again, and over time this reduces any sleep related worries. It also helps you identify and address and fix any behaviors that you might be implementing in an attempt to kind of compensate for bad sleep or lost sleep, that can actually perpetuate insomnia or make the problem worse. CBT-I also helps correct any unrealistic thoughts or incorrect thoughts that you might have about your sleep or unrealistic expectations that you have around sleep. The usually just end up putting extra pressure on you. You feel like, "Oh, I've really got to get these eight hours of sleep," for example. And that in itself makes sleep more difficult.

With that being said, there are some core components of CBT-I. All practitioners generally follow a similar pattern in terms of how they implement or the actual components that they're using, but they might just have slightly different philosophies as to the best way to encourage people to observe the techniques and the components. But generally speaking, it won't vary that much from provider to provider, because they're all evidence-based techniques.

With that being said, what I would like to do is just talk about how I approach CBT-I. Now, with my company, InsomniaCoach.com I offer a phone coaching package and also offer an online course. I'm going to talk about the online course, primarily, because it's more structured. It helps me use that as an example for how we introduce each stage of CBT-I and what's involved.

When I work with new clients, they generally like to start with sleep education, and that's just because all of us, I'm not talking specifically about people with insomnia here, but virtually everyone has unrealistic expectations or beliefs about sleep. Most of us don't really understand what sleep is or what normal sleep is. I like to start off with sleep education, just to kind of challenge any incorrect thoughts or assumptions about sleep,