Intro

These notes from are from my insomnia counseling that I went to.

Details

SESSION 1: Purpose of Sleep

• Mood
• Memories
• Physical recovery
• Hormones
• Cognition
• REALLY: We don’t really know why, but we know it is needed

Insomnia: Disruptions of sleep that impact daytime function

• Difficulty falling and staying asleep
• Waking up too early

Sleep Cycles

Awakenings: 2-3 brief awakenings are natural/normal during sleep (9-10 micro-awakenings)

• N1: Fragile, transitionary stage of sleep (can easily be awakened)
• N2: Stronger sleep stage (only drastic noises or lighting)
• N3: [Deep sleep] Most restful – usually overhyped – frontend of sleep
• REM: Dreams, emotions, mood, energy, and memories – backend of sleep

Sleep

• Sleep drive: Builds over time of the day (don’t go to sleep early since it can cause insomnia) – usually 16 hrs but can be more
  • naps are similar to “snacks” for sleep
• Circadian rhythm: Consistency

Sleep Hygiene

• Sleep environment: Noise, light, temperature
• Reduce caffeine: None within 10 hrs of bedtime (or in other words, none after noon)
• Avoid: Watching the clock, phones, or TV
• Avoid large meals, exercise, alcohol, and nicotine: Within 4 hrs of bedtime

Insomnia Coach (phone app: sleep diary)

• Within 2 hrs of wakeup and NOT in bed
• Perception of sleep is more accurate than smart devices
• Don’t use sleep recommendations – will make it manually in class

SESSION 2

Sleep Efficiency training: Goal of 85%

Sleep Window: total sleep + 30 min (e.g. 5.5 hrs asleep = 6 hrs in bed)

• Takes 2 weeks to re-acclimate

Slowly increase sleep window to increase total sleep time

Sleep Drive: 24 hrs - [TIME ASLEEP] +/- 30 mins

Wakeup time: anchor for sleep drive and circadian rhythm

Sleep Time: bedtime 0100 to wakeup 0730

7 Sleep Rules:

1. I must get out of bed at [WAKEUP] time: 0730
2. Go to bed when sleepy but not before [BEDTIME]: 0130
3. Get up when you can’t sleep
4. Use bed only for sleeping – BED IS ONLY FOR SLEEP (NOT BED IS PLACE TO BECOME SLEEPY)
5. Avoid napping
6. Create a wind-down routine before bed
7. Don’t occupy mind/think in bed

SLEEPY: eyes heavy, head nodding

STAY AWAKE UNTIL EARLIEST BEDTIME: do something standing up, boring but not too engaging (nothing that increases/fluctuates body temperature)

SLEEP CHANGES TAKE: 10-14 days (first 7 days are “tantrum phase” to reconfigure pattern) to build consistency

SESSION 3

Conditioning: can have conditioned insomnia where laying in bed results in doing everything but sleeping (thinking, worrying, etc.) ** very difficult to break once conditioned: break pairing with everything and then re-pair for bed + sleep only

Stimulus Control and Conditioning:

• 30-60min BEFORE bed/sleep: slow and not too active activities
• In Bed
• BED: sleep only
• only go to bed when sleepy
• get out of bed if unable to sleep after 15-20mins, do something relaxing, return to bed when sleepy, common first 2-3weeks of re-conditioning
• 30-60min AFTER bed/sleep

SESSION 4

Bedtime: 0000-0730

• Try breathing/relaxation exercises during most restful time in order to train parasympathetic nervous system
• Worry time: if we don’t give ourselves the chance to worry before bedtime, then we will worry/think at bedtime
• Do worry time BEFORE Buffer/Winddown zone
• WORRY TIME is without: tech, music, distractions, anything stimulating
• –> do some journaling maybe; give it 10 min timeframe; then do relaxation afterwards; STOP after timer 10min goes off
• worry time isn’t meant to be productive!!
• give it a schedule – anchor it to something; after work in car, after lunctime, etc.

Cognitive Model

SITUATION/EXPERIENCE -> [AUTO] THOUGHT -> EMOTION -> BEHAVIOR occurance -> interpretation -> feeling -> action

FRAMING

How do you frame your bad sleep? GOAL is to not frame it so negatively – instead of “I’m so tired because i slept so well i won’t make it” turn that into “i’ve survived tired days before and i can do it again! i’m doing the best i can”

HOMEWORK

• note/jot down any negative thought about sleeping – how do I talk about it?
• 3 mins of nice steady breathing
• daily worry time

SESSION 5

stick to bedtime: 0000-0730

homework: 1-2 to improve on sleepwise from checklist

SESSION 6

• Keep improving sleep: track and strive for 85% efficiency (time asleep/time in bed)
• Move up sleep bedtime by +15min increments
• Sleep tracker only necessary when sleep improvement is desired
• Flexiblity (i.e. sleeping in): only when stable, do 1x/week, don’t over do it (e.g. just sleep in 1 hr) <– eliminate sleeping flexibility when disturbances start happening again
• Plateau: stablizing for 2+ weeks; maybe hitting natural limit; diet, stress, physical activity, change winddown nighttime activity

Action

Get better sleep!