I’ve been struggling with chronic insomnia for maybe a year and a half and have obviously been tired most of the time.(I've had difficulty going to sleep most of my life, but it has gotten much worse.) When I decided to see a sleep specialists, it took 6 months to get an apt. at Cleveland Clinic. I saw an MD sleep disorder specialist last November. We talked a long time about insomnia and how I was handling it. She gave me a script for something that will help me feel drowsy, but you wouldn’t have to take it. For now, I’m taking the lowest dose possible and the goal is to not need it at all. She said my issue was psychophysiological insomnia, and I would benefit from seeing a PsyD sleep psychologist. (They said there are only about 200 in the country.) She told me some tips I could start doing now that the psychologist would talk to me about. It took another 4 months, but I saw her yesterday also at Cleveland Clinic.
She used an illustration to explain the problem and apologized for it being a little crude. When you sit in a chair, you can’t make yourself go to the bathroom even if you tried. Your brain is conditioned that you don’t go in a chair. But when you sit on a toilet, you will go. When you potty train a child, you are teaching the brain to associate the toilet with going. For people without a sleep problem, their brain is conditioned that when you lie down, feel the pillow, turn out the lights, close your eyes – it knows you are there to sleep, like the toilet example. For those with a sleep problem, their brain doesn’t take all those sleep cues and knows it’s time to sleep. It is like the chair and trying to go and you can’t.
Also, you have a sleep drive just like a hunger drive. When you get up in the morning, the sleep drive starts moving upward until it will hit a peek, and you respond to it like you would a hunger drive. When you go to sleep, it burns up and starts all over in the morning. If you go to bed before you have reached the peek of your sleep drive, you will have trouble going to sleep.
So what have I been doing wrong? I’m spending too much time in bed when I’m not sleepy enough to go to sleep. When I can’t sleep, I turn on the light and do something in bed – read, knit, watch TV (which I don’t do but many people do.) That is bad conditioning. Knowing I take a long time to get to sleep, I was going to bed too early (anticipating the insomnia) and then spending hours in bed not sleeping. Also bad for conditioning. I thought it was all my thinking about things that was keeping me awake. But I was having all those thoughts because I wasn’t tired, and if I was up and out of bed, those thoughts would probably not be running around over and over in my head.
See my next blog for how I'm fixing the problem.
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