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Chronic Insomnia Treatment & Success Story Using Cognitive Behavioral Therapy (CBT)

By Nick Robinson – Publisher & Editor, Sleep Like The Dead

Originally published May 2008
 

Below I discuss chronic insomnia, mostly as I experienced it for over ten years. More importantly, I discuss in detail how I learned to control the problem.

My primary motivation for doing this is to tell my success story and let you take from it whatever you wish.

I have carefully worded the information to be simply my story of how I gained control of insomnia. I do not make any suggestions for people with insomnia, nor do I claim that insomnia sufferers will have any success if they try my solution.

I can only say that my solution has greatly helped me and is based on cognitive-behavioral techniques (CBT), not sleeping pills.

Part 1: What Is Chronic Insomnia

Insomnia is the inability to obtain adequate sleep. Notice the word “adequate.” This means that if you have difficulty sleeping at night but the sleep that you get is adequate -- that is, if you are not tired during the day -- then you do not have insomnia.

Rather, insomnia is reserved only for those people whose quality of life suffers because they do not sleep well.

There are two main types of insomnia: short term and chronic.

Short-term insomnia

Short-term insomnia is the inability to obtain adequate sleep for a brief period of time, usually just a few days or weeks. The insomnia goes away entirely once the factor that causes the insomnia ends or the person adjusts to it.

Factors that often cause short-term insomnia include stress, poor sleep habits and behaviors, a poor sleep environment, a lack of physical and / or mental activity, physical or mental illness, and use of certain drugs, including caffeine and alcohol.

Occasional bouts of short-term insomnia are normal. Nearly everyone experiences them from time to time. For example, the death of a loved one, a divorce or the loss of a job can put much stress on a person which can result in an inability to sleep. However, the insomnia stops once the stress level falls, either from getting over the death, settling the divorce, finding another job, etc.

Chronic insomnia

Chronic insomnia is the inability to obtain adequate sleep that continues after the original cause of the insomnia ends. Chronic insomnia can last indefinitely, even the rest of one’s life, if no effective treatment is received.

Chronic insomnia grows out of short term insomnia and is often primarily caused and perpetuated by irrational, negative thoughts and self-defeating behaviors related to sleep.

Here is the classic way that chronic insomnia often starts and develops:

To further explain and illustrate how and why chronic insomnia starts as well as last indefinitely, I will share my story with you. If you suffer from chronic insomnia yourself, this story will probably sound more or less familiar to you.

Part 2: The How and Why of Chronic Insomnia

My Story: The Sleepless Night

My insomnia began during a stressful time in my life. When I was 23 years old, I was faced with a perfect storm. Problems related to my school, work and family life had hit me hard -- and on the very same day. (In case you want to know the gory details: I realized I probably was not going to pass a class that I needed to graduate; I was laid off from my job; a friend had become very ill.)

This caused me to feel a crushing amount of stress. I could not help but take the stress to bed with me that night. My mind and heart raced for several hours after I went to bed. On top of this, I also knew that the next morning I was to give an important presentation at school. So the longer I lay awake, the more pressure I felt to fall asleep. This pressure, of course, only increased my stress and made it even harder to relax. With each passing hour, I grew more and more exhausted, panicked, and frazzled.

That night I truly did not sleep, not one second. I had lain in bed for at least seven hours, tried my best to sleep -- and failed. This had never happened to me before, not even close. I had experienced nights of poor sleep before, but nothing like this.

Many people experience a situation similar to this at least once their lives. But most don’t develop chronic insomnia from it. In other words, once the cause(s) of stress that is preventing sleep goes away, most people usually start sleeping well again – as they did before the stress hit them.

However, I did develop chronic insomnia from my experience. In other words, my stress or “perfect storm” eventually went away, but my insomnia remained.

There are two main reasons why this happened. One has to do with my thoughts related to sleep and the other has to do with my behaviors related to sleep.

My Thoughts

I allowed the night in which I did not sleep to set a precedent in my mind. Prior to this experience, I did not know that I could go an entire night without a wink. I had never given the idea of not being able to sleep any thought at all because I did not think it was possible. But the sleepless night changed all of this in my mind, unfortunately.

After this bad experience, I now thought and worried about sleep. And with each subsequent night, it seems that I thought and worried more and more.

I thought and worried that I would take too long to drift off; that I would wake up in the middle of the night and not fall back asleep quickly; that I would wake up too early and not get back to sleep; that I would never be able to sleep like I used to before the insomnia; that I would suffer through the following day if I did not sleep; that insomnia would have disastrous effects my personal, school and work life.

Most of all, however, I thought and worried that I would not be able to sleep at all.

All of this thought and worry, of course, caused me great stress and anxiety which, entirely by itself, caused me not to not sleep or not sleep well. I would lay there in bed at night terrified and panicked that I would not sleep. My heart would pound, I would sweat and shake. I would almost feel as if I was losing my mind and that the walls were closing in on me.

I tried the best I could to not think and worry about sleep, but I could not stop.

It’s sometimes said that chronic insomnia is insomnia that’s taken on a life of its own. This is what is meant by that. The thinking and worrying about insomnia leads to stress and anxiety which causes and perpetuates the insomnia.

My Behaviors

Thoughts and worries alone, however, do not cause and perpetuate chronic insomnia. Certain behaviors are also needed. These behaviors are often intended to be ways to cope with and overcome the insomnia. However, they only succeed in perpetuating it.

For example, in my case, here are the main behaviors I used to try to cope with my insomnia:

These behaviors were crucial in keeping my insomnia alive because they were self-defeating and only reinforced my thoughts and worries about insomnia. (For a detailed explanation on why this is the case, see behavioral techniques.)

The Result

After a month or more of constant thoughts and worries about sleep combined with the behaviors described above, I had officially fallen into the dark abyss of chronic insomnia.  

My persistent sleeplessness had caused me to evaluate sleep negatively. In other words, I hated going to bed at night because I knew it would be little more than several hours of torture. If I just looked at my bed I would have feelings of dread and nausea. More interesting still is that if I heard someone just casually mentioned the word sleep or something related to sleep (dreams, mattress shopping, napping), I would feel anxiety rush over me. In short, I had learned to hate and fear the idea of sleep and everything related to it.

The Cycles

Fortunately, the insomnia after a few months largely went away. I’m not totally sure why it did so, but at the time I also was desperately experimenting with different ways to deal with my insomnia. I must have stumbled upon somewhat of a solution, but I do not remember what it was.

Even during this period when I was sleeping better, I always had a sense of unease in that I knew the insomnia was just dormant, not controlled. I also knew that it could and almost certainly would come back given the right circumstances.

And sure enough it came back. I don’t remember the specific cause other than it was something that caused me stress, such as having a “big day” planned for the next day. And this triggered the insomnia again. All of my anxiety related to sleep came rushing back as if someone turned on a faucet. Just as with the first time, the insomnia would last much longer than the thing that caused me stress. Eventually, however, after many weeks or months of agony I would manage to start sleeping at least somewhat better again – but only temporarily.

I went through this cycle of on-again off-again periods of sleep many dozens, perhaps even hundreds, of times. I experienced extended periods of maddening sleeplessness followed by usually short periods of decent sleep, over and over again. At my low point, I thought that this is how things would be for the rest of my life.

Next: My Recovery Begins

 


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