Tag: Cognitive Behavioral Therapy

Today on the show. I have an interview with Martin Reed. Who’s going to talk to us about approaching insomnia differently? Martin is an insomnia coach. And has this certification in Clinical Sleep Health. He’s going to provide some really practical advice on the show today. And I have to be honest to say that I really needed this and utilize some of it in pregnancy. I had horrible experiences with restless leg syndrome, and then later it changed. Lots of insomnia and it took me a little while to get into this rhythm, to work through and overcome it. So if you have trouble sleeping, like many people do, you’re really gonna want to tune into this episode. Martin, tell us a little bit about your own struggles with insomnia and how that led you to helping others with their sleep.

Martin: I was always one of these people that never had an issue with sleep. I loved to sleep. If it was advisable, I would have put it on my resume. You know, it was just the IXL that, and so it was something I never really thought about back in, it was, a long time ago, 2000. I think it was, I immigrated from the UK to the US and I was also getting married at the same time. So lots of big life changes. And at that time I experienced some sleep disruption. Never really thought much about it, you know, because everyone has some difficult nights from time to time. And I figured that it was just one of those things and it will get better, but it didn’t, and it was strange.

Because then I started to get a little bit more concerned about it. Not, not like crazy concerned, but this is an emergency, but just more concerned about it. And I started to do things to try and fix the problem, right? Because in life, when we have a problem, we try and fix it. But instead of sleep getting better, it seemed to get even worse. And then this led to more REM. Now, you know, I was starting to get really concerned about what was going on. So like what most of us do when we have issues or problems, we turn stopped to Google and see, see what the solutions are. And to be honest, that wasn’t a lot of very helpful information out there, I think has got a little bit better sense.

But back then, there was a lot of information that wasn’t helpful and it mainly centered ironically on sleep hygiene, which unfortunately is one of these things that people with chronic longer-term insomnia are often told about already know about. And we actually know that it’s not helpful for people with chronic insomnia because it’s more to do with prevention rather than treatment or cure.

You know, it’s a bit like if we get a cavity, we brush our teeth, then it’s not really going to help. But if we brush our teeth before the cavity, it’s helpful, then, you know, and, and I also thought it was a little bit condescending that someone would say, “well, if you have a hot bath or make sure there’s no light in your bedroom, or you set the right temperature in your bedroom, then everything’s going to be okay”. And so I was just really struggling, you know, because there was this problem that I’d never experienced before. 

There was all this information out there that just didn’t seem relevant or helpful. But, tubs, I kept on looking and I came across these techniques, which we now know, which I now know of as, grounded in Cognitive Behavioral Therapy for Insomnia CBTI techniques. And it’s just about changing our behaviors in a way that helps create better conditions for sleep. 

So I found these two specific techniques, that was, don’t spend as much time in bed. Which seemed completely illogical because I wanted to spend more time in bed to try and catch up on sleep and get more sleep. And upon reflection, you realize that more time in bed usually means more time awake and therefore you end up kind of perpetuating this sleep disruption. And another technique was to just get out of bed. If you’re struggling in bed, you’re just spending a lot of time away. So figure figured, you know, all right, thIs sounds different. 

These don’t sound logical at first glance and maybe there’s something to them, you know? So I tried them out and I found them really helpful. I started to regain that sense of sleepiness when I went to bed at night, by going to bed a lot later than I was. And it also just made the nights a little bit more pleasant because I had that option now, instead of just staying in the bedroom, being in bed didn’t feel good. I could just, like, get out of bed and maybe watch some TV or read or just do something to make being awake a bit more pleasant rather than just tossing and turning. So anyway, to cut a long story short, as I found these techniques helpful, I figured these techniques need to be out there more.

There’s not enough support out there for people with chronic insomnia. There’s a lot of misinformation. I ended up just starting off by creating, like a forum, just people, for instance, with insomnia, just to get support. As I found that these techniques were actually really helpful, not just kind of a flash in the pan that helped for a week. And then I was back to square one, but I actually found that they were helpful over the long term.

I figured maybe I can be someone who also shares these techniques. And so there were some people in the forum. I said, “Hey, let’s. I’ve learned about these techniques. If you’re interested, let’s see if they help you too”. And they were helping other people too. So I figured out there must be rid of that. It really is something to this. And so that just kind of led me to where I am today. Over the course of a number of years, I decided that I want to get the word out about these techniques. 

I want to help people coach them through this with evidence-based techniques, not this kind of sleep hygiene stuff. And so that was when I ended up going back to school, I obscured my master’s degree, becoming a health coach, getting certification in Clinical Sleep Health and sending up in Insomnia coach.com, which is my sleep coaching business for people with insomnia. So, it was basically a journey of my own experience. And that’s what led me to where I am today. 

Carrie: What you say, is there some kind of time limit for people? If you, for example, if you’re laying in the bed past. Is it 20 minutes, 30 minutes, then you should probably get up and do something different or try something else?

Martin: It’s a tricky one. Because, if we’re following, kind of the latter of the technique, we usually see people suggesting. If it’s like 20 minutes or 30 minutes of wakefulness then to get out of bed. But sometimes I find that’s not so helpful because it leads us to kind of lying in bed. Has it been 20 minutes? Has it been on my own, 15 minutes? Is it 10 minutes? Maybe I should check the time when we do all these things that ratchet up that brain activity. 

So usually I find it helpful to just be like, what does it feel like to be in bed? If it feels pretty good, you know, you’re calm and relaxed, then maybe we don’t need to get out of bed because that implies that conditions might be right for sleep. So there’s no need to jump out of bed. And that way, when we just use how we feel as a gauge, we might be less inclined to monitor for time or to check the time during the night, which usually isn’t very helpful. 

Carrie: Let’s talk about that. Some more, like, as far as behaviors that you see people with insomnia engaging in. That isn’t helpful. So for getting a good night’s sleep. So one of the things you would say is like clock checking, like what time is it? And then doing that calculation. Okay. Now I’m only going to get six hours of sleep. 

Martin: Exactly. I think, I don’t think we need to be like, really committed to avoidance. Sometimes we’re going to see the time. That’s fine. It’s when we kind of seek out the time. I think that’s when it can be a little bit problematic. I’m still waiting to hear from someone who told me who has chronic insomnia, who told me that checking the time during the night, like actively checking the time through the night, made them feel good and was helpful.

Usually the best outcome is neutral, but most of the time, like you just said, it leads us to think, okay, how much sleep if I go, how long have I been awake? How much time do I have left? Just get all those cogs tony again. And it seems like such a small thing. Just not to check the time during the night.

I have so many clients that tell me that was one of the most helpful things they did just making that change because it’s one less thing for the mind to be concerned with during the night, in terms of other behaviors, we commonly see people with chronic insomnia, completely understandably engaging in, but that kind of backfired on us is like a touched upon just spending too much time in bed or allotting too much time for sleep. And so we might be giving ourself a sleep schedule where we’re going to be in bed. 8 hours, for example, because we want to get eight hours of sleep or I, you know, I’ve had clients that have moved on to spending nine hours in bed, 10 hours in bed, 11 hours in bed, because they’re just so desperate to kind of get more sleep, to create conditions for sleep.

But unfortunately, this backfires on us because. What happens is we usually then go to bed before we’re sleeping enough a sleep. We can go to bed. It’s really easy to confuse fatigue with sleepiness. Fatigue is kind of feeling run down, worn out, exhausted difficulty, concentrating that brain fog, which I’m going to throw it out there. I’m going to guess that 99 to a hundred percent of people with chronic insomnia experience all of the time. And it’s really easy to confuse that with sleepiness and to think, that means it’s time for bed. That sleepiness is just finding it hard to stay awake. And that only occurs when we’ve been awake for long enough.

And when we have a lot of concern about sleep, sometimes we need to be awake for a little bit longer than we used to be in the past to build up enough sleepiness, to kind of overpower all that stuff that’s going on in our mind. So, spending too much time, allowing too much time for sleep, getting out of bed all different times.

You know, according to how we sleep from night to night time, the ironic thing that we see with people with chronic insomnia is often let’s say, you’ve set your alarm for six AM, you fall asleep? Finally at like 5:30 AM. So you get half an hour asleep, human nature. You’re going to want to turn that alarm off and get that sleep because it’s now happening. And it feels great at the time to do that, but unfortunately, it’s a little bit like kicking the can on the road. You know, we might get that bit of extra sleep when we do that, but we kind of setting ourself up for sleep disruption the very next night, because we’ve been sleeping for later in the day. We’re back to, then we’re not going to have as much time awake during the day to build up that sleepiness for the next night. 

Carrie: So naps good or bad, or is it hard to know? Just kind of depends on the person. 

Martin: Think for safety. Naps are always appropriate. You know, if we actually feel like we’re going to fall asleep without warning and we need to drive or operate machinery or something like that, you know, safety trumps everything. But ideally we want to avoid those daytime naps just because they’re going to reduce what we call sleep drive. One way we can imagine sleep drive is like, if we take a balloon and we’re blowing air into a balloon, every puff of air into that balloon is like an hour that we’re awake and we sleep when that balloon bursts.

So when we first wake up in the morning, you know, an hour, every hour of waiting, a furnace blowing air into that balloon blowing air into that balloon. And, and the idea is by the time we go to bed, that balloon is really close to bursting. We get into bed, pop the balloon burst and we sleep. So if we imagine that kind of analogy for naps, our balloon is about half full during the day. Then we nap. We’re kind of letting air out of that balloon. And then we got the rest of the day. We ended up going to bed but the balloon is still a little bit floppy, you know, not really close to bursting. So it’s one of these things that, and that might feel good at the time during the day, but then we’re kind of setting ourselves up for some potential for sleep disruption the following night.

Carrie: That makes a lot of sense, actually. It really does.

Martin: Another reason why it can be helpful to just avoid those daytime naps is it can also be just another area of concern because people with chronic insomnia. Often try to nap during the day because they’re chasing sleep. We’re so desperate for sleep to happen, whereas people without chronic insomnia they’ll nap during the day, because they’re sleepy, they’re finding it hard to stay awake.

So a lot of the time, especially my experience, I see clients. They try to nap during the day, but then they can’t nap. So that generates even more concern because then they’re like, oh my goodness, I’m really struggling to sleep at night. And I can’t even sleep during the day when I try to nap. So just by removing naps from the equation, we’re eliminating that potential source of more concern. And we’re also banking all that daytime sleep drive to help with sleep at night. 

Carrie: There’s so much of this, that’s connected to stress. So it’s like I’m stressed and then I can’t sleep. But now, because I can’t sleep, I’m stressed about not sleeping. And that really leads into the thought process that people get into with insomnia. So talk with us about that. Some of the common thinking errors that people have.

Martin: Absolutely. My thinking on thinking, my thinking on thoughts has definitely evolved over the last few years when I first learned more about these CBT I techniques. The traditional way of thinking that is the, we have, like dysfunctional thoughts, thoughts that are inaccurate or incorrect, and that we should perhaps evaluate them, criticize them, or try and change them into more accurate, or more positive thoughts.

My thinking now is that. We don’t need to really do any of that because thoughts are thoughts. Sometimes thoughts are true and they’re accurate, sometimes they’re not. So, but we don’t necessarily need to get into an argument with our mind because these are thoughts. Thoughts can make us feel good. Thoughts can feel unpleasant, but they’re still thoughts. And we can still control our actions and our behaviors, regardless of what the mind tells us. Even though sometimes that, that prompting from the mind. Can lead to us responding. Behaviourally almost instantaneously and make us believe that thoughts control our actions with some practice.

We can help to kind of decouple our actions from our thoughts. So I don’t know if they asked you a question, but generally now I take the approach that there’s no real dysfunctional thoughts, per say. There are just thoughts and that we can always work with our thoughts in a way that separates our actions from our thoughts so that we can still do things that create good conditions for sleep. And we can still do things that help us move toward the kind of life we want to live, even with all those thoughts going on in our minds. 

Carrie: I think really learning to become an observer of your thoughts and not having to get sucked into every single one that you’re having or believe that it’s somehow. Character reflection on you or that you have to act on it kind of what you were saying. It’s like, you can have a thought. And certainly, we have thoughts all the time that we don’t act on.

Sometimes we have thoughts that we should act on like, I should exercise. And we don’t. And then other times, you know, we have thoughts and we’re like, that was out of left field. That’s not really who I am or what I lined with. So do we have a misperception though, sometimes about sleep just from what we’re told with doctors and you know, I have to get my eight hours and you know, I’ve just heard conflicting things on that. I’ve heard some people say, you know, well, no, you don’t necessarily have to get eight hours. It just depends on your age and your own kind of individual makeup. Some people need more sleep than others. Any thoughts on that?

Martin: Definitely. You know there’s a lot of misleading information out there about sleep. A lot of it does focus on sleep duration. So many of us can have the belief that we need to get eight hours of sleep, or we need to get a certain amount of sleep. The thing about that is anytime we read information about, we should be getting a certain amount of sleep, it’s always just based on averages. It’s a bit like saying everyone should be five foot, 10 inches tall, just because that’s the average height. I don’t know if that is, but I’m just guessing here, but you know, all I’m just getting at is it’s just one of these things that’s based on averages.

So there are always going to be happy, healthy people that exist outside of these averages. Just like with our height, we can’t control sleep duration. We can help, we can use our behaviors in a way that creates good conditions for sleep, but in terms of how much sleep we’re going to get, we have no control over that. And often we get most caught up in the struggle when we do try and control that a lot of the clients I work with, they find the best, just such a relief to know that they don’t need to aim for eight hours or seven hours of sleep. 

You know, they just need to allot an appropriate amount of time for sleep. You know, give themselves the opportunity to get sleep. And the body is always going to generate at the very least the band and minimum amount of sleep we need. No matter what, as long as we’re giving it the opportunity to generate sleep, we never lose the ability to sleep. So it’s really about just trying to not control things that we cannot control and sleep duration is one of the things that we can’t control.

Unfortunately.

Carrie: That’s an interesting concept that I’ve never really thought about or pondered. It’s like, I don’t have control over what my body does, how long it stays asleep and whether or not, you know, I’m able to wake up rested. It’s like I have to provide the opportunity, but then my body has to kick in and, and sleep with it. Interesting. 

Martin: Exactly. One thing about, well, just to add onto that one thing that we often see when we read these articles about sleep duration. They’re really aimed primarily at people who aren’t getting enough sleep because they’re kind of burning the candle at both ends. They’ve got a busy home life. They’ve got a busy work life, so they’re just not giving themselves the opportunity to sleep. We’ve got, I think a lot of this advice or information about try and get seven to nine hours of sleep or whatever it is people are saying these days is, comes from a good place where it’s aimed at people who are only giving themselves four hours to sleep because they’re not prioritizing sleep. 

Because they’re too busy, doing everything else, people with chronic insomnia at the opposite, they are prioritizing sleep. They are giving themselves plenty of time for sleep. So I think the messaging comes from a good place, but it’s just aimed at a different audience. Unfortunately, the only people that are really paying attention to all this information are the people with chronic insomnia who it doesn’t apply to quite so much.

Carrie: So I would imagine there’s a lot of people listening to this podcast who deal with Anxiety and OCD, and they’re saying, okay, the problem I have, I feel maybe physically tired, like I’m ready to go to bed, but then it’s like, my mind is on overdrive and it wants to think about all the things I have to do tomorrow, or what happened today or things that are bothering me that I can’t control. Are there any helpful tips for people who just have a hard time shutting their mind off, who want to go to sleep? 

Martin: Definitely. Well, I think first and foremost is making sure we only go to bed when we’re truly sleepy enough for sleep. I’m talking about finding it hard to stay awake. Because, our sleep drive system will always overpower like that arousal system or the mental chatter once it’s strong enough, no matter what, without fail, it might take a night or two, but sleep will always happen, that sleep trifle always be strong enough at some point.

So we can always get ourselves one step ahead by making sure we only go to bed when there’s that strong sense of sleepiness. And then in terms of. All that mental chatter, all the mental gymnastics, really all that is, it’s our brain looking out for us. You know, it’s not a brain trying to cause us problems. It’s like our brain is being a really overly enthusiastic friend. Who’s trying so hard to help us out. It’s just kind of getting in the way. So I think just recognizing that, you know, this isn’t an adversarial relationship. It’s just our brain trying too hard to help us out. That can be helpful. And just recognizing that that’s what our brain does.

Our brain’s number one priority is to look out for us. Often we get most caught up in all this mental stuff. When we quiet, understandably, try to fight them or avoid these thoughts, these feelings, these emotions, because they’re unpleasant. So naturally we don’t want to experience them. But unfortunately that’s when we usually get most caught up in the struggle, trying to fight them, trying to suppress them.

It’s not usually helpful over the long-term short-term. Sometimes we can, like push feelings and thoughts away. They always come back and then when they come back, they tend to be stronger. It’s a bit like pushing a beach ball down under the water, you know, it’s just going to push back harder and harder. The more we put, try and push it away. Sometimes I think it’s just helpful to recognize, like, this is my mind looking out for me, I’m feeling, identifying and acknowledging everything it is feeling. I’m feeling this is my anxiety coming back. This is my frustration and my anger, whatever it is, you’re feeling. Just identifying it, labeling it, recognizing it, not trying to fight it or push it away can be really helpful. 

Just the fact that we’re thinking certain things or our mind is racing. Doesn’t mean we’re not going to be able to sleep. We can still sleep when we have difficult thoughts and difficult feelings and difficult emotions, but it becomes a lot more difficult for that to happen when we try and get engaged in controlling them and pushing them away or trying to avoid them, trying to fight them. And I think, you know, as a last resort, kind of what I touched upon. Aaliyah was if you’re just spending a lot of time in bed and it really just does not feel good to be in bed. It might be helpful to just get out of bed and just do something a bit more pleasant until conditions feel a bit better for sleep.

Carrie: Talk with us about what the CBT I program that you have looks like, is it over a course of a certain number of weeks or a certain number of lessons that are involved in it? What does that look like? 

Martin: My course is kind of grounded in many of these techniques that are taken from CBTI. It’s not CB type itself because technically that is a therapy. And I’m not a therapist. So I just coach people on these techniques. There’s kind of, I take what I personally found helpful from this collection of techniques and what other clients have found helpful along with just some other things that are more grounded, maybe more towards the act model, acceptance and commitment therapy. 

So, it kind of combines them, a little bit of cherry picking. And my online course runs for eight weeks and it’s conducted online. Clients can fill out sleep journal. And check in with me as they progress. And the way it’s currently structured is the first week is just about education, you know, sleep education, because like we touched upon, there’s a lot of confusing and maybe misleading information out there about sleep, how much sleep we need, what a normal night of sleep is like. And then as the weeks progress, we start to introduce these behavioral changes that aren’t intended to make sleep happen or to control sleep, but rather to help address any behaviors we might have implemented to try and improve our sleep that are kind of backfiring on us and to just change our behaviors in a way that creates good conditions for sleep.

So we kind of come up with a sleep schedule and earliest possible bedtime. Consistent with our bedtime in the morning, we talk about what to do during the night. If we’re awake, like you just touched upon all the mind games going on. What if we wake up in the middle of the night, we can’t fall back to sleep. What do we do? And we also just go through ways that we can explore our thinking, you know, not to control our thoughts, but just to maybe change our relationship with our thoughts where maybe we’re less influenced. By our thoughts and feelings, we’re less inclined to try and control them. And we kind of get independence back over our behaviors, but it’s the, our thoughts. Aren’t kind of dictatorial and control all of our actions. They’re the kind of core educational components, but really it’s kind of, it’s quite different for every client I work with because it’s very customized in terms of the specific challenges that each client is facing. We work together to focus on where the client feels the priority should be in terms of where they’re struggling and what their challenges.

But, so it’s, so it’s educational based and the changes, the components are introduced gradually over a course of eight weeks, which I also find is helpful. So it’s not. We should do this, this, this, this, this, this, this, this, this go, you know, there’s completely overwhelming. We just say, okay, first week, let’s just do focus on some more education the second week.

Let’s see if we can change the sleep schedule a little bit, the third and fourth week. Maybe let’s practice getting out of bed if being in bed doesn’t feel good. You know, so it’s all gradual so we can learn a new technique, become a little bit more comfortable, confident with it before we then add most stuff.

Carrie: So as we’re winding down at the end of every podcast, I like to ask our guests to share a story of hope, which is a time in which you received hope from God or another person.

Martin: You know, I think it would really go back to my own experience when I was first struggling with insomnia. And I learned about techniques that, once the hygienic pastes that were a little bit different and that in itself. Just gave me hope because when I was just finding the sleep hygiene stuff out there, that wasn’t helpful to finding these new techniques gave me hope and it gave me the motivation to give them a try. And I think that kind of inspired me to use those techniques, to offer hope to other people as well. You know, it’s this kind of knock on effect, first of all, through the forum and then through how that’s expanded. You know, through my own podcast as well. And just working with clients, seeing that transformation, sharing their transformation, just spreading that hope out there to others as well.

Carrie: That’s awesome. Thank you so much for coming on and sharing your wisdom with us about using these techniques that are very practical for overcoming insomnia. 

Martin: Absolutely. It’s been a pleasure to me? 

Carrie: We would love for you to help us get the word out about the podcast. I know, you know, at least one person in your life right now, who is having difficulty sleeping, feel free to forward the link to this episode to them and let them check it out.

You can always rate and review us on iTunes, and that helps our show as well. Thank you so much for listening.

Christian Faith and OCD is a production of, By the Well Counseling. Our show is hosted by me, Carrie Bock. Licensed professional counselor in Tennessee, opinions given by our guests are their own and do not necessarily reflect the views of myself or By the Well Counseling.