What helps, what hinders

Sleep is personal, sleep is interwoven into the fabric of our deepest beings. It’s not surprising, then, that we work out ways of dealing with sleep that are as individual and distinctive as we ourselves are.

What things have you found that help?

Foods you’ve found that help?

Techniques do you use to get to sleep? To get back to sleep after you’ve awakened in the middle of the night?

Hormone replacement therapy
: does it help your sleep?
Your experience going on hormone replacement therapy? coming off it?

Findings are equivocal: some studies say that it helps sleep, some that it doesn’t, and a recent survey of the literature concludes that there’s evidence both ways.

Progesterone: have you found it to be effective with sleep?

The babbling mind—
“We talk to ourselves all the time,” writes Allan Hobson; “We cannot imagine thinking without telling ourselves things; plans for the day, reactions to people, abstract analyses… fantasies.” Hobson is not, to my knowledge, an insomniac, but novelist Anne Lamott is: “Left to its own devices, my mind spends much of its time having conversations with people who aren’t there. I walk along defending myself to people, or exchanging repartee with them, or rationalizing my behavior, or seducing them with gossip, or pretending I’m on their TV talk show or whatever.” In her novel Unless, Carol Shields describes “the lifelong dialogue that goes on in a person’s head, the longest conversation any of us has. O hello, it’s me again. And again. The most interesting conversation we’ll ever know, and the most circular and repetitive and insane. Please, not that woman again! Doesn’t she ever shut up?”

Maybe it’s louder in some people than in others (loudest in writers?), but I bet it comes with the territory of being human. Man, the speaking animal, the babbling animal. No other creature is like this. Language is what makes us human. Language enables thought, the kind of thought that leads to further thought, that propels us forward to conceptualize, reflect. It serves us well, in most respects, pushing us to higher-order activities of abstraction and imagination, but then it gets out of control, it won’t shut up, to the point that we can be sitting on an idyllic beach, and we go on babbling. The Buddhists call this the chattering monkey that scrambles from thought to thought. Anne Lamott compares her mind to a spider monkey on acid: “I wish I could leave it in the fridge when I go out, but it likes to come with me.” …

Is this clamor louder in writers than in other people? So many writers are insomniacs— Marcel Proust, Franz Kafka, Mark Twain, Alexander Dumas, F. Scott Fitzgerald, Jorge Luis Borges, Rudyard Kipling, Victor Hugo, Edgar Allen Poe, Vladimir Nabokov, Charles Dickens, Joyce Carol Oates, Jacqueline Susan, Rick Bragg, Ann Lamott, maybe even Shakespeare—that it’s practically an occupational hazard. For all I know, I came by my insomnia just by hanging around this illustrious lot. Do people who deal with words all day long sleep worse than people who deal with visuals—do artists have less insomnia than writers? —Insomniac

How to get the mind to shut up?

Anybody but me see a connection between wakefulness and words, and visual imagery and sleep?
Visualization techniques you’ve found that work?

Why are so many writers insomniacs? Are more writers insomniacs than artists?

Books you’ve read that have helped?
Things people have said that have helped?

What is the smartest, most helpful think a doctor has ever told you?
What is the dumbest, least helpful thing a doctor ever told you?

The up side to insomnia?

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  1. I’m on HRT…bio-identical…doesn’t help.

    I have taken progesterone, it didn’t help, but mind you, I am not consistent.
    I too deal in words…speaker/writer: lindanacif.com
    I too have blurred vision in the morning
    I too wake up when i don’t like my dream

    Meditation gets the mind to shut up…but you must learn patience

    I sleep if I am 100% happy and have nothing to do the next day…which means about once a year.

    The latest most interesting observation by a new therapist was that I am emotionally hungry…that when I am satiated instead of starving, I will sleep!

    Reading books like “Kitchen Table Wisdom” that is soothing, loving and profound has put me to sleep…for a couple of hours

    Every article, book, etc. says the same thing.
    I’m tired of hearing “new advice” I have already tried.

    Having a flexible schedule helps

    Quiet, a dark room, an orgasm or two (-:

    Knowing it is my plight in life helps…in other words, living with insomnia as others accept diabetes or a heart condition.

    Although there are days when I prefer to be alone, most of the time, I am social and positive.

    I’m really sleepy, but if I have more observations i will share them with you.
    Thank you for coming out of the closet.

  2. I’m on a roll, I can’t stop; have posted on several other topics today. Thanks again for soliciting conversation on what would bore my better-sleeping buddies to death.

    I know there is a hormonal component to my sleep problems. Before the ‘pause, I did not need to keep a calender to know when my period was due…I would suddenly and dramatically experience total emotioinal desolation and even more hard-core insomnia…medication-proof insomnia. Then even before I was aware of my blood flowing say the next day…I would realize my period had started because my deep depression would lift like a phsical THING. and for the next night or two I would experience REAL sleep, but because of the deep deficit that was impossible to make up, I also spent those days in a fog of half-sleep.

    During early menopause, when insomnia became even more unbearable I tried different hormones, none of which made a dent in sleep or fatigue.

    I also agree that words are the foe of sleep. During college I tried to major in journalism, but the mental strain of producing papers guaranteed a word-haunted night and maybe several additional days of zoned-out exhaustion. I gave up trying to be a writer, because the process would never fail to spin me further off-kilter. I believe that my insomnia even killed off my imaginative thinking. As a young teen-age babysitter, I was sought after because I could entrance kids with spontaneously made-up stories. By my senior year, late-night study sessions completely finished destroying my sleep system forever…I also lost my ability to conjure up imaginative scenarios. That’s when I switched to journalism, and despite encouragement by my profs, I could not continue due to the increasing repercussions of trying to dredge up words. I too, would dream/hallucinate visions of words (and NUMBERS!) swirling against my closed eyelids while I hoped for cessation and sleep.

    I remember what sounded like a good technique for aiding sleep by keeping a journal…the idea being that once you got the days issues and anxieties, wrote it down, you’d be more “clear” to leave it behind and sleep. NOT. It seemed ANY writing close to bed would trigger what I almost consider a mania.

    The SMARTEST thing a doctor ever told me was an earnest “we really don’t know much about sleep”.

    The DUMBEST (this is harder to choose)…let’s see. “You’ll sleep when you’re tired enough” (the more tired the LESS likely to sleep); “it’s not fatal” (maybe, but my mom died of sudden heart failure at 70 and I suspect it was related to her chronic insomnia). There was also a doctor who almost brutally insisted I try a few months of “sleep restriction”. Surely the most demeaning was when the first doctor I ever went to for insomnia quietly suggested I just get married.

    the UP side? wohoa….that’s a tough one, because I did not even get to associate my insomnia with writing talents like the famous authors above. Maybe it’s this: I’ve become really intimate with my bedside radio. It’s on pretty much all night, low enough to ignore, but still possible to tune in if I’m really miserable from the boring self-awareness. I’ve learned really dumb stuff about the “shadow people”, ufo’s, conspiracy theories, nutritional supplements, and sometimes interesting political or philosophical commentary. Recently (on a Benedryl night) I heard an interview with Woody Harrelson and Will Ferrell. I was in and out of a Benedryl haze and I swear Woody and Will were in my bed and excellent company. That’s my only up side so far.

  3. One more serious thing on the UP side. I know that my condition has caused me to really suspend judgement of others and what may appear to be their shortcomings. NO ONE really knows what another person is dealing with. I can’t even blame the clueless doctors. They are just doing their best with limited knowledge. (But I DO wish they would be wise enough to just say they don’t know when they don’t.)

  4. It’s been almost a month since I first wrote and I have noticed something about us insomniacs. We need to be understood more than understand. Rarely have I seen a dialogue among the bloggers…only monologues. Could it be that we are as guilty as the sleepers who don’t understand us? In comparison to other therapy groups where people like to listen and share, would you like to be in a room with other insomniacs and have to suffer twice, three times, or more what we have already suffered in our own bones? It certainly has helped me to know I am not alone, but is this a case where misery does NOT love company? Maybe because there are no answers, and because what helps me might not help you, sharing only augments the suffering…and maybe not. Any thoughts?

  5. thank you for your postings. i am not sure this will make sense my mind, as usual feels as if it is under water. I rarely sleep anymore it has just gotten worse and worse. I too listen to the radio all night. Too many paniced thoughts of seeing years go by burning inside to do my work. I am a visual artist. If i take enough medication and then the next day drink ginseng teas and use energy sprays for under the tongue and iam not in a relapse from my chronic fatigue then i can sometimes get a few hours of work done before i crash. And doctors usually they are dismissive. It is as if they are blind and deaf.Spiritually i have had to accept that i am in a place of liminality.

  6. linda–I do think we insomniacs are starved not only for sleep…but to be heard and understood…we do totally understand each other…the only “up side” I can think of is…well, it does instill compassion for the suffering of others…but also frustration…because we know we have no solution to offer…

  7. I went from “ordinary” HRT to BioHRT as I felt I was addicted to ordinary HRT. I think BioHRT is a rip-off. My sleep got worse and I developed night sweats up to 5 times a night. I didn’t need that as well as insomnia. Also BioHRT isn’t bio at all, it’s not identical human hormones and it was extremely expensive even with some help from my health fund – no help from Australian Medicare. Also the doctor who prescribed it charged an arm and a leg and told me progesterone in the BioHRT would make me sleep. It didn’t. I went back to my usual GP who actually said “Bollocks” re the BioHRT and put me back on ordinary HRT with a lower dosage of progesterone than before which is the current thinking re safety of HRT for women who are years past menopause.
    I will address the other issues introducing this discussion.. but not all at once, my brain is mushy and I feel myself becoming angry with it all.
    I do agree with Cathy that the only upside to insomnia is that you walk in another’s shoes and can empathise. Otherwise you can keep it.
    Love to you all.

  8. I probably didn’t make it clear enough above that yes, I do agree that insomnia is hormone related and that I sleep a bit better on ordinary/artificial HRT that BioHRT which is equivalent to taking nothing.
    Re getting my mind to shut up, I did say this elsewhere, sorry, just getting used to the site: As a child I didn’t sleep well, it has been a worsening life-long problem. My mother taught me how to play boring word games as a child (she still does herself, aged 89). Now, I visualise the alphabet in Braille when awake in the night. I am not blind, but learnt to sight read Braille as part of a Special Education degree. If I lose the alphabet, I start from “A” again, while waiting for part 2 of my medication to work. This seems like a combination of visualisation and words. My main way of processing incoming data is 1. auditory-digital (I tell myself things), followed by 2. visual (I see pictures). If one’s main processing mode was auditory, does that mean that singing to yourself or listening to music would be the most beneficial aid for sleep? Or for some people is the opposite the case ie, if your work is all about words, are you better listening to music???
    If I let my mind have free reign, I think about all sorts of trivia, then I think about thinking. Then I think “I’ve just got to think these thoughts about x, y and z, before I can stop thinking. Then I think of something else to think about. Auditory digital: yak, yak, yak monkey mind. NOT problem solving or anything useful.
    Watching the hypnogogic images (visual input), usually forest paths appear which is helpful, if/when it happens – certaining not every night. That experience has a mind of its own, I can’t force it to happen.
    I can wake with a quiet mind, then meditate for an hour (I use the Holosync meditation program) and during that, the yak, yak, yak turns on full blast. How on earth can I be more noisy in my head when awake in the night and during meditation than when awake in the day?? Nevertheless, I love that meditation program and it gives me the discipline I need to find the time.
    Food? Now I don’t think there is any food that keeps me awake. As a child though I would wake in the night with a craving for pork sausages and chips! Fats, carbohydrates required? Not much protein…
    I don’t like coffee so have never had a problem with it. I did give up drinking tea for a long time hoping to be totally caffeine free, but it made no difference. I still don’t drink tea in the evening though. I might need to ask my GP to check my insulin levels as I can get really hungry in the evening after dinner which isn’t normal. I don’t like to go to bed hungry.
    The only book that has has any relevance to me re insomnia is Gayle’s.
    The most helpful comment a doctor made to me was his suggestion that I had a problem with my reticular activating system, which meant it was neurochemical and not my attitude. The least helpful was the “blame the victim” comments: “This patient has a very negative affect.” (In a letter written to my GP). This specialist wanted me to join a CBT support group costing $500. Of course I had a negative “affect” when seeing this specialist. I was tired and ratty and he was only interested in sleep apnoea . I also got the talk about sleep hygiene…
    To any one who enjoys listening to relaxation CDs look at the following:
    You must use stereo headphones, and just set your CD player to tracks 2 and 3 only. Track 1 is a very short introduction to the company and Paul Scheele who leads you through the relaxation process, and track 4 brings you out of the relaxation into wakening which you don’t want when you are trying to drift off into sleep.

  9. I might get weary with my own comments.. I realise what marginal1 meant when when she (?) said she was on a roll. Last night I was awake thinking as described above. I had to force myself over and over again to visualise the wretched alphabet as it does actually shut the thinking up – eventually. And I’m analysing what I’m thinking and why, and tying it into my theories about insomnia being related to how you process incoming data in your mind. Sooo.. my major sensory processing system (auditory-digital) keeps me awake: words and more words. My second “choice” – visual – can get me to sleep if I can force it to take over. But it mustn’t be interesting. My third – kinaesthetic – seems to play no part, ie I have no impulse to “feel” feelings (eg, non-verbal relaxation) or get out of bed and walk around. My least “favourite” – auditory – is interesting. While I love music, especially of the quiet, peaceful sort, I don’t want it playing in the bedroom at night, nor could I listen to books like Gayle. I want absolute silence. So yes, I believe there is something powerful about the connection between words (what you tell yourself in your mind) and wakefulness. That doesn’t mean that I don’t like the relaxation CD I mentioned above. I love it, but I am not motivated to use it at bedtime, even though I “know” it’s good for me.. Why why why??
    PS It might be the headphones. I can’t ever sleep on my back, so can’t fall asleep with them on. Also, the little whirr at the end of a CD as it slows down startles me and back to square one.

  10. What helps, what hinders,it’s all become real confusing lately.
    Drinking milk doesn’ help, alcohol used to. Now too little or too much alcohol has me waiting for morning ready to run. Prescribedrugs help at least once a week but the dragged over feeling in the morning is hard to shake although a 16oz cup of spanish coffee usually does the trick.
    I’m amazed and relieved that for the first time in decades I’ve come out with this (except for us)asymptomatic-non diagnosable-non respected condition. What is even more amazing is that we haven’t come very far since I first had the onset of this dilemna.
    Dark rooms, silence and good ventilation are in now way helpful for me, they just don’t work.
    I just continue struggling to get a sleep at night regardless of how many hours. I so admire people who can just decide to take a nap during the day and just drift off to sleep at night. I feel like I hit the LOTTO when I can get 5 or 6 hours of uninterrupted sleep. If this sounds a little bit incoherent please forgive me In haven’t slept in awhile.
    Buenas suenos………….

  11. Gayle, Thank you for such a great book. It was you and this book that has given me an incredible sense of relief. I absolutely do not know anyone personally who suffers with Insomnia, so consequently, no one with whom to discuss this. gracias

  12. Doing all of these things, not just most of them, really has helped me:

    – Not eating for at least 3 full hours before bedtime (this one seems to be the most important)
    – Lifting weights in the morning before work
    – Not consuming any caffeine
    – Not consuming any alcohol
    – Not consuming any sugar in the evening
    – Instead of reading in bed which puts me to sleep prematurely, trying to stay up as late as possible by watching TV
    – Having a job that doesn’t come home with me mentally and emotionally at all

    I do have insomnia tonight, because I went windsurfing in the evening and didn’t eat dinner until after 8pm. And I was so tired I fell asleep at 10pm. I also had some caffeine today.

    It is hard to always do everything right, but you need to do ALL of these things perfectly for a few weeks before you can conclude they don’t work and you need drugs or cannot be helped.

  13. Emailed to Gayle before I was aware of this site!

    My mantra for Disordered Sleep (idiopathic) insomnia: r/d/TMS, r/d/TMS, r/d/TMS (transcranial magnetic stimulation)

    In reference to the article:

    Gayle Greene: “Bring the agony of insomnia to light.”

    February 15, 2008

    “Insomnia is one of the great unacknowledged problems of our time. It is under-researched, underreported and underground. The Heath Ledger tragedy brings it to light. Let’s keep it there.”

    Dear Professor Greene:

    I think your call for the heightened recognition of disordered sleep (insomnia) and calling for the intensification of its study and treatment efforts re: this disorder, is timely and appropriate.

    Until 2007 ineffective pharma has been the only available medical treatment available, however in the last few years a technology: transcranial magnetic stimulation (TMS), the first viable/effective treatment (w/minimal or no side effects!) for this condition may well be close to “off the shelf” status. Since 2007 I’ve made a personal exploration of: TMS (Transcranial magnetic stimulation), and have become convinced that among other conditions: disordered sleep/insomnia/CNS (non-obstructive types disordered sleep) may be relieved/possibly even cured by TMS.

    Unfortunately, as all health technology is money driven and TMS, in the private sector is still a “venture capitalist’s” game, the focus of TMS has been directed toward treating Major Depression (seen as an easy sell/easy fix) along w/a side increasing list of possible applications, w/the noticeable absence of the treatment of Disordered Sleep. I’ve maintained for some time that Major Depression is actually a cardinal symptom of Disordered Sleep.

    I agree w/you that advocacy for disordered sleep, especially resulting from CNS type insomnia, is desperately needed. I think TMS’s is an extremely valuable tool which could improve and even save lives.

    IMHO to get TMS “focused” on disordered sleep, essentially shifting its current focus away from “pure” psychiatric conditions (which I intuitively sense, are in the main sleep related) and psychiatry’s 180 degree out of phase “mind set” e.g.: psychiatric conditions = disordered sleep, to what I believe the actual pathological sequence to be: disordered sleep = psychiatric conditions, the combined forces of capital and “demographics” are needed. E.g.: the creation of a non-profit “entity”, tasked to advance R&D and deployment of insomnia specific clinical treatment modalities, w/initial focus on disordered sleep/insomnia.

    IMHO beginning will require a: “core of coalescence”: a small group of individuals, which possess professional (not exclusively medical) standing, dedicated to advocating for the victims of (non obstructive) disordered sleep of, the development of a strategy to push (as the first most promising tool) TMS, and finally the aggregation of capital needed to “underwrite” a much larger percentage of TMS’s (private/public) R&D effort toward the development of clinical applications for disordered sleep treatment.

    I am on familiar terms w/a number of top TMS researchers, and in actuality many of THEM would like to see TMS R&D pushed toward disordered sleep, however they need both financial and political support to shift their resources toward treating disordered sleep.

    I’d be interested in your input.

    Meanwhile: good luck w/”Insomniac”!

  14. Follow-up to previous comment:
    It’s essential that the terms we (insomniacs) use are highly accurate. For example: “Insomnia” to the “general” public (including many insomniacs themselves) simply means: “transient trouble getting to sleep” or: ”emotional/psychological” problems.

    When in actuality for MANY PEOPLE Insomnia is a MEDICAL CONDITION. In some cases sufferers may have LITTLE OR NO TROUBLE falling asleep but have difficulty maintaining sleep & or experience unrestful/non-restorative sleep FOR LIFE! For this reason I suggest the use of the term: Disordered Sleep.

    This is because research seems to indicate that insomnia is actually a symptom of the destruction/disruption of normal sleep structure. I.e.: insomnia is an observable pathology/entity at a brain/eeg level.

    It’s a cerebral/electro (& possibly hormonal) entity, not a problem simply caused by too much caffeine, hysteria, or any of the many simplistic descriptions used to refer to a very serious psychosocial pathology: DISORDERED SLEEP/IDIOPATHIC INSOMNIA!

    Ironically a very fine TMS researcher receives millions of dollars from the Pentagon to study TMS’s potential efficacy in treating military combat sleep deprivation, keeping soldiers alert after many sleepless hours w/out drugs. But civilians that desperately want restorative sleep AND a less war-torn world are out of luck. The tax dollars of insomniacs spent to make more efficient war! I’m sure the researcher cited above would much rather turn their effort toward helping millions of non-restoratively slept civilians around the world. The question is: WHERE’S THE MONEY!!!!!

    Maybe if humankind slept better, it would resort to wisdom before war!

  15. I am reading your book, Gayle, and I believe you are the first person I have ever heard describe what I go through with chronic insomnia. Many thanks to you. Reading the posts I see there are others as well. I am 53, an LCSW, and here’s my experience. As a child I sometimes forced myself to stay awake at night, beginning around age 8, because my parents fighting (domestic violence they call it now) was so loud and scary. I needed to be awake to take action if things got out of control. As a teen I remember being very sleepy on my way to school every morning. During my pot smoking days from about 18 yrs to 25 yrs I do not remember having problems sleeping at all. (Although a trial of pot in recent years did not help.) After I had a child at age 26 who was colicky and never slept, my insomnia began. It has progressively gotten worse. At first I could catch up on bad nights, but not anymore.

    I have tried EVERYTHING you mentioned in the book and then some. I took Ambien off and on for many years. Last fall I threw it away because it did not seem that overall the quality of my life was any better, the Ambien caused lightheadedness and other side effects, and I have read that in the long run Ambien interferes with the bodies ability to get restful sleep. I am like the person you mention in your book, Gayle, who is trying to cope with insomnia without drugs and has not much of a life. I have decided to trade the problems of isolation for the problems of living on drugs. If there’s any chance of my body being able to recover and sleep reasonably well on its own I want to allow it to happen. This is just my path; believe me when I say that I understand the torture of not sleeping and the desire to make it stop.

    I did an in-patient sleep study at Stanford, an out-patient sleep study, and completed their sleep group twice. The in-patient sleep study was one of the most horrible experiences of my life and I regret ever doing it. Concerned that I could not sleep at home in my nice bed, I told the doctors that I could not imagine being able to sleep in a hospital hooked up to tubes and wires. They insisted I do it and assured me that people sleep more than they think they will. The end result was that I did not sleep long enough for them to be able to come to any conclusions. With at least two sleeping pills, I slept only 192 minutes. They did not really seem interested in the fact that in 192 minutes of sleeep I had 52 “unexplained awakenings”. I saw some of the most famous doctors there from all over the world and they seemed happy once I was able to sleep 4 or 5 hours, even though I still felt so awful.

    I have a few ideas on what helps. I agree with not eating for 3 hours before bed. Consistently practicing deep relaxation during the daytime. I use Michael Krugman’s Sounder Sleep CD’s and have tried many types of relaxation and find these are the ONLY ones that consistently bring me to a state of deep relaxation. (Thanks Michael if you are out there.) Exercise. I think I have RLS (restless leg syndrome) and/or PLMD (periodic limb movement) and find what helps with this is walking. Also, taking B-Vitamins made my insomnia worse–and I have since read that this sometimes happens. My Anthroposophic doctor has me taking several remedies and eating my protein, fats, and salt early in the day as they alert the body and eating a vegetarian dinner. I do not take any caffeine, refined sugar, or alcohol.

    Sorry this is so long but one more thing that insomniacs may want to consider. Cell phones, cell phone towers, cordless phones (other than the older 900mGHz models), and wireless routers all have been linked to multiple health problems including sleep disorders. I have not seen this mentioned anywhere here, but I know of a number of people, including children, whom were able to sleep when these devices were not present or were switched off.

    I have researched this subject (above) for some years as I had an exposure to high electromagnetic fields (unbeknowsnt to me at the time) for years due to old wiring in my home. I believe this affected my nervous system and contributed to worsening my insomnia. I agree with Gayle in keeping the bed a least 3-4 feet from electrical appliances. Having said all this, my insomnia continues and I feel terrible most all the time, my only encouragement right now is that I recently have had a few nights were I slept pretty well. So I know it is possible for my body to do this thing called sleep without drugs or too many shenanigans. Or maybe it’s just a fluke.

  16. I think the letter below to Gregg Jacobs – who I was referred to as “the expert” in the field in 2005, might be helpful. In my opinion Cognitive Behavioural Therapy (CBT) has very limited use in the treatment of chronic Insomnia. I know Gayle makes the point in her book that Insomnia research is now supported by its being regarded as a comorbid condition. I think to regard it as such is actually a distraction. There is always a deep seated ’cause’ of this distressing symptom. In my personal and research experiences some of the causes are: Depression, Anxiety, Guilt, Unresolved sexuality/libido.

    A number of natural and chemical remedies can provide temporary amelioration. Bananas/lettuce/nettle/Trazadone and the like/cannabis (be sure it is a “head high” and not a “body high” or you’ll not sleep a minute, particularly if your libido is strong!).

    I have now come out of my insomnia after 7 years of sleeplessness – but I know that the chained beast lurks and could break loose. I would be glad to help anyone take a psychotherapeutic approach to relieving their symptoms. One thing is for sure. If anyone tells you to not drink caffeine after 6:00pm then they are patronizing you and you should look for a new Doctor! It was particularly disappointing to me that Gregg Jacobs never paid me the respect of responsing to the two or three letters I troubled to write to him. Insomniacs need a close worker to undertake this delicate unravelling – someone between a priest and a doctor…

    Feel free to contact me on freerockspirit@aol.com. I’m not too good at checking sites!

    The letter:

    Dear Gregg,

    I am writing to follow up on my e-mail of December 2nd. I am becoming more and more convinced of the efficacy of psychotherapy in the treatment of insomnia.

    I have re-read your book “Saying Good Night to Insomnia” and find no reference to treating the psyche deeply damaged by extreme life events. For example, in your section on Negative Automatic Thoughts (NATs) you suggest that insomnia is (partially) the outcome of a mind preoccupying itself with negative thoughts. You make suggestions and give case studies. These refer to job related, day to day anxieties. While you do refer to deeper sources of anxiety such as bereavement – you do not give any advice about reframing NATs associated with deeper emotional distress. I suggest that NATs associated with such stressors as: bereavement; PTSD; taboo related guilt (the emotional association of those who have, or perceive they have committed crimes against their fellows) cannot be re-framed for two reasons. Firstly, for many insomniacs the “thoughts” are not thoughts at all. These clients report the sensation of a free-spinning empty spool, but no film loaded into the projector. Secondly, and most importantly, that which is truely negative is so. Some, clients suffering from deep emotional stress may find some relief in the cogintive behavioural techniques you suggest. Many more will gather increasing negative effects and even those who find temporary relief in cognitive behavioural therapy will eventually move deeper into distress and psychosis. The key to the treatment of insomnia in such clients in deep emotional distress is dynamic psycotherapy. This should include dream analysis because dream imagery is the gateway to emotional effects at levels deeper than conscious thought.

    I have never felt more sure of a position. A dangerous stand to take in science! Please don’t think I underestimate the importance of cognitive behavioural therapy in treating the worried well. My interest is in what I am calling ‘The Macbeth Syndrome’:

    to refresh your memory, in Act 2 Scene 3 after brutally murdering Duncan and his guards:

    Macbeth: But wherefore could I not pronounce Amen? I had most need of blessing and Amen stuck in my throat.

    Lady Macbeth: These deeds must not be thought, after these ways; so it will make us mad.

    Macbeth: Methought, I heard a voice cry, Sleep no more! Macbeth doth murder sleep; the innocent sleep…etc
    (Works of William Shakespeare; Pope London 1776)

    Lady Macbeth is actually practising your NAT re-framing!

    Tight lines,
    Peter Davies

  17. Thanks to all of you for leaving your comments.
    I hoped to sit down and respond to each and every one, but that’s becoming less possible as the number of responses increases, and as my life refuses to de-clutter. I just wanted to say thanks to you all.
    to Linda–who I met, right? I meant to follow up.
    to Nodnoble: Thanks for that info about Trans Magnetic Stimulation info–so interesting– i hope to follow up.
    I want to say to freerockspirit, ust above, the lines from macbeth (near and dear to me as they are–it’s one of my favorite of Shakespeare’s plays) I don’t agree that most insomnia is a burdened mind, soul, or conscience. I don’t think there are any one-size-fits-all descriptions of insomnia: we each came to this problem by a different route… and each of us needs to find our own way out of it. Psychotherapy may work for some people, but not for everyone–nothing owrks for everyone. Some insomnia is rooted not in a tormented soul but in some yet to be identified neurotransmitter, some neurobiological glitch, that we’ll someday understand, just as we understand the deficiency of orexin in narcoleptics. Some is rooted in hormoanl imbalances, some in head injury. Tormented soul? no. Unless you’re embarked on a career of killing, but even Saddam Hussein slept well. It’s about the sleep system.
    so try everything you have time and money for, and maybe psychotherapy will help–but no one thing helps everyone.

  18. Hi Gayle,

    The point you make is valid. Torment depends on self knowledge. I doubt Saddam Hussein had much – – but, just my conjecture! We live in a culture where there is an increasingly high degree of self knowledge and with it comes the torment – sometimes expressed unconsciously and played out in insomnia. It’s a kind of self actualization deficit – if you will. I remain convinced that insomnia can best addressed through a combination of dynamic psychotherapy, changing life circumstances and a dose of the medication of choice. I look forward to the debate going on.

    Once again – thank you for starting the wonderful site,


  19. Any opinions on sleep-resrtiction therapy? The Dr. I amseeing has his treatment based around circadian rhythm and re-setting your body’s natural sleep-cycle.I have decided to try this after 20 years of insomnia. I am tired of the endless cycle of medications and herbal remedies, etc. I don’t want to take pills to sleep for the rest of my life.
    Thanks for the wonderful website.

  20. I suffered from extreme chronic insomnia for 10 years, from the age of 10 to 20. At the worst, I was getting 10 minutes – half an hour of sleep per night and I was so tired that every joint and sinew hurt and my muscles felt as though they were frying under my skin. It was at that point that I was referred to the sleep clinic at the local hospital, where a doctor told me that some people just don’t need that much sleep and that I shouldn’t think I need eight hours every night, just because I read it in a magazine. Hmmm…

    What eventually cured it? I took a week off. I know that sounds nuts, but that was really it. I’d always been a diligent and conscientious student and I was on my Easter break. I’d done all my university work except one, non-assessed, essay.

    Normally I would have been sure to complete the essay on time but, on a whim, a friend of mine invited me away for the week, leaving the following day.

    I packed my text books and notepad but, all the week I was away, I couldn’t bring myself to touch them. I said to myself, ‘f*ck it’. I knew the essay would be handed in late. I didn’t care.

    I’ve had the occasional problem with sleeping since and I even had recourse to sleeping pills a couple of years ago after my mother died but, generally, I find that I get along okay. I take some St John’s Wort every day (takes a few weeks to kick in) as there is a history of depression in the family and I heard that low serotonin can cause insomnia as well as depression. It seems to work well for me.

    Also, going through meaningless lists is good – some people have mentioned visualising the alphabet; I listed all the characters in an Australian soap opera, going house by house, through the history of the series.

    I have also found that it can help to get up, write a list of what you need to do the next day (worrying about writing lectures is usually what keeps me up at the moment), then go to the loo, take a painkiller (to relax any tension you haven’t noticed) and go back to bed.

    My boyfriend listens to radio podcasts on his i-pod when he can’t sleep – that works for him.

    I’ll never drop off to sleep entirely easily – I can only sleep in one position, it always takes a while, I can’t sleep sitting up, on planes or trains (no matter how long the journey!) and I can’t nap in the day, but it has been a lot better these last 11 years.

    I had to let go of being a perfectionist, of trying to be a good girl and do everything right. I had to learn to be more selfish and irresponsible. That, in the end, was the only thing that worked for me.

  21. Developed insomnia at 40, thought due to difficult times. Became chronic: lost memory, balance, concentration and energy and finally, at 56, a doctor put me on HRT and I was cured overnight! Weaned off it after eight years and obviously no longer menopausal, but have serious bouts of insomnia, which no longer cure with HRT, but will come and go for no fathomable reason. Also believe it is hormonal/chemical and not a neurosis as medicos seem to think. Avoid caffeine after lunch and find good old Horlicks helps, as well as herbal sleep aids, mainly based on Valerian.

    Enjoyed the program and at least to know I am not alone.

  22. I know there hasn’t been a post in this section for a while, but I was hoping other people might be able to contribute ideas for techniques for falling asleep. The techniques I have in mind are not general cures for insomnia, but localized “tricks” that can help a little here and there.

    For example, I was once advised to try to subtract down from 100 by the number 7 or the number 6. I actually found this helpful, but only for a few times, and then running through the numbers became rote and had no effect. It’s all about achieving some middleground of thinking techniques that are neither too automatic nor too demanding, taxing, exciting, etc. I’ve tried addition and subtraction with other numbers but to no avail. Someone else suggested trying to think of every player on a sports team and the player’s jersey number (unfortunately, my memory for those sorts of things is not great, no doubt in part because of sleep deprivation). I’ve also heard of people who tell stories to themselves until they fall asleep, but I’ve never been able to keep my mind focused enough on that sort of creative open-ended task.

    Anyway my thought was that compiling a big list of these little tactics might be helpful. Does anyone have other suggestions for specific tactics?

  23. Alex – there are nights when nothing helps, not even pills, and I suppose everyone is different anyway but the following helps me: watch unexciting TV rather than read before bedtime (images not words); be ready for sleep at your optimal time which for me is between 10-10.30pm; have a good daydream ready to fall asleep to so you don’t have to work at it.

  24. Would like to know more about the california poppy supplement, protopine, mentioned on p. 294 of Insomniacs. Have googled and looked for this but not found it for sale. Can you tell us a brand, manufacturer, common name, etc? Thank you!
    I posted a long post yesterday but I think it was on the gayle green blog page, under comments. Neither this nor the blog have anything past 2009 as far as I can tell, though I never heard about the book before reading a review a few months ago.

  25. Howdy! This post couldn’t be written any better!
    Reading this post reminds me of my old room mate! He always kept talking about this.
    I will forward this article to him. Fairly certain he will have a good read.
    Thanks for sharing!

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