Sleep Myths and Facts About Sleep

Information Explosion = Media Myths:

When CBTi first evolved some 40 years ago, computers, the internet and sleep science were all in their infancy.  Sleep Myths dealt mainly with misunderstandings about sleep on a personal level, that is, your individual reaction to your sleep.  For instance your belief that you should stay in bed longer to sleep more.  Or worrying that tomorrow would be a disaster because you were awake at in the middle of the night.  I will call these Mind Myths as they are sleep myths that you generate in your mind from your own personal experiences with sleep. 

Then along came the information explosion and a new class of myths created a new generation of insomniacs and made it even harder for you to overcome your insomnia. These are the myths created by misinformation in the media.  An example of a Media Myth is that you need 8 hours of sleep a night, a myth that we thoroughly extinguished in lessons 2 and 3.  Another is that your health will suffer horribly if you have insomnia, an issue we resolved in lesson 3 on insomnia.

Unfortunately, with media myths, bad news, whether true or not, tends to catch on like a wildfire and is difficult to extinguish.  Even after the initial outburst of inaccurate information dies down, it soon appears elsewhere and continues to spread. 

I will refer to these as Media Myths.  So to sleep well, you will need the tools and knowledge to deal with both Mind Myths and Media Myths.  (4:00)

There are two characteristics that these groups have in common.  The first <ding> is that they are half truths.  They have a grain of truth, but not the whole truth.  Because they don’t give the whole picture, they are myths. 

The second <ding> is that they can cause stress and anxiety.  <short ominous music> Negative emotions, especially stress and anxiety, are sleep killers.  In fact stress and anxiety play such a major role in insomnia that many sleep experts see insomnia as an manifestation of hyper arousal, period.  They find in working with hundreds and thousands of people with insomnia, that in nearly all cases, if they can help with the hyper arousal and hyper anxiousness, then the insomnia disappears.  So it will pay for you to be especially attentive to this lesson on Sleep Myths and the next lesson on Stress Reduction.  Not dealing effectively with your stress inducing sleep myths is the #1 issue that you will likely deal with in successfully completing this CBTi or Cognitive Behavioral Therapy for Insomnia Program.  Compacting your sleep and Sleep Buddy are difficult to implement, but the process is pretty straight forward.  It just takes fortitude and persistence.  Sleep myths is the most nuanced and difficult to master.  That is because, as you will find, it is full of contradictions and it takes skills, and practice to not be mislead.  I plan to have an extra lesson after the final CBTi element to help further with Sleep Myths which I hope you find useful. <music ends>

Media Myths

Let’s start with media myths.  This is not part of a normal CBTi or Cognitive Behavioral Therapy for Insomnia program but I think you will find it especially helpful.

Sleep Book makes me angry 6:17

In the many, many hours I spent researching material for this course, I read many books.  I am in the middle of a New York Times best selling book on sleep right now.  The author is a highly regarded sleep expert and appears on all the top American talk shows.  The book is exceedingly well written, entertaining, and packed full of fascinating information about sleep. 

But from the moment I read the first page, my blood was boiling.  Why?  My anger starts with the opening paragraph where the author gives a dire warning that 2/3rds of us fail to get the recommended 8 hours sleep a night.  By now, you should now how I feel about this 8 hour sleep fallacy.  I believe the author has good intentions to educate the public about the importance of sleep, but in my opinion, throughout the book, entertainment overshadows accuracy and time and time again readers are mislead by half truths.  Most of these half truths will elicit anxiety and fear in readers as you are lead to believe that if your not getting 8 hours of high quality sleep daily, your world will implode.  The likely impact of this book is to produce many, many people with insomnia. And readers already suffering from insomnia will find their symptoms worsen, not improve.  This highly popular book, like nearly all articles on sleep, gives one side of the story and draws conclusions where non are warranted.  Maybe I should write the author a letter thanking him for a boatload of students for my class on curing your insomnia. 

OK, I will get off my soap box and we can continue with the course.

To deal with Media Myths, it helps to have some perspective on how the world of science works.  I have worked in the area of science most of my life and have run many experiments.  I have a reasonable understanding of statistics, experimental design, and especially the limitations of scientific results.  I even listen to a podcast on statistics for goodness sake. 

To show how easy it is to be mislead even if you are knowledgeable, I misnamed my podcast.  When I first started this project, I bought into the myth that poor sleep lead to all sorts of dire health outcomes.  And so I named it Sleep to Healthy.  But after extensive reading and talking to many sleep experts, I came to realize that it shouldn’t be Sleep to Healthy, it should be Sleep to feel and function well.  I have since changed the logo and much of the information on the website, but for now I am reluctant to change the name as it takes a long time to build a following on the Internet.  So if you occasionally fall victim to misleading information on sleep, you are in good company.

In any case, in lesson 4, which was an overview of CBTi or Cognitive Behavioral Therapy for Insomnia, we learned that you don’t cure insomnia with sleep facts.  You conquer insomnia with changes in your behavioral and thoughts.

Here is my advice on handling Media Myths and facts about sleep:

1 – <ding> Ignore headlines

The first is to start ignoring headlines and articles.  Don’t click on that sleep or insomnia headline regardless of how enticing.  People who write these articles and headlines want eyeballs.  Truth is usually of secondary importance.  Unless you are trained in scientific methods and willing to dig into the facts by finding and analyzing the original source of information, ignore every article and headline you come across.  At least until your insomnia is cured.  The bad easily outweighs any good that you are likely to achieve by clicking through.  Everything you need to cure your insomnia is in this course.  For now at least, restrict your media diet.

Lets hear for Dr. Daniel Erichsen and his concept of a Sleep Information Detox 11:17   <173, various snipets>

2 – <ding> Critical Thinking

The second thing, should you decide to ignore the 1^st rule, or if you have some advice you have already absorbed from the media that you can’t shake, is to educate yourself on how to think critically about the article you read.  I am going to give you a few tips that will tear apart nearly every article you are likely to read.  And you don’t need to be a sleep scientist.

When you are reading something about sleep, ask these questions:

1. Ask yourself if this is a case of causation or correlation.

Causation means that A caused B.  Smoking causes cancer.  There is a logical and provable link between the chemicals in smoke and the reaction of highly exposed lung tissue.  Remember that it took decades for science to prove this causation to a point that public policy decisions were made.  Yes, there were powerful industry lobby groups, but it took a long time for scientists to plug all the loopholes in the scientific experiments.  This should remind you that proving causation is exceedingly difficult to achieve, and in strict scientific terms is never achievable to 100%.  So any time you hear a claim that anything sleep related causes anything, be extremely, extremely skeptical.  It is very hard to prove that A causes B, that lack of sleep causes anything.

The cousin of causation, A causes B, is correlation.  A is correlated to B.  This mean that A and B appear to behave in tandem.  When A goes up, B goes up.  For instance, cancer is correlated to the number of ashtrays in a home.  The more ashtrays in a home, the more likely the occupants are to get cancer.  Ashtrays don’t cause cancer, but they are correlated. 

Sleep is especially susceptible to this misinterpretation because many factors that cause poor sleep also effect you health.  For instance sleep apnea, where you stop breathing many times through the night, impacts your sleep and your health.  The same goes for stress, pain, heart problems and many other conditions that cause both sleep problems and health problems.  Sleep isn’t the cause of the health issue, it is just one of the symptoms.  It would be like having a head cold and blaming your sore throat on your runny nose.  They are both just symptoms of a third factor, your microbial infection.

Training yourself to notice the difference between causation and correlation will help you in all your consumption of media.  Look for the word “Causes” in the article, not the headline.  If they don’t specifically say causes, then assume it is Correlation, because Causation is like gold to the media and they will use it whenever possible.

1. Ask how big the study was.

Doing research is expensive.  The bigger the study, the higher the cost.  So scientists try to glean the most information from the fewest participants.  This is fine to test an idea to see if it has some merit.  It is misuse when you start drawing unjustified conclusions.

I want to see how wearing a blue shirt effects coin tosses.  I wear my blue shirt and flip 3 coins and observe the outcome.  I see that I got 2 heads and so conclude that wearing a blue shirt results in getting more heads.

In this experiment, I have a 100% chance of getting at least 2 heads or 2 tails, and I have a 25% chance of getting all heads or all tails. 

This is an extreme case of what small studies do.  They exaggerate outcomes.  Coin tossing is as simple as you can get.  Real life, with complex brains, behaviors, demographics, cultures, health conditions to name but a of the many confounding factors, are very complex and require multiple studies involving thousands of people by many independent researchers with in depth understanding of the subject to reach any reliable conclusions.  These are few and far between, so most findings can be safely ignored.

Don’t give a research finding more credibility than it deserves.  Look for how many participants there were.  If they don’t say, assume it was a small, inaccurate, study.

A related issue is that negative results seldom get reported.  This means that if research shows that sleep does not cause a problem, you will never hear about it.  Also, there might be other studies that refute the findings of the one you are reading, but they either get ignored or don’t get published.  So just be high skeptical about any conclusions you read about.

1. Ask who was studied and how closely they resemble you. 19:00

Young people respond differently to sleep issues than older people.  Healthy people respond differently than less healthy people.  Males respond differently than females.  Different cultures and races can respond differently.  So first thing to ask is who did they study and do they resemble you?  Likely not.

As a person who currently has insomnia, there are two classes that you should be particularly aware of.

The first is that Good sleepers respond differently than those with insomnia.  Most studies on sleep and health recruit good sleepers.  That is not you, at least right now.  As a person with insomnia, you develop coping skills to deal with your sleepless night.  People who sleep well don’t.  So when they disrupt a good sleepers sleep, they are going to respond differently than you will. 

The second is that there is a huge difference between disrupting a healthy sleeper’s sleep and having a poor nights sleep as a result of a personal situation, whether caused by stress or a physical factor such as pain.  Disrupting sleep is done externally without regard to the person’s sleep pattern.  It is artificial.  Insomnia is a natural response to a stressor.  For instance, with sleep disruption, you may be woken during deep sleep, whereas with insomnia you will wake when your sleep it at a lighter stage, or during a normal nocturnal awakening.

One of my favorite examples of how results from participants in a study is applied to an unrelated group.  This is the recent research that an important function of sleep is to flush the brain of chemicals responsible for Alzheimer’s in the brain.  The conclusion is that poor sleep equals Alzheimers, a finding sure to strike fear in the heart of many of us. 

When I dug into it, it was research done on a few mice.  Going from a healthy young rodent with a puny brain to conclusions about an elderly human seems a bit premature, don’t you think?  

So don’t compare apples to oranges.  If they are testing apples, and you are an orange, ignore the results.

1. The fourth and final line of critical thinking is to keep in mind that sleep is of the mind, not the body. Any conclusions that indicate negative outcomes for the body from lack of sleep likely don’t hold much water.

Yes, there is some connection.  Growth hormones are released during sleep.  And your sleeping mind will discourage bowel movements in the middle of your sleep.  But sleep is primarily about the brain consolidating memories.

That should give you enough for now.

Bottom line is to ignore all articles on sleep.  I would recommend ignoring them for life, but certainly at least while you are on this CBTi program.

I interviewed Dr. Neil Stanley, an author and highly prolific Tweeter.  I will put a link on the sleeptohealthy.com website to his Twitter feed.  He gives a daily critique of sleep myths in the media that you might find helpful if you have trouble shaking media sleep myths.

Mind Myths

So lets move on to Mind Myths which is really at the heart of CBTi and sleep myths psychology.

If you are familiar with CBT or Cognitive Behavioral Therapy, you may have felt at a loss so far as the first two elements of CBTi don’t resemble anything in CBT.  You will find this section on Mind Myths is closer to the CBT that you know and love.

As mentioned earlier, many sleep experts consider insomnia a hyper-arousal or hyper-anxiety issue.  CBT was developed to help people with depression and anxiety issues.  Since sleep is severely affected by stress and anxiety, it is a natural fit to use some of the principles of CBT to cure insomnia.

First, I will review with you the powerful impact stress and anxiety have on your sleep and how it fits into the CBT model.

Next, I am will review the CBT model of Observe, Thoughts, Emotions and Action and how it can lead you down a fruitful or harmful path.  This model was covered in Lesson 4 on The Strange World of CBTi.  You might want to revisit Lesson 4’s page on SleepToHealthy.com as there are some helpful diagrams on this model that make it much easier to understand than anything I can explain verbally in a podcast.

Finally I will give you some powerful hands on CBT tools that help you get off your destructive paths and get you into more helpful and healthy ways of dealing with sleep and sleep myths psychology. 24:50

Stress: 24:50

An essential ingredient of good sleep is an absence of fear.  If your brain senses danger, it is not going to let you go into and stay in the vulnerable sleep state.  Emotions related to fear include: Fearful, anxious, stressful, tense, discouraged, powerless, alarmed, cautious, nervous, scared, angry, apprehensive, abandonment and vulnerable.

If you are feeling any of these emotions, you are likely going to have a hard time sleeping.  We are going to deal with how to disengage your fear response in this and the next lesson.

But first we are going to have to deal with the Sleep Better Paradox

The Sleep Better Paradox

I am going to explain why pink elephants might be stopping you from sleeping well.  It is part of the great cure-insomnia paradox.  It is why most sleep solutions don’t work, and one reason why you might fail at CBTi, so listen carefully:

If I ask you not to think of a pink elephant, you can’t help but to think about a pink elephant.

If I ask you to think about a blue duck, a pink elephant won’t even occur to you.

A big part of the solution to your insomnia is to stop thinking about the pink elephant (which is sleep). 

Instead, start thinking about a blue duck (which is focusing on being relaxed, not sabotaging your sleep and on how you are feeling and functioning).

This is the great paradox of curing your insomnia:

In order to sleep better, you have to focus on your sleep.

But focusing on your sleep creates sleep anxiety which hinders good sleep.

I have a great diagram that explains it much better than I can do justice orally on this podcast at my website sleeptohealthy.com.  Here is how the great cure-insomnia paradox goes:

If you try to sleep better, you focus on your sleep.  You measure your success by how well you sleep or how many hours of sleep you get.  This creates sleep anxiety which your brain interprets as fear, and the brain won’t sleep well in a state of fear.  So any methods or potions you use end up in failure.

On the other hand, if you don’t think about sleep and don’t change your harmful thoughts and actions, your insomnia won’t go away.   

So you are stuck between a rock and a hard place.  Work on your sleep and fail or don’t work on your sleep and fail.  It seems like there is no way out.

The resolution of the paradox is to focus on the things that result in a mind that is conducive to sleep and let the mind decide what to do, which most times, but not always, will be to sleep.

The goal goes from sleeping well to feeling and functioning better, which is why you want to sleep well anyway, right?  The end goal is to not have to give sleep a moment’s thought, just let it happen.

The work ahead of you is to improve your habits, thoughts and emotions for their own sake.  Don’t you feel better when you follow good habits?  Don’t you feel and function better in a state of relaxation rather than stress?  Wouldn’t you rather have positive emotions than negative emotions? 

You achieve this by taking the position of an impartial observer rather than the person caught up in the emotions of frustration, anxiety and stress.  It is like the difference between watching a rainstorm from inside a dry shelter rather than standing out in the rain.  It still rains, sometimes life sucks, but you can gain a sense of detachment which lessens the impact and allows you to make better decisions and take wiser actions.

When you stop trying to control sleep, but create a mind that is ready to sleep, an amazing thing happens.  Your brain does what it is designed to do, sleep.

This paradox is part of what makes this course difficult to teach.  I have to focus on sleep in order to get you to stop focusing on sleep.  I hope that I am having some measure of success.

So let’s stop focusing on the pink elephant and let’s follow the blue duck, shall we.

Here is Dr. Daniel Erichsen’s take on the pink elephant paradox: <#121 – Pink Elephant> 30:00

And here is another perspective on the sleep paradox issue <#184 – Goal feeling good>

You can measure something but not make it your goal.  I could measure how many steps I take to walk from here to the store, but it doesn’t mean that I have a goal of a certain number of steps.  A successful trip to the store is returning with the proper groceries, not how many steps I took. The number of steps is just information. 

When you record information about your sleep, you do so to get information that you can use to make decisions to adjust your behaviors or thoughts.  In fact, the only time you need to know how much sleep you got is when you are compacting your sleep and you need to set a goal for bed duration.  Other than that, measuring how much sleep you are getting serves no useful purpose and, as Dr. Erichsen says, can become extremely counter productive.

So I would just measure sleep when you are compacting your sleep.  Other than that – who cares?  If you are feeling sub-par, irritable and sleepy, you know you are not getting enough sleep.  Whether you are out by ½ hr or 3 hours really doesn’t matter.  It just means that you need to adjust your actions and thoughts as instructed by CBTi.

And as Dr. Erichsen says, if you keep a sleep journal, remember that life is more than about just sleep.  Make comments about how you are feeling about life in general.  This will more accurately point you in the correct direction for change.  For instance, if you are feeling more hopeful and in control, then you are on the right path and you can continue with what you are doing.  If you feeling irritable, depressed and find it hard to focus, then you need to make adjustments in your CBTi methods.

CBTi not magic bullet

CBTi is no magic bullet in this regard and can be part of the sleep myths psychology.  Any of the CBTi elements may trigger anxiety for you due to your specific situation and life history.  If you sense anxiety, adjust what you are doing or drop the CBTi technique.  It might not work for you at this time.  This is where working with a sleep professional can help.   As examples, some people find relaxation techniques stressing.  Some people fail miserably at compacting their sleep because they find it stress inducing.  Always let your body’s and mind’s response be your guide.  37:26

There is not a single activity that will be relaxing for everyone.  But everyone can find activities that are relaxing.  You just may need to get creative.  That is why CBTi advises you to relax before bedtime, but does not prescribe a particular method.  You will have to find your own groove.

The irony is that any time you find yourself doing something to sleep better, drop it, or proceed with extreme caution.  See if you can’t adjust your motivation.  Rather than taking chamomile tea to sleep well, take it to rel ax and enjoy yourself.  It if stops becoming relaxing and enjoyable, the try something else.  Don’t make the decision based on your sleep.  Disconnect the activity from sleep and the myths and facts about sleep.

The thing that makes the solution to sleeping well hard to grasp, is that most of our goals in life are achieved by focused effort on the goal and the activities that lead to the goal.  Get fit by going to the gym.  Loose weight by willing yourself to eat healthily.  Gain proficiency by practicing for 10,000 hours.  And so forth.

But sleep is of the mind, not the body, so it doesn’t work that way.  As we covered in the last lesson, Sleep Buddy, it is more like a personal relationship than a physical object.  The sleep process is so deeply embedded in our brains from many millions of years of evolution that we have virtually no direct control over it. It literally has a mind of its own.  Your sleep system is going to take in a wide variety of factors and decide if and when it will allow the brain to go into the sleep state.  There is no point in fighting it, so you might as well accept it.

CBTi can be a way out of the paradox.  Focus on your unhelpful behaviors which we covered in Lessons 5 and 6.  Focus on reducing stress for its own sake which we cover in this lesson and the next.  And don’t do things to sabotage your sleep which we cover in the final lesson.  Note that CBTi does not try to control sleep.  It aligns your habits with your natural sleep rhythms.  Then it reduces stress and avoids destructive habits.  Sounds like a plan to me.

 

CBT 1 – model: 40:10

<2 Transition> Now it is time to turn to the world of CBT or Cognitive Behavioral Therapy that CBTi is based upon.  

 

As a quick primer of CBT or Cognitive Behavioral Therapy, CBT was developed in the 1980s as a merging of two earlier therapies.  It has been shown to be very effective at treating depression, anxiety disorders and many other mental health issues.  It is particularly relevant to CBTi in its application of reducing anxiety.

Many sleep experts classify long term, chronic insomnia as primarily an anxiety or hyper arousal disorder.  In fact, It is highly unlikely that your insomnia is a pathological condition, that is that there is something broken.  You don’t get surgery to cure insomnia.  Other than melatonin which can help adjust your circadian rhythm, nothing you take changes the chemistry or neural programming in your brain.  Curing insomnia means improving your actions and thoughts, period.  Don’t make it something bigger than it is.

Let’s start with the observation –->  thought –> feelings –> action model of CBT.

I have a diagram of this on my SleeptoHealthy.com website.  It is easier to visualize and understand with the diagram so you might be well served to check that out.

The observation – thought – feelings – action model means that you observe something, this leads to you thinking about it which leads to your emotional response and then you take action based on your thoughts and emotions.  Let me illustrate the model for you with an example.

Starting with the observation stage, let us say that you observe or notice that you are not sleeping well and that you feel sleepy, irritable and foggy during the day.

Your thoughts are how you interpret what you noticed.  You judge being sleep deprived as bad for your health, you anticipate that your work will suffer, and you dwell on how you your irritability will impact important relationships.

This leads to your emotional reaction which is to feel frustrated, worried, anxious and fearful.

Given your thoughts and your feelings, you decide to try harder to sleep by going to bed earlier and rigidly following advice from the internet on how to sleep better.

The result of these actions leads back to the first step, observation.  You now observe that you sleep is getting worse, not better and that your irritability is starting to harm your important relationships.

And so the downward cycle continues.

The CBT approach is that you can intervene in 2 places.  First, you can intervene in the thought stage.  In this case you could replace the thoughts with thoughts like “Loss of sleep doesn’t effect my health much – and – I can do fine at work even if I’m not feeling 100% and I can handle a few days not feeling great.

Now that you are learning about CBTi, you could also add the thought “I know what to do about this – I need to work on compacting my sleep” or “I am stressed right now from that assignment at work.  Not sleeping well is a normal response to this stress that will pass as the situation at work gets resolved.”

Having these more accurate and more helpful thoughts means that your emotions can be less negative and even positive which reduces your fear-related emotions.

The 2^nd place to intervene is your actions or behavior.  Rather than trying harder to sleep, you can take steps to correct any issues with your lifestyle not being in tune with your sleep pressure, your circadian rhythm, your levels of anxiety or any insomnia causing situations that you have.  You will not try to control your sleep, but rather take care of your sleep drivers and let sleep take care of itself.

Using this CBT or Cognitive Behavioral Therapy model of Observe – Thought – Emotion – Reaction, you can catch yourself thinking unhelpful thoughts or taking unhelpful actions and self-correct.

2^nd CBT – cognitive distortions / the wolves within:

The 2^nd aspect of CBT was demonstrated in the example in the “Thoughts” stage. 

Perhaps you have heard the Cherokee Legend of the grandparent and their grandchild.  The wise sage explains to their grandchild how they have two wolves at war inside them.  One wolf is just, courageous, wise, temperate, calm and kind towards themselves and others.  The other wolf inside them is cruel, cowardly, selfish, emotional and unjust.  These two wolves are constantly battling for control of the person’s mind and actions.

The grandchild asks their grandparent what determines which wolf wins the war.  The wise grandparent replies “The one you feed”

In CBT, cognitive distortions or reframing is about replacing unhelpful, untrue statements with helpful and more true statements.  You want to feed the more helpful wolf with truer, more helpful statements.

Neurologically, every time you think a negative, unhelpful thought, neural connections are strengthened and the thought pattern reinforced.  Over time, it can be exceedingly difficult, perhaps sometimes impossible, to unwire the brain.  Each time to catch the unhelpful thought an replace it with a more true, more helpful thought, the original undesirable neural pathway is weakened.  Over time, the better thought replaces the unwanted thought, and you can proceed along the correct path effortlessly.  But rewiring the brain takes focused work and takes time.  The brain is not like a computer that can be re-programmed in an instant.  It is organic, not directly controlled, and takes time.

In this CBTi course, you are learning the truth about sleep.  But the media and your previous experience with sleep is trying to convince you otherwise.  Reframing is about the process of replacing the unhelpful, less true statements with more helpful, truer statements and beliefs.

Naming the Wolf:

One way people have found helpful to make this transition is to give that part of your mind that feeds the undesirable wolf a name.  By naming that part of your mind, you are given a degree of control, influence and detachment.  You can give it any name you want such as George or Sally, or it could be a descriptive name like “my negative self” or “the darkness”. 

When you notice your mind feeding the unwanted wolf with thoughts such as “I will never be able to sleep well” or “Tomorrow will be horrible”, you simply call yourself on it by saying to yourself “there goes Sally again, trying to persuade me with lies” or “I’m noticing that my negative self is trying to take me away from my CBTi”.  You could try this technique and see if it is helpful for you.

Another way to change your unhelpful and less accurate thoughts is to write out and say aloud the more accurate and more helpful thoughts that you are trying to replace it with.  The more ways to experience the better thoughts and beliefs, the more firmly they will be entrained in your mind. 

In practical terms, if you just think the better thought, your brain has one impression – the thought.  If you write it out and speak it, you have 1 – <ding> the thought, 2 – <ding>  the physical action of writing, 3 – <ding> visually seeing it on paper, 4 – <ding> the audible sensation of hearing it and 5 – <ding> the action of speaking it.  This gives your brain 5 impressions rather than 1 and will speed up the learning process. 

This is not a one time exercise.  You may have to repeat writing down the better thoughts many times before they become habit.

Regardless, replacing your entrenched beliefs will take time and effort.  Just listening to this lesson will not cut it.

CBT worksheets  49:50

To help, I have put some CBT worksheets on my SleepToHealthy.com website.  These sheets are designed to 1 – <ding> help you have a more impartial, accurate view of your anxiety producing situation, 2- <ding> reduce your anxiety level, 3 – <ding> give you some positive counter measures and 4 – <ding>  give you positive feedback on progress.  You can use these sheets any time, including in the middle of the night if you are having trouble sleeping.

The most comprehensive sheet has 7 columns.

Column 1 <ding> is for naming the situation.  Let us imagine that you are up in the night and you can’t get to sleep.  In column 1 you might write: I am up at night and can’t get to sleep.

Column 2 <ding> is for measuring your negative emotions.  In this case you might feel anxious and give it an 8 out of 10 where 10 is extremely high and 0 is non existent.  You also might be feeling fearful at an 8.5 out of 10 level.  You will want to focus on levels that are 4 or 5 and higher, levels that cause issues, not at levels that have no real consequence.

Column 3 <ding> is for your thoughts that underly the negative emotions.  Here you might write “Tomorrow will be a disaster”, “I have to get back to sleep soon because I only have 3 hours left before the alarm”.  Don’t try to use reason at this point.  Even irrational thoughts that cause highly negative emotions should be named.

You don’t need to go crazy and catch every emotion and every thought.  Just name a few and proceed.  You will find that by addressing one thought or emotion, the others are diminished, so you don’t need to be especially thorough.  It is better to make it shorter and to do this exercise more often than to hammer out a small novel but only do it twice a year.

The 4^th column <ding> is for evidence of the thoughts.  What has happened in your life that would lead you to this thought.  In this case you might write:  I have had bad days at work before after a bad sleep.  And “I have had nights before where I don’t get back to sleep”.

Column 5 <ding> is for evidence against the thought.  This is a turning point that starts to lead you out of your negative spiral.  Appropriate responses might be: “I have had horrible nights sleep before and still done quite well at work.” and  “just because I might not feel great tomorrow doesn’t mean that my performance and interactions are out of my control – I can handle it even if I feel suboptimal”  and “I normally get back to sleep when I am awake.  It is more likely that I will get back to sleep than it is that I will be awake for the rest of the night, especially if I practice my CBTi techniques.”  .

It is important that you don’t write out pie-in-the-sky unrealistic statements.  They should be as true or truer than evidence you wrote in column 4.  For example, writing “If I put my mind to it, I can do anything.  I will go back to bed and get right back to sleep.” Probably isn’t realistic or helpful. 

If you get stuck on finding evidence against your thought, ask yourself what a good friend would say.  Or what someone who sleeps well might say.  If you need help, you could try sending me a line I can see what I can do to help.

Column 6 <ding> is for adaptive thoughts.  These are helpful thoughts that you could use to replace the negative thoughts in column 3.  Again, they should be as true or truer than the thoughts in column 3.  So you could write “I may not feel 100% tomorrow, but I can still perform well and enjoy other’s company” and “I’m going to get my mind off the clock, cover up the clock, and use the Sleep Buddy approach”

The final column <ding> might hold a surprise for you the first time you use it. 

Here you write out the negative emotions listed in column 2 along with their level of intensity.  You should be pleasantly surprised at how much your emotional intensity can drop in a few minutes of writing.  In this case the anxiety fell from an 8 to a 3 and the fear dropped from a 8.5 to a 5.5.  Over time you will notice the negative emotions melt away as you work your way across the columns.

Getting this feedback is vital for motivating you to repeat the process.  I will also give you a hint: The more you don’t feel like completing this exercise, the more you need it and the more you will benefit from it. 

It is vitally important that you write out the process and not try to do it mentally.  The effect is just not the same and the impact will be greatly diminished if you try to take the easy way out.  There is something magical about pen to paper or typing it out – ideas and perceptions are released that stay hidden when doing the exercise mentally.

I have put some worksheets with examples on my SleepToHealthy.com website to help you through the process.

Michael Swartz also as an alternative method that you might find helpful: <Michael, 12 – Off mind, onto paper> 56:18

Although the impact can be speedy and effective, expect to fill in many worksheets.  You have spent months or even years rehearsing your unhelpful thoughts.  It will take more than 1 sheet to reverse the ingrained beliefs.  But over time you should find yourself using the sheets less and less frequently. 

As with all the CBTi skills, this skill will last you a lifetime and you can always return to this exercise in the future should you revert back to your old unhelpful ways.

There are many resources online and many health professionals are familiar with CBT if you need additional help. 

If CBT does not seems to work well for you, there are alternatives.  These include ACT or Acceptance and Commitment Therapy, The Work by Byron Katie, The Myth of Stress by Andrew Bernstein.  Also, learning about Sto icism can be helpful. They all have the common theme of changing how we react in the world but each uses a very different approach.  Don’t be afraid to experiment and find the mode that works the best for you.  I plan to cover these in the final lesson.

 

Summary:  That is a lot to take in.  If you go to sleeptohealthy.com, you will find helpful tools and diagrams.

Whole books are devoted to CBT or Cognitive Behavioral Therapy so it has been difficult to select which aspects would be most helpful to successfully execute CBTi.  I would appreciate any feedback you can give me on how effective this lesson has been or not been for you.  If you have experience with CBT, I would appreciate any improvements you might suggest.

The take-home message from this lesson is to identify your personal insomnia sleep myths and tackle them.  The best way is to use the CBT worksheets on the SleepToHealthy.com website.

This will be a great lesson to review any time you feel defeated by your insomnia.

 

So that is it for Sleep Myths.  Today I gave you the tools you need to rip apart any sleep myths that might be hindering your journey to a good night’s sleep.  You have a good understanding of the sleep paradox, how you need to focus on how well you are feeling, not how much sleep you are getting.  You also have a worksheet that can help you put automatic negative thoughts, or ANTS, to rest.

I want to remind you that if you want to do some of your own research on this CBTi or Cognitive Behavioral Therapy for Insomnia element, in CBTi terminology, Sleep Myths is called Cognitive Distortions.

Next lesson we will be covering Stress Reduction.  Everybody has stresses in their life.  It is normal and healthy.  But sometimes things build up and it puts pressure on your sleep.  Wouldn’t it be nice to have some tools that dissipate the pent-up stressors so you can relax, enjoy life and sleep well?  Listen to the next lesson to learn how.

<sound snippet – Who? – # ? – : – >        

<2>Assignment: (give an assignment with each lesson)

Assignment

The assignment for today is to complete at least 3 of the CBT worksheets.  It is better to tackle them initially when you are not feeling especially stressed out, so don’t procrastinate and wait for a time when you feel out of control.  Practice when things are calmer so that you know what you are doing under more pressing circumstances.

A bonus assignment would be to use the critical analysis techniques on an article on sleep that you notice in the media.  I will put a worksheet with reminders of the technique on my SleepToHealthy.com website that you can use.

Hey, I would love to hear how you make out with these assignments.  Send me a note using any the 4 methods available on the website – voice message, text message, email or fill in the contact form.  Let me know if you have any questions, what you find especially helpful, or even better, what you find frustrating about this course.  Thanks for your feedback.

Disclaimer

And here is the disclaimer spoken in one breath….

This podcast is not a substitute for advice from a qualified healthcare professional.  The sole purpose of this podcast is to educate and entertain.  As we do not know your particulars, we cannot and do not provide professional or medical advice or services.  We strongly encourage you to consult a healthcare professional before incorporating any ideas in this podcast.  Listeners who use the information in this podcast do so at their own risk.

Outro:

By structuring this as a course on curing insomnia, it keeps you focused on the core skills you need to improve your sleep. You don’t need tons of sleep trivia and people’s opinions about sleep.  You just need to know proven instructions on what you can do today, to sleep better tonight, so you can feel and function better tomorrow. This allows you to repeat lessons as it’s hard to absorb all the knowledge the first time through, and the information will make more sense after you have the context of the whole course.

You, like most people, will likely benefit from repeated listening.  The lessons will be updated based on student feedback. So the next time you listen to the same lesson, it may be improved since last time.  And that’s about it. Thanks for joining my in my sleep class.

I look forward to seeing you again on the next episode of the sleep to healthy podcast. See you then.