Best podcast for busting Insomnia Myths- Must listen- It will really help

Well worth the listen- changes your entire attitude about sleep! 

 

https://insomniacoach.com/busting-sleep-insomnia-myths-jade-wu-ep13/

 

With all of the hype about what lack of sleep does to your body & brain this podcast

"Listen to the podcast episode (audio only)

Dr. Jade Wu is a clinical psychologist and behavioral sleep medicine specialist at Duke University School of Medicine. Her current research focuses on treating sleep disorders in those with chronic illness. In the clinic, she uses treatments that do not involve medication to help people with insomnia, circadian rhythm disorders, and other sleep concerns.

In this episode, Jade and I discuss a number of concerns that are common among people with chronic insomnia — we talk about how much sleep we need, whether we can lose our ability to sleep, whether insomnia is caused by a chemical imbalance in the body, whether chronic insomnia causes any serious health problems, and whether we have any control over the negative impact insomnia can have on our lives.

We also talk about why cognitive behavioral therapy for insomnia (CBT-I) is such an effective treatment for people with chronic insomnia, even if it’s present alongside another health condition.

Many people have inaccurate beliefs about sleep and this is a big contributor to sleep-related worry and anxiety that can perpetuate insomnia. My aim with this episode is to help change the way you think about sleep and insomnia. I hope this will help reduce the intensity of any worry or anxiety that might be making it more difficult for you to improve your sleep and encourage you to pursue CBT-I so you can enjoy better sleep for the rest of your life.

Click here for a full transcript of this episode."

I saw a psycologist for CBT for insomnia.  Also did an online course called "Shuti".  That was before

I came to find out that my insomnia was "drug induced" from Atavan.  CBT-I assumes your insomnia

is because of poor sleep habits.  Since mine was a result of altered brain function, CBT-I didn't help me

sleep any better..... just my experience.

The sleep expert from Duke medical school seems to disagree and gives the science behind why everyone should be able to sleep-even with other debilitating diseases. Worth listening or reading the transcript. I also took CBT-I course and had same attitude but after listening am hopeful to give it another shot.

Menemsha,

 

Lots of good info on sleep and thanks for posting this.  This still sounds like the "traditional" premise for CBT-I.  I spent $600. @ $150/hr to figure out my problem was that benzodiazepines had chemically altered the sleep architecture of my brain (among a host of other modifications).

 

Jade Wu:

"...But in fact is the behavioral changes and cognitive changes that really solve the problem."

 

 

This may work for some.... and I wish them all the success in the world.

 

I truly wish there was a cure for benzdiazepine induced insomnia and the host of other benzos sxs (other than time) .... I'm really "tired" of 2 hours a night of toxic REM sleep!

 

If our "medical professionals" had recommended CBT/Psycotherapy for our our problems (anxiety, insomnia, etc.) BEFORE reaching for the script pad, very few of us would be on this website looking for answers to a problem for which science has no solution.

 

 

 

 

Benzodiaepines Effect on sleep

 

https://en.wikipedia.org/wiki/Effects_of_long-term_benzodiazepine_use

 

"...Sleep architecture can be adversely affected by benzodiazepine dependence. Possible adverse effects on sleep include induction or worsening of sleep disordered breathing. Like alcohol, benzodiazepines are commonly used to treat insomnia in the short term (both prescribed and self-medicated), but worsen sleep in the long term. Although benzodiazepines can put people to sleep, while asleep, the drugs disrupt sleep architecture: decreasing sleep time, delaying time to and decreased REM sleep, increasing alpha and beta activity, decreasing K complexes and delta activity, and decreasing deep slow-wave sleep (i.e., NREM stages 3 and 4, the most restorative part of sleep for both energy and mood).[31][32][33]

 

 

 

 

From podcast:

 

Martin Reed: All right, so what was the next question I have for you that I hear sometimes. Okay. Is insomnia caused by a chemical imbalance in the body?

 

Jade Wu: That is also a no. So it kind of dovetails on to what we’ve been talking about how insomnia is not a physiological problem with sleep, but I do find that, that’s a common misconception. And in fact I’ve heard many different theories from my patients about why they have insomnia. I’ve heard stuff about the pituitary glands, about GABA, about serotonin, and the truth is that none of those things are the culprit.

 

Jade Wu: And if it were just one neurochemical or one circuit or one brain region, then it would be a much simpler fix, or it would be a pharmaceutical fix that will solve the problem. Whereas we know that sleeping medications actually don’t solve the root of the problem. And that’s why you have to take them, and take them, and take them, and take them, instead of taking them for a short amount of time to reset your brain. So if it really was a chemical imbalance, then we would expect medications to work better.  But in fact is the behavioral changes and cognitive changes that really solve the problem. Which tells me that it’s not a chemical imbalance in the brain.

I agree with topofthebottom:

 

Benzo induced insomnia is a completely different "animal" than what people experience with non drug induced insomnia.  There was nothing short of another Rx drug (and even those did not work for me for more than a day or 2) that was going to make any type of difference during Benzo induced insomnia for me and many others on this forum!  Why?  Because Benzos temporarily break your sleep switch by down regulating GABA.  CBT is great for chronic insomnia or those that don't have insomnia caused from some Rx drug, and I wish I would have went that route BEFORE Benzos, but CBT will not touch Benzo induced insomnia for most.  It can't as it can't heal nor regrow GABA receptors.  I tried CBT, sleep restriction, etc. and nothing worked during the thick of my WD when I had severe insomnia. 

 

After your sleep starts to return, CBT has a better chance to make a difference IMO and experience.

 

It does not address use of any medications

for sleep. And many with insomnia will seek

and try meds. And many will get benzos.

And many meds for sleep affect sleep

architecture. It becomes a whole

different issue.

It does not address use of any medications

for sleep. And many with insomnia will seek

and try meds. And many will get benzos.

And many meds for sleep affect sleep

architecture. It becomes a whole

different issue.

 

I understand how it works, I did the same thing...I had sleep issues and then got on Benzos and then had way worse insomnia after I CT'd the Benzos,  What I am saying is if you are already in Benzo-induced insomnia, CBT is not effective at all.  It can't be, because it can't fix down regulated GABA receptors.  CBT should be tried BEFORE going on Benzos or other drugs, but people are on this forum because they already took Benzos or some other Rx drug.  CBT makes sense for those that have sleep issues but never took drugs but CBT will not help those who have insomnia caused by tapering or doing a cold turkey from Benzos.

 

I am not advocating for drugs...I would never do that.  But after the temporary damage caused by the drugs is done, CBT is of little value until you heal and you won't heal until you are off of all drugs.  However, I am sure there is good sleep information in general in the podcast and that is worth listening to.

Thanks for positing. I think it’s so important for all of us to be aware of alternative approaches to treating insomnia. I went to two different CBT-I therapists, but sadly no luck with it. Like others have noted, I assume it might not work for all of us who are truly dealing with a physiological issue due to benzo use, however, I often wonder how many of us are out of the physiological phase of the insomnia and have developed true chronic insomnia due to all the weeks/months of benzo induced insomnia. After months/years with insomnia after benzos it’s hard to tell what’s what any longer and so I would absolutely encourage all to take the approach of the insomnia being psychophysiological and engage in CBT-I just in case the insomnia is no longer benzo induced. 

In my experience, you can't develop "chronic" insomnia from Benzo-induced insomnia.  If the Benzos caused your insomnia in the first place, and you still have it, it's still the temporary Benzo damage causing it.  Your brain knows how to sleep and wants to sleep.  Your brain doesn't "learn" to not sleep because of the Temporary insomnia created by Benzos, especially if you never had any sleep issues before Benzos.

 

Trurst me, you'll know when your Benzo induced insomnia ends.  Mine took a long time to get back to pre-Benzo status.  Some people take 2-3 years or longer for sleep to resolve.

 

At just about 3.5 years off I am sleeping very well pretty much every night.  I don't take anything for sleep and never did CBT-I. 

 

I am not saying CBT-I can't or won't help you, but I am going to say no during Benzo induced insomnia?  There might be an exception or two, but I doubt it.  The only way out of the mess is to go through the process and stop blaming or trying to attribute your symptoms or lack of sleep to something other than Benzos.

What I mean is that when insomnia is triggered for whatever reason we can develop negative thoughts and behaviors and anxiety about sleep that perpetuate the insomnia. It’s very easy to get stuck in an insomnia cycle so that even when we are healed the insomnia can remain unless treated. When people who develop chronic insomnia that have not been on a med or benzos, it’s usually triggered by an acute episode (stress, newborn, medical condition). When those issues resolve many find the insomnia remains. This could easily happen for an individual who first had benzo induced insomnia, but it can become its own beast  even when benzos may no longer being affecting the sleep. Doesn’t sound like it was your case and certainly not everyone’s but I can see how it could most certainly happen.

That's called "sleep anxiety," and I had it pretty bad for some time.  It went away.  I didn't treat it with anything other than father time!

 

You are doing exactly what I did.  Trying to "connect the dots" to find out if something else is causing the insomnia.  If you never had insomnia before Benzos (I did, and that's why I went on Benzos in the first place) it will resolve given enough time with or without treatment.

 

Of course we develop negative thoughts and behaviors.  Who wants to go without sleep?  I was so stressed out by not sleeping that just the thought of my bedroom made me panic stricken.  Today, I love my bedroom as I know I will get decent sleep.  It's all temporary.  It all fades and ends one day. 

 

I am not dismissing CBT-I.  I know it can have value at some point AFTER you are mostly healed, but it won't do much while your GABA receptors are still temporarily not working.  Your body's brake pedal (GABA) is temporarily broken and your body's gas pedal (Glutamate) is stuck to the floor...that's why you or anyone else with Benzo induced insomnia can't sleep.  CBT-I won't magically repair your body's brake pedal.  Time will.  Your body knows how to repair the damage.

 

Plus it would be nice if you filled out a signature listing what you were on or are still on?  Good luck.

 

Yes it is sleep anxiety, but sleep anxiety  and hyperarousal are mostly the reasons for why individuals suffer with chronic insomnia. The conditioned state of hyperarousal in the bed I think can become chronic so in that case CBT-I can work while waiting it out may not work for some who have been conditioned to that anxiety state at night.

 

You are right I am trying to connect the dots. I get afraid that I might not know I’m healed because I do experience some sleep anxiety at night, although not always, and I often wonder if it’s just become chronic insomnia due to that or if benzos still are having an impact. I wasn’t saying cbt-I can work if it’s strictly benzo insomnia, I’m saying that benzo insomia can turn into chronic insomnia due to sleep anxiety/conditioned arousal and it could be difficult for some to determine what’s what, so giving cbt-I a go if you’re suffering for over a year might not be a bad idea just to see. It would be a shame for people to wait and wait and wait thinking it’s all still benzo related when there’s a chance it may not be anymore.

 

When you were going through the anxiety that came with not sleeping, how did you know you were healing? Did your sleep get better even despite the panic and anxiety at night? I think if my sleep quality were to change then I might know better that I am healing

 

Thanks for your thoughts it’s nice to have others on here sharing what they’ve been through even though they are healed already. I’ll get a signature in there soon. I was a short term benzo user (2 months) following a horrible reaction to Zoloft.

Sleep comes back for most sort of like the stock market.  UP and DOWN...1 step forward 2 steps back.  I made some nice gains with sleep meaning that I was getting some sleep for 2 or 3 days in a row, but then I would get slammed back to zero or no perceived sleep for a day or 2 followed by some sleep.  It was a real roller coaster ride.  Even after getting some sleep for 4 or 5 days in a row I would always get the zero or no perceived sleep at least one or 2 times per week.  Eventually it became more days in a row with about 1-4 hours per night.  It took about a year to get 3-5 hours per night most nights and then that slowly kept increasing, but I still had the nights when I got zero here and there.  In fact at 18 months off I had a 29 day insomnia only "wave" where I had 4 zero nights (no perceived sleep) and a lot of 1 or 2 or 3 hour nights.

 

I could have easily let myself believe I developed  "chronic non-Benzo insomnia" as I already wrote a success story at month 15.  But I read where others had late waves too.  I tried not to let it bother me, but it did.  I'll admit at that time I thought I was "broken" as I just had about 6 months of 4-6 hours per night most nights.  I tried CBT-I during that wave and it couldn't touch my temporary insomnia.  CBT-I made no difference for me and I was pretty much healed.  Maybe it will work for you or others?  No reason not to try it.  After that wave evened out, my sleep came back.  At 32 months off I had a "mini-wave" of 3 nights of very poor sleep; 1 zero night and 2 one or two hour nights.  That passed too.  Now I get a 2 or 3 hour night about once every 2 months or so.  But I also get a lot of great nights of 7-10 hours.

 

I know where you are coming from but having Benzo induced sleep anxiety doesn't mean it will create long-term "chronic" non-Benzo insomnia.  If it could, I should have gotten it.  I know there are exceptions, but your body wants to sleep.  I had pretty severe sleep anxiety and dreaded when late afternoon rolled around as I knew the night wasn't going to be fun.  I learned acceptance and gratitude from Aloha, MTFan, Siggy and others that also had severe insomnia.  It didn't fix it, but it helped me cope better with the sleepless nights and when I stopped worrying about getting sleep and worked hard to not give a rat's arse if I slept or not, sleep slowly started coming back. 

 

Symptoms are signs of healing.  It may not seem like it, but they are.  Symptoms and insomnia are signs your body is repairing the temporary damage caused by the Benzos.  It never felt like I was healing until I would look back and realize I had a good day here and there and sometimes more than one good day in a row.  It's super easy to focus on the negative, the extreme, the worst case scenario.  Those are all Benzo WD lies that you believe when you are in WD.  But they are simply not true.  But you will know when you are healed.  After my sleep started coming back around month 10, I felt like I was completely healed around month 15.  However, I know for a fact I was completely healed around month 24 as I had zero symptoms and they had been gone for a few months.  They never came back and I will be 3.5 years off next week Wednesday. 

 

I honestly thought I was stuck for life.  I thought that everything that was happening to me was permanent.  It wasn't.  It's all gone now.  It will end for you too.

 

Thanks for sharing your story! It’s nice to see the details of how it all progressed as well. I’m definitely feeling like I’ll never sleep again but honestly I think having the mindset that I may never sleep normally again is better for me mentally than constantly wondering and being anxious about when normal sleep will come. Accepting that it is forever is actually helping

Not expecting any sleep is another strategy that works well for some.  I learned that from Aloha.  When you go to bed, don't expect any sleep, none, zero.  Then if you nod off here and there or get an hour or two, you'll be pleasantly surprised and happy....or at least I was.  I would go to bed with the idea that I was just going to "rest my body."  My brain couldn't sleep much, but my body needed some rest.  Several times when I didn't think I got any sleep my wife informed me I was snoring a few times, so I must have gotten some?  That's why when I say zero sleep I qualify it with "no perceived sleep." 

 

You also get "micro sleep" that helps sustain your brain during longer periods of very little sleep.  You can Google that if you want to.

 

ACCEPTANCE goes a long way to things slowly getting back to their pre-Benzo state even if that means accepting something that isn't currently true.  Your current insomnia is TEMPORARY.  It will end, but keep doing what you are doing to deal with it.  You've got this!

 

 

ThEwAy2

 

I am so thankful for your posts, I read them when I feel terrible it really does help put things in perspective.

I wish you were here in my home during the nights when I feel so scared about not sleeping. I am happy your postings are here to comfort so many of us that dont have a good understanding of this. I am not a good writer but you explain to a tea exactly what has happend to me during this whole terrible experience that has lasted so long and I still have a way to go.

Thank you for being a part of this and helping all of us.

Lisa