@stuart I did 14 months of CBT at a local sleep clinic. The only things that helped were the standards: room totally dark, room cold, very heavy blankets, no clock watching, get up and do something else in another room if you can’t sleep, no electronic devices for an hour before bed (I’m bad at that one), no caffeine after noon, no alcohol after 6:00 p.m., gradually decrease exposure to lighting after 6:00 p.m., maintain strict sleep schedule, create and maintain strict bedside routines (like brushing your teeth, hair, putting on lotion, setting something out with lavender), etc. But after 41 years of chronic insomnia, no, I cannot simply override all of my mental programming that not-sleeping is the enemy, that I won’t be able to sleep, and that things will suffer the next day like if I have a test or a major meeting. It’s very serious now that I have so many sources of serious chronic physical pain. Not sleeping now doesn’t just mean reduced brain power, it means an extremely physically painful next 2 to 3 days, which makes me even more scared of insomnia. In CBT they try to tell you you’ll be just fine if you don’t sleep, but that’s not true. Not sleeping is hell. It reeks havoc on work productivity and personal relationships.
I have ADHD and OCD so my brain just does not shut down my racing thoughts without the sedative-hypnotic Ambien. It’s unbelievably challenging for me to be calm. Ambien is the only thing I ever found that truly helps me fall asleep and stay asleep. Actually, the Dimetapp from 1987-1995 helped. It had something in it that wasn’t lame melatonin, but they were made by the Feds to remove it
Too bad, because it was easier to get, and safer, than Ambien. Fortunately, I have never had any problems with Ambien. My former doctor had a lady who slept with her baby in her bed - which you’re not supposed to do anyway - then took Ambien and rolled over and smashed the baby, suffocating it without her even knowing it until the morning. My doctor was sued for negligence. In my mind, the woman was the negligent one for having the baby in the bed with her in the first place. Needless to say, he was loathe to prescribe Ambien to anyone so I changed to a new doctor (actually she has a Doctorate of Nursing, and nurses are nicer) who I really love and helps me out, for the most part.
As for CBT, I say do it, it’s easy, no big deal. They mostly assign you reading material and a couple of sleep studies. You will learn some things from their handouts; I did. But it was no cure. Honestly, I think before spending the money on CBT, though, I’d buy yourself a famous sleep aid book, read it carefully and apply the suggestions diligently. If that doesn’t help you, then try the professionals. I didn’t learn that much from them that I hadn’t already read in a book.
FYI, ADDs sleep easily, but us physically restless, very busy ADHDs do not. Be forewarned that those who teach CBT usually can’t remotely fathom that somebody has a problem getting to sleep every single night. They likely will not believe you about your stories of insomnia and will argue with you that you are mistaken and only imagine it. I had to get the testimonies from my previous romantic partners who absolutely witnessed me having sweet problems Every. Single Night. That is my very least favorite thing about CBT (and the general public, the vast majority of whom sleep just great) - they just won’t believe you when you say all their suggestions, including Melatonin, just don’t work. I would give anything to have a doctor or a nurse who has the same kind of insomnia I do.
The book “The Sleep Solution” from 2018 is currently considered the best. I also found some simple tricks I didn’t find anywhere else in “Midnight Mind,” a simple, short, easy read.
An ADHD tip that I don’t think would work for a non-ADHD is that I’ve accidentally found some puzzles like word search or Suduko can put me to sleep. But they have to be puzzles I don’t really care about - like a crossword doesn’t work, because I get too invested in getting them done that I get wide awake and intellectually overstimulated. Ditto with sewing. Reading helps, especially if it’s something like “National Geographic” that takes my brain to a totally different place with totally different problems.
Two years ago, I was accidentally given a TV for my bedroom - long story. Before then, I had hardly watched any television in my entire lifetime (I see movies in theaters), and my TV was always in my living room, as it was at my parents’ house. I have since discovered that watching TV in bed actually helps me fall asleep, despite the blue light pollution - because it takes my mind away - as long as it’s not too interesting nor too violent. I just have to make sure I set a timer for it to go off. Animal and nature shows have soothing voices without shouting or gunshot, that is usually my go to style of sleepy time programming.
Same thing goes for reading material - it can’t be too interesting, or I won’t fall asleep.
I hope some of these suggestions help you. Having nocturnal enuresis, I also try not to drink any fluids (including soup, yogurt, ice cream, etc.) after 6:00 p.m. Every time I wake up to pee is a renewed battle against insomnia to get back to sleep.
