Tips to help sleep: so many of us have that awful withdrawal insomnia

[Chompoo]

@theopold you're not the first person with AD withdrawal who doesn't think you have food intolerances. Only to find out later that improving your diet improves all your symptoms, including insomnia.

 

I got these diet tips from an antidepressant group on Facebook. From sleeping 0 hours for 8 days in the very beginning of WD, I started to have nights of 7-8 hours from month 5. onwards This is in comparison to another guy on the same Facebook group who didn't follow the diet tips. After 2.5 years, he's still sleeping 4-5 hours on most nights.

Up to you to believe. I'm not the one who's sleeping 0 hour nights here.

[Ariel]

Wrote this to someone earlier, posting here in case it may be useful to someone/anyone down the line. 

 

What I can share from personal experience is that insomnia-related discomfort can be significantly alleviated by removing the "second arrow". 

 

Are you familiar with the Buddhist parable of the second arrow?  

 

Sleep issues are among the most common symptoms of drug withdrawal syndrome. One can stringently follow all the best practices for sleep hygiene, etc., and still sleep can be elusive because the iatrogenic injury is a wild card. One cannot necessarily actively do anything to make it better; one can only attempt to not overtly interfere to make things worse (which, arguably, can make things a bit better, to a degree). 

 

One can view certain challenges as first arrows, i.e. value-neutral (albeit painful/uncomfortable) factual circumstances. In this analogy, sleep issues are the first arrow. 

 

Working with the psychological aspect -- our reaction, i.e. the second arrow -- makes a pivotal difference in our subjective experience of sleep challenges (and everything else). The second arrow impacts how we perceive and handle the first arrow. Our reaction shapes our response, e.g. reacting to a perceived problem vs. responding to a situation/circumstance. 

 

When we practice acceptance and release the tension of worry there can be a real shift in perception. Letting go of the struggle and finding a place of neutrality affords us the opportunity to be with what is -- as it is, and as we are, in the moment -- without getting lost in stories or cognitive distortions that add stress and cause a negative feedback loop.

 

I don't know that insomnia can ever not be somewhat uncomfortable, as sleep is a fundamental biological need, and when this need is not met, it affects us. Nevertheless, I know from personal experience that it is possible, with a "no second arrows" mindset, to approximate something like making peace with sleep issues.

 

Good sleep will always be preferable to poor sleep, and also we can teach ourselves to view the latter as a non-event, and not dwell on it.

 

Whatever inevitable physical consequences there are -- first arrows -- we can take those in stride and tend our needs accordingly, without adding second arrows. Adopting this attitude may not cure insomnia but it can make living with insomnia a lot more manageable.

 

In my life, "no second arrows" is a daily practice applicable to just about every aspect of existence. Whether we call it a mindset, attitude, psychospiritual practice, coping technique, survival strategy, whatever -- it is quite effective. 

 

And the best news is that "no second arrows" is both a tool and a transferable skill, i.e. we can learn to use it and get better at it with practice, and benefit from it across all areas of life.  

[Ariel]

Beautiful poem for the sleepless among us! 

 

With Astonishing Tenderness

 

When, in the middle of the night,
you wake with the certainty you’ve
done it all wrong, when you wake
and see clearly all the places you’ve failed,
in that moment, when dreams will not return,
this is the chance for your softest voice—
the one you reserve for those you love most—
to say to you quietly, oh sweetheart,
this is not yet the end of the story.
Sleep will not come, but somehow,
in that wide awake moment there is peace—
the kind of peace that does not need
everything to be right before it arrives.
The peace that comes from not fighting
what is real. The peace that rises
in the dark on its sure dark wings
to meet you exactly as you are.

 

by Rosemerry Wahtola Trommer 

[theopold]

Hey @Ariel

 

On 6/18/2024 at 8:41 PM, Ariel said:

Whatever inevitable physical consequences there are -- first arrows -- we can take those in stride and tend our needs accordingly, without adding second arrows. Adopting this attitude may not cure insomnia but it can make living with insomnia a lot more manageable.

 

My insomnia is very bad right now.  Maybe 3.5 hours last night, and about 4 hours the night before.  I've copied the above quote from you into this message because...It just so happens that I had been dealing with a particularly nasty obsessive/intrusive thought for the last couple of days as well.  And...I was actually able to finally get some relief from that nasty issue yesterday by working on actively "removing" the second arrow of fear.

 

And so, I was feeling a little blessed and also relieved having made some progress with that issue yesterday...only to be hit pretty heavily by second arrows coming from the insomnia last night.  Funny, not-so-funny story about last night...I woke up in the middle of the night, was trying to distract myself with some reading for a bit.  Reached over to the side table to grab a drink of water from my water bottle, and knocked it over, causing it to "hit" my phone, and...my damn phone lit up, showing me the time.  And, yeah...inadvertently seeing the current time, figuring out how much sleep I'd had up to that point, that was all I needed - apparently - to kick off a pretty rough bout of anxiety and fear.  Once I'd calmed that down, that was it for sleep last night. 

 

Getting back to my point, I've read/re-read the various posts on sleep tips here.  I've also read your recent posts on the topic of insomnia.  But I still wanted to just ask...any tips on beating the second fears from insomnia?  Probably just the same process, i.e. find a way that works for you personally to remove the fear, but...I figured it couldn't hurt to ask anyway.  Also, anything you do, or don't do, the morning after?  For example, I've been taking it easy the last couple of days - no exercise, just relaxing as much as possible on the couch during the day, etc - and as mentioned, if anything my insomnia got worse!! 

 

So, sitting here today I'm now thinking I should be a little more active today, maybe try to tire myself out a bit?  But, then you read another post on this topic where maybe that's not recommended??  And, yes, lol, I know everyone's different - just wondering what the consensus, if any, might be on being "active" during bouts of insomnia? 

 

And finally, something I think each and every one of us can relate to...I am now almost 3 months into withdrawal - from the sertraline - and even after this (comparatively) short period of time, I cannot help but reflect on how one symptom/effect after another just...wears...you...down.  And, of course, the weaker you get/feel, the harder it is to "fight".  As mentioned above, I just yesterday beat that nasty obsessive thought that was - literally - torturing me, and now with this horrible, horrible insomnia flare, I wonder wear the strength comes from - in addition to the fact that with the insomnia, every little thing hits just that much harder, obviously.  Anyway...suggestions or support, do let me know your thoughts!   

[DaBro]

The last few comments resonate with me. 5.5 years out for me and I still get insomnia now and again. This week I had 3 nights with 4 hours in a row which is thankfully very rare these days. 
 

my tips for managing the second arrow or emotional response over the years has been to:

 

- When you sleep or wake in the night say to yourself “oh, this again, I’ll just follow my routine” rather than get annoyed

- Don’t look at the clock or don’t have one

- Distract the mind. I listen to a bland podcast if I can’t get to sleep or do A to Z in my mind if I wake up in the small hours

- After an hour or two or if you find yourself getting angry/frustrated get up and take a walk around the house. Make a cup of tea. Stroke the cat

- Rest as much as you can. Rest and peace while awake while not as good as sleeping is better than tossing and turning

- I have a large armchair that I can curl up in. I find raising my head aids sleeping 

- I have learnt to feel the head sensations (tinnitus and a tugging sensation in my brain) that seem to partner insomnia. I wait and enjoy feeling them subside, knowing sleep follows

- When I don’t sleep I tell myself that I’m going to have an ‘uphill’ day. They are tough but I’ve survived several hundred of them and I’m still going. They are an inconvenience but not the end of the world 

 

tips and learning from me

- sleep hygiene doesn’t help. It’s a good practice though. WD is physiologically different to a lot of things that sleep hygiene tips are there for. Don’t get obsessed with pre sleep do’s and don’ts. Enjoy good times. 
- Magnesium Glycinate 

- Deep Breathing, Yoga, lip and neck stroking and other things to stimulate parasympathetic nervous system help (a little)

- Be kind to yourself 

- Explain to family and friends that you get bad sleep sometimes and may miss social events or be quiet and reserved some days and it’s nothing about them. 
- I’m a scientist so I like to track things. I tracked my bad days and can see the numbers reducing over time. When I was 3-6 months into WD a full nights sleep was rare (perhaps once or twice a week) now a bad night is rare (perhaps once or twice a month). It’s a journey with ups and downs but always slowly improving 

 

no silver bullet unfortunately 

be kind to yourself and patient 

enjoy the kindle books you read in the night. 

[theopold]

Thank you so much for your comprehensive and very informative reply, @DaBro  As always, everyone who is a member of this site is just so kind, thoughtful and supportive 🙏

 

4 hours ago, DaBro said:

- I have learnt to feel the head sensations (tinnitus and a tugging sensation in my brain) that seem to partner insomnia. I wait and enjoy feeling them subside, knowing sleep follows

 

I was literally thrilled, lol, when I read this comment!  I have low level tinnitus quite often, but thankfully for me personally it has never really "bothered" me that much.  But, man oh man...maybe it's been mentioned by others on here and I've just missed it?  I'm talking about the "tugging sensation in the brain".  I get that every time I'm laying in bed during an insomnia episode, and it is SUCH a freakin' relief to know it's not just me, lol!!!!!   So yeah, thanks very much for mentioning that 🙏

 

4 hours ago, DaBro said:

- sleep hygiene doesn’t help. It’s a good practice though. WD is physiologically different to a lot of things that sleep hygiene tips are there for. Don’t get obsessed with pre sleep do’s and don’ts. Enjoy good times.

 

Yeah, I've been wondering about this lately.  When the insomnia first really hit me a month or so back, I set up a pretty substantial sleep hygiene regime.  Since then, I've had several occasions where I omit various things - not using an eye mask, for example - and I personally have never noticed any kind of resulting patterns - either good or bad. 

 

In a similar vein, for the life of me, I cannot figure out why, 3 nights ago, for example, I woke up in the middle of the night but fell back to sleep after a short time, and yet, as mentioned above, was unable to do this over the 2 subsequent nights, despite obviously being increasingly more tired?  Point being, I guess, as already mentioned, I am also starting to feel like WD insomnia is very much it's own "beast".    And what I wouldn't give to figure out how exactly to tame it!!!

 

4 hours ago, DaBro said:

- Explain to family and friends that you get bad sleep sometimes and may miss social events or be quiet and reserved some days and it’s nothing about them. 

 

Thank you for pointing this out!  It seems pretty "obvious" now that you've stated it, but...to this point I do put additional pressure on myself at night when I have some type of social event, etc, the following day.  Your "tip", then, makes perfect sense...just be proactive with folks about the situation, and help yourself to take at least that one stressor off your plate.

 

4 hours ago, DaBro said:

When I was 3-6 months into WD a full nights sleep was rare (perhaps once or twice a week) now a bad night is rare (perhaps once or twice a month).

  

Just curious here...did you, or do you, ever have nights without ANY sleep?  Bit of a selfish ask on my part at this very moment, because already today I've started notching up my bow with this potential second arrow, or emotional response, heading into tonight.  The underlying fear comes from the irrational thought that...if I go long enough without ANY sleep I'll have to be hospitalized soon 😱  Catastrophizing, in other words...

 

4 hours ago, DaBro said:

enjoy the kindle books you read in the night. 

 

And, just to end with a bit of (attempted) levity...I wear glasses, so when I am reading in bed in the middle of the night I often find myself wanting to read while lying on my side, but it's basically impossible with eyeglasses - for me at least! 😖 Damned if I don't keep trying, though!

[DaBro]

Agree 100%. 
 

on the zero sleep question. Yes I did. I found (at my worst point) normally I would be so exhausted I’d get some sleep on the 3rd night, so the longest I would go with zero sleep was probably 60 hours. Glad those days are gone. 

[DisplayName3332024]

All I want is my sleep to improve but I haven't seen any recovery so far. I'm a fairly young dude in my early twenties but I wonder if "recovery" is possible on your sleep architecture? I don't mind having this anhedonia, but I'd prefer to sleep 5 hours of uninterrupted sleep someday.

[Onmyway]

@DisplayName3332024that will come slowly as well. If you're having trouble falling asleep background music or sleep hypnosis tracks may help. I liked Sleep Cove stuff in the beginning.