Bye, Bye, Beddie

Before I developed insomnia, I always made sleep a priority—I stuck to a strict bedtime, never allowing myself to get derailed by Netflix binges or the other pitfalls of less dedicated sleepers. I was proud that I almost always woke up before my alarm and never needed coffee to help me function. You could say I was a bit smug about my superior sleeping habits.

Once I developed insomnia, I learned pretty quickly, though, that I'd actually been routinely committing one of the cardinal sins against sleep: I was hanging out in my bed pretty much all the time.

Do any quick Internet search for how to sleep better, and you'll find a list of tips. It is a very rare list among them that doesn't mention the following: "Use your bed only for sleep and sex."

Well, whoopsy-daisy; I'd made a habit of using my bed for pretty much everything! As someone who's spent most of her life in group living situations, I've long been used to spending much of my time in my bed, as it's the only private space where I can relax. During the COVID stay-at-home orders, my bed turned into the home base for all my leisure activities. iPad gaming, book reading, virtual happy hours, movie nights, lunch, dinner, snacks—it all happened on my bed!

As soon as I learned that daytime bed use is a sleep-hygiene no-no, I stopped. When I wanted to play iPad games, I did it at my desk or on the couch. I started eating my meals at the coffee table. On those occasions when I really needed to be alone and horizontal, I'd unroll my yoga mat and have a quick lie-down in my home office. I missed my mattress, but I was going to do whatever it took to sleep better!

Whatever it took to sleep better meant not only staying out of bed during the day, but also leaving the bed frequently during the night—specifically, I was supposed to follow this rule: "If you've been in bed for 30 minutes and still can't sleep, get up and do something relaxing until you feel sleepy."

I didn't know it initially, but this practice of getting out of bed, along with the sleep restriction that I described in my last post, is one of the hallmark techniques of cognitive behavioral therapy for insomnia, and it's known as stimulus control.

"Stimulus control" isn't a very self-explanatory term. What's the stimulus, what are you controlling, and what does it have to do with insomnia?

As it turns out, the meaning is rooted in behaviorism and the concept of conditioning. I am not a psychology professor, so if you really want to learn more about sleep-related conditioning, you might want to hear it from someone other than me, but in a nutshell, it means that if you stay in bed when you're wide awake, frustrated, or unhappy often enough, you're creating a subconscious association between the bed and those negative feelings. Pretty soon the bed itself becomes a stimulus for anxiety, stress, and subsequent sleeplessness! That explains why every time I went to bed, even if I was sleepy, I'd instantly become overwhelmed with panic and lose my sleepiness.

In stimulus control for insomnia, you get up before you start feeling frustrated, and you stop spending so many wakeful hours in bed, so it ceases to be a stimulus for those stressed-out wakeful feelings. Ideally, it should be a stimulus for the exact opposite – relaxation and sleep – which is why you're supposed to reserve the bed only for sleeping and not for all the myriad activities I had once used it for.

This is all well and good and logical, but – like all things about insomnia – not easy.

Since I'm basically a semi-sentient corpse when I'm awake during the night, I found it hard to get out of bed and find things to do, but I was committed to the cause! In early spring when my insomnia was still relatively young, I made myself a kit, complete with blanket, warm sweater, solitaire word game, book and book light, and a mug with a chamomile tea bag at the ready. With all these supplies next to my bed, I hoped to be able to drag myself to the couch and get comfy without having to exert too much brainpower.

The insomnia kit helped me feel a little more in control for a few nights, but I soon realized that reading a book on the couch wasn't always what I needed or wanted. Sometimes I was too tense to lie still. Sometimes my eyes hurt too much to read. Sometimes I was too hot for a blanket. But always, I was too tired to think. So the next development in my get-out-of-bed kit was an auxiliary brain.

I made a list of all the problems that plagued me when I couldn't sleep, and I came up with simple solutions that had worked for me in the past or that I had read in one of the many articles about sleep I'd been consuming. I compiled all these into a cute tiny deck of cards so that when I was awake during the night, I could easily reach for it, flip to whatever problem seemed to be the worst at the moment, and draw a random solution that I could try.

I was so proud of my deck of insomnia cards, but I never even cracked it open once! Turns out, when I'm awake at night and too tired to think and too frustrated to sleep, I'm also too tired and frustrated to remember new tricks. Instead of trying any of the constructive activities I so lovingly curated for myself, I resorted to the tried and true: sitting semiconscious on the couch, trying (and mostly failing) to read, or doing some light exercise until my panic would ease up. It was better than nothing, but never felt like victory.

I still struggle with stimulus control to this day. Thanks to my sleep training and several months of practice, I sleep relatively normally at present, but every once in a while, I'll think too much about insomnia during the day, and I'll get a little too anxious when I go to bed at night. Or I try to push the envelope and go to bed too early, or I have a bad night because I'm not feeling well. Then I find myself back in my old shoes, tangled up in the sheets and painfully conscious of the minutes ticking by. So I get out of bed, and wonder what to do with my time.

 

My latest idea was that I could sit on the couch and try to tell myself a story. It doesn't have to be a good story, just something to fill the time—but since sleepless nights usually find me with the mental capacity of an amoeba, I'm not sure I could even handle that. 

 

 

I haven't had much trouble falling asleep in the last month, but I know my time will come again. I can only hope that when it does, I'll be able to overcome my primal fears and waste no time getting back to bed, where I really prefer to be!