Dr. Nick Wignall continues as Dr. Margaret’s guest this week, as we switch from focusing on emotional fitness to the 100% effective CBT tool for curing insomnia, called sleep compression.
It’s hard to believe that in ten years of doing SelfWork, I don’t remember an episode where we were focusing on insomnia, although I hear about it on a regular basis all the time. We’ve talked about “sleep disturbance” frequently in the context of classic depression, bipolar disorder, nightmares, or anxiety. So when Nick told me one of this areas of expertise was insomnia, I jumped at it.
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Dr. Wignall introduces the idea of sleep compression…
But I think ideally, we wanna start to be thinking about our struggles, not just in terms of how they look or appear superficially, but in terms of the mechanisms driving them. And when you look at insomnia through that lens, the un – even though superficially it involves sleep or lack of sleep or struggle with sleep, a more helpful question is, what’s the mechanism causing the struggle with my sleep?
And this completely changes the way you think about insomnia and sleep struggles – Sure does. The more the better. So there’s a bunch of stuff we can dive into there, but I think, and I will try and make the case for why, you will actually have better, a better chance working through and, and ultimately getting rid of sleep issues and insomnia if you treat it like an anxiety problem, not a sleep problem. Because, and this is true for insomnia, it’s not necessarily true for other sleep.
There’s other sleep disorders. So there’s things like sleep apnea or narcolepsy or there’s all sorts of other types of sleep disorders. But for insomnia, there is literally nothing wrong with your brain or body’s ability to sleep. Right. There is no pathology involved in insomnia.Your body is working perfectly well. So, it isn’t a deficit problem.
It’s an interference problem. It’s not that you lack the capacity to sleep. Something’s getting in the way. And the main thing that’s getting in the way is anxiety. ”
How does sleep compression work?
Nick goes on to describe the technique called sleep compression (a term I’d never heard) that is a CBT – or cognitive behavioral therapy tool – that is 100% effective for insomnia. It’s fascinating to hear and makes such common sense.
If the goal is 7 hours of sleep per nite on average, then you back up how many hours you allow yourself to sleep. Maybe 6 or even 5 1/2. Then you literally don’t get in bed until you’ll sleep that amount of time. Then you make yourself get up. You do this long enough and you’ll gradually eliminate the anxiety around sleep – and tap into your body’s desire for sleep – and get your ritual back on track. This can take weeks or months… but it works.
Let’s continue hearing from Nick:
“By getting into bed and being completely, totally sleepy, because you’re only getting five hours of sleep every night, you will fall asleep right away, and you will sleep through the night.”
“So your brain relearns – Yeah. That your bed is associated with sleep and relaxation, not worry and anxiety. So you do this for a few weeks, can be up to a month or two, and you are retraining those associations with bed.”
“So now you’ve done. Well, you’ve done this for a few weeks, say. Now, if you’re sleeping, if you’re falling asleep pretty quickly and you’re sleeping through the night, then, uh, what I would do or your provider would do is say, “Okay, you’ve been doing five hours. Let’s work back up. Let’s go to five and a half hours for a week.”
And if, if you’re still doing well, if you’re getting in bed and falling asleep relatively quickly and sleeping through the night for the most part, a couple caveats on that. Um, it’s normal to take up to 20 or 30 minutes to fall asleep.”
His advice throughout this episode is spot on about sleep – and he swears that this technique has helped everyone in his practice – at least those who stuck with it.
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