I’ve never been a great sleeper – mostly thanks to my active and anxious brain. As I got older and started going through perimenopause and then menopause, it only got worse. When my autoimmune disease developed, I had to add regular steroid use into the cocktail of factors preventing me from sleeping soundly. On a good night, I was getting about five hours of quality sleep, but many nights I was struggling to get just two or three hours of broken sleep.

Cognitive Behavioral Therapy Did NOT Work for Me

For a time, I tried cognitive behavioral therapy (CBT), hoping that changing my sleep practices would improve my insomnia. This involved:

1. Implementing good sleep hygiene practices (no caffeine after noon, dimmer lights in the evening, devices put away for a couple hours before sleep, dark/cool room, bed used only for sleep)
2. Modifications to my sleep schedule (staying up later/sleep compression and getting out of bed when I haven’t fallen asleep in 20 minutes)
3. Relaxation practices before sleep (deep breathing, progressive relaxation, guided meditation)
4. Homework (keeping a sleep journal to analyze)

I did all the steps, but I found myself obsessing over my insomnia and actually sleeping less. The practices of CBT felt like an overwhelming and stressful second job.

When something isn’t working for me, I acknowledge it and go back to the drawing board.

Back to the Insomnia Drawing Board

I did some digging into other insomnia treatments. I knew I didn’t want to take prescription or OTC medications for sleep (too many side effects).

I also knew melatonin didn’t work for me, and I didn’t want to mix in any additional herbal solutions, given all the medications I take for pemphigus. People seem to think supplements and herbs are nothing but wholesome and helpful. This is patently false! The supplements and herbs you buy at the natural health store can come with dire consequences and side effects, but I’ll save that post for another day.

When I looked at issues with my sleep patterns – my most significant struggle was staying asleep. Waking up at 3am and not being able to fall back to sleep was a real problem.

I read a couple interesting things about 3am waking:

1. Traditional Chinese Medicine says that waking around 3am could be due to an imbalance in a person’s lungs, related to how effectively they breath. They suggest the issue is often linked to emotional factors, such as grief or dealing with loss, and that those emotions are blocking a person’s ability to take deep restorative breaths. Practitioners suggest deep breathing exercises, meditation and yoga to improve lung function and grief release. I’m not sure how I feel about traditional Chinese medicine, but I know grief and loss are major factors with my recent pemphigus diagnosis.
2. Endocrinological Factors may be at play. The natural rhythm of the human body causes cortisol levels to start climbing around 3am in preparation for waking and facing the day. Perhaps the prednisone I take combined with my body’s natural spike in cortisol are just driving me awake every night at 3am.

Neither of the above factors are really in my control at the moment, but I think they’re worth acknowledging and observing.

Landing on Acceptance and Commitment Therapy

Then, I read a number of articles about using Acceptance and Commitment Therapy (ACT) instead of traditional Cognitive Behavioral Therapy.

I came across this in one article:

If you have exerted a lot of effort and invested a lot of time, energy, and attention in trying to control your sleep, what you think, or how you feel — and still feel stuck — this suggests that none of these things can be controlled. And trying to control what cannot be controlled might be creating a struggle that’s making things even more difficult.

Ultimately, this resonated and ACT has worked for me. Letting go of the stress has actually allowed me to sleep better and longer. I’m still not getting eight to nine hours each night, but I’m reliably getting about seven hours a night.

I feel more productive during the day and more at peace when I’m wakeful at night. With these practices in place, I’m able to move through my day feeling more resilient. I’ve come to enjoy getting out of bed at 5am. I savor my quiet time with coffee and breakfast. I do my workout – rotating cardio, weights, and yoga. I read or watch the Today Show. It’s very peaceful!

The short, simplistic description of how ACT works is that you basically let go! You shrug off the negativity associated with insomnia, and stop judging your failure or inability to sleep. You set the journals/tracking aside and cease your endless focus on sleep hygiene practices. Essentially, it holds you in your present moment and helps you reframe your thoughts about insomnia.

I’m certainly no expert, but I think this article about ACT is a great summary for anyone interested in exploring the technique. There’s a ton out there to read!

If you’ve struggled with insomnia and have tried everything else, consider ACT – it might work for you, too!