Insomnia insight #455: CBTi vs ACT/Natto - find your way!

A common question from the community is which is the way to follow where there are conflicting ideas. In CBTi we are told to get out of bed if we can't sleep.

In ACT we hear that we should stay. Natto says to befriend wakefulness. In this video, we look at various ideas of how to sleep well when you've been struggling. We find ideas that truly are conflicting and some that are closer than you may imagine.

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Are you thinking of a joining a movement helping the world sleep better? Would you like a fresh start and a new career as a sleep coach?

If the answer is yes, then check out our sleep coach certification program! Next batch starts May 15. 3 slots available.

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Would you like a roadmap from Insomnia to immunity? Download using below link.

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Have a question for open class?

Please submit here and I will try to respond soon in an Open class episode.

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Would you like to work with a sleep coach? Awesome! Here are some great options:

- The Insomnia Immunity Group Coaching Program.
- BedTyme, a sleep coaching app for iOS and Android offering 1:1 text based coaching.
- Zoom based 1:1 coaching with Coach Michelle.

The Insomnia Immunity program is perfect if you like learning through video and want to join a group on your journey towards sleeping well.

BedTyme is ideal if you like to learn via text and have a sleep coach in your pocket.

The 1:1 Zoom based program is for you if you like to connect one on one with someone who has been where you are now.

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Do you like learning by reading? If so, here are two books that offer breakthroughs!

Set it & Forget it by Daniel Erichsen

This is Natto by Daniel Erichsen

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Not sure where to start? Check out these playlists!

This is natto - the perfect place to start learning!

Success stories - if you need hope and inspiration, this is for you.

Insomnia insight - a list of every single episode.

Talking insomnia - guests with trouble sleeping or experts share their stories / tips.

Hypnic jerks, hypnic awareness and other common issues.

Fatal insomnia - for those concerned about ffi and sfi.

Speed bumps - when you think you had a setback or “relapse.”

Unrefreshing sleep - when you always feel tired or exhausted.

Momsomnia - if you’re a mom or becoming a mom.

Health and sleep- if you’ve worried about health consequences of not sleeping.

Best!

This content does not constitute medical advice, diagnosis, or treatment, and should never replace any advice given to you by your physician or other qualified healthcare providers.

[sharang]

Watching Netflix in bed and allowing my anxiety to hang out with me defo helps I don’t even react to anxiety anymore I let it be because here with daniel I remember I used to sleep fine even when I had anxiety

[bogdanivascu]

this was my precise problem with CBTI, the emphasis on controlling did rise the level of my anxiety. I became anxious when failing to observe a small rule, then anxious when the results failed to show up. Plus the "force yourself to think positive" approach reinforced the "control is important/you're failing to control" pattern - as the insomnia refused to fade away, forcing me to acknowledge that the whole "lie until becomes a truth" is failing. Thus reinforcing my anxiety and augmenting the whole thing

[adamford]

A very timely video for me. After 20+ years of dealing unsuccessfully with insomnia I was advised (Sleepstation) to try sleep restriction. My issue is middle of the night waking. Sleep restriction means literally no lying awake in bed. Every morning I’d wake at 3am go downstairs & watch tv or read. After a few weeks of this I was completely exhausted. However, when I told them it wasn’t working I was advised to ‘keep going’ & ‘you’re doing great!’ They’re rational was that restricting time in bed builds sleep pressure & in time extend the time asleep. I was so knackered I’d fall asleep but it didn’t stop me waking at 3am. As Daniel eloquently mentions it just made another rule for me. In fact it became a new pattern where every night I was getting up & doing something then going back to sleep for an hour then getting up to go to work. The seemingly’good’ advice ensured I d developed a Pavlovian response to being awake. Thank goodness to you & dr guy meadows for countering the tide of effluent that is spread around the web. 🙏

[Sunflowersarepretty]

The advice to leave your bed when not being able to sleep started all of my struggle. Ughh if i had a time machine, i would save this video and channel and watch it before i followed that silly advice 😭😭 those who find scs right when their struggle is starting are so fortunate because its not going to spin out of hand with the knowledge they'd gain from here 😭😭

[rajunand]

Currently trying the Citi way for midnight awaking for a month and half with no luck, , yess i feel pressured to go in the other room without waking my family during midnight awaking, , guess have to go the Act way now, which sounds much easier and less pressured

[totoroblue]

Yes please invite Dr Guy Meadows. I remember his book mentioned to just lie in bed and rest in a state of quiet wakefulness, as opposed to like waking up and do something we feel like doing. The line between resting in quiet wakefulness vs trying to sleep is kind of hard to tell.

[screamingpiano]

"ACT is about facing the emotions that you've been scared of, and you're willing to be in these emotions and sit in these emotions, THEN we can see that they are not dangerous, THEN we can see we are safe, THEN these emotions fade away."

Spot on Daniel!! Emotions are just emotions. Discomfort, not danger. And it's only discomfort if you label it as such, most of the time it's just energy charging around our body at a perceived "inconvenient" moment :)

[anitazuck]

Team NATTO, here. Thanks for making it so clearly the path to take, Daniel.

[leisurelyloner]

I started having sleep problems fairly recently, and after reading up on CBT-I I had the worst nights of my life when I tried the "Get out of bed if you're not asleep in X minutes" technique. Thankfully, I found Martin Reed's more recent recommendations to stay in bed as long as you feel relaxed and only get out if you feel distressed, and then just yesterday (in "The Sleep Book") and today (on this video here) I learned that ACT actually recommends against getting out of bed entirely. If I had tried to stick with this, I could have worked myself into a long-term problem. The issue is exactly the self-monitoring, as you stated. I've let go of this idea and some of the more stringent CBT-I rules and I think this will work better for me.

[josujan]

The advice to "go to bed when you're sleepy" works poorly in my case, also, and perhaps it's because I'm an evening person; typically I don't feel sleepy until I get to bed and stay there for a while. For me it's an alien piece of advice to tell me (for instance) that I could read something until my eyes start closing. It doesn't happen. Even if it happens sometimes, it's an exception, not the rule, and when I was "hyperaroused" at night, I didn't feel really sleepy, ever (or hardly ever). The real answer, for me, has been to go to bed, and stay there, for the most part, and to do it mainly based on the time of night it is, not based on how sleepy I feel (because I don't feel sleepy)

[jerry]

Hello Dr Daniel. I have been struggling with maintenance insomnia for quite some time now. It’s gotten really bad during the pandemic. I have read most of set it and forget it and I believe my anxiety behind not sleeping has gotten better. Instead of pacing around the house I am sitting and relaxing and watching one of my favorite comedies. But, I’m unable to sleep. My wife always encourages me to stay in bed with her, but I do not want to wake her with my restlessness. A funny aside, we took an overnight trip with our daughters where we all slept in bunk beds. That was one of my best nights sleep in a while. I was diagnosed with mild to moderate sleep apnea and I cannot tolerate the cpap. I may go ahead and get the dental device. I agree with you that the less you think about a problem, the less of a problem it actually is, but solid sleep is important. With it I can lose the 40-50 pounds I need to lose that will significantly reduce my sleep apnea, which will make my sleep better. So right now I am stuck and I need to change that. Please help!

[lisaallen]

Hi Daniel. If you decide to stay in bed and relax, how do you do this without having some sort of expectation to get to sleep? ACT and guy meadows says when you wake up in the night, do nothing. Stay still, relax, and sleep will come. This has not worked for me. One night, I was lying for hours in my normal sleep position, sleep was not coming. So I turned over on my back, once I realized I was done for the night. I dozed off for a bit. Then tried this the next night and didn’t have the same results. How do you befriend wakefulness and relax in bed with no expectations to sleep? Would a good approach to this be, “I’m very awake, but my bed is comfy, I’m just going to lay here, and if I doze, I doze, without any expectations?

[MsFattyb]

Thank you for that. I will preface by saying I am familiar with your excellent work though there must still be gaps that lead to trouble for me. My history is someone who the vast majority of my life has had minimal difficulties with falling asleep or staying asleep. In recent years though there has been an increase in anxiety associated with time to fall asleep or even middle of the night waking. without return to sleep.  

For me, the issue is not whether or not to stay in bed with wakefulness, it's how to cope with the surge of emotions that invariably arise when laying in bed awake. After a certain period of time, I might develop restlessness or more arousal that obviously interferes. I used to believe that wakefulness would result in a very terrible next day of functioning (which I've learned isn't at all true). But I know from experience that a certain threshold of reduced sleep hours will lead to fatigue or reduced attention/concentration the next day that is certainly tolerable but is nonetheless annoying or frustrating. I understand that it is the expectation for a following day of reduced attention or fatigue that leads to increased arousal when laying in bed that has to contribute to the hyperarousal associated with continued wakefulness. And I am much better with accepting these occasional wakeful nights but obviously not completely. There is clearly a certain unwillingness to accept the negative consequences for excessively wakeful nights. Having the education and awareness doesn't seem enough to eliminate this. Based upon everything I've heard and read on your channel and my other inputs, there is no "solution" here but I suppose I wish that sleep wouldn't have to be a potential struggle waiting to possibly happen each night. Somewhere along the way this has happened and this is where I am now. Much better with coping than before ACT/Natto though! Oh, humanity! Am I missing something?

[PM-egqu]

If I get out of bed when I wake up and go to the couch sometimes I never feel sleepy again to go back. This is only after 4 to 5 hours of sleep....My body seems to think its time to get up for the day...now whats best? Its one or 2 AM. Another question, my problems all started in my 60s..I have been told as you get older you sleep lighter and wake more. I am just assuming this is part of my issue. Would you agree that age affects sleep patterns?

[judithrussell]

I found Guy Meadow’s Sleep School App really helpful but I found it hard to do body scanning etc without feeling that it needed to make me sleep even though he explained it was meant just to be calming. I find your method better I.e. do nothing.

[jsjs]

What about cases that are related to medication/reactions. Current or past ones?

[danh]

I definitely think getting out of bed when it doesn't feel right helps massively. I've had terrible nights where I have stayed and tossed and turned with zero sleep. Definitely give me anxiety towards the bed. I'd even see a bed on a movie and it would give me anxiety.