How Cindy tackled the insomnia that appeared after her baby was born by accepting nighttime wakefulness and eliminating safety behaviors (#31)

Transcript

Martin Reed:
Welcome to the Insomnia Coach Podcast. My name is Martin Reed. I believe that nobody needs to live with chronic insomnia and that evidence-based cognitive and behavioral techniques can help you enjoy better sleep for the rest of your life.

Martin Reed:
The content of this podcast is provided for informational and educational purposes only. It is not medical advice and is not intended to diagnose, treat, cure, or prevent any disease, disorder, or medical condition. It should never replace any advice given to you by your physician or any other licensed healthcare provider. Insomnia Coach LLC offers coaching services only and does not provide therapy, counseling, medical advice, or medical treatment. The statements and opinions expressed by guests are their own and are not necessarily endorsed by Insomnia Coach LLC. All content is provided “as is” and without warranties, either express or implied.

Martin Reed:
Hi, Cindy. Thank you so much for taking the time out of your day to come onto the podcast.

Cindy Xia:
You’re welcome. Thanks for having me here.

Martin Reed:
It is great to have you on. I’m really excited for everything that we’re going to be talking about. Let’s start at the beginning. Can you just tell us a little bit about when your sleep problems first began, and what you feel caused those initial issues with sleep?

Cindy Xia:
So it started when I had Feena in October last year. And I had a great pregnancy, a great birth. I felt really good. Feena was actually a pretty good baby. And for the first few days I was actually still doing okay. I was really sleep deprived from looking after her, but I had no problems just passing out whenever I had the chance. And then around a couple of days in, I just remembered feeling really off, really jittery and just feeling like I couldn’t switch off. And now I think back, it was sort of probably the beginning of my postpartum depression, but I felt it as anxiety. And so it sort of built and built and built to the point where I couldn’t sleep anyway. And then around nine days postpartum, I had a really scary mental health crisis, where I think the cumulative effects of the sleep deprivation actually made me hallucinate. And I had this really scary…

Cindy Xia:
I thought it was a psychotic episode. I’m not sure what it was. But I was lying in my bed, trying to nap. And for some reason I thought my whole house was floating in the clouds. I wasn’t dreaming, I believed it. And I just remember thinking, “Oh no, something’s wrong with me. I need to get help.” So then anyway, long story short, the crisis team was called. They came in and then they looked at me and they said, “Well, you’re not psychotic.” And I was like, “Oh, thank goodness.” And they said, “But you really, really, really need to sleep, because sleep deprivation is torture, and it can drive people crazy. You have to sleep. So let your mum look after your baby for the night. Here’s some sleeping pills. Go and sleep for eight hours and go.”

Cindy Xia:
So I was very relieved. I was just like, “Oh, it’s just sleep. Easy. I’m super tired.” And so that night it was fine, I was knocked out for eight hours and I felt good the next day. And then I noticed something over time. I started to notice that it was harder and harder to fall asleep at night, even though I knew my baby was with my mum, I knew that she was okay and that they were giving me quetiapine for sleep. And I knew that the amount of quetiapine I was taking, it should be enough to knock me up. But I think there was one night where it didn’t knock me out, and I was so freaked out. I thought, “Oh my gosh, something is happening in my brain. Why can’t I sleep even with these drugs?”

Cindy Xia:
Yeah. And then it got to the point where I think it was also the anxiety from my hormones, it was also making it very hard to sleep as well. So yeah, it was pretty traumatizing. And it got to the point where Feena was actually sleeping quite well. She would sleep four or five hour blocks quite early on. And the big irony was that she was sleeping, but I wasn’t sleeping. It was quite fun. So yeah, that’s how it started. It started with a mental health crisis.

Martin Reed:
Yeah. So do you feel that part of the problem was maybe you just weren’t expecting sleep disruption, or maybe you were expecting some sleep disruption, but when it was combined with everything else that was going on, it just kind of made the whole reaction just even more intense?

Cindy Xia:
Yeah, I think I wasn’t expecting any sleep disruption, at least not in the form of insomnia. Because I had expected to be sleep deprived because everyone tells you a baby… well, you don’t even sleep when you have a baby. If you don’t sleep, you don’t wake up. So I expected that, but I just thought if you’re sleep deprived, you will sleep so much easier. So I thought I would have no problem sleeping. And I actually had no problem sleeping in the beginning when I was still feeling quite good, but I did not expect to be so wired. That’s how I felt tired but wired in the early days.

Cindy Xia:
Again, I think that was hormonal. And I don’t think I could’ve slept even if I tried. But back then, it just made me panic because I thought the insomnia was… Basically, I just thought my brain was broken. And then what was scary was that even after being Feena was sleeping well, and even after my hormones seemed to be getting better, that insomnia actually stuck around. Yeah, that’s when I knew I actually had a bit of a problem.

Martin Reed:
Yeah. So I think a lot of people listen to this are just going to identify with a lot of what you said, regardless of if they’re new parents or not, especially that phrase you used where we can feel tired, but wired. We really feel that strong sense of fatigue or sleepiness, but we’re just so wired, it seems to be really difficult to sleep.

Martin Reed:
So with that in mind, I think many people will probably also recognize that, well, there’s a clear and obvious trigger for some sleep disruption here, the new baby. Most of the time when we experience some sleep disruption, our sleep just gets back on track all by itself once we’ve adapted to whatever that trigger is, or got used to it, or we’ve adapted. But in your case, it didn’t. Like you said, Feena started to sleep well, but you were still struggling, even though that wasn’t the obvious trigger or the obvious factor now for that sleep disruption. So with that in mind, what do you think it was? Why do you think you continue to struggle with sleep even when your daughter was clearly no longer the primary cause of that sleep disruption?

Cindy Xia:
I think because it was the first time in my life that I struggled with sleep in this way, because in the past I was a pretty good sleeper, but I would not be able to sleep if, say I was sharing a room with someone. That was my thing. I just couldn’t share a room, and I would know I would have a bad night. But I knew if I could sleep alone, I would be fine because I didn’t feel any pressure. But it was like after having Feena and after going through all that craziness, it was almost like that sleeplessness had crept into even when I was sleeping alone. And I felt like I had no more safety behaviors to go back into. Because I was sleeping alone, my baby was in a different room. She was with my mum. And that was really frightening, because I thought, “Well, in the past if I had problems sleeping, I could just move to a different room or tell that person to go away. But now I can’t sleep and I don’t know why. I don’t know why I can’t sleep, and I don’t know what to do about it.” So I guess it was a sense of helplessness and not knowing why this was happening.

Martin Reed:
Yeah. So you mentioned that in the short term you were on sleeping pills, found them helpful at first, but then it felt like they just stopped working. I think people will probably identify with that as well, that experience. What kind of other things did you try at that point in a bid to improve your sleep?

Cindy Xia:
Quite a few things. So the first thing was, I thought that my baby was a trigger for my sleeplessness. So I thought, “Okay. I can’t keep her in the same room, because I’m probably waking up to all the noises,” so that’s why I moved her out of the room. It was coming to summer when Feena was a newborn, so it was getting quite warm. And so I thought, “Okay, I read that elevated body temperatures makes it harder to sleep.” So I thought, “Okay, I’m going to sleep, drag my mattress downstairs under the air-con, blast it at 20 degrees and try to sleep.” I thought… Oh, there were loads of things. I thought, “Oh, blue light is bad. Don’t use your phone after dark. Don’t even look at it. Don’t even touch it. Don’t even think about it. Don’t drink tea,” even though I water down my tea like five times before I drink it, but, “Don’t drink tea because that bit of caffeine is going to keep you up for five hours.” So I tried to eliminate all the possible causes of sleeplessness, basically. It didn’t work.

Martin Reed:
Yeah. I think a lot of what you’ve described there are what we consider these sleep hygiene techniques or rules, whatever you want to call them. And I think people with insomnia are experts on sleep hygiene. They’re probably the most hygienic sleepers are people struggling with sleep that you could ever imagine. And I really think that sleep hygiene, especially by itself, just really isn’t helpful for people with insomnia, because I think it just draws even more attention on sleep, and leads us to put in more pressure on ourselves to sleep. And now we have this huge list of rituals. So not only are we struggling to sleep and desperate for sleep, we now feel that we have to add these 10 different rituals onto our days and our nights.

Cindy Xia:
Yes. And if one of the conditions is not quite right, then that adds more anxiety to it as well.

Martin Reed:
Yeah, exactly. So I think you mentioned that you found this one specific video on the YouTube channel, that you found really helpful. And it’s kind of like your first step, that light bulb moment. Can you tell us a little bit more about what that video is about, and how you identified with it, and why you found it helpful?

Cindy Xia:
Yeah. So as with many people struggling with sleep, I scoured Dr. Google and Dr. YouTube, and looked everywhere. And a lot of the results were just sleep hygiene things. And I just thought, “I’m trying all these things, it’s not really working.” And then I came across your channel. I’m not sure exactly what terms I looked up, probably how to fall asleep or something, quick, without medication. And I came across your video, which was Letting Go of Sleep Efforts and Safety Behaviors. And I don’t know, there was something about it that was just so counterintuitive to everything that I was reading online, because everything I was reading online was just more sleep efforts, basically. But your one was the complete opposite, saying don’t even try. In fact, those things would actually make you insomnia worse. And the only thing that can help you sleep is just staying awake long enough and just being calm enough before sleep, basically. And I just thought, “Oh great. This is finally… I don’t have to do anything. I’m good at doing that.” So I just decided to do nothing. And that first night, actually, I slept straight away that first night. And it was really good.

Martin Reed:
Yeah. Yeah, I think that is a big thing. And I think it’s almost extension of this idea of the sleep hygiene rituals. They draw more attention to sleep. We’re doing all of these things in an attempt to make sleep happen, but at the end of the day, sleep is something we can’t control. And it’s often when we try and control it, when we try and put all that effort into sleep, that sleep becomes more difficult or more elusive. So if we can focus our attention on maybe just creating good conditions for sleep to occur, like only going to bed when we really feel sleepy enough for asleep, being active during the day, as much as we can. Those kinds of things are way more helpful than trying to directly control sleep or directly put effort into sleep, because that really just makes things more difficult.

Cindy Xia:
Doesn’t work at all.

Martin Reed:
But at the same time, I think it is important to emphasize that it’s completely understandable why we would do all these things, because everything in life responds positively to effort, sleep is the exception to that rule. We aren’t to know that until we put all this effort in and it kind of backfires on us. So I’m really keen to just get the message out there that if you do identify yourself as being in this struggle, putting all this effort into sleep, and you’re finding that nothing’s improving, that’s understandable. It doesn’t mean that there’s something seriously wrong with you. It’s not you, it doesn’t mean you’ve got this different, more virulent strain of insomnia. It’s all completely understandable and predictable why you’re still struggling. And it’s probably because you’re caught up in that struggle. So if we can shift away from that, that’s often when we start to notice those improvements.

Cindy Xia:
Yes. And I think, actually, insomnia is actually really common. And I would be surprised if a lot of people don’t have it, because I think it’s a sign that you are human. We naturally worry about things, and we naturally try to protect ourselves against or react against something that is frightening us, or something that seems out of our control. So I think, yeah, instead of thinking something’s wrong with me to have insomnia, I think that’s normal. Well, it’s not ideal, but it’s not surprising.

Martin Reed:
Yeah, definitely. And I think there’s also a difference too, between temporary more short-term sleep disruption, because that is definitely a part of life. There’s nothing we can do to prevent difficult nights or sleepless nights. That’s just part of being human. And that is a difference between what we consider to be chronic insomnia, the longer term problem. That longer term chronic insomnia is typified by whatever that initial trigger was, is probably not even present anymore. Now our issue is more to do with a change to how we think about sleep, and how we react to our thoughts, and any behaviors we have implemented in an attempt to understandably improve our sleep, but have backfired and made conditions worse for sleep. A common example would just be spending huge amounts of time in bed to generate more sleep, but really all we end up doing is just generating more wakefulness.

Cindy Xia:
Yes. Yes. I was doing a bit of that in the beginning, because when you have a child sleep becomes more valuable than gold, which there’s your sleep pressure right there. And so whenever she slept at night, whether it’s at 10:00, or at 9:00, or 11:00, I’ll be like, “Okay. Right. It’s time for me to go to bed and make the most of this.” But actually normally, because I’m normally a night owl and I normally sleep at quite atrocious hours, like 1:00, or 2:00, or 3:00. So my circadian rhythm was already not helping at the same time.

Martin Reed:
Yeah. So one thing you touched upon is you saw this video and then it kind of clicked about putting effort into sleep, and safety behaviors, doing things to try and protect our sleep. And I think you mentioned that you just became more accepting of being awake at night. You just learned to be okay with having difficult nights, okay with feeling the effects of a night of insomnia during the day. This is a big challenge faced by people with insomnia. How do we accept this? How do we become okay with difficult nights?

Martin Reed:
So I’m really keen to hear your thoughts on that. How were you able to kind of recondition yourself to be accepting of wakefulness, and not see sleep as something you had to battle with?

Cindy Xia:
It’s a process. It does not happen overnight. And the first night that I saw your video, I slept while there not because I was obviously very tired. But the process of accepting wakefulness for me took many months, I think, because it’s one thing to understand it intellectually and go, “Oh yeah, that makes sense. I just have to accept it.” And it’s another thing for your body and your mind to follow, because if you’ve been primed to fear something, it’s very hard to uncondition it. It’s possible, but it’s very, very hard.

Cindy Xia:
So for me, I focused a lot on number one, was just realizing that I don’t have to sleep, because in the past, when I was sleeping on my own, and I could sleep whenever, I never thought, “Oh, I’m going to sleep now,” when I go to bed. I always thought, “Oh, I’m just going to lie here, think about a few things, and look at my phone, and close my eyes.” And I never thought, “I’m going to try to sleep. I’m going to try to sleep.” And I always remembered that back then, I would think, “If I can’t sleep, I’m just going to get up and read a book.” I’ve always believed this my whole life, I was going to do that.

Cindy Xia:
But obviously, when I had a baby, I just thought, “I feel like reading a book would be wasting this precious sleep time.” But then realizing that actually, I can just get up and read a book. I’m not tied to this bed. No one is watching me. It doesn’t matter. So that kind of alleviated some of the pressure to try to sleep when I’m lying there. And the other thing was, I guess, dealing with the brain-deadness the next day. I think what really helped was when I was watching your videos, you talked about sleep drive. And firstly, that’s a great name for being completely trashed, that’s basically how I felt. I just think, “I have great sleep drive.” And so it just turned that feeling into a positive thing rather than something that’s negative.

Cindy Xia:
It made me think like, “Oh, it’s okay. I’m just collecting sleep drive, so tomorrow I could sleep extra well. And if not tomorrow night, then the next night. It’s fine.” And also, because I had been sleep deprived to the point of hallucination in the early days, and I had recovered from that, I guess I wasn’t as… Well, I was afraid of that, but I also knew oh, it’s fine. I’m probably not going to get as bad as that, so it’s okay. I mean, even if I hallucinate again, it’s okay. I guess, because I had hit rock bottom, so I just was more accepting, being tired was fine. So it was definitely a process. It takes a lot of time to decondition yourself. And I think the first time when it started to get better was when I had those sleepless nights, but it wasn’t that bad. I felt quite like, oh. I got up, I did a couple of things, went back to bed. Got up, and I was like, “Oh, I feel fine.”

Cindy Xia:
So then the next night I thought, “Oh, if I have one of those nights again, I’ll be all right.” And so I think it was that little moment when I thought, “I will be okay,” was when I started to be more accepting.

Martin Reed:
Yeah, why do you feel that those sleepless nights felt a little bit better? Do you think it was just a change in your reaction to them or your relationship with them? Or was it because you were doing different things, like instead of struggling, you were getting out of bed and reading a book or something like that? Why do you feel like those sleepless nights started to feel better?

Cindy Xia:
I think because, firstly, I started to realize that I was able to sleep. That’s the first thing, and I wasn’t just lying there wondering why my brain’s broken. And the second thing was, I just thought, “It’s just a matter of time. It might not be tonight, it could be tomorrow night.” So I think just realizing that everything was going to be okay and that there is a way out of this and I just needed to give it time. And right now, tonight might not be a night where I get lots of sleep, and that is okay. And just having things to do actually really helps. Because it’s super boring just lying there. I would much rather go on Facebook for five hours at night, than staring at the ceiling and wondering why I can’t sleep. So yeah, it was just a combination of lots of things.

Martin Reed:
Yeah, I think that understanding the concept of sleep drive, like you touched upon, can be so helpful. All we mean by sleep drive, for people not familiar with it, is the longer we’re awake for, the stronger that pressure to sleep becomes. None of us can stay awake indefinitely, we’ll always sleep in the end.

Martin Reed:
When we’re struggling with insomnia, the brain can play tricks on us, right? We can have a really difficult night, and then we start to really become concerned that the next night is going to be really difficult too. Whereas the reality is after a really difficult night, the chances actually start to tip in our favor that the next night or the night after that will be a little bit better, because of that accumulation of sleep drive, because there’s been less sleep, more wakefulness, it increases the likelihood of sleep on subsequent nights. And that in itself, just understanding that concept can be really reassuring, just as you touched upon.

Cindy Xia:
Yes. Yes.

Martin Reed:
Something else I really liked was how you said, “In the past, when I went to bed, I never went to the bed and thought, okay, now I’ve got to fall asleep.” But yet, when we’re struggling with sleep, we start to put that pressure on ourselves, right?

Cindy Xia:
Yep.

Martin Reed:
And it’s like if a client asks me, “What do I do to make myself fall asleep when I get into bed?” And it’s kind of like, well, how about you just go and ask someone who sleeps really well and ask them what they do to fall asleep. And you’ll probably just get a blank stare, because the very process of falling asleep involves no attempts or no effort to fall asleep. And if we can recognize that we’re trying, that could be part of the problem. So I think that was really, really interesting the way you mentioned that. And it’s kind of ironic because I think deep down, we all know this. If we have a history of being able to sleep well in the past, we can remember that this was never anything I put effort into or thought into, so why am I doing it now?

Martin Reed:
And just so much of our thought processes and our behaviors change. Like you touched upon in the past, “I would just read a book if sleep wasn’t happening,” but then your mindset changes. “I don’t want to read a book, because that might take sleep away from me.”

Cindy Xia:
Yeah. Yep. Exactly. Absolutely.

Martin Reed:
Everything just changes. So sometimes it can be helpful to just try and identify all these changes we might’ve made, and see if we might be able to just pick away at them and start to undo them, and see what kind of effect that might have on our sleep.

Cindy Xia:
Yes, absolutely. And I remember in the early days of insomnia land, I would even try to monitor when I would fall asleep. I would think, “Oh, if my leg jerks once, it means I’m getting there.” Or if I start getting those dreamy thoughts, I go, “Oh, I’m nearly there.” And obviously, that would wake me up on it. And I’d go, “Darn it. I was so close. So close.” And whenever I had a dream, that was the best thing, because I knew I had slept. I thought, “Yes, I did. I had a dream.”

Martin Reed:
I noticed a few weeks ago, maybe more recently, you posted into the forum and you shared this really great analogy about sleep anxiety and how it relates to performance anxiety. You’re a professional musician. Can you tell us a little bit more about that?

Cindy Xia:
Oh yes. It’s great. So yeah, so performance anxiety in musicians, or if you’re doing public speaking, I think it’s considered the third biggest phobia in the world. More people fear performing than death. I don’t know. Don’t quote me on this. No, it’s very funny. But yes, performance anxiety it’s very, very similar to sleep anxiety, because you feel this intense pressure to succeed in what you want to do on the stage, and that will generate anxiety, but often the anxiety will also inhibit your ability to do that very task. So it becomes this negative feedback loop to the point where you just completely crash and burn on the stage, and then those bad experiences will also make you obsess about future performances.

Cindy Xia:
And so a lot of people think, “Oh, well, when I’m on stage, I’m just going to try harder so I don’t make mistakes, or try hard to focus.” And that’s very, very counterproductive, because often leads you to fulfilling the prophecy. So that’s very similar to sleep anxiety, because the more you think, “I am going to sleep so well tonight. I’m going to try so hard. I’m going to have all these things ready. My sleeping pills, and my perfect blanket, my lucky socks, the temperature set at the perfect degree,” and I don’t know, “my melatonin and all sorts. And then I’m going to sleep.” And then obviously, the harder you try, then you are not going to sleep and it sort of all goes down from there.

Cindy Xia:
Yeah. And the thing when I’m coaching my piano students to get through performance anxiety, I say to them, “Don’t worry about making a perfect performance, because that’s actually nearly impossible, actually. Yes, you can prepare for it, but in the actual day, yeah, you really can’t control anything, really. You almost have to just expect the unexpected and you go in there and just play your heart out, play your music. You have to be prepared for anything to happen, and you will have to know that you will be okay regardless of even the worst catastrophe.” So I guess if you take that analogy to sleeplessness or sleep anxiety, the only way to sleep well is to know that you will be okay, even in the worst catastrophe, which I guess is having zero hours that night and tossing and turning and feeling anxious, and feeling horrible. You will still be okay even when that happens in the worst case scenario.

Cindy Xia:
Yeah. So it is very hard because it does take time to train yourself out of that negative loop of, I have to try. Because it’s very counter intuitive. It’s like you have to not try to make it work, basically. Yeah. So it’s quite interesting.

Martin Reed:
Yeah, it is really interesting. Let me ask you this. Do you ever think that maybe there’s even an advantage to some of this performance anxiety in terms of you’re about to get on stage and maybe you feel that adrenaline and maybe it actually, in some way, helps your performance? Keeps you more focused?

Cindy Xia:
It does actually. It does, because I mean, I love performing. I love it so much. You get to a point where no matter how… Okay, there’s a myth that great performers never feel performance anxiety. That’s not true. Everyone feels it, everybody. But you get to a point where you feel the performance anxiety, and it doesn’t affect how well you play. I know that I could be vomiting backstage with nerves, and having all these catastrophic thoughts of, “What if I make a mistake and I can’t recover from it?” I could be having all those thoughts, but I know that the moment I walk onto the stage, despite having all these physical reactions and the thoughts and everything, and slippery fingers, and racing heart and blah, blah, blah, I know that I can still deliver the best performance.

Cindy Xia:
And actually, the reason why I’ve been able to do that is because I have practiced performing under those conditions. Yeah, and I love performing. And now when I feel the anxiety or whatever, this performance anxiety, I feel pretty excited because I know it’s like, oh, it’s my time to perform.

Martin Reed:
Yeah, absolutely. Yeah. The reason why I ask you that is because we have this belief that anxiety is bad. All anxiety is bad and it must be avoided at all costs, and often that’s when we can get caught up in it. So I’m definitely not suggesting that performance anxiety is something we should strive for when we’re trying to sleep. But what I’m trying to get at, is it’s okay and it’s understandable to experience anxiety.

Martin Reed:
And just like you touched upon, it really is… How we get caught up in anxiety or how we respond to anxiety is really just down to our reactions to the thoughts we have that generate that anxiety. And it can be so helpful to recognize that thoughts and anxiety can definitely make us feel uncomfortable, but they’re not a danger to us, and we don’t have to try and fight them, or avoid them, or suppress them. If we can just get to a place where we can acknowledge that these thoughts are thoughts, our brain is hardwired to generate thoughts, often it can be another way that we eliminate this struggle, and this battle internally, when we find our mind racing. And all that effort that goes into suppressing, or challenging, or doing anything with thoughts, the truth is we don’t have to react to them because they are just thoughts.

Cindy Xia:
Absolutely. Absolutely. That’s one thing that I learned a lot about as well, that, yeah, our thoughts are just thoughts. Our brain is trying its best to protect us, but sometimes it has what I call an allergic reaction, which is reacting to something that’s actually not dangerous. And the best way is just to let it freak out a little bit, and just go, “Cool,” but I’m not going to change any of my behavior to face this threat that doesn’t exist in real life. Because otherwise, your anxiety will start to target itself, because it can’t really find anything else to target, so it will start picking on itself. And that’s when you get into a real bad loop, because then you start to fear the fear, which will will generate more fear.

Cindy Xia:
So, yeah. I read somewhere that… It was a really good quote. It said, “People with anxiety disorders… That anxiety is like discomfort, but not danger.” So it feels like danger, because that’s how we react to danger. But sometimes we can react as if there was danger when there isn’t any. And the key thing is not to change our behaviors as if there was something dangerous. We’d just go about our day, acknowledge that I’m feeling anxious, I’m thinking catastrophic thoughts. Cool. I’ll just do my thing. Yeah.

Martin Reed:
Yeah. Yeah. I think you made a great point there as well, where you say, “Often the fear becomes the fear.” We are fearful of experiencing fear. And I think the challenge is the brain just cannot separate real threats, like there’s a grizzly bear about to break in through the front door and attack us in our sleep, and just a perceived threat, like if I don’t fall asleep, some kind of disaster will happen tomorrow. So the body will react the same, regardless of whether it’s a real threat or a perceived threat. And then if we try to push that thought away, we try and suppress that thought, then I think the brain can be like, “Oh wow, you’re trying to suppress this thought. It must be real. It must be really serious. We need to think about it more.” And it just ramps up that intensity, and that’s when we can really get caught up in our thoughts.

Cindy Xia:
Yes. Yes. Absolutely. Especially the thought of… Because this is I guess the most common thought of an insomniac, which is, “What if I don’t sleep ever again?” Or, “What if my insomnia comes back?” Or, “What if, what if, what if…” It’s always the what ifs. And these days, if I think these thoughts, I just laugh at it because I don’t believe it. It’s the same as saying what if I walked outside and, I don’t know, an alien abducted me? Something kind of ridiculous. And I just go, “Is there something I should be worrying about? Oh, nah.” So if my brain starts thinking, “What if you don’t sleep tonight?” I just go, “I don’t know. You tell me. It’s fine. Everything’s all right.” Yeah. Hearing the thought, but just shrugging it off.

Martin Reed:
Yeah. And I think it can be helpful too, to just recognize that the brain is always going to want to focus on or think about the worst possible outcome. Because at the end of the day, that is a survival mechanism. That’s why we’re all alive today is because our brains are hardwired to consider what the worst possible outcome might be to protect us from that. But then again, we get caught up if the worst possible outcome is often the least likeliest outcome. There’s often that thought that we have often isn’t that accurate, but really we don’t even need to get too involved in that, because these thoughts are just thoughts.

Cindy Xia:
They’re just thoughts.

Martin Reed:
We don’t have to respond to them. They can make us feel uncomfortable for sure, but they’re not a reflection of who we are. They’re not a prediction of the future. They are just little bursts of chemical activity in the brain. And we get to choose how we respond to those thoughts.

Cindy Xia:
Yep, absolutely. Yeah.

Martin Reed:
So we’ve really focused on the thought processing side of things, and you touched upon trying not to allow our thoughts to control our behaviors. So extending on from that, on the behavioral side of things. Were there any changes you made to your behaviors in terms of when you went to bed, or when you got out of bed, that you feel contributed to your kind of transformation?

Cindy Xia:
What I did was I compared my safety behaviors and all of that with how I used to sleep, and I tried to go back to how I used to sleep. I mean, I used to sleep atrociously, but not because of insomnia, because I just didn’t… I used to love being awake, and I would just think, “Stay up late and watch shows.” And, “oh, okay, fine. I’ll go to sleep. Ah, boring.” So I used to find sleep boring, and I used to love being awake. Whereas on the flip side, when I struggled with sleep, I found that sleep was amazing and I hated being awake. So it was more about thinking, “Okay. Well, what did I used to do,” which was basically nothing, “to go to sleep?” And doing more of that.

Cindy Xia:
So one of the things I used to do for me, which is not recommended for other people, but I like to lay in bed awake purposefully. I know they say don’t do that because it’s not good. But for me, because that’s what I used to do, I used to just lie in bed and go on my phone, and just relax, and just feel like bed is a safe place to be. You don’t have to sleep, you can just lie there, that’s fine. So yeah, I did that. I also did a lot of things that broke my mental barriers about how I thought I should sleep. So for example, I mentioned how I thought I couldn’t sleep in a hot room. Well, one night I just thought, “You know what, I’m going to sleep bad even if I slept in a cold room. So I’m just going to try and sleep in a hot room tonight. I don’t care.” So I moved my mattress back upstairs, and it was 27 degrees, which felt hot to me, and I slept that night. And so immediately, my brain just went, “Oh, you don’t have that problem. You can sleep in a warm room.”

Cindy Xia:
Other things like drinking tea at night, one night, I just thought, “You know what? I’m just going to drink a cup of tea right before bed.” Don’t do this with coffee, that probably won’t work. But a diluted tea, it’s fine. I just thought, “I’m going to do that.” Slept fine. And I thought, “Oh great. I can drink tea again.” And I guess my biggest one was sleeping next to my baby. That was a really huge thing for me, because I had to always sleep really far away from her, because I felt like she triggered my anxiety. But one night when I was feeding her in bed, I fell asleep with her, again, not recommended for safe sleep guidelines.

Cindy Xia:
So one night I fell asleep with my baby next to me in bed. And that was amazing, because I realized I had no problem sleeping with my baby next to me. So basically, everything I thought I couldn’t do, I couldn’t sleep next to my baby, couldn’t sleep in a hot room…. So all those safety behaviors, I broke all of them, and that was so big. It just made me realize, oh, the only thing that will make me sleep is being awake, being tired.

Cindy Xia:
And so now, comparing my behavior now when I go to bed, I have no sleep hygiene behaviors whatsoever. I do everything opposite of what people say you should do when you go to bed. Use your phone, go to bed really late. I nap as well, I love napping. I nap hours a day. It doesn’t affect my night sleep, because I don’t force myself to sleep. If I know I napped three hours in a day, then I just think, “Oh, I’m probably not going to sleep till 2:00 or something,” so I just stay awake a bit longer. Yeah. So I think it’s just doing the opposite of what your anxiety is telling you. And that really changed how I saw my ability to sleep.

Martin Reed:
Yeah, that’s great. I think first and foremost, you deserve a lot of credit just for giving yourself the opportunity to test all those safety behaviors and all those rituals, just to see if they really were helpful, or if they weren’t helpful, if you could still sleep in a hot room, or if the room had to be a certain temperature. Because just tackling that or running an experiment, just testing those beliefs, sometimes then you have to deal with that fear of, what if I’m setting myself up now for a difficult night? So I think you have to be willing to experience some difficult nights when you give yourself that opportunity to test these beliefs and these behaviors. And sometimes, too, that first night or those first few nights, maybe you will struggle, because maybe you’re paying attention to monitor for the effect of the change that you’ve made. So it might take a little while. But from your experience, did you find that the first time you tried to sleep in a hot room, or the first time you drank tea, or the first time you tried to sit with your daughter, you slept well, or did it take a few attempts?

Cindy Xia:
I think for me, I was lucky because a lot of it happened accidentally. So for example, the hot room, baby next to me one happened at the same time. And also, the nightlight was on. I had actually never slept in a room with any kind of lighting. And so that actually broke an old safety behavior from even pre-insomnia. And so I thought, “Oh wow, I can sleep with a nightlight on?” And so yeah. So a lot of them happened accidentally, which was really helpful. So once that happened, I thought, “Okay, I’m going to drink some tea tonight.” I knew the tea wouldn’t actually harm me, because I’d been drinking tea at night for years. Yeah, and then using phone.

Cindy Xia:
Yeah, so I think mainly because I wasn’t thinking, “I’m going to test this tonight.” It was more of once I had a little bit of confidence, I thought, “I’m just going to add an extra thing I used to do in the past and it’s going to be fine. And if it’s not fine, I don’t think it’s because of the tea.” Yeah.

Martin Reed:
Just taking a step back just to get the bigger picture here. So how long would you say this journey was, from your lowest point of struggling with sleep, to getting to this stage where you don’t even really think about sleep, or maybe you don’t even care about sleep anymore? How long was that journey, would you say?

Cindy Xia:
I think about four months. If you count day one as the day I called the crisis number, till the… Four months was when I went back to work, and that was when I found your video. That’s when my sleep got instantly better. But I would say that even during that time, I was having bouts of pretty good and okay sleep, considering I had a baby. But obviously, had a lot of sleep anxiety, and lots of safety behaviors. But I was obviously sleeping because I was just really tired, and I had all this medication knocking me out.

Cindy Xia:
And around Christmas last year, I decided to cold turkey my medication, my sleep medication. Bad idea as well, but anyway, I did it. And I experienced a whole string of zero sleep nights. I think it was just a withdrawal from the drugs. And that really freaked me out. And then that’s when I realized I actually had a problem with insomnia, because at that point I was waiting for things to get better. It hadn’t gotten better, it was getting worse. And that’s when I was like, “Okay, I need to do something.” Then I found your videos. I went, “Oh, okay, nothing’s wrong with me. I just need to do nothing, basically.” And then my sleep improved right away, I would say almost right away, but I would still have the anxiety. I’d still have those thoughts in the day going, “But what if you don’t sleep again tonight?” And I actually tried to not take note of how often I had those thoughts. I would say I would had them, I don’t know, like three thoughts every 10 minutes. It was ridiculous.

Cindy Xia:
Walking through the day like, “Oh, do you remember the time you had a psychotic episode because you were sleep deprived? What if you don’t sleep again? What’s stopping you from not sleeping tonight?” Yeah, and then that’s when I thought, “Oh my goodness, this is going to take a little while to go away.” Sleeping better didn’t cure my anxiety. It wasn’t that. It was more I started to remember my relationship with sleep. So what I mean by that is because in the past, my relationship with sleep was like… Sleep for me, it’s like a cat. You can’t get a cat to sit on your lap by chasing it.

Cindy Xia:
I’ll just be like, “Oh yeah, I’ll just sit down. The cat can come sit on my lap anytime. If you don’t come, it’s okay.” But then after I struggled with sleep, I was just chasing this cat around with a broom and saying, “Get back here.” And I was like, “Why am I not sleeping?” And then afterwards when I started to learn more about what sleep actually is, and actually realizing I couldn’t control it, and realizing that doing nothing actually just improved my sleep. And that’s when I was like, “Okay, that’s right. I used to just wait for this cat to come rather than chasing it around.” And so I think when my relationship, my core relationship with sleep changed, that’s how I slept better.

Martin Reed:
Yeah, I think that’s great. I love that analogy of chasing the cat around. I have cats, and I think anyone else that has cats will definitely… Cats do what they want, and it’s when we want them to do something that they do the exact opposite. And I think sleep is exactly the same as that. When we really, really want it and we start chasing it, it becomes increasingly elusive.

Cindy Xia:
Yep, exactly.

Martin Reed:
But I also love the fact that you described that there was still anxiety. You still were having anxious thoughts. And it also sounds like there were ups and downs. It wasn’t like every single night was better than, or as good as the last. And that’s really helpful for other people to hear, because sometimes we can gauge continuous improvement as a reflection if we’re making progress, when the truth is there’s always going to be ups and downs. The key is to just keep moving forward, and just try and keep on going.

Cindy Xia:
Yes. And I think it’s important not to use sleep as the measure of your success. It’s more of your relationship with sleep that is the measure of success. Because I have nights where I’m just not tired. That’s just how it is. I am just not tired. Or sometimes my baby keeps me up to 4:00 AM, and by that time, my body’s like, “Nah, you’re not going to go back to sleep.” And I guess it’s like learning to be in tune with your body again. And rather than forcing your body, saying, “Where’s the off button?” And press the off button, knockout. Our bodies don’t operate like that. We aren’t robots. We can’t just press a button, we can’t switch off.

Cindy Xia:
I think that’s the struggle with a lot of people with insomnia. They just think, “I wish there was just a button for me to press to turn my brain off and go to sleep,” but it’s not like that. It’s about finding that relationship with your own body again. And I guess almost like respecting your body, respecting that you’re afraid, you don’t feel like you want to protect me right now. You don’t feel safe and you don’t think it’s safe for me to be unconscious. Okay. Okay. I see. That’s okay. That’s okay. Yeah. And it’s almost like I’m letting my body just do what it wants. And whatever it chooses to do, that is okay. I trust it. I trust it will rest when it wants to rest, it will be awake when it wants to be awake.

Cindy Xia:
And yes, I mean I have nights where I get very little sleep, not very often anymore. I reckon probably once every three months, which I reckon is probably the same as the general population. And I have a baby. I think I’ve done amazing, honestly. I sleep so well, considering I have you. Yeah. Yeah, I think one of the nights was because we both caught a cold and she had a stuffy nose, and I just thought, “Okay.” But I wasn’t worried about insomnia. I just thought, “Oh yep, this is going to be a little bit tricky.” Still slept, so okay.

Cindy Xia:
There was another night where I think I had a five hour nap. That’s not really a nap, that’s just a sleep. But anyway, I had a five hour nap in the afternoon. And then I got to the nighttime and I thought, “Okay, all right. I think I’m fully nocturnal now.” And it was fine, I just got up and did some laundry and then around like 4:00 in the morning I thought, “Oh, I’ll just lie down a bit,” and I still slept. So it’s fine. You don’t have to sleep, just do whatever. That’s my philosophy at night.

Martin Reed:
Yeah. I love it. And I love how you just emphasize that really it’s just about a change in our relationship with sleep. To be one maybe where we just trust our body’s natural ability to sleep, and just let it do what it wants to do. Sleep might not happen tonight, or it might take longer to fall asleep. Maybe that’s okay. Maybe we don’t have to try and change that, or try and put effort into… Or just try and get involved in the process. Sleep is an autonomous process. We can make sleep more difficult, just like we can make breathing more difficult by holding our breath. But at the end of the day, the body knows how many breaths it needs to take throughout the entire day. Very few of us focus on making sure we get a certain number of breaths every day, so why do we need to focus on making sure we get a certain number of hours or certain number of minutes of sleep each night? The body takes care of this. The body wants to take care of this by itself.

Martin Reed:
Moving towards a place there where we can just be a bit more trusting, change our relationship with sleep. I think that’s the key to longterm success, really putting insomnia behind you for good.

Cindy Xia:
Yes. Yes. Absolutely. I was talking to a friend recently and she was mentioning how, when women go through menopause, they often go through insomnia, because she’s going through sleep disruption at the moment, and I’m kind of coaching her through it. And we both laughed and we said, “Oh, we’re fine.” We’re all set for menopause insomnia, because what we’re going through now is just going to set us up to be bulletproof in the future, so I’m not worried about that. Yeah.

Martin Reed:
Yeah, absolutely. I think that’s great. Well, Cindy, I think this has been a great conversation. I really appreciate you taking the time to come on, especially with the little one there, who’s been really well-behaved. She’s doing great. That’s so cute. I do just have one last question, which is a question that I ask everyone who comes on, just as a way of finishing off the discussion. So I’d like to ask you that question too. And the question is this. If someone with chronic insomnia is listening and they feel as though they’ve tried everything, that they’re beyond help, and that they can’t do anything to improve their sleep, what would you tell them?

Cindy Xia:
The first thing I would say is I feel for you. It is so hard. It is hell. People do not understand how hard it is, because they think, “How hard is it just to sleep?” It’s the first-world problem. Maybe it is. So the first thing I would say is I really, really feel for you. It is absolutely horrible, and it can really bring you down to the worst mental state ever. But the second thing is, is that you will be okay. Your insomnia is not special. Your brain is not broken. You can sleep, you will sleep because your body is programmed to sleep. And yeah, you will absolutely sleep. It is not an easy journey. It does take a lot of time, because again, the fear response in the body is very, very strong. That’s why we are alive. It will take a lot of time, and a lot of patience from you, and you will have lots of ups and downs.

Cindy Xia:
And yeah, it is a process, but once you’ve gone through it, you will realize that if you can conquer this, you can conquer absolutely anything, absolutely anything, because insomnia is so hard. Yeah, people who don’t have it, don’t get it. Yeah, I always love talking with people who had insomnia because we can always joke about it. And I say, “Hey, welcome to insomnia land. How many zero hour nights have you had?” Yeah. But no, anyone who’s listening and who thinks their brain is broken, you are not broken. You will be fine. You will sleep, but more importantly, you will love being awake, and that’s what will help you sleep. Yeah.

Martin Reed:
I love it. I think that’s a great note to end on. So thanks again for coming on, Cindy. It was great to talk to you.

Cindy Xia:
You’re welcome. Thank you.

Martin Reed:
Thanks for listening to The Insomnia Coach Podcast. If you’re ready to implement evidence-based cognitive and behavioral techniques to improve your sleep but think you might need some additional support and guidance, I would love to help. There are two ways we can work together. First, you can get my online coaching course. This is the most popular option. My course combines sleep education with individualized coaching and is guaranteed to improve your sleep. You will learn new ways of thinking about sleep and implement better sleep habits over a period of eight weeks. This gives you time to build sleep confidence and notice results without feeling overwhelmed. You can get the course and start right now at insomniacoach.com/online.

Martin Reed:
I also offer a phone coaching package where we start with a one hour call. This can be voice only or video, your choice, and we come up with an initial two-week plan that will have you implementing cognitive and behavioral techniques that will lead to long term improvements in your sleep. You get unlimited email-based support and guidance for two weeks after the call along with a half-hour follow-up call at the end of the two weeks. You can book the phone coaching package at insomniacoach.com/phone.

Martin Reed:
I hope you enjoyed this episode of the Insomnia Coach Podcast. I’m Martin Reed, and as always, I’d like to leave you with this important reminder — you can sleep.