How Celia improved her sleep by abandoning all attempts to control her sleep and accepting and acknowledging anxious thoughts rather than trying to fight or avoid them (#29)

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, Celia, thank you so much for taking the time out of your day to come onto the podcast.

Celia Garforth:
No problem. Nice to see you. Thanks for having me.

Martin Reed:
It’s great to see you too. I’m just so excited to have you on, because I remember when we first started working together, you actually shared that one of your goals was to be a success story and to come on as a guest at some point in the future, and here you are now.

Celia Garforth:
Yeah. It definitely was. As I said to you in our emails to start with, I discovered you and your work through the podcast and it was listening to the stories of other people that you’d worked with that actually made me… Because I’d heard about CBT-I and I’d always been resistant to trying it because it seemed quite horrible. So listening to the podcast was really, really motivating for me to reach out and actually get things started and do it for myself. So that was a bit of a north star for me as I was going through it, just knowing that at some point in the future that I could come on and talk to everybody else about my experience and hopefully help some people in the way that the people you spoke to before helped me. So thank you.

Martin Reed:
Absolutely. Hopefully everyone listening to this by the end of this discussion will think, maybe in the future I’ll be on this podcast as a success story too.

Celia Garforth:
Exactly.

Martin Reed:
So let’s rewind and go right to the beginning. When did your sleep problems first begin and what do you think caused your initial issues with sleep?

Celia Garforth:
I mean, probably my dad, because it’s definitely, I guess, a learned behavior in my family. My dad has always been very anxious and he always had sleeping issues, which probably projected on to us. I have two sisters and both of them are not great at sleeping. And so probably from a very young age, I remember having weird control issues around sleep, and I used to share a set of bunk beds with my sister and I had these weird things where I had to make sure she was asleep before I could fall asleep. And there’s all these kinds of weird things that I learned growing up around sleep, so it was never an effortless thing that you don’t think about, it was always something that was in the back of my mind. And I probably medicated my way through bouts of sleeplessness in the past, and at university I had issues with it and I smoked a lot weed.

Celia Garforth:
I know we spoke quite a few times about how that had been a bit of a crutch for me longer term. It was always bouts of, I guess, transient insomnia that came and went, but it would last a few days or when I’d have jet lag. I was always like, I will never sleep on planes or I’ll have troubles. When I go somewhere different and I’m in a different sleep environment, I won’t be able to sleep very well. So that was the story of my life.

Martin Reed:
Mm-hmm (affirmative).

Celia Garforth:
Never had the healthiest relationship with sleep, but it was totally manageable and not something that was really causing too much I guess, negative impact on my life more broadly. Then I guess when, probably what you’d technically diagnose as more like chronic insomnia started after the birth of my first son, which obviously a very stressful time anyway. I’m in Australia, my whole family is in the UK. Obviously because of COVID, couldn’t see any of them. That was all that extra issue going on, so I was very anxious new mom. I think as well, I was projecting a lot of my own baggage when it comes to sleep onto my relationship with my son’s sleep. And I know a lot of new moms are obsessed with their children’s sleep because it’s all… You’ve got kids, you know what it’s like.

Martin Reed:
Yeah.

Celia Garforth:
The whole schedule is based around them sleeping and then having to go sleep with them at a certain sleep window. And so you’re just constantly obsessing about their sleep, and I had this added baggage of, oh, it’s going to affect my sleep. And if he doesn’t nap then, and I read too many stupid sleep consultant training books for kids that basically told you if your kid didn’t sleep perfectly, then they were a write off and they were never going to have a good relationship with sleep.

Martin Reed:
Right.

Celia Garforth:
Seriously, the baby sleep consultant industry has a lot to answer for in causing my issues. And of course my son was actually as babies go, pretty much a perfect sleeper. Almost from get go would sleep through the night, but I was just still projecting all this stuff onto him and trying to control his sleep. And when he’d have a bad night or he wouldn’t nap, I’d get more anxious and I think it all just came to a head, and I started just not sleeping. And it flipped from worrying about his sleep to just constantly focusing on my own sleep. So this was probably when he was about six months old. We were mid COVID lockdown, which is very lucky out here. We only had one lockdown and life has been pretty much fairly normal since, so it’s definitely not a woe is me story. Lots of other people have it a lot worse than me.

Celia Garforth:
So I guess that was when my sleep started getting worse. I think unlike previously when I had transient insomnia and it went away, I was then just focused on relying on the old crutches I had. Well, I couldn’t smoke weed because I was breastfeeding. So that was fun thing. And I couldn’t really take sleeping pills, so I guess, I didn’t have any of my crutches. So then I was spiraling into this space where I don’t know what to do, looking for options, Googling, spending my days obsessed with it.

Celia Garforth:
I think I’m someone who probably didn’t cope that well not being at work if I’m honest, because that was a very good distraction for me. And I think being mom in lockdown with nothing to focus on except my own sleeping issues was the perfect storm for me just getting stuck in the spiral. And then I reached out to psychiatrist and a psychologist, and then I started taking prescription medication for anxiety, which definitely helped for a short period of time. And then that stopped working and then that made it even worse because I was like, “Oh my God, I’ve exhausted all the solutions.”

Martin Reed:
Yeah.

Celia Garforth:
That’s it. I’m condemned to a lifetime of not sleeping. What the hell am I going to do? I’m sure you’ve heard this story a million times before. It was very much a vicious cycle of just self perpetuating, spiraling and hunting for external solutions and not realizing that there was really no external solution and I just needed to change my relationship with sleep and stop worrying about it essentially. So yes, I guess when I found CBT-I, actually my psychiatrist recommended a free online course for it here. So I did that, but I found it really difficult because I did the sleep restriction, but I wasn’t sure if I was doing it right. And then I tried it for a week or two and it worked and then I’d have a couple of bad nights and I would just spiral again and it was just very up and down. And I probably wasn’t properly committed to it either. So that’s when I initially made contact with you, I think.

Martin Reed:
That’s great. It was really interesting when you interjected upon yourself. You said you’ve probably heard all this before because from person-to-person insomnia is so similar. It’s quite remarkable. And regular listeners of this podcast will know that we actually have this model for the development of insomnia called the 3P model whereby the first P is predisposed. Some of us are just a bit more predisposed to insomnia. So in your case, it sounds like maybe there was some issues with insomnia running in the family. It brings more attention to sleep, more focus to sleep. Maybe we’re a little bit more responsive to sleep disruption. You want to control sleep. And then we have that second P, the precipitating event, which is what triggers the sleep disruption. Could be anything.

Martin Reed:
Definitely having a child qualifies. The pandemic, COVID, that qualifies. Getting a new job, changing job, anything that affects our life can lead to some sleep disruption. And normally sleep gets right back on track, as it sounds like you often experienced yourself. You would go through these periods of sleep disruption, but then it would get back on track, but sometimes it doesn’t. And that’s usually down to the third P in our model, which is the perpetuating factors. And these are all the thoughts and behaviors that we have because we want quite understandably to improve our sleep, but fortunately backfire and have the opposite result, and they keep the sleep disruption alive because we might do things like spending more time researching sleep, for example, thinking about sleep, putting pressure on ourselves to sleep, maybe spending more time in bed, maybe trying to nap during the day, modifying our days all around sleep.

Martin Reed:
So all these things that we then do because we want to improve our sleep can actually keep insomnia alive. And apart from the specific details, that’s really what insomnia is all about, and we see it from person-to-person. So it’s really interesting how you describe that and then actually made that observation yourself. You’ve probably heard this all before, because it does follow that really predictable pattern.

Celia Garforth:
Yeah, it is. And it’s funny because obviously now I’m hyper aware of other people with sleep issues and constantly referring them to do CBT-I. And it always tends to be actually a lot of people I work with. I guess I worked in quite a high stress job. I work in advertising. It’s not exactly low key. And obviously during the pandemic, I think even over here in Australia where we haven’t had it as badly, people are experiencing a lot more stress and anxiety and sleep disruption. And it always tends to be the more control freak Type A people who are used to controlling every aspect of their life. And I think it’s that illusion of being able to control sleep, I think that gets you into such hot water in the first place. And also is just makes you feel so helpless and hopeless when you’re going through it, because you just don’t know what to do in every other aspect of your life.

Celia Garforth:
And this is like parenting too with a child. You can’t control them either. But with every other aspect of your life, the more you try, the better the results. And so you’re conditioned to try harder and do more and invest all this energy into something, and it’s actually the complete opposite with sleep. And I think that’s the trap, isn’t it?

Martin Reed:
Yeah.

Celia Garforth:
Part of the predisposition is probably a lot of people who are a little bit more controlling in other aspects of their life.

Martin Reed:
Yeah. I would completely agree with you. And I think it’s really important to not be hard on ourselves because we are implementing these behaviors because like you said, pretty much everything in life responds positively to effort and sleep is the one thing that doesn’t. So when we go through life connecting effort to success, 99.9% of the time, that’s probably true, so we want to do the same for sleep. But sleep is one of those rare exceptions. And the more we try, the more we strive, the more we put effort into sleep, the harder it seems to become and the more elusive it is.

Celia Garforth:
But interestingly and I spoke quite a bit to my psychiatrist about this, that’s probably why I found your program really useful because it did feel like you were implementing something. Because I think the worst part for me was feeling like I was treading water and I wasn’t getting anywhere. And at least with almost a structured program, you’re like, “Well, even if I’m not seeing necessarily my sleep improving in the short term, I know I’m doing something positive and putting effort into something that is going to help in the longer term, if that makes sense.”

Martin Reed:
Yeah. I think it does-

Celia Garforth:
It’s channeling your efforts into something more useful, I guess.

Martin Reed:
Yeah, exactly. I like to say that we can’t control sleep, but we are going to want to put effort or put control into solving the problem of insomnia. So what we want to do is put all of that effort and attention into creating good conditions for sleep and putting all that effort and attention into exploring the thoughts and behaviors that can perpetuate sleep disruption, because we’re always going to have difficult nights every now and then. And it’s almost always down to our reactions to those difficult nights that determines how long they stick around for. And if we address those thoughts and behaviors that perpetuate sleep disruption, it’s really hard for insomnia to stick around for the long-term.

Celia Garforth:
Yeah. And that is definitely the biggest shift. I know I said this to you before, but the biggest shift for me is how I respond to bad nights because of course, I still have them. They’re not as bad as they used to be. So when I was probably in the worst period, I would go a few nights with just having two or three hours sleep, heavily sedated. I’d wake up my husband. I’d be in floods of tears. I’d almost be having a panic attack. It was awful. And now if I have a bad night, I just get up, go and sit. It’s calm, it’s peaceful.

Celia Garforth:
I don’t like it. It’s not great, because no one likes being awake in the middle of the night, but it’s actually fine. And then the next day I get up, I stick to my routine and I get on with things. Maybe even it’s a few nights or a week where it’s not great sleep, but it always gets back on track. And the more times you do it, the more times you get used to it. And now it’s almost just a part of life and it’s fine. Sometimes you have days where you’re not feeling as great as other ones and that’s just fine.

Martin Reed:
Yeah, absolutely. Like you touched upon really, a lot of it does come down to our reaction to the difficult nights. Because the more we react, the more we can perpetuate that sleep disruption often due to heightened arousal; more worry, more anxiety about sleeping. When we’re worried about sleep or anxious about sleep, our body then needs to generate more sleep drive. So in other words, we just need to be awake for longer in order to overpower that arousal.

Celia Garforth:
Yeah.

Martin Reed:
But if nothing else that shows that sleep always happens in the end, it’s just when we have a lot of arousal, a lot of anxiety. Unfortunately, we need to be awake for longer to overpower that. So it can be helpful to take a two-pronged approach and ie, can help build sleep drive by allotting an appropriate amount of time for sleep, and we can see what we can do to help weaken or to help lower that arousal system. When we tackle sleep drive and arousal, we often see some long-term improvements in sleep.

Celia Garforth:
Yeah, totally. I’d be lying if I said I was never anxious about sleep, but it’s something that lessens with time and you go through periods of great sleep and not so great sleep. Like you say, it’s totally how you react to it. And my husband says this to me when I’ve had a bad night. He’s like, “The difference is you’re like a different person.” I think one of the biggest things for me as well doing your course is just understanding the basics of sleep and how sleep works. I’ve done the course. I know everything there is to know, not everything, but I know what I need to know about sleep therefore I don’t need to spend the next day searching for solutions. That’s dumb. And I think that’s the biggest difference.

Celia Garforth:
Before where you’re constantly searching for solutions and stuff, now it’s just like… And I remember saying to my sister who’s actually a doctor, so I would constantly ring her when I was having a terrible time in the middle of the night. I was like, “What should I do? What should I do?” And she kept saying to me, “You don’t need to do anything. That’s your problem.” And I think it takes a while to internalize that advice, but I think that’s the biggest thing for me was… And it comes back to that putting effort into the wrong place thing. It’s like you have a bad night, instead of waking up the next day and making a whole plan for the next night and what you’re going to do and how you’re going to solve it. You’re just like, “That’s dumb. I may have a good night the next night, I might not, but it actually doesn’t matter.” That’s it.

Celia Garforth:
There’s no need to spend the whole day Googling it. There’s no need to invest energy in worrying about it. I’m just going to get on with the day and that’s it. And that’s a really, really hard mind shift, especially for someone who has always had an obsession with sleep and was worrying about my son’s sleep. And that’s probably the biggest thing for me is, on a constant recovery journey is just reminding yourself that if you feel yourself falling into that spiral where you are looking things up, it’s like, no, I’m done. There’s nothing more I need to know, and there’s nothing more I need to do. Just stick with the basics of what I’ve already learned and that’s it.

Martin Reed:
Yes. And spending all that time searching for solutions or researching sleep is completely understandable why we would do that because again, we want to solve the problem. But it tends not to reveal any big insights. It tends only to just draw more focus and attention to sleep and make us worry more about sleep. And that can be one of those behaviors that perpetuates sleep disruption. In connection to that, another common perpetuating behavior is trying to conserve energy or adjusting our days based on how we slept. So we might cancel plans, we might stop exercising, things like that. Or maybe even call in sick to work.

Celia Garforth:
Yeah. You can’t do that with a child, unfortunately. Call my son.

Martin Reed:
Right. Exactly. But I think in a way it’s good when we have some kind of obligation that keeps our day somewhat structured, like going into work or having to take care of our children, because if nothing else, it ensures that we do have to get out of bed in the morning, we do have opportunities to do things other than think and worry about sleep throughout the day. Often we can have that temptation, just going back to the work example, to call in sick to work because we just feel like we can’t do it. But then the issue is, we probably end up staying at home doing even more thinking or worrying about sleep, maybe napping during the day. Not giving ourselves that opportunity to see if we can have some good moments during the day, because when we cancel our days in response to difficult nights of sleep, then we guarantee that difficult night equals difficult day. And again comes back to perpetuating that sleep disruption.

Celia Garforth:
Yeah, totally. Again, when I first was having sleep disruption at the beginning before I got on the recovery journey, it was very much… Because I was on maternity leave at the time, I even made my husband take two weeks off work because I was like, “I’m not coping. I can’t look after Louis during the day.” I mean, it was helpful obviously because I wanted some help during the day because I wasn’t feeling great. But I then felt like I was suspended in this emergency crisis status almost. And that I think then perpetuated the issue of me feeling like there was something wrong with me and I had to solve it. I’ve been back at work six months, so I haven’t called in sick once because of sleep, even though I’ve had a few bad nights and you just get on with it.

Celia Garforth:
At the beginning I told my boss when I went back to work, I’d had had sleep issues and he used to ask me about it, and I actually said to him, “Don’t even bother asking me about it. I don’t want to talk about it. I want to pretend I’m a normal person that doesn’t have this because that will help me be a normal person who doesn’t have sleep problems.” And remarkably, if you don’t tell anyone you’ve had a bad night, then no one notices because you just get on with it and you almost forget, weirdly.

Martin Reed:
Yeah.

Celia Garforth:
So yeah, it’s a real kind of… You just got to get on with it. In fact, my youngest sister who has two children and both her kids are terrible sleepers. She’s same to me, “Every time I’ve had a bad night because of the kids, I just get up and you’re sleep walking through the day, but you just pretend that you’ve had eight hours and you’re fine, and that’s it.” So it’s almost pretending with yourself that everything’s fine and then it is.

Martin Reed:
Yeah. I think sometimes maybe taking that approach of faking it until you make it can be helpful.

Celia Garforth:
Yeah, exactly.

Martin Reed:
If nothing else, it just helps shift that focus and attention away from sleep and often the less attention we pay to sleep, the easier it becomes. On this note, I remember when we first started working together, you were still on maternity leave, and then you were returning to work whilst we were still working together. And you told me how important it also was at the same time for you to just stay physically active, to stay mentally active. You joined a morning boot camp. You were swimming. You were keen to start cycling to the office when you went back to work.

Celia Garforth:
Yeah.

Martin Reed:
What was it that prompted you to be so enthusiastic and determined to remain so active even when you were still struggling with sleep? I mean, was that something that was just always part of your identity or was it you just wanted to shift, focus and attention away from sleep?

Celia Garforth:
Definitely a bit of both. I’ve always been super active. Part of it was having a routine and I always felt better even if I’d had a bad night. In fact, sometimes I’d get up and be I like, oh. I say to my husband, “I just cannot cope with the idea of boot camp this morning.” He’d be like, “Get out of here, go.” And I’m fortunate enough to live by the ocean and it’s beautiful and you get out there and you’re with a group of people and you’re forced to be in the moment and socialize with the people and feel like… You don’t talk about it, you just get on with it, you do the boot camp, get in the sea, have a swim.

Celia Garforth:
And it’s just remarkable how that just sets you up for the day and you feel like you’ve achieved something. And I’m sure that being physically active during the day and you’re in the sunshine right from the beginning of the day, I’m sure that helps with setting a circadian rhythm and all that kind of stuff as well. But it’s also just a determination to not let it beat me into submission. And it helps with anxiety too, you feel the adrenaline. And everything about exercise has always been very helpful for me with mental health and just setting yourself up positively for the day. And it was a challenge to myself that I could go to boot camp regardless.

Martin Reed:
Yeah. I think that’s a really big point that you can still do regardless of how you sleep, because it can just be so easy to believe that we are just completely incapable after those really difficult nights or when we have stretches of really difficult nights, our brain is just urging us to rest and do nothing and just recuperate and conserve energy. But unfortunately, that doesn’t usually prove to be too helpful. It doesn’t really help reduce fatigue. It just leads to more time thinking and worrying about sleep. But if we can just… even if it’s just a case of faking until you make it, just try and do some kind of activity, if nothing else, if it’s something you enjoy, it’s going to give you a little bit more enjoyment out of your day. It’s going to improve the quality of your day a little bit. It does help reduce fatigue because you’re moving about. And it can help you recognize that you do have some degree of influence over the quality of your day, and you can still have some certain amount of capability during the day, even after difficult nights.

Martin Reed:
And when we repeatedly prove this to ourselves, it can lead to us putting less pressure on ourselves to sleep and not seeing difficult nights as being a guarantee of a completely awful day every single time you have a hard night.

Celia Garforth:
Totally. And I used to say to my husband, if nothing else comes out of this bad experience, then at least I’m going to get my body back after having a child because I go to boot camp every day. And so at least that’s some positive.

Martin Reed:
Yeah.

Celia Garforth:
I don’t know. It’s just having little things where you’re focused on them and part of not identifying as an insomniac, therefore you can’t do anything. I think it’s really important as well to step out of that identity as someone who has bad sleep, because I think that’s just so unhelpful and that’s, I guess, the part of the faking it thing as well. I think I used to, when I’d have a bad night sleep, it’s like, I’m a bad sleeper therefore I can’t do this. And the same, actually, when I started sleep restriction, it was almost quite freeing because I’d always… I know you said at the beginning that a lot of people with sleep issues go to bed too early. That was definitely me.

Celia Garforth:
When I was pregnant, I needed a lot of sleep, so I’d go to bed at 8:00 or 8:30 and sleep 10 or 11 hours. And I think that almost continued into office because also when Louis was little, I was getting up a lot in the nights, so we would go to bed early. But by the time he was sleeping through the night, there was absolutely no reason for me to go to bed at 8:30, but I still was, and I’d wonder why I wasn’t falling asleep.

Martin Reed:
Yeah.

Celia Garforth:
And so when I looked into sleep and I’d always been obsessive about I have to have eight hours and I have to be… but I was in bed for 10 or 11 hours, and it just eat up so much of your life just being in bed. And when I first read about sleep restriction, it sounded awful, which was probably why I was resistant to do CBT-I in the first place. I was like, “Five or six hours. How do people cope on this? I will never be able to cope on this one, blah, blah.” But as soon as I actually tried it, it was like, “Oh, I can. Maybe I am one of these people who can stay up later and still get up early.”

Celia Garforth:
And actually that was so freeing and it’s been really helpful now I’ve gone back to work as well, because sometimes I do need to work late and I don’t have a panic attack about it because I’m like, “It’s actually fine if I work till 8:00 or 9:00 and then still have an hour or two before bed, and then I still can get up for boot camp because I don’t need eight hours.”

Celia Garforth:
The myth busting around that on your course was so helpful for me. And in a way, like I said, it felt quite liberating because now I can do stuff with my evenings, and not… I used to be so fiercely protective of my evenings, like never plan anything in the evening during the week. It was very much just like, no, I can’t do anything after 6:00 PM because that’s my sleep time. And now it’s fine and I really enjoy staying up till 10:30, 11:00, and my husband hates it because that used to be when he could stay up on his own and play PlayStation. And now he goes to bed before me, and he very much begrudges it, but it’s great for me.

Martin Reed:
Yeah. I think all those concerns you had about sleep restriction, are completely understandable. I think just the terminology there; sleep restriction, my sleep’s already restricted. I’ve got insomnia for goodness sake. Really all we’re doing is just reducing the amount of time available for wakefulness whilst building that sleep pressure, building that sleep drive to help sleep happen. So even if, let’s say for example, you’re going to be following a sleep window only allotting six hours for sleep.

Celia Garforth:
Yeah.

Martin Reed:
If that’s the case, then we would typically expect you to be averaging less than six hours of sleep, when you’re observing six hours for sleep. So we’re never taking that opportunity for sleep away from you, we’re just making the amount of time you allot for sleep a bit closer to what your current reality is, closer to your current average nightly sleep duration, to build that sleepiness and reduce that nighttime wakefulness. And like you said, if you’re able to give it a go and be consistent with it, at least for a few weeks, it does tend to bring some really positive results. If nothing else, it can just help you rediscover that sense of sleepiness instead of fatigue as bedtime approaches. And it can just be so freeing being able to spend… just having less time available for nighttime wakefulness and maybe even having a little bit more time in the mornings to actually do things that you enjoy or to be productive.

Celia Garforth:
Totally. And that, I definitely remember when I started sleep restriction, feeling sleepy again in the evening. I’ve never been a person who would fall asleep in front of the TV, but as soon as I started sleep restriction, I was dozing off and it was like, oh, this is great.

Martin Reed:
Yeah.

Celia Garforth:
I mean, the first few weeks, I did have occasions where I’d feel sleepy on the sofa. And then when I get into bed, you’d be ping wide awake. Which is probably quite, I think normal experience for people going through it for the first time. But it was really, really useful for me to recognize when I was sleepy again versus just going to bed just because, oh, it’s 8:30, I should go to bed, even though I wasn’t really sleepy all ready for bed. And I definitely recognize that I would have… Even previously when I was pregnant or before I had sleep issues more chronically, I would be in bed at 8:00. I’d say, I think I’d been asleep for eight hours, but probably it was quite broken sleep and I definitely wasn’t asleep for a lot time. And when you restrict the window, you know that you’re in such a deep sleep for that amount of time, and then you still wake up feeling refreshed. It’s almost like you’re just being a bit more efficient with your sleep versus stretching it out and spending loads of time in bed.

Martin Reed:
Yeah, absolutely. On that note of sleep efficiency, what that means as well is that because we’re spending less time awake in bed, we are retraining our brain, that the bed is a place for sleep rather than all this time spent awake during the night. In effect, we’re just making the bed a much stronger trigger for sleep, just because most of our time is spent in bed asleep rather than awake, which it might be if we’re allotting way too much time for sleep at night.

Celia Garforth:
I definitely developed a bad relationship with my bed. You go in the bedroom and just look at the bed and just be like, “Oh, that’s bad signs.” And now it’s not at all like that. I’m still pretty strict about, I’ll never spend more than half an hour in bed if I’m not asleep. I don’t use the bedroom for anything else.

Martin Reed:
Yeah.

Celia Garforth:
So it’s definitely good to retrain your relationship with the bedroom.

Martin Reed:
Yeah. So when we were working together, as every client I work with experiences, you are no different. There’s a number of ups and downs over the eight weeks of working together. Now, a common experience you shared with me was, and I think you just touched upon it earlier, was struggling to stay awake until bedtime, drifting off whilst you’re watching TV, but then you get into bed and it just feels impossible to sleep. And I remember you told me that you’d try reading again, but then you’d find it hard to focus on the book you were reading. That might be the time when you’d resort to that external crutch like smoking. And you’d find you then maybe you would fall asleep, but then you’d wake really early and find it hard to fall back to sleep again.

Celia Garforth:
Yeah.

Martin Reed:
How did you tackle these challenges?

Celia Garforth:
I just guess just a bit of perseverance, to be honest. I mean, obviously you were really supportive and helpful through it as well. And I guess just trying different things. I got a bit frustrated with myself because I would just resort to get up and smoking some weed. And like you say, it did put me to sleep, but then not for very long and I’d wake up feeling a bit shit. So actually, what I used to do is just come and sit outside on the balcony where I am right now, and just listen to some white noise or an audio book instead. So I guess it was just a bit of trial and error and finding things. Like I said, like trying to read a book. I felt like I was reading a book deliberately to fall asleep and so I couldn’t concentrate on it. So I think I needed something slightly less, I guess, involved, or I could just sit with my eyes shut and listen or deep breathing and then go back to bed. So I guess it’s probably just a bit of trial and error and finding the right thing for you.

Martin Reed:
Yeah. Well, first of all, maybe it’s helpful for us to just emphasize why we often see that real intense sleepiness before bed, and then it disappears when we get into bed and often it is related to that conditioned arousal. We’ve just learned through repeated nights of difficulty sleeping that the bed is a place that’s unpleasant to be. So we can really sleepy before bed, then we get into bed, the brain kicks into gear and says, “Uh-oh! Here we go. This is not a nice place to be.” And then we lose that sense of sleepiness.

Celia Garforth:
Yeah.

Martin Reed:
That’s when we can be tempted to resort to those external crutches or those sleep efforts. And usually the most helpful thing to do is whenever being in bed doesn’t feel good, just get out of bed and do something that might make that wakefulness just a little bit more pleasant. That comes with the benefit of just shifting attention away from sleep. It definitely prevents you from putting effort into sleep because you’re getting out of bed, and I think it just also helps prevent you reinforcing that negative association between the bed and unpleasant wakefulness. Because if you’re getting out of bed whenever it doesn’t feel good to be in bed, you’re training yourself that the bed is only a place for sleep or pleasant wakefulness.

Martin Reed:
But it does take time, and it’s a case of just repeatedly getting out of bed whenever being in bed doesn’t feel good. And resisting that temptation to reach for those external crutches, whether it’s a pill in the middle of the night or a supplement in the middle of the night or smoking in the middle of the night. Because all those sleep efforts do is reinforce. If we do fall back to sleep, they reinforce this belief that we need them to generate sleep, which is never true. And if they don’t help us fall back to sleep, then we can worry even more because that crutch is no longer working.

Martin Reed:
I remember when we were about halfway through working together about four weeks in, you were making good progress and then you had that one difficult night, which I think every single client I have experiences. And then you have that difficult night and it brings back all those old anxieties. It can even bring back some of those old bad habits. Now you’re going back to those crutches. You feel like I’m never going to improve. It’s one step forward, two steps back.

Celia Garforth:
Yeah.

Martin Reed:
How were you able to get through that and just have that belief and motivate yourself to stay persistent and consistent with what you were doing up to that point?

Celia Garforth:
Right. It’s not like I didn’t feel… I felt all of those anxieties that came back, but probably because I felt like I didn’t really have a choice, but to stick with it and keep moving forward because the other option was going back to where I had been, and I knew that I was making progress and my husband kept reminding me, he was like, “This is not anywhere near as bad as it used to be. This is fine.” And I was just quite strict with myself. I kept going to boot camp, I went to work, I focused on work, I tried to be present with Louis. And then the more times that happened, the more it was easy to tell myself that it’s actually fine to have a few bad nights here and there.

Celia Garforth:
But even a week. Like last week I was a bit ill and was up half the night, one of the nights and I felt awful the next day and then I had to be rough like disrupted nights. But you just get on with it and then your sleep just rectifies. And I don’t know, it’s just such a different mindset shift. Maybe my sleep isn’t even any better than it used to be but it’s fine.

Martin Reed:
Yeah.

Celia Garforth:
And I know I don’t need eight hours or nine hours of sleep and I’m not going to die from not having eight or nine hours of sleep a night. I know I can get on with work and everything the next day. I know I’ll sleep fine eventually, and I’ll actually have a really good deep night’s sleep at some point after that and I’ll get back on track and that’ll be fine. And then probably a few weeks or months down the track, it’ll happen again. And that’s just it. When I fully first started speaking to you, I was obsessed with being cured, and I think that’s a really unhealthy thing to fixate on as well, because there is no magical cure. There’s no silver bullet for having perfect sleep. It’s just something that you live with and it’s fine.

Celia Garforth:
Like I said before, it’s how you react to it, and just not letting yourself spiral into all those negative thought patterns that gets you through it. I actually happen to know people around me that are very supportive, but definitely was helpful too. My husband would parrot it back to me, things that I’d told him that you’d said to me, and I was like, shut up.

Martin Reed:
Oh, that’s great.

Celia Garforth:
Yeah.

Martin Reed:
I think it’s amazing, isn’t it, how… Let’s say we have, during this journey of changing your thoughts and behaviors about sleep, how you can go for let’s say a week or two weeks or three weeks, and then feel really good about your progress. But then you just have that one difficult night and the brain focuses all this attention on that one difficult night instead of the seven, the 14, the 21 decent nights you had before that.

Martin Reed:
It really is quite amazing. But because that’s where the mind wants to go, the mind doesn’t really care about good stuff because it doesn’t have to problem solve the good stuff. So it focuses all of its attention on the problems. And this can lead to this idea that you’re not doing as well as you actually are. If you can take a step back and think, well, actually I had a good week, I had a good two weeks, I had a good three weeks, this is only one night. Because if we don’t actually do that consciously, the brain will just be like, no, this is it. We’re back to square one, when that is far from the truth.

Celia Garforth:
Yeah, totally. And I think I’m definitely an anxious person in general and I worry about things. And I think negativity bias is just something that you do and catastrophizing, and there’s a whole heap of cognitive distortions that you have when you’re a slightly anxious person that just makes it so much worse. Actually, one of the things that I did do… I found a sleep diary, because I kept a sleep diary probably I continued doing it after we finished and I stopped doing it around Christmas because we went away on holiday and I was just feeling great with having such a good run of sleep, so I stopped doing it. But when I’d had a few difficult nights, I’d actually go back and look at the sleep diary and be like, “Oh, I’ve actually been through this before.” Oh yeah. Over here, a few weeks ago I had two really bad nights. And then the third and fourth night, I was fine again.

Celia Garforth:
And so it was just reminding myself almost going back and looking, oh yeah, this has happened already and it was fine, and you’ll get back on track rather than… So I think having that macro view and zooming out and being like, “Oh, look at this.” Instead of being like, “Oh my God, everything was great before and now it’s rubbish.” It was like, “Oh yeah, look, I’ve done this before. I’ve been through this before.” And the more times you go through it and cope with it and get back on track, the more it just becomes part of the journey of just life and just how it goes.

Martin Reed:
Something you touched upon earlier was that desire to get results. So in a way it is understandable why we would be disappointed whenever we have those bad nights, because we’re so desperate to get results, to get rid of this insomnia. Whenever we have those difficult nights, it can feel like a real setback, but the truth is, they’re all part of the process, and occasional sleep disruption from time to time is part of life. There’s nothing we can do about that. But what we can do is just make those one-off difficult nights more likely to just be one off difficult nights rather than something you struggle with every single night for the foreseeable future.

Celia Garforth:
Yeah.

Martin Reed:
And so I think maybe shifting attention on to just implementing these behavioral changes to create better conditions for sleep, rather than that ongoing monitoring and evaluation can be really helpful because at the end of the day, if we are able to tackle those thoughts and behaviors that perpetuate sleep disruption, the results are going to come by themselves. And insomnia just cannot survive for the long term without those perpetuating thoughts and behaviors.

Celia Garforth:
Yeah, totally. And I think I did indulge in quite a lot of, oh, if only I hadn’t worried so much about my son’s sleep and I really wish I could go back to that time when I was much better at sleeping, even though at the time I thought I was a terrible sleeper. So it’s always that stupid rose-tinted glasses thing. I think all that stuff is in the past, and it was just indulging and I wish I’d done this differently or that differently. It was just so unhelpful because you just stuck it. And that goes back to this whole finding a cure. It’s not an illness that you can cure, it’s something that’s always going to be there if you let it. So I think it’s an ongoing relationship. It’s not a cure or not cure. It’s not like you’re better or you’re not better. Anyone can get it at any time and you can slip back into it at any time. It’s more about just managing your relationship with sleep better and not reacting to it and not going down into that spiral.

Martin Reed:
Yeah, absolutely. And I think over time that definitely becomes easier as you regain that sleep confidence. When your confidence is quite low, it can just feel like every night of less than perfect sleep or less than kind of sleep you want. Can feel like a real setback when it really is just all part of the process. And I remember that when we were working together, it was at the time when the elections were going on here in the US and everything that was going on. And I remember you saying to me, you experienced some sleep disruption, found yourself you were spending that time to unwind before bed, but then you would just find that your mind was just wired. I think you called it, you’re doom scrolling on Twitter and scrolling and scrolling through that.

Celia Garforth:
Yeah.

Martin Reed:
And then you would feel really frustrated and disappointed with yourself the next day, because you had a difficult night of sleep, and because maybe then you reached for those external crutches; you’ve reached for the supplements, you reached for the pills, you’d start smoking or whatever. So I think it can be really helpful to just recognize that difficult nights of sleep every now and then are just a normal part of life, especially if we can recognize or identify an obvious cause of them.

Celia Garforth:
Yeah.

Martin Reed:
Often there is quite an obvious cause to these temporary nights of sleep disruption, but sometimes there’s not. But either way, worrying about a previous night of sleep isn’t going to change that. Usually the most helpful thing to do is to just keep moving forward. Even if you are implementing these behavioral changes and you feel you didn’t stick to them one night, that’s okay. All that matters really is the present. But in terms of long-term improvements, what you do the next night and what you do that day is far more important than what you did yesterday or last week.

Celia Garforth:
Totally. And I think that’s been a big shift for me as well as not spending the whole day dissecting what I did the night before and trying to diagnose why it happened. I remember at the beginning I’d literally spend the whole day being like, “Oh, maybe it’s because I didn’t go for a run this morning or I had a cup of coffee or all this stupid stuff.” I didn’t have a long enough bath or all these stupid things that you’re self-diagnosing that definitely have no impact whatsoever, and it’s just a complete waste of time worrying about… So much energy just focused on worrying and hunting for problems that aren’t there and hunting for solutions that aren’t there.

Martin Reed:
Yeah, exactly. I think that is a common trait among people with insomnia is that ongoing experimentation and monitoring. So let’s use working out for an example. We might start paying attention to what time we work out in the day and how that affects sleep or what kind of exercise we’re doing and how that affects sleep. And to be honest, exercise, isn’t going to create sleep. Exercise is good for our overall health. It makes us feel better during the day, lowers fatigue. Lots of good things associated with exercise, but exercise isn’t going to create sleep. So we can easily get distracted trying to look for all these things that might influence sleep when really sleep is pretty straightforward. In order for sleep to happen, we need to be sleepy enough for sleep, so we need to be awake for long enough. And conditions need to be right for sleep. And that really comes down to arousal. We need to have low levels of arousal.

Martin Reed:
If we have any kind of arousal around sleep, we’re worried about sleep or putting effort into sleep, striving for sleep, then our body needs to generate more sleep drive to overcome that arousal. So we need to be awake for longer, and that’s why we experience less sleep when we have a lot of worry or concern around sleep, and doing things like monitoring for the effects of what we do during the day on sleep or doing all these different kinds of experiments. They’re not going to generate sleep, but they are certainly going to generate more arousal because we’re paying far more attention to sleep. We’re putting more effort into sleep. We’re implying that we can control sleep when we cannot control asleep.

Martin Reed:
So they are a common trait among people with insomnia. And I guess what I’m really getting at is, we don’t need to do them. We can just abandon all those unhelpful sleep efforts. And like you mentioned, it can just be so liberating to realize that we don’t have to do all of these things and have all these rituals and pay all this attention to what we do during the day, or worry about how it might affect our sleep.

Celia Garforth:
Yeah. I think the best thing my husband said to me was just like, “You’re not allowed to talk about sleep anymore.” And he was just like, “I’m so bored of you going about it.” And now he just literally pulls me off on it. He’s just like, “No, that’s part of your weird sleep story that doesn’t exist and we’re not talking about that anymore.”

Martin Reed:
Yeah.

Celia Garforth:
And I think having people around you that keep you honest is quite helpful as well. I used to ring up my friends and my sisters on and on crying on the phone and moaning on at them, and it’s just, what a waste of time and what a waste of… It’s not great for them either, and they worry about you and it completely just reinforces the problem. It’s just working it into this massive thing when it just doesn’t really need to be at all. And the best thing to do is just to avoid talking about it or thinking about it as much as possible, which is easier said than done, of course. I often fall back into thinking about it, but now I catch myself and distract myself doing something else or go and write it down and then put it away. Just whatever you can do to recognize that you’re having that thought, but then put it to one side, I think is really helpful.

Celia Garforth:
Because it’s impossible to block out anxiety and thoughts like that, and it’s impossible because it always comes. And like I said, you’re never cured. And maybe I will be in 10 years time and I’ll never think about sleep ever again. But I think it’s really unrealistic to think that after an eight week course you’re going to be completely cured and that’s it, and see you later, job done. I think it does take a certain… I’m hesitant to say effort because I know we’re not supposed to put effort into it, but I guess it takes a bit of discipline to stop yourself indulging in things that will make it worse and starting to recognize patterns before you fall into those traps.

Martin Reed:
Yeah. I think you made a really good point about thoughts, not trying to suppress thoughts, especially thoughts that might otherwise generate worry or anxiety because as soon as we try and suppress that kind of thinking, the brain thinks, “Oh, wow, this must be a real threat. We need to think about this some more.” And it pushes back even harder. And then you’re just constantly involved in this battle trying to suppress thinking, which never works, but it sure can be exhausting. And I think that can be a big contributor to this fatigue that we often feel when we have insomnia not only generated by less sleep, but also all the cognitive arousal, all the thinking, all the worrying, all the trying not to think about sleep, all the effort that involves can just be exhausting.

Celia Garforth:
Yeah. Really exhausting and a total waste of time. And I say this to my husband now, I’m like, “Oh God, I wasted half my maternity leave just worrying about sleep. And I’m determined not to let it take over my life in that way again.” Which is very different to saying I’m not going to have sleep trouble again.

Martin Reed:
Yeah. And I think it can be really helpful to just recognize that thoughts are thoughts. That’s all they are. They’re just thoughts. We have thousands of thoughts throughout the day. We pay very little attention to almost all of them. But when we’re worried about sleep, those ones we tend to fixate on and focus on. And it can be hard, but often just recognizing the thought, identifying it as a thought, oh, here it is. It’s that thought. I’m worrying about sleep again, and not trying to suppress it, not trying to push it away.

Martin Reed:
I think that’s often the easiest approach to take, because it’s a little bit like a playground bully. We recognize that thought, we recognize that bully is there, if we don’t react, if we don’t try and push them away, don’t try and run away, the bully soon gets bored and those thoughts drift away just like all the other thoughts that aren’t related to sleep that enter and leave our mind throughout the day. They enter and they leave because we don’t pay that much attention to them. If we can get to that point where we treat those sleep thoughts the same way, it can just make things so much easier.

Celia Garforth:
Totally. And it’s also not allowing those thoughts to influence how you act as well.

Martin Reed:
Mm-hmm (affirmative). Yeah.

Celia Garforth:
Acknowledging that you’ve had that thought. And instead of then spending the rest of the day Googling, how do I sleep better? You acknowledge that you’ve got the thought and then go, “Cool, I’ve had thought. That’s fine. It’s there. It’s in the back of my mind maybe, but I’m not going to act on it at all.”

Martin Reed:
Yeah.

Celia Garforth:
Yeah.

Martin Reed:
I think just one of those big thoughts, I’m sure you’ll recognize this one is just, oh, I had a really difficult night, so maybe I should reach for X tonight to try and help me to sleep, whether that’s a pill or a supplement or smoking or anything like that. Because I had a difficult night, maybe now I should go to bed earlier, or maybe now I should try and nap during the day because your brain wants to problem solve. None of us will be alive if our brains weren’t hardwired to problem solve. But the problem with sleep is often a lot of the solutions we come up with, they might actually give us some short term relief, going to bed early might need to a little bit more sleep that night, but it can then lead to more sleep disruption on following nights.

Celia Garforth:
Yeah, totally. And the part about going to bed early was really good to break. And that’s why sleep restriction really helped is just giving a bit of consistency to my sleep patterns because I’d have a few nights of really terrible sleep and then I’d conk out and sleep for 10 hours and then the next night I’d be back to not sleeping again. And so I think just generating that consistency was what’s really important in breaking those up and down cycles for me.

Martin Reed:
Yeah. I mean, that is one of the big reasons why we see these roller coaster nights of really long nights of lots and lots of sleep, and then nights of very little to no sleep. It’s often caused by an inconsistent sleep schedule and allotting too much time for sleep. So if we align a lot of time for sleep when sleep drive builds to that really intense level, we’re going to fill all that time and sleep. But then when sleep drive has been relieved, because we’ve got all of that sleep, then we’re not spending enough time awake to build that sleep drive up enough to sustain sleep the next night. And so we hit that roller coaster of long nights, short nights, and that can just be so frustrating and just lead to more sleep related worry, which in turn generates more arousal.

Celia Garforth:
Yeah. It’s that roller coaster of like, oh God, what’s this night going to be like? And then you feel great after your 10 hours and then you feel terrible again.

Martin Reed:
So we’ve covered a lot in this conversation. Just upon reflection, just to summarize, what would you say were the things that prove to be most helpful for you helping you to get to where you are now?

Celia Garforth:
I think probably the number one thing was the recognition that I shouldn’t be problem solving around this anymore and making my peace with not always striving to get eight hours, I think was probably the single biggest unlock for me. And just that whole, like I said to you, my sister saying you don’t have to do anything. Internalizing that advice and that knowledge is probably the most important when it comes to thought patterns. And then I think just practically the sleep restriction definitely was really, really helpful just in generating that consistency and building up that sleep drive.

Celia Garforth:
So I was tired each night when I went to bed because that almost just acted as a circuit breaker so that I could start getting on track again. So yeah, I’d say those two things were definitely the most helpful for me. And then there’s all the ancillary stuff around making sure you get up at the same time every day and the boot camp and not staying in bed when you’re not asleep. But I think those two things; the sleep restriction and the just recognizing that… or making my peace with not problem-solving around sleep and worrying about it all the time and that the liberation that comes with that, I think as well was the biggest thing for me.

Celia Garforth:
And then probably with hindsight now it’s also the third piece around of knowing that I can cope with difficult nights and not letting that spiral. So that’s definitely been a helpful learning experience too.

Martin Reed:
Yeah, absolutely. A lot of it I think comes down to acceptance in a way, just accepting that what happens at night is what happens at night. I’m not trying to control it. And putting all those instincts to control into more productive areas like controlling what you do during the day, for example, staying active, resisting that temptation to just spend the whole day researching sleep, giving yourself that opportunity to improve the quality of your day independently of sleep. All of those things can be just so helpful in addition to all the other behavioral techniques that we’ve already discussed.

Celia Garforth:
Yeah, definitely.

Martin Reed:
All right. Celia, I really appreciate all the time that you’ve given up to come on to the podcast today and to talk about your journey and your transformation in your sleep and your mindset around sleep. But I do have one last question for you, which is, it’s always the last question for every guest, so I’m not going to break precedent here. I’m going to ask you the same question. If someone with chronic insomnia is listening and feels as though they’ve tried everything, that they’re beyond help and they just can’t do anything to improve their sleep, what would you tell them?

Celia Garforth:
Well, first I’d tell them to do your course because it really did help. Having something to focus on that wasn’t sleep, but still felt like you were doing something and your effort was going into somewhere positive. And then I guess I’d just give the advice of stop trying to problem solve around sleep, and the advice that my sister gave me; you don’t actually have to do anything. That’s the beauty of sleep. Do less. And I know if someone had said that to me probably at the time I would have punched him in the face. But with hindsight, I think learning to internalize that and not indulging all these thoughts and letting yourself spiral would be my biggest piece of advice. And also please don’t give up hope because honestly, I was in such a bad place. I was in the depths of despair and hopelessness, and you can drag yourself out of it. Life doesn’t have to be that hard. It doesn’t have to be like that.

Celia Garforth:
There’s definitely a way to make significant improvements and have ongoing better relationship with sleep. So yeah, I guess that would be my advice.

Martin Reed:
Great. Well, I think that’s an excellent note to end on. So thanks again for your time and for sharing your experience. I think is going to be really helpful for a lot of people. So thank you, Celia.

Celia Garforth:
Good. Thank you. It’s been great talking to 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.