8 ms·
A new insomnia therapy
- fredley 8y agoThe article is very long-winded. TLDR: CBT and observing a few physical parameters that affect your sleep (temperature, light, sound), as well as getting the right amount of sleep (not too much, not too little) will sort out most people. For me strictly banning all screens from the bedroom has helped too (I have an alarm clock with no backlight so I can't even check the time). I did exactly this sort of thing years ago via Sleepio[1], which I highly recommend. It is a guided CBT course that completely sorted my chronic insomnia, using pretty much all the methods described in TFA. It will take you less time to sign up than to actually read said long-winded article. 1: https://www.sleepio.com https://www.sleepio.com
- xyzal 8y agoI cannot recommend Sleepio enough everytime someone mentions sleep trouble. The time-in-bed restriction regimen is in my opinion particularily helpful and I revert to it occasionally when I don't sleep well a few nights in a row with good results.
- fredley 8y agoTotally agree with you. It seems so counterintuitive that when you're struggling to sleep you may need less time in bed, but it really helps in the long run.
- pratyushag2 8y agoYes, Sleepio is very helpful!
- santoriv 8y agoI know this isn't really the point of the article but I was having issues waking up for several hours during the night for the last couple of years. About 5 months ago I started doing a 3-day a week weight training program which includes full body compound movements (squats, deadlifts, etc.) and now I sleep like a baby through the whole night every night. I know that may not work for many people but it worked wonders for me. As an added benefit I've lost a bit of body fat, feel better mentally and physically, and have been able to reduce my blood pressure medication dosage by 2/3.
- egjerlow 8y agoWhat exactly is new about this? CBT+sleep efficiency is pretty much the standard advice for insomnia (after having tried reducing blue light, regular schedule etc)
- m0nty 8y ago> What exactly is new about this? My thoughts exactly. I've tried all the things in the article (inluding CBT) and they are ineffective for me. This is acknowledged in the article ("we're all different") but the overall tone is that of a "miracle cure" when it's just patiently and steadily applying well-known ways to improve sleep. This is good, but it's not revolutionary. The only part of it which resonates for me is that the majority of doctors and other medical professionals are truly, utterly crap when it comes to insomnia. They don't think it's important and they don't care that it's a living hell - "after a couple of nights without sleep, you'll sleep through anything", as one doctor glibly told me. But I've been 100 hours without sleep and that's nowhere near a record compared to other insomniacs. Anyway, let's not get too distracted by a flashy headline and the overall tone of the article. The very fact that a group of medical professionals is taking sleep seriously is significant in itself. I hope it starts a trend.
- gnulinux 8y agoThis is exactly like my experience. I've seen more than 10 doctors for my desperately aggressive insomnia. Neurologists, psychologists, psychiatrists. Not only in US, even in some European country. They always acted like "yeah just perform sleep hygiene and you'll be gucci" "doctor, I do do that but I still can't sleep for days" "it's ok habits take time" Uhhh. To me it just seemes like being unable to sleep (at all) multiple days a week seems alarming enough medical issue that they'd try harder. One time I was prescribed Ambien. I used it for 3 days and it gave me some sort of psychotic episode, it was a terrifying experience I was locked in my own body. My doctors reactions was something like "do you even want to get better???" I hate insomnia.
- m0nty 8y agoThe drugs are appalling. They have all sorts of weird side-effects but offer only marginal benefits in terms of sleep amount and quality. I have used Mirtazapine to good effect, however, so you might yet find something which does suit you. The only other thing which has worked is just learning to accept the suffering and not get too stressed out about it. Losing sleep is bad, but getting angry about it just pushes me over the edge, so I avoid getting angry.
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- nemo1618 8y agoI really can't stand how articles like this bury the actual information (in this case, basically just CBT) deep in anecdotes and other context that I don't care about. Is it just me, or has it gotten worse lately? Maybe in the Age of the Short Attention Span, journalists have to come up with other ways of making the reader stick around?
- fredsted 8y agoThe longer you stick around, the more ads can be shown.
- emerongi 8y agoIs there a name for this writing style? I remember writing essays in school padded with a lot of babble, just because there was a word limit. As an adult, anyone who writes like this is just wasting my time. It's low information density.
- swingline-747 8y agoCopy-writers' job security and greater eyeball time to sell ads. Succinct or GTFO. ;)
- thecatspaw 8y agoits long form journalism excerpt from wikipedia > Typically this will be between 1,000 and 20,000 words. Long-form articles often take the form of creative nonfiction or narrative journalism.
- ianai 8y agoLong form journalism conveys an equally large amount of information as length. Articles like this just add fluff - anecdotes and tangential subjects that don’t add meaningful contextual value.
- pixelrevision 8y agoWell there’s “click bait”. The headline does not match up with the content at all. The article is about insomnia, the headline is about a cure.
- doon123 8y agoAn Honest Question, why are sleep related articles able to gather so much traction here on HN?
- Insanity 8y agoBecause a lot of software engineers tend to have bad sleeping schedules perhaps. I do enjoy explorative coding at night and often end up staying awake too long for getting enough sleep.
- stupidcar 8y agoInsomniacs have more wakeful hours available to them, so, statistically speaking, they're likely to be overrepresented amongst active HN users at any given moment, resulting in a boost to sleep and insomnia related articles.
- ericdykstra 8y agoSleep is one of the three pillars of health. There are also many fitness and diet articles that gain traction. As to why health is popular on HN, it's hard to be interested in the other stuff if you're dead! (I don't actually know why, I'm interested in these all personally, but nearly never upvote the articles myself)
- apatters 8y agoWell, many developers probably aren't in the best health because the job requires sitting all day. Everyone wants to be healthy so there will be a natural demand for articles about it amongst developers.
- davidhyde 8y agoThat's a good question. Maybe its because we are so hungry for information here on HN. Reading HN articles is a mild addiction for me. Perhaps not as detrimental as other addictions but the one adverse thing it does affect is my sleep. To me, writing software is primarily a research activity. It always has been, no matter how proficient I think I am at a language. That's probably why HN articles appeal to me so strongly; it's what I do all day long.
- rq1 8y agoJust fell asleep reading the article.
- ArcticCelt 8y agoWe simply misunderstood the headline; It's not an article about a new cure for insomnia, the article IS the new cure.
- Void_ 8y agoThere's one instance of f-word in this article. Would it have been so hard to replace that one word with something kid-friendly? Seems like a very sneaky way of putting language like that in readers' minds.
- bryanlarsen 8y agoTLDR: limiting caffeine and other stimulants and "sleep efficiency training" is successful for 80% of patients. The description of sleep efficiency training starts at the picture labelled "A patient at the sleep clinic". That section appears to contain highly actionable advice.
- exodust 8y agoThe article lost me in a sea of introductory fluff, and I never made it to the end. As always, the best solution is good old fashioned discipline. Get up at the exact same time every single damn day. No matter how late you stayed up. When you wake up, and it's 7am or whenever your alarm goes, get up. Don't close your eyes again. The rest is about pretty good diet and reasonably regular exercise. And no, you don't need to give up coffee. Have it as strong as you like.
- cowpewter 8y agoWhat's finally helped me fall asleep pretty consistently is listening to hypnosis videos with a pair of those sleep headphones (flat padded speakers embedded in a soft headband). I used to listen to podcasts, and it helped to have something other than my thoughts to focus on, but I'd still frequently be awake 3-4 hours after lying down. With the hypnosis tracks, I'm consistently out within an hour after lying down. I'm particularly fond of this one: https://www.youtube.com/watch?v=bFqEWrw6jyg https://www.youtube.com/watch?v=bFqEWrw6jyg Of course, my wife still falls asleep within 10 minutes (I'm so jealous of her ability to just roll over and be out), versus my 45-60, but it's a vast improvement to not be lying awake for hours every night.
- albanberg 8y agoSleep can often be improved by doing a short (15 to 30 min) simple (you don't have to be limber or do difficult poses) viniyoga program that is set up by a properly trained instructor. A new client will need 3 or 4 meetings with the instructor over a couple of months. The practice/program is done at home either in the morning or at night.
- euthymiclabs 8y agoAs many others have noted, the title is inaccurate; cognitive behavioral therapy for insomnia is a well established treatment. There are a few other minor inaccuracies in the article: chronic insomnia requires only 3 months of sleep disturbances, not 6. And the case for the dangerousness of insomnia is dramatically overstated. But with that said, the reality of insomnia treatment in most countries is that doctors either 1) don't know about CBT for insomnia or 2) don't have a way to refer people to see a behavioral sleep specialist. I practice in Seattle, and there are only 4 clinics that have behavioral sleep specialists. In more rural areas, it's even more uncommon. So in truth, for most patients and most doctors, this does feel like a brand new therapy. Thankfully, "sleep efficiency" training (aka sleep restriction) is a simple algorithm that doesn't really require hand holding, and works reasonably well when practiced through a book or online program. Motivation tends to be better when you meet with a therapist, but the recovery rates are similar for highly motivated people. Disclosure: I provide in person CBT for insomnia and run a pay-what-you-can CBT for insomnia web app at SlumberCamp.co.
- Apocryphon 8y agoNot in the U.K., it would seem. The article gives the impression that CBT for insomnia is relatively new there.
- euthymiclabs 8y agoGood point. The science has been around since the 60's and 70's, but the evidence base has only become overwhelmingly positive over the last 20 years. And from a guidelines perspective, the European Sleep Research Society started recommending it as the first line treatment in 2017 (https://www.ncbi.nlm.nih.gov/pubmed/28875581 https://www.ncbi.nlm.nih.gov/pubmed/28875581). I'm not as up to date on NICE and NHS guidelines.
- 0xcde4c3db 8y agoAre there any high-quality studies supporting the efficacy of CBTI? Most of the ones I've seen are terrible.