CBT-I (Cognitive Behavioral Therapy Insomnia) for Parkinson's Insomnia

[staceysack]

I have read in multiple places that Cognitive Behavioral Therapy for Insomnia works for people with Parkinson's. I can't seem to find anyone who has tried it. Has anyone here tried it? Did it work?

[MBAnderson]

I think it is worth a try. I tried it. It helped a little.

Then they taught me to meditate, but I didn't keep at it.

[staceysack in reply to MBAnderson]

Thank you for responding!!! I appreciate it!

[SGlass]

I used self hypnosis - mediation - mindfulness for years. I started using it for pain control. Then it became my prayer time and now in addition I use it to relax and clear my head to go to sleep. It takes time and consistency to develope. Start with focusing on doing it for a minute. Over a week work up to several minutes. In a month you may get to half hour. Six months can be an hour. You are training new pathways in your brain around ones that keep you awake. Google these methods and there are several descriptions of the process. If my anxiety is to high take 10 mg of Melatonin or rescue Sinemet if in restless leg. Hope this helps.

[jocelyng]

I did CBTI well before I was diagnosed because I had been sleeping fitfully for a long time. There’s definitely a program you have to follow. I did it while I was “under treatment,” but I didn’t stick with it. Now, I try to use deep breathing when I wake up during the night.

[MarionP]

I have that insomnia now but it is secondary to a medication I have to take.

As a psychologist I knew about CBT and knew it could work, but I never had the patience to try doing it on myself, plus there are times when I have a little bit of an obstinate streak, or maybe I just I'm not very good at discipline without an immediate or palpable sense of reward or progress, and CBT is a lot of work. But what does work for me is I just try to quit worrying about it (ironically, that is partly CBT too), and read something or listen to BBC or a podcast or even television until I get tired enough. Especially if you do those things lying in bed then when your body's ready to take you it can as long as you're not smoking or something that will burn the house down. It depends whether you have to be up and doing something and can take naps during the day. But as we age anyway we tend to sleep less, in some ways need a little bit less sleep, and if you just try to not let it bother you and think this just comes with the territory and I catch up and sleep as my body wants me to as it guides me into it then you'll be fine.

The first thing a psychiatrist will ask you or even a GP when you talk about sleep and that you have insomnia is " But are you able to have sleep at other times and what is the total amount of sleep you get in an entire day?" If you're able to answer 6 hours or more then they generally tend to not be too troubled about it.

Sometimes help is when you act like a blade of grass instead of a stiffer tree, as the saying goes, I thought it was Buddhist myself about how in a major storm the tree is broken because it does not flex, whereas a blade of grass bends over and when the storm is gone the blade of grass is still there and continues. Well now that I think about it I think it was Tao.

Anyway the point is sometimes we become insistent on when we do our sleeping when the stages of our life are moving along and we forget to move along with them.

Plus I have to toilet my dog at least three times after midnight between midnight and 6:00 a.m. anyway, because she just cannot hold it and it hurts and no matter the cycles or how we water, this is always been the case in her life, she has to be walked around 12:00 to 2:00 and again around 3:30 to 4:00, and again around 5:30. And even when she only needs to go out twice, my own bladder requires me to get up and urinate myself a couple of times. So even when I use the final solution I mention below, I'm still having my sleep broken a little bit every night, for one reason or another. In fact here it is approaching 2:00 a.m. and I suppose I "should" be asleep.

Now when none of that works and I have really worked myself into a lather about it (which keeps me from sleeping even more), I talk to the doctor about a nice low dose of clonazepam, and again you may have to go to a psychiatrist who is not as afraid or as bullied as general practitioners are with media hype about benzos, and psychiatrists are also more familiar with the fact that under proper use there is not a lot of fear about increasing risk of dementia etc. and which I think is more hype than anything else.

Of course I'd be remiss if I didn't mention that it's possible you have a sleep disorder all on its own, and perhaps it makes sense to go talk to someone about getting a sleep study done... Especially if you're really tired during the daytime and it may be that you have some kind of heart condition or some kind of apnea, which they will pick up in one night if they are tracking your oxygen saturation as you sleep. For example, before I saw my neurologist for my annual this year they did exactly that, track my sleep for a night and it turns out my oxygen saturation was below very important minimums over 30 times and I got a little bit of a lecture about doing CPAP, or if I wouldn't do CPAP then agree to a longer-term more elaborate sleep study. The point is it's easy to just think that your insomnia is within the light illuminated by your flashlight, when it may be just outside that area in the dark where your flashlight is not shining, and you have to remember to do your rule-outs (see a doctor).

[staceysack]

Update - I am in my 3rd week of CBT-I. It was hard as hell in the beginning, no doubt. It has helped a little for sure. I am much calmer when I wake up during the night and most times I can go back to sleep so that's a plus. I was only sleeping 2 hours or so on a bad night and I can't drive to work like that so it was a necessity to fix it. I am now sleeping 3-4 hours on a bad night and usually the time slept is all at once where before it was broken. I have had quite a few nights with 5+ hours straight. Deep breathing, yoga, meditation, etc. all help but when I wake up shaking, it's really hard to do any of that so I am usually awake until that passes. If anyone is interested, I got this book: Quiet Your Mind and Get to Sleep: Solutions to Insomnia for Those with Depression which is basically CBT-I. Sleep well everyone