overcoming insomnia without drugs - methodist col insomnia without drugs.pdfmicrosoft powerpoint -...

david.weidner@va.gov

david.weidner@va.gov

david.weidner@va.gov

david.weidner@va.gov

We have not been able to discover a single psychiatric condition in which sleep is normal

-Dr. Matthew Walker

Spielman’s 3 Factor Model

david.weidner@va.gov

Biological MakeupGenderChildhood experiences

Spielman’s 3 Factor Model

david.weidner@va.gov

EventsMilitaryIllness or MedicationDivorceDeath of a loved one

Spielman’s 3 Factor Model

david.weidner@va.gov

Behaviors:-Trying to sleep more-Staying in bed-Naps

david.weidner@va.gov

david.weidner@va.gov

david.weidner@va.gov

Wake

Sleep

Sleep Drive

SleepWakeAdapted from Edgar DM, et al. J Neurosci

Courtesy of Phyllis Zee

6am 12pm 3pm 9pm 3am 6am

david.weidner@va.gov

Wake

Sleep

Sleep Drive

SleepWakeAdapted from Edgar DM, et al. J Neurosci

Courtesy of Phyllis Zee

6am 12pm 3pm 9pm 3am 6am

david.weidner@va.gov

Wake

Sleep

Circadian

Clock

SleepWakeAdapted from Edgar DM, et al. J Neurosci

Courtesy of Phyllis Zee

6am 12pm 3pm 9pm 3am 6am

david.weidner@va.gov

Wake

Sleep

Circadian

Clock

SleepWakeAdapted from Edgar DM, et al. J Neurosci

Courtesy of Phyllis Zee

6am 12pm 3pm 9pm 3am 6am

david.weidner@va.gov

Wake

Sleep

Sleep Drive

Circadian

Clock

SleepWakeAdapted from Edgar DM, et al. J Neurosci

Courtesy of Phyllis Zee

6am 12pm 3pm 9pm 3am 6am

david.weidner@va.gov

Wake

Sleep

Sleep Drive

Circadian

Clock

SleepWakeAdapted from Edgar DM, et al. J Neurosci

Courtesy of Phyllis Zee

6am 12pm 3pm 9pm 3am 6am

david.weidner@va.gov

Wake

Sleep

Sleep Drive

Circadian

Clock

SleepWakeAdapted from Edgar DM, et al. J Neurosci

Courtesy of Phyllis Zee

6am 12pm 3pm 9pm 3am 6am

david.weidner@va.gov

S S

S S

Step 1: Restrict TIB

W S W S W S W

david.weidner@va.gov

W

S

= 8 hours

W= 6 hours

S

S S

S S

Step 1: Restrict TIB

Step 2: Gradually expand TIB

when indicated

W S W S W S W

W WSW S

david.weidner@va.gov

6 hour sleep window

S S

S S

Step 1: Restrict TIB

Step 2: Gradually expand TIB

when indicated

W S W S W S W

W WSW S

W S Sw w

w

david.weidner@va.govIncrease Sleep Window

IVAN PAVLOV

david.weidner@va.gov

Sympathetic vs. Parasympathetic

david.weidner@va.gov

david.weidner@va.gov

http://www.ufmcpueblo.com/wp-content/uploads/2017/04/square-breathing.gif

david.weidner@va.gov

Situation Mood Thoughts Evidence that the

thought is true

Evidence that the

thought is not trueAlternative thought

Rate mood

now

What was

the situation

in which

you were

started

thinking

about sleep?

Describe

mood in

one word

and rate

the

intensity

(0-100%)

What were you thinking

about? Circle the

thought that bothers you

the most.

Write why you think the

circled thought is true,

but stick to factual

evidence only.

Write down why the

circled thought might not

be true.

Considering the evidence

for and against the

thought, write an

alternative, more helpful

thought

What is your

mood now and

how intense is

the mood?

david.weidner@va.gov

• I’ve done this before, so I know I can do it again.

• I don’t have to feel comfortable all the time. I am human.

• One night of poor sleep is not the end of the world.

• This feeling will pass.

• Waking up at night is normal

• Having poor sleep one night will likely improve my sleep the next night.

david.weidner@va.gov

david.weidner@va.gov

Wake

Sleep

Sleep Drive

Circadian

Clock

SleepWakeAdapted from Edgar DM, et al. J Neurosci

Courtesy of Phyllis Zee

6am 12pm 3pm 9pm 3am 6am

david.weidner@va.gov

1 Wake-up at the same time every day2 Go to bed at the same time every day.3 Get up when you can’t sleep. 4 Use the bed only for sleeping. 5 Avoid daytime napping.6 Create a buffer zone7 Don’t worry, plan, etc., in bed.

david.weidner@va.gov

CBT-I Coach App

david.weidner@va.gov

Matthew Walker

Harvard Website

david.weidner@va.gov