An Algorithmic Solution to Insomnia

A subtext here might be to try sleep restriction when you have a period of funemployment or PTO and can deal with the consequences of being sleep-deprived and/or can distract yourself from nodding off e.g. by going for a walk, and while you don't need to operate machinery, e.g. a car.

A word of caution on melatonin supplementation: https://ai.hubermanlab.com/s/NKoA_QuI

Obviously YMMV, but I've found having an exhausted body works wonders for falling to sleep. So, don't just exercise, do something physically tough that drains you. If you have to do that in the form of running/jogging/biking, fine. But you can also tend a garden. Clean the house. Organize something. Lots of things that are physically demanding.

I'm also skeptical of the advice to not nap. I'd go so far as to say that if you are avoiding naps, you are effectively teaching your body to avoid sleep. Don't do that. Try to move napping, sure, but don't be shocked if eliminating it has bad effects.

I learned recently that magnesium absorption through the skin is part of how epsom salt (MgSO4) baths “work”.

Also Sulfate bioavailability is why people take MSM for arthritis, so it’s a twofer.

How effective is cbti against the non-restful sleep component of chronic fatigue syndrome?

During these times I toss and turn all night and can't seem to fall asleep. I might also end up in some kind of near psychotic thought loops, where I tried to endlessly solve the current major stressors in my life. Or I may spend hours frantically and compulsively picking at acne on my face chest neck back and ass, in some kind of half asleep hell that I can barely escape. The affective experience is awful

Then after 8 hours of this finally I'm so exhausted that I can now sleep 8 hours. Hooray I just spent 16 hours in bed. Guess what I'm still f*** tired for the rest of the 8 hours I'm awake. And I spend those 8 hours in bed too sometimes because I'm too sick to actually leave the bed.

This idea that you can't stay in bed for longer than 20 minutes unless you can sleep is very challenging for someone who is already spending all day in bed because they're sick, and setting up this expectation, I've found, is a recipe for non-acceptance and self judgment.

Another thing that doesn't work so well about the cbti suggestions is that if I go to sleep only when I'm dying... I might not sleep for 2 days, because that can trigger a manic episode. I end up crashing after 48 hours or so - that's when I'm dying to sleep. Then I sleep 4 hours and do it again for 48 straight hours. A little bit terrifying right?

Instead the best thing I found was to accept that sometimes my sleep will be like this hellish nightmare, because of disabling chronic fatigue flare up and psychiatric issues. Giving myself permission to have awful hellish sleep nights seems like the honest best I can do - anything else seems to be gaslighting me and making me feel awful.

The problem with any kind of conscious cognitive technique, it seems, is that there are large stretches of time where I don't seem to have full conscious experience or control of my behavior. Given this and my propensity for mental OCD, I have had really negative effects from cognitive behavioral therapy in the past. Instead of letting me recognize and eliminate cognitive distortions, the CBT routines seem to add new forms of suffering rumination.

So I'm worried that cbti could have similarly aggravating effects for people who have underlying psychiatric issues. Note that the author did specify that the doctor worked to eliminate psychiatric issues from consideration before moving to CBTi. I don't think that will be enough to prevent people from trying to self help with cbti after reading this article... So I am noting here that if you have psychiatric stuff, your outcomes could be significantly improved - and potential dangerous bends in the road avoided - if you consult with a well-trained, well published, and highly experienced PhD in this field.