How to Get Sleep in Anxious Times With Dr. Donn Posner


Don't know about you guys, but my sleep has suffered at times quite badly during the last few months. Today's guest really got me thinking about this issue in a whole new way I. he normalizes the sleep problems. Many of us are having. If you're sleeping poorly right now, he says don't freak out. It's natural and normal. Second he has a whole bunch of tips for how to deal with insomnia. Some of which I had never heard before, and I'm already starting to operationalize my own life. His name is Don. Posner he's one of the leaders in the field of cognitive behavioral therapy for insomnia. Titles are founder and president of sleep, well, consultants and Adjunct Clinical Associate Professor Department of Psychiatry and Behavioral Sciences at Stanford University School of Medicine. Not only did done patiently answer all of my questions, but we also played him. Some listener voicemails from you guys. One last thing to say before we dive in here, you'll notice over the course of this week. That are episodes this week. Have a theme which we're calling primordial needs today. We're doing sleep. Wednesday it's sex, so it's fun week here on the show. Stay tuned for all of that I. IT sleep and on near here we go. Great to meet you and thanks for doing this. I appreciate it sure thing good to be here. You gave a talk recently. That got some attention. deservedly. We'll get now more attention now that we're putting you on the show about acute insomnia. Can you tell us what that means and why? You're worried about it right now especially. Let me clarify a couple of things. Let me maybe work backward. The best way to define acute insomnia is to define chronic or long term insomnia, which we in the field called insomnia disorder. And the way we define that is that a person is having trouble initiating sleep to begin with. Or they wake up in the middle of the night and can't get back to sleep. Or they wake up sort of at the end of their night and never get back to sleep, right? And so those are really three flavors of insomnia if you will beginning middle and end. We like to say chocolate, Vanilla Strawberry, and then there's neopolitan which is a mixed bag right so that's insomnia. If that is happening and we say what's problem with to sleep or staying asleep, it's if you take longer than thirty minutes to get to sleep on average if you are awake for some combination of thirty minutes in the middle of the night, or you wake more than thirty minutes earlier than your desired time. If that's happening three or more nights a week for longer than three months. And you have associated daytime symptoms, that's insomnia disorder and I want to underscore that last piece which is. Really, a twenty four hour disorder. It has to have impact on your day. For us to say that this is really an insomnia disorder problem. You have to have something like fatigue sleepiness. Concentration problems, performance, problems and so forth. So chronic insomnia is those symptoms more than three months. So now going back to your question about acute insomnia, acute insomnia is all of that. Less than three months when I give talks, and when I asked the audience how people here have ever had a bad night's sleep I know I'm going to get a laugh and one hundred percent of the hands go up. We've all had that experience. And all of that is normal nothing to concern ourselves about it, and we don't even talk about anything as diagnostic as acute insomnia until we get to at least three days. But then anywhere between three days and three months is considered acute insomnia, and that means that you're having those problems either initiating or maintaining sleep. And you may or may not have daytime symptoms yet. And it's usually due to some stressor, and we say anything from the Bio psychosocial spectrum. I now say to my trainees. You could probably open the dictionary. Put your finger down on a word and find something that causes insomnia. Whether. It's an illness physical pain a change in your environment, a psychological stress like stress at work tax time those sorts of things and I also hasten to add that. The Valence of that does not have to be negative. Right change is stressful so getting married and getting a new bed partner in your bed. Can Change Your sleep patterns. Having a child. Is a precipitate for an acute insomnia until you can get that kind of straightened away. The thought process is absolutely very much that that's a normal reaction distress. Maybe even a good one because. If we go back evolution narrowly speaking. Sleep is a dangerous activity. Right if you're asleep, you're vulnerable. It must be important for that reason because every species, does it. And so, it must provide very important function, but it's dangerous, so we always say that sleep is deferred when the lion walks into the mouth of the cave. and. Therefore, we could say that acute insomnia is adaptive. If, you understand so even now in our culture. It's adaptive in the sense that you're making changes. You're trying to deal with. Whatever's coming down the pike. But we always expect that. If you then adapt appropriately or the problem itself goes away, or you get on some medication or the stressor itself remits then we expect the acute insomnia to remit, and so all of that we consider to be normal, and it is for a smaller subset, but yet epidemic numbers that sort of gravitate into this chronic insomnia realm, which is where people like myself and my colleagues come in terms of helping people to treat that.

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