Ashley Mason

but that I've co-opted and I've moved into cognitive behavioral therapy for insomnia because it fits with the theoretical framework, is something called scheduled worry time. This sounds a little bit pedantic and silly, but hear me out. If a patient came to me and said, Ashley, I worry all day. I'm worried about all of these things. My life is just a constant ball of worry.

but that I've co-opted and I've moved into cognitive behavioral therapy for insomnia because it fits with the theoretical framework, is something called scheduled worry time. This sounds a little bit pedantic and silly, but hear me out. If a patient came to me and said, Ashley, I worry all day. I'm worried about all of these things. My life is just a constant ball of worry.

And I said, okay, I've got a solution for you. And it's two words. Ready? Stop it. That wouldn't work. It doesn't work. I take the opposite approach. Okay, this is really important to you. This is something you're doing all the time, all day. Guess what? What do we do with things that are really important to us?

And I said, okay, I've got a solution for you. And it's two words. Ready? Stop it. That wouldn't work. It doesn't work. I take the opposite approach. Okay, this is really important to you. This is something you're doing all the time, all day. Guess what? What do we do with things that are really important to us?

We schedule them. Exactly. Back in the day of paper calendars, this felt like a different exercise. Now people get out their phones, but I have them get out their phone or whatever and say, all right, we're going to schedule a worry time and it's going to be an hour a day for the next seven days. It is non-negotiable.

We schedule them. Exactly. Back in the day of paper calendars, this felt like a different exercise. Now people get out their phones, but I have them get out their phone or whatever and say, all right, we're going to schedule a worry time and it's going to be an hour a day for the next seven days. It is non-negotiable.

I may or may not schedule an email to go out to you at the end of that time and you have to go and reply to it and tell me what you did. And what we find is that when people work with this during the day, it does two things. The first is, let's say it's 9 a.m. and you are trying to do something in your life and instead a worry pops up.

I may or may not schedule an email to go out to you at the end of that time and you have to go and reply to it and tell me what you did. And what we find is that when people work with this during the day, it does two things. The first is, let's say it's 9 a.m. and you are trying to do something in your life and instead a worry pops up.

You can actually think, oh, okay, I don't have to deal with this now. I'm going to write this down because at 4 o'clock I've got scheduled time to deal with this. So that way you're uncluttering the rest of your day by moving all of the worry into that scheduled time.

You can actually think, oh, okay, I don't have to deal with this now. I'm going to write this down because at 4 o'clock I've got scheduled time to deal with this. So that way you're uncluttering the rest of your day by moving all of the worry into that scheduled time.

I'd say that probably between a third and half of my patients who come in with insomnia, they've got some bad sleep stuff for sure. But for some of those people, it's a primary anxiety disorder and sleep is suffering also. Whereas other folks, it's primary insomnia and that's driving them anxious.

I'd say that probably between a third and half of my patients who come in with insomnia, they've got some bad sleep stuff for sure. But for some of those people, it's a primary anxiety disorder and sleep is suffering also. Whereas other folks, it's primary insomnia and that's driving them anxious.

But to rewind back to your earlier question about the middle of the night versus the beginning of the night. So the other thing that scheduling worry time does, besides uncluttering your whole day, is it helps you get it done during the day so that when your head hits the pillow, it's not there. Oh, I already worked on this.

But to rewind back to your earlier question about the middle of the night versus the beginning of the night. So the other thing that scheduling worry time does, besides uncluttering your whole day, is it helps you get it done during the day so that when your head hits the pillow, it's not there. Oh, I already worked on this.

And also the knowledge, oh, I have time set aside tomorrow to work on this or to think about this. So I don't have to do that now. Cognitively, this all makes sense. And you would maybe think you can think your way out of this, but you can't. You actually have to try it. And I've done this with a lot of people.

And also the knowledge, oh, I have time set aside tomorrow to work on this or to think about this. So I don't have to do that now. Cognitively, this all makes sense. And you would maybe think you can think your way out of this, but you can't. You actually have to try it. And I've done this with a lot of people.

I've done this with doctors, police people, people from all walks of life can really find this valuable. The other thing when it comes to falling asleep at the beginning of the night versus the middle of the night is that there's sometimes low hanging fruit that we can think about. Just not drinking very much fluid with dinner and after dinner is huge.

I've done this with doctors, police people, people from all walks of life can really find this valuable. The other thing when it comes to falling asleep at the beginning of the night versus the middle of the night is that there's sometimes low hanging fruit that we can think about. Just not drinking very much fluid with dinner and after dinner is huge.

And also throwing an electrolyte tab in there can really help. Granted, it's got to be the right osmolarity and everything else, but there are ways to find this. Don't slam Gatorade at night. That's not what I'm suggesting. But just throw a noon tab or whatever element, whatever... electrolyte replacement, I've had some male patients go from waking up three times in the night to one time.

And also throwing an electrolyte tab in there can really help. Granted, it's got to be the right osmolarity and everything else, but there are ways to find this. Don't slam Gatorade at night. That's not what I'm suggesting. But just throw a noon tab or whatever element, whatever... electrolyte replacement, I've had some male patients go from waking up three times in the night to one time.