Katie Fischer Certified sleep consultant for children, adults and families for Crouch End, Muswell Hill, Highgate & North London

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Just being able to talk to a professional, who specialises in sleep was super valuable to me

Adult Coaching

If you are seeking tailored advice and support with your own sleep challenges, I offer two options:

  • 1-hour coaching calls with further follow up available by email or phone
  • Cognitive Behavioural Therapy for Insomnia (CBT-I) treatment across 6 sequential coaching sessions.

How I can help you. profilek38

Only 5% of adults report they have never experienced insomnia, and it is a very common and normal reaction to stressful life events.

A standard 1-hour coaching call with me would suit adults with less complex sleep issues, those experiencing intermittent or recent difficulties falling or staying asleep or those looking for some guidance on a particular area, such as how to decompress at the end of the day or adjust sleep scheduling, assess and manage underlying medical conditions that affect sleep quality (sleep apnoea, restless legs, PLMD etc) or effective relaxation techniques.

My CBT-I coaching program would suit adults who are struggling with longer-term poor sleep or chronic insomnia, which may be affecting their daily functioning with irritability, fatigue, drowsiness or impaired performance, and leading to negative thought cycles night to night.

Sleep problems I can help you with include:

  • Sleep onset insomnia
  • Sleep maintenance insomnia
  • Frequent awakening or sleep that is non-restorative
  • Daytime fatigue
  • Nighttime anxiety or a busy mind when trying to sleep
  • Stress-management and winding down before bed
  • Sleep challenges related to pregnancy or menopause
  • Delayed sleep phase
  • Early waking
  • Restless legs
  • Support with snoring or sleep apnoea that is affecting your sleep or a bed partner
  • Nocturia (frequent night time urination)
  • Dietary adjustments to support healthy sleep
  • Parasomnias

Common behaviours underlying insomnia:

If you are having trouble sleeping, here are 4 common behaviours to be aware of, which can begin to create a cycle of poor sleep and turn what may have been a transient period of insomnia, into something more sustained and chronic.

1. Spending longer in bed than you can actually sleep

When we’ve had a series of nights of poor sleep, it’s a natural response to try to ‘catch up’ by going to bed earlier, lying in, or doing both at either end of the day. For those who tend to have a lower sleep need or strong wakefulness system, this may not lead to consolidating more sleep – it may just lead to more time spent in bed awake, building the connection to the bed as a place of wakefulness and difficulty sleeping. Scheduling your sleep around your individual sleep need is key, so that you maintain enough prior sleep pressure to fall asleep easily. The longer you are awake, the more that you increase adenosine, which is a neurotransmitter that helps regulate sleep. Compressing your hours spent in bed will also deepen your sleep and reduce fragmentation.

2. Trying to force sleep

When we can’t get to sleep at the beginning of the night or during the night, intuitively we’re more inclined to remain lying in bed and keep persevering with trying to sleep, than get up, do something relaxing to detract from not sleeping and try again when we feel cues of drowsiness. As we lie in bed awake, we begin to mentally coach ourselves, trying to force sleep, becoming increasingly aware that time is ticking away. However, often the opposite happens – the more we actively try to make ourselves sleep, the more we become tense, frustrated and anxious about the fact that we are not sleeping, which induces a stress response.

3. Focusing on negative sleep thoughts

Trouble sleeping often goes hand-in-hand with experiencing a busy mind or pervasive, anxious thoughts in bed. Typically, you may find that as you lie in bed awake, you’re worrying about how tired you be will the next day, how you will cope with managing work, childcare or other demanding tasks, how low you will feel or how a poor night of sleep will affect your behaviour. Often our thought processes around being fatigued and the consequences of lack of sleep actually make us feel more stressed, low and irritable than any tiredness we experience. It’s really important to remember that sleep is just one element of our sense of wellness. Overactive brains can also sometime lead us to underestimate how much we're actually sleeping. In one study, just over 40% of patients with insomnia understimated how much they slept on a given night by more than 1 hour.

Have you survived nights of insomnia before?
Have you slept well but still had negative outcomes the next day?
Is your daytime functioning only affected by your sleep?
Is sleep always bad, or are some nights better than others?
Are you actually achieving more hours of sleep on average than you think?

Learning to switch negative sleep thoughts to positive ones and induce relaxation again to turn off a stress response are key elements of CBT-I.

4. Lack of exercise

Energy expenditure to get your heart rate up and tire out muscles is a brilliant sleep tool, which doesn’t involve any active sleep strategies. When we’re tired and sleep is disrupted, exercise is often the first thing to go from our daily routines. However, it is really worth motivating yourself to get moving with some moderate to intensive activity after a poor night of sleep, because it helps to build sleep need again for the next night, as well as release endorphins that trigger a positive mindset.

We can’t force sleep, but can take control of our exercise routines, and set manageable targets to increase frequency and intensity of activity in our week to support more restful sleep.

How I can help you. CBTI

Clinical research has shown CBT-I to be the most effective first-line treatment for chronic insomnia, improving sleep in 75 to 80% of insomnia patients, as well as reducing or eliminating sleeping pill use in 90% of patients. More effective than sleeping pills in three major studies, this drug-free therapy has no side effects, and maintains long-term improvements in sleep.

The combination of worry about sleep and maladaptive sleep habits can transform a brief period of insomnia into a case of learned chronic insomnia. I will teach you evidence-based techniques, based on Dr Gregg Jacob's CBT-I groundbreaking research at Harvard Medical School, that you can use at home to improve your sleep. CBT-I achieves results because insomnia can only be effectively treated by addressing the underlying causes – negative thought cycles and habitual behaviours – which play a primary role in perpetuating insomnia, and can be learned and unlearned.

The behavioural element of my program supports you in establishing a positive association between your bed and successful sleep, which means that falling asleep and staying asleep becomes more natural and automatic, and more reliable sleep patterns are achieved from night to night.

The cognitive restructuring element involves education on individual sleep need, effects of sleep loss and subjective estimates of sleep based on a variety of studies involving insomnia patients, which challenge common misconceptions publicised by the media and some sleep scientists. Through sequential sessions, we work on shifting negative sleep thoughts to positive ones, that are more accurate and adaptive.

The mindfulness element involves understanding what happens to the body when we experience a stress response, and how daily activation of psychologically-based stressors (family, relationships, money, work, the pandemic etc) can lead to elevated nocturnal stress hormones, frustration and wakefulness, further stress response and a resultant insomnia cycle of negative sleep thoughts and low mood. I will teach you how to invoke a counterbalancing relaxation response that you can use to take a daily pause, as well as achieve relaxation in bed.

The benefits of improved sleep, less sleep-related anxiety and a holistic review of lifestyle habits that impact sleep quality include:

  • feeling more organised with more control over your life
  • having more energy
  • improved physical and mental wellbeing

My CBT-I program is also suitable if you wish to reduce or eliminate sleep medication or as an adjunctive treatment if you are receiving drug therapy to manage depression or anxiety or working with a therapist.

Poor sleep is not something that needs to be endured

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