By finite thinker, I mean you look at things as black or white or try to understand and/or define everything. You don't appear to have any gray areas or be willing to let things slide. Just my observation.

What do you do in the few hours before trying to fall asleep ? 20 minutes is not enough time for many to get settled for sleep. You should never lay in bed for 2 hours trying to fall asleep. If you allow your brain's sleep cycle to function without interruption, you should be falling asleep within 20 minutes at the most.

Have you tried using foam ear plugs to help with the ambient sounds ? How about music or other sounds to block ambient noise ?

Can you get comfortable quickly and easily when you get in bed ?

I need soft pajamas, very carefully selected sheets, a warm bed, a carefully selected pillow, etc. so when I get in bed, I can quickly get comfortable. I use an electric mattress pad to prewarm my bed and turn it off when I get in bed. Those few minutes of cool sheets will often be a problem so a prewarmed bed solves that problem.

If I am not asleep within 20 minutes, I get up and sit in my recliner and do something mundane with the lights down low until I feel sleepy again. You should not be getting in bed until you are sleepy. You may need to get up earlier so you feel sleepy earlier.

I also take 600 mgs of gabapentin to help my nerves (mind and body) let go.

A neurorehab specialist expressed how important quality sleep is to the struggling brain. The brain can only detoxifies during slow wave sleep. If you are not experiencing REM sleep, slow wave sleep is not happening. So, finding a way to get good quality sleep in important.

When I am not getting quality sleep, my day will be a mess including foggy brain and the rest.

btw, I struggle with Central Sleep Apnea sometimes. When I have CSA episodes, my days are miserable. My CSA is due to inflammation in my upper neck. I know what a day feels like when my brain has been starved of oxygen.

Regarding slowed processing speed. I have clinically diagnosed slow processing speed. It is not something that can be self-diagnosed. Mine is somewhere between 10% to 25% of what it should be, depending on the scale used. But, for me it is more of an imbalance. The occipital lobes are at 10 to 25% of normal but my frontal lobe is at 4 times normal. So, I have a serious imbalance between occipital (primary sensory processing) and frontal (cognitive) that is like trying to read a license plate of a car doing 5 mph as you drive past at 60 mph.

But, regardless of my dysfunctions that include seriously poor visual and auditory short term memory, I can still perform at high levels. I just do things a bit differently.

I know what my diagnosed dysfunctions are but I only use that to accept that when I have a struggle, not to try to push through but instead to slow down and use work-arounds.

Research shows that those who learn to use work-arounds rather than push through do much better.