Ericc,

I agree with the need to learn good sleep hygiene. An added point for you is to purposely expose your mind to stimulations and experiences in the last hour before going to bed that replaces your head bump anxiety with entirely different thoughts.

It sounds like you are experiencing a PTSD like form of OCD. It takes effort to replace those thought patterns. It is a primitive thought level that is part of your mind's survival system. At this point, it is the beaten path of thought through your mind. You need to establish a better, safe path of thought.

You need to treat your mind like it is a toddler or puppy. It is predisposed to act impulsively due to the repeated anxieties. Telling your mind "No, Don't think that way." does not work any more than telling a toddler or puppy No. Replacement behaviors work better. In some cases, this is called CBT, Cognitive Behavior Therapy. That would be used for reactions to thoughts/events.

When you are asleep, you can't tell your mind NO or use CBT. Instead, try to replace the thoughts/behaviors before.

When I had dogs, they liked to bark. They would not respond to "No bark." I taught them to whisper. When they barked, I would replace that behavior with a command to "Whisper." Their minds switched to whisper. No problem. This replacement behavior also often works with toddlers.

You can use this with your brain. Find a stimuli that is not triggering but is able to grab your attention. It might be a music playlist, A video, a book to read. Full your mind with these non-triggering images, sounds, and words during the last hour before bed. Have your bedtime tasks done before settling down with this so that when you get in bed, nothing breaks your stream of thought related to the last stimulations you experienced.

I'll explain how I use this. 20 years ago, my mind would not let go of the days events and just relax. I found a few videos that I would watch as that last stimulation. I watched Celtic Woman performances hundreds of times as I prepared to get a good night's sleep. My mind had their music and dancing playing. I learned to get great sleep. Before I learned this, I dreaded trying to sleep. I had stressful dreams and never got a good nights sleep.

After I over came by early struggles, I not longer needed to listen to "The Girls" to be ready to sleep, BUT. I still needed to use medication to help me sleep as my body liked to jerk and react to every tactile sensation and heard every sound. I took gabapentin for 22 years before bed. It helped my mind ignore those tactile sensations.

I recently decided to stop taking gabapentin after realizing it might be causing a side effect I did not like. 4 weeks ago, I stopped cold turkey. I entered gabapentin withdrawal and the miserable insomnia it caused. Now, I heard and felt every sensation and would get stuck paying attention to them. I was not falling asleep until 3 or 4 am.

So, I used replacement behavior to overcome this. I started listening to comforting music 30 minutes before going to bed. For me, a long time favorite has been Diana Krall, The Look of Love album.

Now, when I get in bed, my mind is replaying the melody and even words of those songs. It has something comforting to focus on and is able to ignore the ticking clock, my wife's breathing, the cool sheets, and such.

I know others in the TBI community who need to use these techniques to go to sleep, even 15 years after their TBI.

Videos are best in the beginning because they occupy both auditory and visual sensory channels. Having a small library of videos or YouTube channels can fit the need. Repeats can work. I watch How To channels, 4x4 channels (MischiefmakerTV), towing and recovery channels (Matt's Off Road Recovery), sailing channels, and more. They all do not leave me with any triggered thoughts.

It takes work and experimenting to find the substitute stimulation but the work pays great benefits. My sleep is so good, I usually wake up naturally after 7 hours.

It is important that you know you do not have other issues. I have Central Sleep Apnea. It can also cause stressful sleep and even nightmares. I have it under control most of the time. If I have a nightmare about being trapped underwater and struggling to get to the surface, I had a apnea episode. I know I need to correct my sleep posture.

A FitBit or other biometric watch can track some of your sleep behaviors.

I hope this helps.

My best to you.