next »

[drnobody]

Oh help! I know there have been other posts about this, but they seem to be more health oriented, and I just plain have chronic insomnia. Period. I remember being 7 and not sleeping. If I'm happy I think about the good stuff; if I'm depressed my mind races. Sometimes I think it's worse when I am not stressed or unhappy. I have a longstanding Ambien prescription but sometimes that doesn't work (like this week!). Of course it's not supposed to be taken every night but I just don't sleep. Unfortunately, if I don't sleep at least 7.5 hours I am worthless. So my post is partly to cry to someone, but also to find out what other chronic insomniacs do. I don't mean if you have a health issue, but just if, like me, it's just a lifelong condition. I have had every test in the world, done all the relaxation, caffeine, etc. Some works a bit. What else do you take? I've heard about Trazadone--better or worse than Ambien. I really do okay with Ambien, as long as I can convince a doctor I need refills. Is there any hope? Anything else I don't know about? Besides this, I am a picture of health. But this week I want to pull my neurons out at night!

[walkingtree]

I used to have insomnia, but not anymore. Take up a rigorous exercise and it will exhaust your body. Swimming, diving, running, hiking, and weightlifting will help you get over it.

[hegemony]

I hear you.  I have battled chronic insomnia for years.  Along the way I've discovered two things.  One is that there is a kind of pseudo-insomnia that afflicts people like us.  Normally when you go to sleep your mind drifts off into la-la land and when you wake up you know you were asleep.  But with some people in some circumstances, your mind keeps racing in that bored conscious state that you have when you're awake.  And an hour later the alarm might ring and you think, "I didn't sleep a wink for that last hour."  But you were actually asleep.  You can be dreaming that you're awake and bored.  Jeff Warren's fascinating book The Head Trip is very good on this.

One way I found this out is by buying a Zeo, which is that little device you wear on a handband that reports on your sleep.  It comes with a little clock monitor thing (with lights you can helpfully turn down all the way to off, and a choice of wake-up sounds).  In the morning you press a button and you see the read-out of your entire sleep patterns.  What I found out (and this is point 2) is that I can manage with over 7 hours and 20 minutes of sleep, that after 7 hours and 45 minutes I feel pretty good, and that when I get 8 hours and 10 minutes I feel great.  That's very useful because say I wake up at 4:00 am and I can't go back to sleep.  First, I can check whether this feeling is real.  Am I genuinely lying there not sleeping?  Sometimes I actually am getting quite a bit of sleep, even though it feels boring and wakeful.  And then I can see how far I have to go.  If I'm at 7 hours, I can get myself to lie back down and go for that extra 20 minutes that will guarantee I feel okay.  If I didn't have that info, I'd just despair and get up.

Your mileage may vary.  Hope this explanation has been halfway clear.  These two adjustments have made the difference for me.

[melba_frilkins]

If I'm happy I think about the good stuff; if I'm depressed my mind races. Sometimes I think it's worse when I am not stressed or unhappy.

This is weird but...When I find myself with the tendency to have a racing or wandering mind at night, it helps if I give myself "permission" to think about a single problem or scenario, something that is interesting to me. I focus on thinking about that one thing and that one thing only. That seems to give my wild mental energies an outlet and they eventually wind down. If I try to actively relax and fight my desire to have an active mind, it only backfires.

[spectacle]

One of the previous Insomnia Lamentation posts was mine, nobody; I've been taking Ambien nightly for almost a year, and it makes me miserable that I can't sleep on my own.

My doctor is weening me off (she's furious that I've been depending on it for so long) and I've been doing every possible thing I can think of to sleep better without it. All The Usual Suggestions are helping - I'm able to sleep 7.5 hours (that's how much I need) on a 5mg dose. She's moving me to a 2.5mg dose next, and I'm trying not to think about it.  I can already feel myself getting anxious about not being able to sleep.

But yeah, I'm right there with you.  I've been battling insomnia for years.  It really, really stinks. 

I'm going to see if I can get a Zeo, hegemony.  It sounds like it would really appeal to my hyper-logical side ("I know that I got 7.5 hours of sleep, therefore I have NO REASON to be tired!").

[drnobody]

Walkingtree, the more vigorous my exercise, the more it wakes me up. UGH!
Hegemony, Thanks, I am looking that up. It would be helpful to know! Falling asleep is my issue but once I do, I'm good; just can't shut down. Plus I LIKE late nights and teach early so it messes me up more. But I agree with Spectacle, that if I could convince myself I had more sleep I could help work on my mind, or at least play games with it.
Melba, again, if it's just what I think about, it doesn't work! I don't know WHAT gene, I got, but I'd like to send it back!
Spectacle, I'm so sorry. Seriously, I'd be changing doctors. Ambien doesn't do much to me outside make me sleep. Probably since all medicines seem to take a double dose to work well. I'm pretty small, but me and medicines are a crazed mess. Sometimes I can do 5mg but I can't even imagine 2.5. Very often I take half a 10 mg plus one OTC Sominex. That usually does it. In some ways I'm okay with it. It works, doesn't affect my daytime activities and costs me $10 for a three month supply, but I just wonder if there is something else out there that's lighter, or works or some other thing I've never considered. It sounds like I am just one of those whose brain doesn't stop. Yay, me!

[merinoblue]

Chronic insomniac here (sleep onset insomnia, but also, early morning awakening).  I had a long sleep latency in childhood (up to an hour every night), but always thought that was okay, because I was just excited about the day's events.  I was 13 when I had two experiences that only recently made me realize that I had a sleep problem back then. I never thought of it that way at the time. After a series of difficult life events, I developed total insomnia a number of years ago. I stopped sleeping completely, up to 7 nights in a row at one point.  (And no, I didn't have sleep state misperception: I really did not sleep even a minute during the night).

I joined an insomnia forum, found a great community of sufferers, and discovered...insomnia comes in many shapes and sizes.  Yes, there's sleep latency, early morning awakening, terminal insomnia, anxiety-induced insomnia, depression-related insomnia, medication-related insomnia, menopausal-induced insomnia, learned insomnia, insomnia during manic episodes in bipolar disorder, sleep apnea, PTSD-related insomnia, circadian rhythm disorders, shiftwork insomnia...but even within these broad categories, everyone's experience, and what works, varies tremendously. 

When I had total insomnia, nothing worked, not even exercise.  (Exercise made it worse: it dumped more adrenaline into my system and increased my arousal, as you've experienced.)  Let's just say I tried everything under the sun. I finally resorted to medication (Zopiclone, which is an isomer of Lunesta), and learned I could take just a tiny amount to medicate myself to sleep.  Over a number of years, the stress response lessened, to the point where it's rare for me to have to medicate to sleep. 

What works for me is now what worked for me before I developed total insomina: lots of exercise. By that, I mean, if I get a vigorous 45-minute walk during the day, I'll fall asleep eventually (I will probably have a very long sleep latency for the rest of my life, of at least 45 minutes, and up to two hours), and wake up refreshed.  Without that exercise, I struggle to fall asleep, and to sleep soundly.  But it's working because the arousal of my nervous system is back to normal levels.

The synthetic hypnotics (Ambien, Zopiclone, Lunesta, etc.) all have different half-life profiles. If Ambien is not working for you (and it didn't work for many on the forum I habituated), try another.  It sounds very much like, probably for genetic or other organic reasons, you have a strong arousal system, while your sleep system is just fine. (That was my experience). You need something to shut down or taper off your arousal, so your sleep system can kick in. 

Watch for the insistence that your insomnia is all learned, and that you just need some CBT to treat it.  For most people who develop transient insomnia that isn't related to depression, illness, medication, or a mental illness like bipolar disorder, CBT is considered the standard treatment for insomnia. Randomized controlled trials have shown it is as effective or more effective than medication. (There is also sleep retraining to increase sleep efficiency. Again, this is effective for people who have learned insomina). There is a growing (slowly, reluctant) appreciation amongst psychiatrists and even GPs that some insomnia has a genetic basis and cannot be treated with CBT.  And even if it's not genetic, but it's related to some other overarousal trigger, retraining your thinking is not going to bring arousal levels down by themselves.  The CBT approach is overused, in my opinion, and doctors often don't probe beyond anxiety, depression, or sleep apnea, to find the root.

If you'd like the URL for the insomnia forum, you can PM me.  Best wishes.

[bwwm1]

I've developed insomnia in the last few years. It got to the point where I wouldn't sleep entire nights, which is pretty horrible as you all know. But it's much better in the last little while. Regular exercise is essential for me. If I don't do it a few days in a row, I get insomnia. Other things like not working very long hours and relaxing by reading before bed helps. I also sometimes have to take a small does Zopiclone, but not too frequently. This works perfectly for me. Since I've regularized my routine and with the occasional medication, I basically don't have it anymore, and that's an enormous relief. I hope you find something that works for you.

[itried]

I'm a life-long insomniac also. In fact, I'm up now (5 AM EST) because I finally got out of bed at 4 AM after waking up at 3:30 and not being able to fall back asleep. I have a lot going on at work this semester, so when I get up to pee, I get back in bed and start thinking of everything I have to do.

I'm a regular exerciser, so that does help in general, but not always. Various things have worked for me. Sometimes I take two Benadryl pills, and those knock me out cold. When I'm really, really anxious, I take Lorazepam; during some really distressing life circumstances (e.g., big break-up), I've absolutely needed to medicate myself to sleep or else go crazy from lack of sleep and anxiety. Sometimes it helps to just get up in the middle of the night, eat a piece of buttered toast and read a chapter in a book; that can do the trick occasionally.

Insomnia is miserable. When I can't sleep, I lie in bed thinking obsessively, "What will work now to get me asleep? What will work now to get me asleep??" That obsession is almost enough to keep me awake.

It's 5:14 now, and I'm just going to get dressed and go into work. That way I'll at least get some things done, and I can kick out right after my 2 PM meeting.

[merinoblue]

Reading Itried's post, I'm remembering that when I wake up in the night and can't return to sleep, a bite of carbs can conk me out (e.g. a banana or a bowl of cereal).

[itried]

That interesting merinoblue, that carbs sometimes work for you too. I used to eat cereal, but now I don't buy much milk (I can't drink it all before it goes bad). The important thing is that whatever I eat in the middle of the night, it has to be very easy to digest, so I don't feel too full or have trouble digesting when I lie back down.

[merinoblue]

Try half a banana, if you find those easy to digest.

[ucprof]

I have this problem.  I don't have trouble falling asleep but I wake up after 4-5 hours and can not get back to sleep.

In general helpful things for me:

(a) absolutely no drugs aimed at sleep.  You will get dependent and then you really have trouble sleeping if you try to withdraw. 
(b) try not to nap during day.
(c) cold bedroom.  Preferable lower than 68F.  If higher than that put on a fan aimed right at you.
(d) Don't work on serious stuff into the evening.  Don't watch exciting movies right before bedtime.
(e) exercise during day but not too much because it can overexcite you with adrenaline.
(f) no caffeine ever.  And watch the decaf coffee as well and watch the chocolate.  When having problems go cold turkey on all products with even a small amt of caffeine or chocolate.
(g) benadryl can sometimes keep me awake instead of sleepy.  However zyrtec which is now over the counter makes me drowsy sometimes so much so I am tired during the day as well.  But I sleep at night.  That said I only take zyrtec for allergies I do not take it as a sleep aid, ditto for benadryl. But I am happy to get a side benefit if I am having allergy problems.
(h) remove all distractions from the bedroom including other people and pets, as needed.
(i) do not set an alarm.  Try to arrange your schedule so that if you are up in the middle of the night you can make up the sleep in the morning.  Not everyone is able to do this but if you can set your schedule somehow to give you that extra time it may be well worth it.
(j) stay hydrated during the day.  dehydration can contribute to insomnia at night.

[crumpet]

Thanks UCprof...

I'm experiencing a bout of insomnia at the moment. I go through these phases when really stressed at work. Your post reminds me of a bad cycle I get into: insomnia, coffee to make it through the day, stress, insomnia. I think I need to try to cut out the coffee again, even though I only drink a small amount of it each day.

[ucprof]

Thanks UCprof...

I'm experiencing a bout of insomnia at the moment. I go through these phases when really stressed at work. Your post reminds me of a bad cycle I get into: insomnia, coffee to make it through the day, stress, insomnia. I think I need to try to cut out the coffee again, even though I only drink a small amount of it each day.

Ouch that's a nasty vicious cycle.  You might have to sacrifice a "no caffeine" zombie day in order to sleep that night but the next day you will be very happy.  BTW some things that help wake me up without caffeine:
shower in the morning, exercise in morning, orange juice or fruit.  A little later in the AM you can have a caffeine free soda (e.g. coke) it might give you a sense of caffeine but it has absolutely no caffeine unlike decaf coffee.  Also try to give yourself some slow wake activities rather then waking up and rushing off to work in the AM (if schedule permits).