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gtarman

Advice on terminal insomnia (wake up and can't fall back asleep)

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Hey SABers. Thought I might ask the SAB brain trust for some advice/tips on this if anybody has any - these last few weeks I've been experiencing relentless terminal insomnia - in this case terminal meaning "at the end" rather than life-threatening. Basically it's just the technical term for the type of insomnia that occurs when you wake up after 4-5 hours of sleep and then you can't fall back to sleep again.

It's really odd - my mind just starts racing full-speed again as soon as I wake up, like it never even went to sleep. I still lie in bed for the rest of the night, but I just have this wakeful energy that keeps me alert and prevents me from falling back to sleep.

I've been thinking that maybe all of a sudden my body only needs 4-5 hours of sleep...although that seems a bit far-fetched seeing as previously around 9 hours was more the standard. But I don't feel horrendously tired during the day usually. But I do often feel drained and burnt out...my stress levels are chronically high, which is just a presently unavoidable product of my current and ongoing life situations....but I'm thinking a lack of good sleep might be compounding that problem.

Thoughts? Advice?

Cheers!

Gman

Edited by gtarman

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If you don't feel too tired then I would just get up. I think the worse thing you can do is to lie in bed getting streesed out about not being able to fall asleep. And besides, there's shit to be done bro! Channel that wakeful energy into something creative. Activity might take your mind off whatever you are thinking about that's causing you to stay awake.

Edited by Alice
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Hav a geez at these two links.. I think you're brain is probably telling you exactly what you need - segmented sleep

http://www.bbc.com/news/magazine-16964783

^

"Today, most people seem to have adapted quite well to the eight-hour sleep, but Ekirch believes many sleeping problems may have roots in the human body's natural preference for segmented sleep as well as the ubiquity of artificial light.

This could be the root of a condition called sleep maintenance insomnia, where people wake during the night and have trouble getting back to sleep, he suggests.

The condition first appears in literature at the end of the 19th Century, at the same time as accounts of segmented sleep disappear.

"For most of evolution we slept a certain way," says sleep psychologist Gregg Jacobs. "Waking up during the night is part of normal human physiology."

The idea that we must sleep in a consolidated block could be damaging, he says, if it makes people who wake up at night anxious, as this anxiety can itself prohibit sleeps and is likely to seep into waking life too."

http://en.m.wikipedia.org/wiki/Segmented_sleep

The theory being that we have evolved to sleep in two 3-4hr segments over the night with a period of wakefulness inbetween, and the rise of the industrial revolution introduced the norm of uninterrupted sleep to increase workers endurance and productivity.

"According to Ekirch's argument, typically individuals slept in two distinct phases, bridged by an intervening period of wakefulness of approximately one hour. People also used this time to pray and reflect, and to interpret dreams, which were more vivid at that hour than upon waking in the morning. This was also a favorite time for scholars and poets to write uninterrupted, whereas still others visited neighbors, had sex, or engaged in petty crime."

"A case has been made that maintaining such a sleep pattern may be important in regulating stress."

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That's a tough one as a lot of insomnia treatments help with falling asleep which doesn't seem to be your problem. You could try a short course of Temazapam to try to re establish a sleeping pattern. Restavit is available over the counter at pharmacies, maybe even just start with half a tablet as 1 - 2 tablets can be a lot for some people. On the other hand prescribed dosage of Temazapam is generally to little, look to other countries dosage if using this. Melatonin may be another thing to look into. The reasoning for meds is if you get used to waking at this time it can be hard to stop. You may be able to use these medications and set your bed time and alarm for the morning and take a month to normalize the way you sleep.

try deep breathing techniques to help fall back to sleep

If you smoke heavily nicotine withdrawal can cause the body to awaken after a few hours of sleep. Also if you drink alcohol before bed or eat a lot of sugar, blood sugar level drops can also cause the body to awaken

A dark room, exercise, avoidance of stimulants, healthy diet and deep breathing ( as if air is passing right through the abdominal) can help a lot. Oh and don't think about the things stressing you out. I know it seems obvious but if you find yourself thinking about it at night just remember there is nothing you can do in about it bed and by stopping your sleep you will be less effective at dealing with your problems in the morning.

Edited by rigger
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as ceres said, just go with it. waking up for some moderate activity in the middle of the night is probably more natural than forcing yourself to get 100% of your sleep requirements in one session.

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Thanks for the suggestions guys.

@Alice, I may experiment with just getting up and using the time..although I have a feeling the reason I've not been horrendously tired during the day (only drained) is because I just rest lying in bed for the remainder of the night. I don't let it stress me out too much - my previous experiences with onset insomnia got me skilled in managing that sort of self-talk.

@Ceres (side-tangent: why is your name not bogfrog again yet?! :P) and TI: That sounds plausible in ways...and I know Timothy Ferriss has found in his sleep experiments that a 5-10 minute waking abut 4.5 hours into sleep seems to dramatically increase the level and quality of his restorative REM-phase sleep, so there may well be some merit to the idea. I just don't think it's my natural state based on experience - this has only been happening in the last few weeks, and in the years and decades of my life prior I've found myself naturally sleeping (and wanting to sleep) right on through to about 9 hours.

I feel like it may be a chronic stress thing - with the stress hormones telling my body it has to be alert and in survival mode all the time, which would reduce sleep to a bare minimum. The annoying thing is I'm doing all the stuff rigger talks about that would seem like the answer: dark room, exercise, avoidance of stimulants, healthy diet and deep breathing, relaxation exercises to quiet the mind etc.

But it seems like the stress has gotten into my bones and become a physiological thing that I can't seem to influence :-/ Re:drugs, I used to use Restavit, although sometimes up to 4 tablets still wouldn't put me down. Plus doxylamine succinate is actually a psychotic, and it took me a while to realize that taking it was majorly screwing up my mental wellbeing.

Edited by gtarman

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that sucks man. you're being crushed in a pincer between stress and poor sleep. you need some kind of strategy for both. stress is always avoidable for part of the time. stressful activity might be unavoidable but stressing about it after-hours is just lack of mindfulness (and i'm not singling you out, we all lack mindfulness especially during stressful times).

i reckon you should just roll with this and roll straight out of bed at midnight/whenever and occupy yourself until hopefully you feel like another sleep because seriously, i don't believe a single person in the history of the earth hasn't benefited greatly from a full 8 or so hours worth of sleep per day.

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Reading your reply that you have always slept fairly well and this has only been happening for a few weeks I wouldn't be too concerned yet.

Do you find you have trouble falling asleep also? Do you find sometimes when you wake you think about what is causing stress at some point? If you wake with an active mind generally it will slow over an hour but maybe over that hour you at some point think of what is causing stress and this is prolonging your wakefulness.

Is it extra daily/regular stress or something more?

Unrelated, I have also seen another therapy which involves getting up at the time you wake and keep doing so until you can sleep the whole night. Don't alter the times you sleep or wake to compensate. This may not always be appropriate depending on your plans for the days you are doing this.

Regarding medication Melatonin may still be worth a look into. Doxylamine succinate isn't really something I would recommend increasing dose with. 100mg is a fair bit! and can cause psychosis at these doses. I guess it's more intended to calm but wont knock you out. It's long half life also presents problems at these doses. You may not find the same symptoms with a higher dose of Temazapam based on those recommended in other countries (if initial dose is ineffective) but both these effect sleep quality to some extent and aren't a long term solution.

Edited by rigger
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hi gman :)

if it isn't really causing you dramas in your waking life ie tiredness/irritability etc i'd just go with the flow and listen to your body talk or body clock or yo rhythm ....whatever you want to call it. I've been a shift worker for years and years and i rarely sleep for more than 4hours at a time but sometimes can multiply those 4 hour blocks 4 times in 48 hours.

If it starts to become a problem , seek professional advice before you become a blithering mess thats incapable of stringing two coherent thoughts together :(.

What's changed in your life that has affected your sleep pattern........diet change, family/relationship shenanigans ,work stress(or lack there of), a sudden abstinance of something? these would be the general starting points for trouble shooting your insomnia.

Always try to keep your bed for sleeping (and ofcourse some hanky panky :wink: ) but the point is about giving your body clear signals not to misinterpret the bed for a general lounge spot. such things as getting used to just lying around in bed all the time eating, or reading or whatever can misadvertantly muddle up things in your subconscious............not wanting to get out of bed is a sign of depression onset(but tha's a whole lotta other stuff there).

maybe some valerian can help?

>Look, i'm sure you being a clued in bloke, that you'd know all of these things - so my advice is to stay aware of your patterns(record them if need be) and try to focus on the way your energy is flowing -hopefully, you'll just revert back to a normal pattern once you've sorted the root of your possible anxiety(if it is indeed anxiety) but only resort to benzo's etc as a last resort. Benzo's actually never helped me sleep better but the beer/benzo buzz was always chillaxing to the maxing.

i mean, don't obsess over it unless it starts to really tip you over.........anyway you could always adhere to some of that advice from bog's post:

This was also a favorite time for scholars and poets to write uninterrupted, whereas still others visited neighbors, had sex, or engaged in petty crime."

^ tha's some gold for free right there mang.

hope you resolve this brother, feeling washed out spazzy and tired sure is a drag

Edited by cheshire
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Have u tried bringing yourself to orgasm?

I know if that ever happens to me, I just give myself an orgasm and pretty much fall back to sleep. Not tryin to be rude or Pervy just being honest.

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lol Incog!

But maybe he is in bed with his missus . If you wake her up for that (or with that ) you may cause more problems.

Stumbling out into the bathroom and sitting on a cold toilet seat may not have the same relaxing effect :)

Edited by rigger
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Hmmmmm

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Thanks everyone for your help and all your thoughtful responses, gotta love the SAB crew. I'm gonna take a little time-out to mull it all over and see if I can get somewhere here. If anyone else has any more advice/experience with chronic stress or sleep problems please still chime in :)

Peace

Gman

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try melatonin before bedtime

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actually yeah, i think slow release melatonin is indicated for that very purpose. more overall restfulness. maybe if you do wake on melatonin you won't feel so alert.

drop me a PM if you want.

it's actually surprising nobody has mentioned tryptophan. i reckon that could be the ticket, it always makes the alarm clock twice as hard for me to deactivate. just remember you have to take tryptophan with as little competing amino acids as possible, or it doesn't get the chance to build neurotransmitters.

i sometimes wonder how much diet alone (sources of protein, whether mixed and what time of day) could push you to one extreme or the other, due to abundant adrenaline/dopamine and the unbalancing effect i'm led to believe that can have on already weak levels of serotonin/melatonin (the opposite scenario could also play out).

Edited by ThunderIdeal
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Good luck gtarman.

It's a tough one because if the stress is bad enough it's going to effect your sleep regardless of what you do. I mean if your going through a bad devorce, death, bankruptcy etc. You may just have to do the best you can until the situation is less stressful over time.

Some natural things to consider are Chamomile. The dosage for any studied improvement is high so you may have to buy the flower in bulk and brew the tea quite strong. Lavender can promote relaxation or sleep. More likely I find you notice the smell of it and this may detract other thoughts. Tryptophan can help but is best as part of a good diet as a whole (which it seems you have).

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i make a "sleepy time" tea made up of chamomile, passionflower and california poppy. chamo doesn't put me to sleep but this combo can, i bough bulk herbs and make up a pretty strong brew with a dollop of honey. i think passionflower is a mood enhancer as well at least i feel a lot more positive about my impending doom than i normally would :crux:

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no nana naps in the day.. i have been only having 4 or five hour a nite sleep but its called working to fucking much no time 4 family or nuthing come home grumpy and fucked its not cool.

anywho maybe find some outdoor shit u like ,jogging[ihate] ,surfing, bushwalk/citywalk /dogwalk. dig a hole till ya fucked ? whatever just tire yourself out physically not mentally :scratchhead:

STRESS IS WAY BAD FOR YA DUDE . i live with loads too. this looks like a puzzle goddamn it :blink: now im thinking to much ummmmmmmmmm

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That's a tough one as a lot of insomnia treatments help with falling asleep which doesn't seem to be your problem. You could try a short course of Temazapam to try to re establish a sleeping pattern.

Temazepam is one of the shorter-acting benzoes. For serious insomnia, people tend to wake up when it wears off after 4-5 hours anyway. A longer-acting one could work, but they can be tricky to get scripts for, and fuck with your sleep quality anyway. Also horribly addictive, any benzoes are definitely only for short-term use.

Ceres' suggestion (2x short sleeps per day) has worked nicely for me at times. It's not for everyone, but can be worth a try if your living situation allows it. The trick is to keep it regular and not skip your afternoon/morning "naps", anymore than you would skip a whole night's sleep. Meals may need to be adjusted too.

When I have insomnia, I tend towards herbs that reduce anxiety rather than herbs that actually knock me out. I find these more helpful - i.e. I mightn't get as much sleep, but am alot more chilled about it and hence able to function better on the sleep I do get. Valerian works great for me, I usually add camomile and lemonbalm too, but mainly just for flavour, not sure how well they work on their own. I believe there can be tolerance issues taking valerian daily though, and I would recommend whole herb over extracts (at least until they can make up their minds which group(s) of compounds are the "real" actives!) Skullcap knocks me out like a light, but I don't find it anxiolytic and it gives me headaches, so I avoid it.

Also a few friends who had similar problems traced theirs to the timing of their daily medications - they just started taking their meds in the morning rather than at lunch/arvo, and problem solved.

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Sounds like it could be caused by stress, I suffer from it too. I recommend that you have no caffeine after midday and start not giving a fuck

Works for me.

Drinking when you wake in the middle of the night is fun if you have nothing to do the next day.

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Temazipam is over rated. It will deffinantly help you get to sleep but ime it wont neccicarily keep you asleep. Olanzapine maybe hard to get a script for but it will give you 8-12 hrs quite easily. The negative is the groggyness you will endure for a week or two while your brain regulates itself.... that and it will make you put on weight no matter what you do. So short term ie 2-3 weeks could help train your bodwah back to a funky groove.

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When I was in amsterdam years ago I found that smacking mary around all day would help me get to sleep, and I would stay asleep all night. And in australia I have found that valerian tea can help a bit aswell. Just soak a couple of teaspoons in cold water for about 12 hours or so in the fridge, then drink it before bed

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g man, I read parts of the replies with care and others, I just skimmed, so sorry if it has been mentioned.

I think there is a fair chance you simply experience a manic episode.

do you think you could have bipolar?

I have observed that people with bipolar, who self medicate with cannabis, (one of the best bipolar drugs!)

often get thrown into a manic state right, after they stop taking the cannabis medicine.

not to say you use, this herb, anyway, I bet you are simply "full of beans". :)

in this state people sleep only a few hours and this situation can last from wees to several months.

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Cheers PH. I do eat beans regularly :P

Not bipolar, or a regular user of cannabis though. I think it is just stress. Oddly enough, last night I read some fiction to calm my mind, and I actually managed to sleep until my alarm went off...even if it meant I only got 6 hours instead of 5 :rolleyes:

But hopefully the reading-before-bed trick works again to get the mind a bit more chilled. I've lately declared war on tabbed browsing as well, as that it something that actually makes my mind fly off in 10 different directions at a hundred miles an hour...it usually scatters and stresses me, I imagine it's what ADD would be like. But I've noticed since I stopped using them that I'm feeling a bit calmer and more focused...just concentrating on one thing at a time.

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