On insomnia

I have always been a bad sleeper. Even when I was a baby. Neither my brother nor I could get to sleep quickly and easily, though staying asleep was much less a problem. The odd thing is that neither of my parents have any sleep issues whatsoever. My dad doesn't know the meaning of the word "insomnia," and although my mom might have the occasional fretful night (thanks, anorexia!), difficulties in falling asleep aren't a problem for her, either. Whether or not my brother has outgrown his issues--to be honest, I've never thought to ask--I certainly haven't.

My breakdown shortly before I started this blog, that epic breakdown that landed me in the Critical Care Unit and then transferred to the psych ward for several weeks, was precipitated directly by my inability to sleep. The meds I was on at the time had gradually been causing more and more sleep issues, but they were actually working for depression and anxiety, so I didn't want to switch. Eventually, I was up all night, unable to sleep. On my lunch break, I would hide in an old storage closet at work and take a nap. Several days before I flipped for good, I hadn't slept at all. I'd tried every form of sleep medication and none of them worked. It sucked. Eventually, on the psych ward I got put on 100 mg of Seroquel to help me sleep, and I ended up falling out of bed the next day because I was so drugged and then got put on fall precautions.

The Seroquel worked for a while, but then left me feeling so drugged the next day it was almost as if I hadn't slept. Insomnia doesn't help anxiety or depression, and soon, I decided to switch SSRIs. Now I take my Prozac and a mildly sedating allergy medication and do, for the most part, okay.

And by okay, I mean back to my usual tossing and turning for an hour before I fall asleep. I did that in elementary school. I did that in middle school. I did that in high school. I would have done that in college, except I was so sleep deprived I often didn't even remember climbing into the top bunk. To my parents, this is completely and utterly baffling. How can you not sleep? Um, I don't know.

Last night was a fairly epic insomnia night, as I didn't fall asleep until 4am and then woke up at 7:30. I was definitely tired. That wasn't the problem. The problem was that my idiot brain would not stop yammering. It's like being seated next to a chatty old lady on a really long plane ride, and this old lady doesn't know how to shut up. She wants to tell you about her grandkids. And then show you the vacation photos. And then tell you about a fantastic hemorrhoid treatment. And don't--trust me, don't--get her started on her lovely Pomeranians. Meanwhile, in the seat next to the old lady, you're exhausted and you want to take a nap, but your headphones are in the overhead compartment, the decoy trashy romance novel isn't working, and there's no other seats on the flight.

That's what it's like for me to try and sleep. I close my eyes. I feel the heaviness and exhaustion wash over me, but there's this little old lady yapping in the back of my skull about her stupid Pomeranians. All I want to do is tell her to shut up about her freaking Pomeranians!! But she's 80 and the plane's crowded and you don't want to look like a jerk, so you basically pretend that she's some sort of rabid animal, and you hunker down, play dead, and hope she shuts up. She shuts up, you get some shut eye.

I've tried yelling at the motormouth in my head. Once I imagined myself turning around and yelling "WOULD YOU SHUT THE HELL UP!" The silence was deafening- I thought my brainpan was going to implode from the lack of chatter. That trick hasn't worked since.

It's not uncommon for me to be worrying, but even when I'm not worrying exactly, it's random useless chatter about Pomeranians and grandkids and hemorrhoid cream. And I don't know what else to do about it. Part of the issue probably has to do with the fact that I'm an extreme night owl and my brain just doesn't start to shut off until at least 1am, which is one of the major check boxes in favor of my decision to be a full-time freelance writer. I would love to get my sleep/wake cycle back to something resembling normal, but I am at a complete loss.

Thoughts or suggestions? I've done the no caffeine after 3pm, the relaxing music, the counting sheep, the tense your muscles and relax them, the meditation, the deep breathing, and nothing flips that stupid switch in my brain to off.

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31 comments:

Libby said...

I don't have trouble falling asleep usually... well... if I don't keep my mind busy, I don't have trouble. I need to watch some TV or read or do some anagrams or something... Then my brain is sufficiently tired. I know the lady with the Pomeranians, too... if I'm not tired enough, she finds me, too.

But my issue has always been staying asleep. Turns out my cortisol rhythms were backward... lowest in the morning and then spiking in the middle of the night. When they spike, you wake up. When they're low, it's hard to get up... you just want to sleep. If I take 2 PS100 pills before bed, I sleep through the night. It's like magic!

But then there are nights like tonight... where I'm soooo tired that I fall asleep on the couch before getting up to take my pills and go to bed. Then I wake up, wide awake, at 2 or 3am... because I didn't take my PS100 at 10:30 like a good girl... *sigh* Bodies can be so frustrating.

now.is.now said...

I go through extended phases of experiencing exactly what you describe. The only thing that has helped me has been to pretend (trick myself, convince myself) that I'm looking forward to going to bed. Why would I be looking forward to going to bed? Because, I convince myself, that I am looking forward to all that time where I won't fall asleep. That time is mine, to imagine, to dream, to fantasize. So, instead of "trying" to fall asleep, I started instead working to love the sleepless hour(s) before falling asleep. Instead of fighting them, I just try to sink into them and enjoy my brain chatter. I try to change my attitude about it so that I find my brain chatter relaxing instead of aggravating. That has helped me quite a bit actually. Definitely takes practice though. You know where I got the idea to do this? Like you, I have never been a good sleeper - even as a baby. Well, in Kindergarten, I used to have exactly the attitude I described to you above. I'd look forward to the time when I was unable to fall asleep. I even had a name for it. I'd call it "imagining time." I used to love lying there, on my bed, in the darkness, eyes closed but mind awake, just thinking. So, I started to re-adopt that approach. And, honestly, it is effective for me. I hope this made sense...

Cathy (UK) said...

This may sound like a simple suggestion... but is your bedroom dark enough? Melatonin as well as cortisol rhythms plays an instrumental role in the regulation of sleep-wake cycles. I have my own fair share of sleep problems, and I strongly identify with the stimulant effect of an over-active mind, but one simple step that has helped me sleep is to put up very thick curtains which completely darken the bedroom.

Medication, including SSRIs, can play havoc with sleep-wake cycles. Having taken tricyclic antidepressants as a teen, and a short course of fluoxetine in 2005, I am now strongly anti-medication. Some psychiatrists deal them out like sweets. For many people the risks outweigh the benefits. Not only do these drugs mess up brain chemistry, they have a variety of systemic effects. Some antidepressants are cardiotoxic, yet doctors continue to prescribe them to the most vulnerable patients, which includes people with EDs and associated heart conditions.

Lou Lou said...

hi, maybe try no caffeine?
that can be tricky, so another thing is colour.
red is a colour you should try to keep out of your bedroom, as it is too stimulating. a good thing to do is make sure you keep electronics like televisions out of the bedroom as it creates an environment where you are used to not sleeping, maybe keep you bedroom as a sleep-only zone, a good idea is to create a real sense of routine around bedtime. keep away from computers and websurfing before bed, try a nightly shower, lavender oils, lavender sprays on your bed, maybe reading in your room. and start a routine for each night. it helps a lot, Violet is the most helpful colour for restful sleep. You can use variations of violet - that is to say a
pastel version of the colour if this is preferred. http://www.colourtherapyhealing.com/colour/colour_in_the_home.php

Katie said...

Oh wow, me too! I make the same distinction between worrying and just random chatter too - most nights I'm not thinking about any one thing and I don't feel anxious, I just can't get my head to shut up. I can lie in bed for anywhere between 1-4 hours before I eventually lose consciousness, too tired to read but somehow still not asleep. I don't drink coffee and I live in the middle of nowhere so my room is pitch black. It's reeeeeeeeeeeeeeeally annoying, with the extra e's being absolutely necessary.

Clearly this is commiseration rather than advice, but if the other commenters come up with anything good I'll be trying it too ;)

Katie said...

oh, and I haven't been on any meds in two and a half years. Citalopram helped me to sleep but also made me insane, and I had the same reaction to seroqual as you did. 50mg turned me into a zombie! I should have read the other comments properly before I pressed submit, I think I got a bit excited by the thought that it wasn't just me!

Erica said...

Have you tried taking melatonin? That usually helps me fall asleep and it doesn't make me groggy in the morning the way most sleep medications do.

I've also found that turning off my computer and TV at least an hour before I go to bed is helpful. Then I usually turn down most of the lights and read for a while to help my mind relax. I hope this helps! I know how frustrating insomnia can be.

Eating Alone said...

I'm no where near as bad as you, but you might try an eye mask- it will keep all the light out and is very soft.

Or try one of those sound machines that give off white noise or sounds like rain or the surf. It can't hurt to try it.

Jessie said...

I have the exact same problem and I sadly haven't found anything that helps. I listen to music. It doesn't help me fall asleep but I can concentrate on it hard enough that it drowns out the yammering voice in my head. So at least I can lie awake listening to music instead of my crazy brain.

Kim said...

I've done all the behavioral stuff too and sometimes, I just have bad nights of sleep. What's frustrating is that I used to be an excellent sleeper. I could even nap. I remember falling asleep on a park bench once (yes, like a homeless person) and waking up an HOUR later. What?! I can't even imagine that now. Even when I'm not worrying about something specific, like you said, there is all this chatter. I'll even start thinking about emails I wrote and if I misspelled something. Seriously. Some nights, it's not an issue at all, but other nights, I'll just lie there, awake. Sometimes, I have the problem of waking up in the middle of the night and not falling back asleep. Sometimes, I have early morning waking. I have all types of insomnia :) The only thing that's worked for me is to accept it. I used to get really pissed off and irritated, and then I'd start panicking that I'd be so tired the next day and would be a bad employee/wife/friend/human. That just made it worse. Now, I just accept it. Sunday, for example, I knew I was anxious for my doctor's appointment on Monday so I just said, "Whelp, it'll be a toss-and-turn night. Oh well. I'm not going to die." And, actually, I didn't sleep that bad.
I do use Benadryl sometimes, if I can tell I just need help getting drowsy. Oh, and I try not to go near my computer after 8pm (though I'm bad at this sometimes). If I get caught up in blogs or news or emails, I'll start thinking about them too much, too close to bed.
That's all I got :)

The girl with the most cake said...

Hello fellow non-sleeper.
I was diagnosed with insomnia at age 7 (it was more likely a misdiagnosed anxiety d/o) and had grown completely dependent on OTC and Rx sleeping drugs by 12. Nightmare. I sincerely think that my insomnia is a curse for something that I did or did not do in a past life....
I have trouble both falling and staying asleep. I am pretty confident that it is due to my genetic predisposition for anxiety, dependence on pills and what has become an utter obsession with my ability to get zzzz's.
Thankfully, at 29 I am in a far better place than where I have been in the past.
For me, it's about not obsessing so much aboou perhaps not getting a full 8 hours. If I lay in bed for 2, sleep for 4 and wake up bright eyed (figuratively not literally), I get up and try to be productive.
Sleep is directly correlated to my mood so as long as I can try and keep that in check, my sleep drama seems a little less tumultuous...
It's just kind of a part of myself that I am still learning to accept.
A couple glasses of sav-b doesn't hurt either. ;)
Good Luck lady. I quite literally feel your pain.

Warmly,
Christina

Carrie Arnold said...

Now,

OMG- I love that idea about looking forward to "Dreamtime." Maybe this isn't a curse or even all that pathological, it's just me. I like that!

Cathy,

I'm neither anti- nor pro-medication. That being said, I've tried to go off the SSRIs, and I invariably end up a suicidal basket case. My brain gravitates towards depression, and the med I'm on now doesn't affect my sleep. I do think SSRIs are over prescribed, just as I think many things are over prescribed, but that also doesn't mean that everyone who takes an SSRI got it prescribed by mistake. And I know you're not saying that, it's just something I wanted to clarify.

Erica,

I will try melatonin. It's worth a shot, anyway.

To everyone,

I don't think the brightness of my room is an issue. I live out in the sticks, so there's not much streetlight, and I turn off anything "glowy" when I go to bed (except my alarm clock).

Thank you all SO MUCH for all of your suggestions.

allegri said...

OMG. I am totally in the same boat. However, Seroquel 300's... and it still takes me an hour to fall asleep... but man do I feel like I am hungover the next day. bleh.

Anonymous said...

I know what you mean about "brain chatter". What works for me is going to sleep while listening to an audiobook. I pick ones that I've heard/read before (so they don't keep me awake), but aren't too boring (so my mind doesn't wander). It really helps me turn my brain off and go to sleep.
-Anon

Kels Anne said...

Hey. I actually sleep with a fan. Even in the winter. Not a ceiling fan..but the kind that you plug into your wall that drown out sounds. I also sleep with..you guessed it..a snuggie. Those do miracles. lol. Really. That helps a lot. Also: Magnesium pills..you can get them at walmart. They are a "sleeping pill" in a sense..but don't make you feel like crap the next day. My aunt takes them every night,,, she has same issues too. Also: When I was yonger, I was on zoloft.. (depression meds) and I'd take them and in an instant I'd be passed out at the dinner table =D
hope that helps!

now.is.now said...

Carrie,

I'm glad you like the idea. Like I said, it's the only thing that's eased my impatience I feel at night time (hurry up and just be morning I hate this having to sleep but i can't business!). I tried sleeping pills and melatonin and sound boxes and routines and yadiyadi... none of it worked for me. Turned out, an attitude adjustment was the best medicine for me.

I hope you find some relief and enjoyment in your nights!

Sortend said...

If you are encountering consistent problems in falling asleep at night and are unable to cure your insomnia in spite of putting in your best efforts, you should soon pay a visit to the doctor. After evaluating you as a victim of the sleep disorder insomnia, the physician may prescribe sleep aid pills such as Ambien, Lunesta et al for you but to extract maximum benefits from the sleep aid pill, it is to be taken as per the instructions of the doctor. However, before you move ahead to treat your insomnia with Ambien, it would be considerably beneficial for you to obtain first hand information on Ambien from the website http://www.sleep-aid-pills.com/.

I Hate to Weight said...

this is a popular post! looks like we all really struggle with sleep. it's so unfortunate, because i always say that sleep is everything.

for me, no caffeine helps like crazy. i cut back a few weeks ago and started falling asleep everywhere. unfortunately, work got so busy, and i just went right back to caffeine.

also, i usually take half an ambien at night. it puts me to sleep fairly quickly. i have so much trouble falling asleep (if lucky) otherwise. if i just take half, i don't have any side effects.

i'm not recommending drugs, and i know it's so much better to do it naturally, but that's what works for mel.

Anonymous said...

http://jama.ama-assn.org/cgi/content/full/301/19/2005
CBT?

Diet Coke Missy said...

I'm the insomniac from hell! I think a lot of it is to do with depression/eating disorder. But it's even getting to the point that I dread going to sleep because the night is so long.

Carrie Arnold said...

Wow- this post was popular!

@I Hate to Weight,

I've tried Ambien, Lunesta, Sonata, Trazadone, etc, and none of them put me to sleep. Make me feel drugged and groggy, yes, but they don't actually help me sleep.

@Anonymous,

I will have to check out that article- I've tried a lot of CBT stuff, but I've never had formal CBT.

Anonymous said...

Hi Carrie,
Well, I do have a similar problem with thoughts racing through my head till 3 or 4 am sometimes.

I don't know if I have an answer for you but I feel better about not sleeping if I tell myself I am resting and that is almost as good as sleeping. And it is! But also, if I don't worry about not sleeping, it makes it easier to go to sleep.........

Have you tried mindfulness training. I've worked and worked on this and can get myself into a little trance like state about 50% of the time now...

XX
Ann

Anonymous said...

I have suffered from insomnia for over 20 years. It was worst when I had my two bouts of really bad depression but I have one good nights sleep to three broken nights.

Some nights I can't get to sleep. Others I wake two hours later and am then awake for three or four hours.

I so get the not being able to switch off the brain. Some nights I sit bolt upright in bed, cross, tense and wide awake.

I too have tried medical, herbal, holistic,relaxation exercises, no caffeine, no alcohol, everything.

The only thing that I have learnt to do is to stop myself worrying so much about how much sleep I get. If I only get two hours,I know I will function for the rest of the day and can try again the next night - always the optimist. We are under so much pressure to be perfect at everything, including getting our 8 hours a night, that it becomes a self perpetuating cycle.

If I am having a wakeful night, I turn on my light and read my book as there is nothing worse than just lying there worrying about not sleeping because then the Pomeranians come at me full throttle - in my case, as my daughter is an anorexic, a rant that seems to encompass the whole universe and can last for some 5 hours!

Anonymous said...

One more idea: get a Pom.
I don't think I have inflicted stories of my dear toy Pom on my flying mates and I shan't bore you all here.
But, the little guy snuggles up beside me and his warmth, rhythmic breathing and stoking his soft silky coat send me straight to sleep.
Just a thought.
M

Telstaar said...

Hey :) I haven't read everyone's responses so I don't know what's been said etc.

I have CFS (as well as AN) and my type of CFS is that of insomnia rather than hypersomnia and it is incredibly annoying because I spend all day dragging my body around exhausted and desperately wanting sleep and then a lot of the time, sleep doesn't come! Like yourself my head is whirring and its hard to get it to slow down, let alone being useful.

Randomly there are kinda two things that have helped and they're interrelated.

Firstly, when I'm already exhausted, I find it a LOT harder to actually get to sleep. Think of an overtired 2 year old and you're pretty on the money. SO if you can get your body into normal healthy sleep patterns (same time to bed, same time awake) then you recooperate some energy, when you actually HAVE a bit of energy, sleep works better!

(So more energy is accumulated through routine, good sleep hygeine, being nicely hydrated, nutrition etc etc.)

However, when you're already out of kilter and exhausted, its just hard to get that energy to begin with to help the sleep! (It does seem a bit backwards that to have more energy would help you sleep better but I swear it does.)

SO, one of the things that I find helps is using methylphenidate. I find that it doesn't really give me any physical energy but it does help to focus and slow my brain down and that in turn just seems to get my body working a bit better (I dont have ADHD). I also have other friends with CFS that have very minimal night time AND day time doses of Klonopin, smaller than normal sedation doses but in the right combination (and often in combination with doxepin) it can help increase energy during the day (yep, a benzo can help with increased energy) and settle sleep at night.

Clearly those options require prescriptions and doctors and the like, but it might be worth considering to help get everything back on track and then coming off them.

Aspects such as having magnesium (particularly if you can get Mg injections) can also REALLY help improve sleep cycle and Mg injections in combination with B12 injections (even when bloods do not indicate low levels) can sigificantly improve sleep quality thus improving the cycle.

As you know, eating disorders often screw up the sleep cycle with poor nutrition but I'm thinking that shouldn't be as much of an issue at this point in time (as in ed = issue, but you're trying to stick to MP etc)... but I find even MORE important than nutrition is hydration and just water often won't work as it impacts the electrolytes too much. But making sure that you drink enough and drink enough before bed really does help improve sleep quality which helps the overall cycle.

Anyway, I hope I've given you some extra ideas to consider or think about and if not, that's okay too :).

Thinking of you! xo

Carrie Arnold said...

M,

I wouldn't mind a Pom, but I think my cat would! It's always nice when she curls up on the pillow next to me and purrs me to sleep, but, being a cat, she doesn't always want to sleep on the pillow and also, being a cat, I can't really force her!

Telstaar,

Thanks for the suggestions- I'll look into these!

Kathryn said...

Have you tried aromatherapy? I'm an insomniac, too, but I've essentially trained myself to have a Pavlovian response to lavender. I smell it, I'm down for the count.

Lisa said...

I struggle a lot with racing thoughts. It's very frustrating.

When I was young (before I even had knowledge of psych/CBT) I had a CD that I had trained myself to fall asleep to. For some reason or another life got in the way and I stopped using it.

I was on remeron for a while. Doctors prescribe it for a variety of reasons--I was on it as an anti-depression augmentor. But it also has the side effect of sleep. I worked on a psych unit for a while and several people took it strictly for that. However for me it caused me to sleep too much-in excess of 14-16 hours a day.

Melatonin is my go-to "drug". It doesn't make me feel drugged and I can choose when to take it (and be awake for nights of college craziness :)

Tammy said...

A very interesting book about brain chemistry is "The Mood Cure" by Julia Ross. She has a clinic that deals with MANY different issues, including insomnia. She also touches base on chemical imbalances in the brain after extreme experiences (like concentration camps and anorexia), and how to HEAL these imbalances! PLEASE read this unbelievably insightful book and see if you get relief from a number of things; I have.

ambien said...

My insomnia comes from anxiety issues when I try to sleep. I found that Ambien didn't make me sleepy but it did relax me enough to fall asleep. There are tons of stories floating around about strange behavior and I have my share. I found this only happens when I try to do things between ingestion and onset. Only take it when you are already in bed, relaxing, and attempting to fall alseep, and you shouldn't have any problems.

Sarah MacAdams said...

sleep is one of the most important things that you can do to keep yourself healthy. There are a lot of people who have problems sleeping in one form or another.
And Best Cure For #Insomnia is Eye Mask buy now from Amazon . 2 in 1 pack just in 13.99$ ..
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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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nour·ish: (v); to sustain with food or nutriment; supply with what is necessary for life, health, and growth; to cherish, foster, keep alive; to strengthen, build up, or promote



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