I’ve had chronic insomnia for weeks: I fall asleep fairly easily but wake up at around 3:00 AM. I tried the usual remedies, deep breathing, not staring at the clock, not eating too late, etc
My GP prescribed a sleeping tablet to break the cycle, but so still woke up in the mid of the night, so after a few days I started to take the sleeping pill when I woke during the night, and it worked a treat! Then I had no pills left, so I had a was able to get a GP call and he prescribed Amytriptaline. I took it got 2 weeks, but it takes weeks to become effective. I had another GP call and he prescribed Mirtazapine. I waited a day before starting this new drug, as advised and after taking a pill I was unable to fall asleep at all, due to restless legs and muscle spasms. I didn’t take any pills for 2 nights, and then took one the next night and I had vivid dreams spasms, and and the following night I had the same bizarre dreams and spasms.
2 days later, I took 1 Nytol antihistamine when I woke up during the night, but it didn’t work.
I take Dabigatran, Fleicanide and Bisoprolol, and Atovastatin, and perhaps this medley contraindicated with the Mirtazapine. Has anyone on the same meds as me been prescribed medication for insomnia that works, without experiencing weird side effects.?
I have no idea what has caused this insomnia. I don’t feel sick, I haven’t lost weight, my BP etc is OK. I’m 70.
Written by
Pacific
To view profiles and participate in discussions please or .
I'm prescribed the lowest dose of the sleeping pill Zopiclone and it works well. I often still wake at 3 am but can easily go back to sleep. It's strange but I hear so many people say that 3am is the time they're most likely to wake up.
Thanks so much for responding. I was prescribed the same sleeping pills as you,but he wouldn’t prescribe any more of them. It’s seems to be the policy at my practice.
It reassures me jean to know somebody else has taken zopiclone for years. I have been using it 5 years. i won't have sufficient sleep without it. i'm on the lowest dose that works for me - 3.75 mg. Have tried to go down lower but it's not really sufficient. i too worry about getting "cut off" at some point. and i too often wake at 3:00 am. lol!
somewhere in my memory I recall that Zopiclone was designed for fighter pilots to use during combat, ensuring they got 4 hours sleep with no residual drowsiness.
according to spiritual practices, 3am is the bewitching hour. I prefer to think of it as our circadian liver rhythm kicks in at that time and wakes us up. With all the meds people take it makes sense that the liver is over active. Just my thoughts! wakingtimes.com/chinese-bod...
Straight away. But I never got up to 15 mg. Even a quarter knocked me out for the first few weeks. Then I went to half. I googled the reviews and read the warnings to gradually increase. Wow 15 mg at first. I feel for you. Half was enough for me. Those dreams were crazy and so real and strangely full of passed away loved ones and friends which upset me. Plus I was wiped at work all morning.
I just read your reply about Mirtazepine - my GP prescribed me 15mg too about 18 months ago. I could only take them for 2 or even 3 nights ( I can’t remember) my dreams were so vivid I woke each night screaming 😱 I had to stop!
Like Jean I too have found Zopiclone a great help. Only take 3.5 (so half the dose most folk take) it helped me through the difficult times before having ablations when af would last for hours at a time leaving me exhausted for days afterwards & unable to get to sleep. Cardiologist requested my GP prescribe it especially when I explained I was not addicted & only used as needed. GP was able to see this as only had one or two prescriptions a year.
I think I could write a book on insomnia. I've tried at least 8 different meds...got restless legs on Mirtazapine, addicted to zopiclone, melatonin didn't work. For me, it's hormonal. Slept wonderfully on estrogen for years but had to go off for breast cancer. Melatonin didn't work. Cardiologist wanted me off amitriptyline when I was diagnosed with AF.
Then someone wonderful on this site suggested I might be taking too much melatonin. He was right! I now take .3 mcg (yes, mcg) and I'm much happier on it. I try not to take it every night and it doesn't work every night, but it's far better than those awful meds. And if I have to I can increase it without worry.
Oh dear, Pacific, I really feel for you. Up since 3.00 am this morning. No identifiable reason for not sleeping, bed at usual time, pain meds taken so not particularly uncomfortable, AF level acceptable, no weird dreams etc. Now my bathroom towels are spinning cheerfully in washing machine, hated alendronic acid with its 30 minutes upright rule taken, out of the way instead of usual prolonged breakfast time, I've researched new kitchen taps and had a nice cup of tea. Sleep problems for years, have tried going to bed on a warm drink and snack, taking a walk, following strict sleep hygiene routines, etc. all recommended by doctor/occ. therapist with limited success. My sleep problems come in waves, I can go several nights with no real problems and then I will have an awake at three patch for several nights. I find getting up (also recommended by doctor/occ therapist) better than laying in bed getting cross, despite the daytime exhaustion that often follows. If wakefulness at three continues I will resort to doctor prescribed zopiclone, after 3 nights and this can help to break the pattern. I too, only have about 1 or 2 prescriptions a year so limit my use of zopiclone quite severely. But you have my sympathy, I only wish I had a cure I could pass on to help, but in the absence of that I share some of my coping techniques.
I've been waking up after about 4 hours sleep for years,sometimes I watch the box for an hour then get back to sleep.Now if I go to bed late ,say midnight,I sleep through till about 7am.In my case its nothing to do with heart issues or medications.I never take sleeping pills.
Recently I have been reading about sleep stages because I have the same 3 am problem. I read that around 3 am is when the liver detoxes which may be why we wake at that time. No doubt medications don't help the liver. I am now trying a supplement that is meant to help . Only the last two nights though so no outcome yet but maybe worth researching. I take flecanide and digoxin .
You learn something everyday don't you Dollcollector. I turn 85 next month and have tried every pill and potion during my AF journey even going so far as a Pace and Ablate procedure last year (which has worked and would recommend it) and I too thought magnesium was good for your heart! Ah well onwards and upwards as they say 😊
it’s a statement about magnesium supplements on the NHS website. Elderly people are often started on lower doses of medication. Perhaps taking certain supplements is deemed to be detrimental. Some of us take several meds too and it’s hard to know what might contraindicate. I had a disturbing reaction to Mirtzapine; we all have different physiologies. I’ve discovered that reading doesn’t make me sleepy at all. Agh!
I will be 62 in March. Dr had no problem with me taking magnesium and no warnings that I would have to stop.
I’ve tried Mirtazipine with no effect and likewise with Melatonin . Lorazepam helps but of course it’s only a short term solution. In the days before PAF I would try 3 glasses of wine which worked but sleep quality was low and I was still tired when I got up.
My semi-success came from healthy eating , exercise and using a CBT via an App called Sleepio which my GP recommended. It’s available on the NHS if you’re in Scotland but not in England. I found it very effective in resetting my sleep maybe 50% of the time.
The underlying cause of my insomnia was lifetime of stress through work, then of caring for aging parents and then from health - like so many others here.
Now with what I’m doing I wake up at least 4 days a week with enough energy to be bright and annoying … the other days I get by. I almost never sleep through the night - but I accept that as just where I am in life. When I do sleep through I am probably unbearably happy …almost hyper.
I couldn't have expressed things better. It's a blight and stress of varying kinds, and an inability to relax because of it, are the likely cause. People who can "switch off" - the vast majority - don't know how very lucky they are.
I’ve had a very rare night’s good sleep …. my other half asked why I was beating my chest and back flipping off the dining table …. I can’t help it … I feel so good😂
I have been an insomniac for years. One thing that really helped me to cope is to know that there is research that says we used to sleep in four hour shifts when we all lived in caves. It was a safety mechanism for security and to tend to babies. I now wake up at 3am and just go and take a second Amitryptaline and also a couple of Co Codamol. I do all the sleep hygiene things like no blue screens after 8pm, no gadgets or tv's in the bedroom, herbal night time tea, writing down three things I am grateful for just before settling down for the night etc. They all help to deal with the underlying anxiety.
last week I bought a blue light blocker small reading lamp from Amazon for £14.99, but I haven’t tried using it for reading yet. It’s a good night light for using the bathroom. If I sat up in bed I would need to put the heater on and wait for the room to warm up. I couldn’t imagine watching TV in the living room in the winter. I’d have to heat this room up too. I feel the cold more than most people.
Hi, i sometimes take a natural remedy called Sominex. My usual wake up time is 4, but with one sominex i sleep through, i find it 'quietens' the mind for a few hours of good sleep.
I might try this if the Mirtazapine doesn’t work. Had another GP phone appointment today and I can start taking 1/2 a Mirtazapine pill. I only have15 mg pills, but I can cut them in half. These meds are off license for insomnia in UK.. I’d found an article on a study by the Americans Journal of Physicians about this; the term is called off label in the USA. It’s for insomnia for older people . The study found that 15 mg in older patients caused over stimulation, with unpleasant side effects.
My, very mean, GP gave me one at night. When I had a review under another GP he told me that it was a very safe drug and that even two would not be considered high so I take one before bed and another when I wake up later. I just get up (it is not good to lay in bed when you are awake) take the tablets, read for a while and then go back to bed and sleep.
I’ve written a letter for the last GP that I saw to ask him if I can restart Amytriptaline; a letter can give him more details about relevant dates, etc.. I really should try reading in bed; tonight!
I've had this quite regularly for years now, certainly well over ten. It's called "sleep duration insomnia" and it's the hardest one to deal with. Most people, if they suffer with poor sleep at all, suffer with "sleep onset insomnia" and that is the easier one to treat. I was managing quite well until we had covid at Christmas but for some reason, that seems to have caused mine to return (or its coincidence).
The way you treated yours is the way I treat mine, taking a sleeping tablet around 3-4am and getting 3-4 hours sleep from it. I see Jean has also kindly responded and I know that she deals with hers, similarly.
The best currently prescribed tablets are the so called "z" drugs, zolpidem or zopiclone. They are generally very safe, do not cause dependence, nor require increasing doses and cause no drowsiness. Despite that many doctors tend to believe they cause dependence and are bad news; in fact, they are good news, or at least the best we have. You need an enlightened doctor who cares, in my view. Too many GPs seem to lack the time, experience or interest to get to the heart of the problem and deal with it.
Amitriptyline, antihistamines (of which Nytol and mirtazapine are both examples) are not sleeping pills, they just have drowsiness as a side effect; but they also have long half lives and create next day drowsiness and a dull mind.
The problem with "z" drugs is also why they are so safe: they have a very short half life and are pretty much out of the system inside 3-4 hours. That means if you take one when you go to bed, you will often wake up in the middle of the night. Also, unlike the benzodiazepine drugs such as temazepam, they are very "light" in action and need you to be trying to go to sleep right from the off. They won't work if you take them before bed, only once you are settled and trying to sleep in bed.
All that said, I guess there are some people who find them troublesome; but in my long experience with them, they seem very safe and are completely non-addictive.
I have spent some time deliberating over when to take meds for sleep. I did try Nytol antihistamine but was wary of taking 2 pills; as you said, you end up feeling hung over; but better than sleep deprivation
The problem with next-day drowsiness is that - from what I've read - it increases slightly the chances of an accident. My friend has recently been given mirtazapine for his anxiety and sleep problems, and he's finding it very effective. I couldn't cope with it at all, sadly. Why doctors fear some drugs but hand others out amazes me. Obviously they have their reasons, but I have never heard from any one who has had a problem with zolpidem or zopiclone and, in my own case, would call them entirely safe. I just wish they had a somewhat longer effect. When needed (nightly at present, sadly), I generally only take 2.5mg, by the way, breaking a 10mg tablet into four with a pill cutter.
I fall asleep OK but am usually awake at 3am. I find cocodamol effective but I don't take them regularly in case I get addicted . My gp will not prescribe sleeping tablets.
I'm on my 3AM awake wave ... I just do my letter writing or reading .. after 60 to 90 mins .. I go back to bed ... most times I fall asleep! .. Isn't it strange - we all awake at 3 AM!
I have had insomnia for the 15 years since I stopped work.My advice is go to another bedroom if you can and get reading for an hour or so.This always works.Ok if you are still working it's more of a problem but if you are retired please enjoy your read.Much better than taking anymore meds IMO.
A short acting benzodiazepam such as Valium (diazipam) would be effective in a low dose. I have heard some people find CBD effective. Neither will affect your afib. etheral
It could be the Bisoprolol that’s affecting your sleep. I noticed that when I was first given Bisoprolol, it disrupted my sleep. So much so, that I was waking every 2 hours. I was given 2.5mg and since reducing last Summer to 1.25mg, I wake up once, but it’s always to go to the loo. Is that the reason that you might be waking? I know it sounds strange, but I try and keep my eyes closed for most of the ‘journey’ to the bathroom ( we have an en-suite, so it’s not far, fortunately). I also try and have very little fluid after about 6.30 pm which also helps.
My doctor also tried mirtazepine about 18 months ago and I only put up with that for about 3 nights as I too got vivid dreams and also muscle spasms like you, so I stopped them pretty quick. Have you tried magnesium supplements at all? I found they have helped me a lot. I take them throughout the day and also about an hour before bed. They don’t work miracles, but worth a try.
I also was prescribed a few low dose zopiclone sleeping pills around that time, which I was told to take intermittently and I couldn’t be prescribed them again, like you found. I only took a few, which got me over a short spell, but they weren’t perfect either.
I’m not saying reduce your Bisoprolol, but you could have further talks with your GP. My heart rate and BP are strangely still the same after reducing from 2.5 to 1.25 very, very slowly ( took me about 4 months) and I no longer wake every 2 hours. We are all very different though and what affects me, might not be like that for you or anyone else.
I am sorry you are experiencing this. I would say however, don’t even look at the clock. I used to and found when I stopped looking , the sleep got better as well. It really doesn’t help.
I appreciate your lengthy reply. I take 1.25 mg; been talking them since 2015, so probably not a factor. My heart rate is around 45 - 50. Bisoprolol with Fleicanide apparently to prevent ectopics, according to consultant electrophysiologist.
My doctor prescribed 30mg Mirtazapine when I was diagnosed with cancer and was finding it very hard to cope. The first dose I took I felt like a zombie the next day and decided they weren't for me. Then I decided to try again and it took a few weeks but they worked and certainly took the edge off my extreme anxiety. I take them last thing at night and although I have vivid dreams they are not overwhelming and they do quieten the chattering voices in my head at night. I don't have any of the other listed side effects.
You have my sympathy with insomnia, my husband suffers terribly and it is the subject we talk about every morning - the quality of sleep of his sleep the night before.
Probably 3hrs, but I soon go back to sleep again until about 7.30-8am. So that's 7.5 to 8 hours. Usually go to sleep about 11.30pm-12 . Oddly this morning I slept until 4am and then went back to sleep.
Hi Jean I take Zopiclone 3.75 mg. But cut them in half. They do get me off. I still wake 2 or 3 times per night and have done for years. So I wouldn't say our friend has chronic insomnia if she only wakes once at 3 a.m. Try going to bed your usual time and when you wake at 3 then take half a Zopiclone. Kind regards Terry. P.s. I do not take them every night.
Try something natural like Chamomile tea and Magnesium Glycinate to help regulate neurotransmitters that are directly related to sleep. However, it may be helpful to first clear your body of all those meds for a few days.
Hi Pacific One of the GPs at our surgery said that amitriptyline should not be used if you have afib because it excites the heart????? This was in connection with searching for a pain killer for nerve pains. Yet, another GP, who probably never read my notes, prescribed it. I was too frightened to take it......... I have used it pre-fib days, but did not find it worked on that occasion.
Definitely contraindicated with afib, although tat doesn't mean everyone will experience bad effects, but will increase your chances of afib occurring.
You seem to have the same problem as me so you're not alone. I was also prescribed Zopiclone to try to break the cycle waking up at around 3am. I'd stay awake for about an hour then nod off again before waking at about 5 am and that was it for that night. Sometimes I woke up more frequently and had longer periods awake so I only managed about 2 hrs a night, which I found difficult. Anything above 4 hrs I cope with easily. After the first course of Zopiclone (14 tablets), my doctor allowed me a second course but neither of them worked and, although, I slept well if I took one, I was back to the same insomniac pattern if I didn't. The reason for not prescribing more is that they are extremely additive and loose their effect if you take them for long periods, so you finish up addicted to them but not being able to sleep.
After some discussion, I manged to persuade her to let me have 7 tablets a month (7.5mg) and, after a while, I learned that cutting them in half would give me around 6 hours sleep a night, which I can easily cope with.
I've been doing this for about 3 years now and I'm not addicted to them and I still get about 6 hours when I take a half tab. On the nights when I don't take one, I'm back to waking up at 3 am as before.
What I suggest, is that you go back to your doctor and see if he or she won't agree to letting you have a few tablets a month so that you get a decent night's sleep some of the time.
So many of us with insomnia! I wake up at midnight and 3am. My latest idea is working and that is listening to podcasts. It doesn't seem to matter what content I listen to I drift off to sleep. The content seems to take over the committee in my head.
I had been on mirtazapine, briefly as it knocked me out. Listening to Dr. S. Gupta on medication. mirtazapine although being one of the safest is still a risk to take with Afib. The docs keep mentioning the QT interval. The interval and weight gain as a side effect are enough for me not to use it. When I am desperate, once every couple of months, I take one-half of a tablet and I sleep, dozy for a couple of days after.
Another trick that helps me is to sleep in a position where I am reclining to a semi sitting position.
I do what you do, Podcasts seem to stop my own thoughts and calm me down. I have tried soothing music but for some reason it irritates me.
Michael Breus, PhDDiplomate, American Board of Sleep MedicineFellow, American Academy of Sleep Medicine. Look up this Dr. He talks of sleep chronotypes and I am a dolphin which means I never really sleep deep. The more I worry about my lack of sleep the more I can’t sleep. Sometimes I just am not tired, I do exercise but nothing seems to matter. All the best.
The 3am waking I gather is due to chronic stress. Cortisol the fight and flight hormone peaks then instead of being a minimum and then sinks instead of rising when you want to start your day! Had this ever since Autumn 2020 after coming out shielding with my partner and long before I got post covid AF in March 2022. Despite all sorts of dietary mods cutting out caffeine exercise magnesium supplements breath work etc nothing works. It is all stress related but my life is very stressful and there is no fix for that .
I’m not conscious of feeling stressed. I feel fortunate, despite what tragedies life has thrown at me. I do acts of small kindnesses every day whether it’s donating to a food bank, saying hello to people who live alone, or sending articles about subjects that are of interest to them. I know COVID was a destructive force regarding mental health. I know so many children who suffered in this way; they had a long and rocky path back to their former selves.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Permanent atrial fibrillation and little or no sleep.
Insomnia and bisoprolol 
Just after some advice
Flecainide and dreams
Cardio workout whilst sleeping 
