Sleep Maintenance Insomnia - 3am racing heart awakening

[daleuk]

Hey guys, so here is my brief story, I am 33yrs old, never had health issues do not smoke/drink and before insomnia was running marathons, for 3 years I have had some difficultly sleeping. It has always been easy to get initial sleep onset but I ALWAYS awaken between 2-3am. When I wake it feels that my heart is racing, as if it was my heart that had woke me, not that I believe I worry once I am awake (not sure if its really possible to determine that). I practice Yoga, Meditation by day, and try breathing exercises on awakening, but it does not do the trick. Sleep Hygiene, I do it all.

Over the 3 years, I have always woken, but sometimes I was able to return to some sort of sleep, I got enough rest to feel half decent (but never great). I even took time off 6 months, and travelled, zero stresses, during this time the awakening persisted.

I have known about CBTi techniques for sometime, the first time I tried Sleep Restriction (Dec 2016) I achieved 6hrs sleep (7hrs total time in bed TTIB), but the awakening persisted, maybe it shifted a little to 3:30-4am.

Since Jan 2019 insomnia was so bad, I moved from Cyprus back to the UK, sunny to winter UK... so I started Sleep Restriction + SAD light, I developed Tinnitus in the process, at the start I got an average of 3.3 hrs sleep, 6 hard weeks later (initially 5.5 was too hard, then 6hrs TTIB), my last and best week was 5 hrs sleep (it was very inconsistent) - this still felt very inadequate and I was not able to continue any further because my awakening became so much stronger heart and I developed chest aches. I went to A&E but they did not seem to be able to do anything for me. My heart rhythm I am told is fine.

My GP is quite useless, hes done all basic blood tests, I am not diabetic, no low blood sugar, no pain, thyroid ok, liver ok, does not understand mental health or anything very well, although he suggests it may be anxiety, although in the day I do not feel anxious but then I though maybe it could be sublingual, the only aspect I do think about is trying to 'cure' insomnia... yes this could be my problem. He suggested try anti-anxiety drug Celexa, I do dislike taking drugs (never had the need before) I tried it for one day... and wow even that day I really did not feel like me, horrible, I read many symptoms subside with time, but actually I didnt like that it would cut my emotions both at the top and the bottom, I like to feel! I read about Mirtazapine, again it sounds such a strong and serious drug. Is there something else better suited to my situation, something to calm the heart or mildly sooth anxiety? or should i go all in with Celexa or Mirtazapine?

*I have been worrying myself about possible insomnia 'causes' such as dental Amalgam and that I had a titanium dental implant about 4 months before I really considered myself to have sleep problems, although the amalgam I have had since a young age and the implant really psychically was successful and gives me no bother; is completely BS and the wrong thing to think as being a possible cause, and I need to forget this and move on???*

I know that when I can sleep 5.5hrs plus, happens every blue moon, I can feel good and enjoy my day.

Most recently I noticed taking 1mg of time release Melatonin, really seems to have slowed my heart rate down and seems to provide a bit of relief, leaves me somewhat groggy by the day, but only 2nd day of trying this out, tonight ill split the pill.

The more I fight it the more it fights me?! so I am to just ignore it, forget about it..?

*Is your insomnia only the awakening? is there someone else that gets the fast heart rate that apparently causes this? is this insomnia and purely cognitive in its cause? is sleepio sleep restriction the way to tackle this? *

I have stepped off Sleep Restriction and taking a break again, and will try again once I can commit to it when I stop work at the end of the month.

[Kkimm]

Hi daleuk

Lack of sleep and worrying about it can be a very difficult and disabling problem and I do feel for you.

I became ill with Generalized Anxiety Disorder about 20 months ago and am now fully recovered, including of all the sleep problems that went with it. This came as a result of 2 life traumas in quick succession and in my case came on quite suddenly.

Prior to this happening I had for many years woken around 3.00 or 4.00 most nights and took a few hours to get back to sleep. I usually spent the time lying in bed worrying and problems always seemed worse at that time of night.

Whilst ill with anxiety I found sleep very difficult, like you I would fall asleep then wake up again. This happened over and over again and I became exhausted. I also had a full range of other symptoms, loss of appetite, nausea, feeling strange and out of my visit, dizzyness, heart pounding etc.

When I went to the GP to seek help he gave me the antidepressant Venlafaxine and although this made me feel much worse and was very frightening to begin with after around 4 months I felt nearly back to normal and was more or less fully recovered within a year and really enjoying life again. I do not know if you would benefit from taking antidepressants as I do not think insomnia is cause enough to start on antidepressants as you should not take them unless they are really necessary as they do affect you in a big way but in my view are an essential support if you are really ill with an anxiety disorder or serious depression.

My sleep problem was helped by another drug called zopiclone which is a sleeping tablet.

I was given 7.5 mg to take a night but I am very aware they are strong and addictive so always just took half a tablet unless I woke again in the night and then took the other half which happened rarely.

The other aspect which is important us to get a good bedtime routine. No screens an hour before sleeping, hot bath to relax and read a book in bed to help if this relaxes you. Make sure the room is completely dark and if possible there are no noises to disturb you.

I found that to begin with Nytol which you can buy over the counter in chemists was very good instead of zopiclone. It is an antihistamine and can also be addictive so it is very important with this or zopiclone that you do not take over the correct dose. Most of the time for me Nytol was not enough and I did need zopiclone until I was gradually able to sleep without anything at all but still stuck to the bedtime routine.

This solved my insomnia problem within a few months but the anxiety took much longer. This was overcome by continuing with the antidepressants and making sure I undertook challenges each day and gradually everything became easier.

I really wish you luck with overcoming your sleep problems and your anxiety.

Kim