71 yr young chronic insomniac. Super healthy and could write the book on sleep hygiene but still jerked out of sleep every night 2-3am. Any new hacks/drugs/ concepts out there for middle of the night wake up?
Middle of the night wake up : 71 yr young... - Sleep Matters
If you "pop" awake and can't sleep anymore then you may be running too low on cortisolin the middle of the night. You get a jolt of adrenaline to stimulate your adrenal glands. I tried taking .5 mg with dinner, and voila! I began to sleep through the night. Subtract the
.5 mg from your regular morning dose. If I wake up too early, like 4 or 5, I take some calcium/ magnesium and sleep for another two hours.
There are unique aspects to sleep with aging that I haven't yet had reason to look at in depth since I'm only 36. The brain gets worse at staying asleep and getting enough rem sleep the older you get. Circadian rhythm problems and short sleep periods become more common. It's one of those problems of aging that many are trying to solve in order to improve lifespan and reduce the health problems that get more common the older you are.
Rozerem is a medication aimed mostly at improving the use of melatonin in older patients since simply supplementing melatonin often no longer works. While previously it was believed melatonin sensitivity and production declined slightly throughout life and consistently more noticeably at around 60-70 years old it seems more recent research shows it depends on health and other signs of aging. Levels decline when other hormones and overall health begins to decline, especially with age, but not in those that do not notice much reduction in physical or mental ability.
Belsomra is another potentially useful medication that showed no side effects, tolerance, or withdrawal in studies. It got stuck with the sedative-hypnotic class (benzos and z-drugs) and some supposed side effects listed that never actually happened in studies, at least in the US that's how it's listed, but it is nothing like a sedative. Instead of making you sleepier or trying to directly downregulate the nervous system and brain activity it blocks orexin. Orexin is one of those things that triggers alerting substances like cortisol as well as serotonin, histamines, and many others to increase alertness and wake you up. People low in orexin develop narcolepsy and belsomra is the result of research into narcolepsy treatments. Unfortunately for narcoleptics they could only figure out how to make an orexin antagonist but fortunately for those of us with sleep disorders it means there is a very unique insomnia drug that sometimes works well for odd awakenings or difficulty remaining sleepy and in bed at night. It really has no proven negatives to taking it.
Of course rozerem or belsomra would require a doctor visit and prescription but coming up with otc solutions is a little difficult since like I said age tends to bring an overall decline in sleep. It's less likely to be a specific health issue or result of stress/anxiety like is common in someone who is in their 20-30s complaining of sleep issues. It's more likely to be the body producing less of numerous things all combining to interfere with sleep so it's hard to know where to start. Websites aimed at making use of longevity research and doctors specializing in the effects of aging would probably be more helpful than sources of general insomnia knowledge. Sometimes the oddest things are connected to a sleep problem.
Cortisol spikes are a common reason to suddenly feel awake and can be triggered by many other problems. Actually the opposite of what the other person said about low levels. Generally low levels are not an issue unless you have a fairly uncommon health problem. Needing to make up for low levels via other methods is definitely a sign of further problems and should be causing numerous daytime symptoms as well.
Cortisol is used to keep you alert and active as well as to control the immune system and reduce inflammation. It's also possible that if increased cortisol or certain steroids helps someone sleep it's not low cortisol but instead is the result of an overactive immune system or other immune system disorder. While lower cortisol helps you feel sleepier the drop in cortisol and histamines at night can cause flare ups of allergy symptoms, chronic inflammatory disorders, and increases in pain such as arthritis and other joint problems because of it.
Normally the body has several systems that can trigger cortisol and it reacts quickly so it is a very frequent cause of sudden bursts of energy or wakefulness or trouble "winding down" and falling asleep at night. It will react to physical issues like low blood sugar as well as mental stress or perceived danger. It's meant to provide you with the wakefulness and motivation needed to fulfill your needs or deal with and get away from a stressful situation. It's far more common to have reasons to lower cortisol for sleep disorders.
Phosphatidylserine is an otc supplement that consistently lowered cortisol levels in studies. Some people also get benefits eating a small amount of low sugar, slower to digest foods closer to bedtime than they normally would to maintain blood sugar through the night. Sometimes blocking out sounds with white noise, thick curtains, or sound absorbing panels can also help reduce wakefulness triggers such as cortisol.
Timing and type of food can have other effects. The function of the GI tract actually has a big impact on the rest of the body and can become less effective at digesting and absorbing nutrients with age. A lot of hormones, neurotransmitters, and peptides sit around in the intestines and digestion or the opposite when there is no food to digest can trigger numerous systems in the body to start releasing energy or generate more or less of those hormones, neurotransmitters, and peptides. Of course digesting food and absorbing the result in the first place is needed to make all those things so they exist to react to your next meal.
Peptide research is gaining popularity but unfortunately are not easily available as supplements or medications yet. They have been found to impact not only metabolism and obesity but also to speed healing by increasing tissue growth and/or reducing inflammation. There is also a creatively named peptide called DSIP-deep sleep inducing peptide that triggers sleep and more deep sleep during the night. You are less likely to wake up from deep sleep. Peptides may be a major part of future medicine but for now unless you want to risk messing with research chemicals we are mostly limited to making diet and meal timing changes as well as supplementing vitamins, minerals and other chemical compounds such as methyl donors that the body needs to try to produce more of these things.
Reductions in dopamine production or dopamine pathway problems is another thing that can lead to sudden bursts of wakefulness or energy but usually this happens prior to fully falling asleep. Dopamine levels steadily recover while sleeping so once asleep for a period of time the body should no longer need to react to a low dopamine problem. However, taking a little macuna puriens or otc l-dopa refined from it to test your reaction to an increase in dopamine should have no more risk than caffeine if not taken in high dosages. Dopamine is related to epinephrine so increases in heart rate or anxiety do happen for some. Those who have low dopamine like me (ADHD) usually find it increases deep and REM sleep making it less likely you wake up in the middle of the night and you feel more rested the next day. Those with normal dopamine levels and function use l-dopa a lot like caffeine or energy drinks because it keeps them awake and productive while potentially causing sleep disturbances. One of those things that you often have no idea whether it's a problem or normal until you test something that alters it.
Magnesium glycinate, nicotinamide (NAD or NMN supplements), and light therapy are the best general things I've found both from research and personal experience for trying to generate a normal sleep pattern and avoid odd sleep or wake times. NAD currently is the least proven for safety and side effect potential but also the most promising and has a lot of research being done on it lately.
I have a problem from time to time waking at say 3.30am and not being able to return to sleep. Because I often go to sleep at 9.30pm that is not necessarily as bad as it sounds.
My current working hypothesis is that this is the Cortisol Awakening Response where the HPA kicks into action to get me going for the day. I have started taking some HPA supplements and have two regimes that I will test for cutting down the response.
I am 61 and male.
Last night I managed to measure over 7 hours sleep (which is rare)
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