Chronic insomnia

[Una1990]

Hey everyone,

I'm currently having horrible sleeping problems, to the extent of sleeping less than 5-10 hours per week. I did manage to see a neurologist in between national lockdowns, and got a zopiclone prescription and have been on it ever since.

I haven't gotten tolerant to it, surprisingly enough, and I can get one or two nights per week of my "natural sleep", which could be best described as being in deep thought.

I have had a bout of insomnia 2 years ago that was treated successfully with the same zopiclone, but I came off it with no problems whatsoever.

I tried sticking to 3 week use of zopiclone this time around as well and continued with melatonin afterwards, but the sleep quality was so awful that I could doze off into an autopilot mode in the middle of the day.

Has anyone had a similar experience?

[welly10]

Hi una1990 I had similar problems last year I got prescribed zopiclone also was on it for 6/7 weeks every day as I suffer with sleep anxiety if I don't sleep my mental health really goes down hill so I was In a vicious cycle.i asked my doctor to put me on online referral course sleepstation they see how you sleep for a week then they use sleep restriction and other methods to give you the best chance of natural sleep its a 7 week course if in UK.really helped me not used zopiclone since.good luck I really know how you feel.

[Una1990 in reply to welly10]

Thank you!Could you please describe the sleep restriction treatment?

[welly10 in reply to Una1990]

You record your first 7 days sleep then send it to the team who then set a sleep regime up for the next week ie go to bed at 1.30 am get up for 6.30 am and so on depending on your first week they adjust it as you go it needs doctors referral.they send you recorded messages and ideas.are you uk if so asked doctors about it.good luck

[kaliska0]

Short periods of insomnia aren't the definition of chronic. From your post it's repeating but it's acute episodes of a few weeks rather than several months or years straight.

Sudden short periods of insomnia are more likely to be psychiatric or behavioral. A sudden source of stress being the most common. Physical causes don't usually just go away with a short period of z-drugs and nothing else done. It would probably be best to see a therapist or psychiatrist and make sure to follow good behaviors for quality sleep.

sleepfoundation.org/sleep-h...

That said it is possible for a few things to come on quickly and then resolve on their own. Very severe insomnia with less than 4hrs per night does make it a bit more likely there is a physical cause and there are no doubt numerous things that can interfere with sleep we don't realize or understand. Potentially it's a variety of things combining with some triggering the others.

Hormones are one of the most likely suspects in sudden short periods of insomnia. Mild PCOS in women can go undiagnosed and cause episodes of high estrogen and sleeplessness that improves when the cysts go away and estrogen lowers again. Other reproductive disorders of both men and women can come and go as well. Some are triggered by ingesting or supplementing certain plant compounds that mimic hormones. Even herbal preservatives that may sound healthier than lists of chemical ingredients can trigger hormone receptors enough to cause symptoms in some people.

While stress is the most common cause of raised cortisol it can spike or just fail to drop at night for reasons other than stress. Cortisol is affected by other hormones, the immune system, glucose levels or hunger, thirst, exercise, etc... If you change the timing of meals or activity you can cause cortisol spikes at the wrong time. If any other system in the body gets thrown off you can end up with high cortisol and that means no or poor quality sleep even if no other symptoms are severe enough to notice. Phosphatidylserine has proven effective in studies at lowering cortisol whether caused by mental stress or a physical problem with the only risk typically being daytime fatigue.

Mild thyroid imbalances can cause insomnia and get worse with yearly temperature changes, diet, or stress. Even for those without thyroid problems some are as sensitive to temperature changes as they are to light changes from day to night. There's a saying of "warm feet, cool head". Researchers have found people sleep best in 65f (18.3c) with enough blankets to keep the rest of the body warm. Some don't really notice if their room is considerably warmer but for others a summer heat wave could add one more factor to a temporary sleep disturbance if you don't cool the room.

Illnesses or really bad seasonal allergies can trigger insomnia for short periods. Sometimes even if your symptoms are so mild you don't recognize it as an actual cold or flu you can still have sudden loss of sleep. Vaccines can also cause temporary loss of sleep for some. First generation antihistamines like bendaryl, unisom (sold more often as a sleep aid), or chlorpheniramine (often sold as chlor-tabs or other brands with chlor in the name) can be particularly helpful for immune system related sleep disorders. Sometimes they are just useful for short term insomnia even without allergies or illness but with a high rate of mild side effects such as dry mouth.

Unless you have reason to suspect one of those physical causes I'd suggest starting out trying daylight therapy sleepfoundation.org/light-t... It's generally easy to add to your day with only benefits. There are all sorts of solutions available but really all you need is enough watts of daylight spectrum (6,500k rating or higher) light. I just put a bright led strip like you'd find in offices or commercial buildings with daylight spectrum bulbs in it on the ceiling directly over my desk. It's on a timer to match my sleep/wake time so I don't have to worry about it. Some have installed the lights over their bed to help wake up faster and get light therapy immediately in the morning.

Other generally safe, low side effect options that can help regulate sleep timing and trigger sleep at night are glycine, magnesium, which you can get combined as magnesium glycinate, valerian root, nicotinamide (a form of vit b3 usually found as NMN or NAD supplements), and infrared or NIR (near infrared) spectrum lighting.

[Una1990 in reply to kaliska0]

Thanks, I will research that.I'm sorry, I reread my post and I need to clarify- first serious episode lasted for about 3 weeks after which I had a slightly improved period of a month, and now it has been pretty bad since last October. I have been to therapy, but that resulted with zopiclone as well. I could probably try another therapist.

[kaliska0]

If a therapist sees no underlying reason such as anxiety that needs medication they are limited to prescribing sedatives. There is no treatment for insomnia itself really. Mostly because insomnia is a symptom of another problem and we are idiots about sleep. Doctors are really horrid at finding an actual cause and research into sleep and sleep disorders just isn't advanced enough to understand it. All most doctors can do is guess, give you some mild sedatives, suggest some behavior changes, and hope it goes away. Even when I went to a neurologist specializing in sleep medicine they merely started talking about giving me stronger sedatives with higher side effects. I went down that road and I highly recommend trying to avoid the point where you are taking high dose antipsychotics or mixing 3-4 sedating medications. It's a dead end and your health will suffer even more than if you just deal with the sleep deprivation.

Always try the sleep hygiene and light therapy type solutions first but if the problem does not prove to be due to stress, anxiety, depression, other mood problems, or your situation and lifestyle then you have to basically stop asking doctors to treat insomnia because those are the only causes they are taught to treat. Try to find doctors that will look into possible other health problems in the hope of uncovering a cause that may not normally be looked for in a sleep disorder Which is quite difficult when you have no noticeable symptoms or only vague things everyone, including yourself, overlooks.

Another problem is that even when you find details of your sleep problem doctors often don't know what to do with it. A sleep study can tell you if you are only getting light stages of sleep and too little or no rem or deep sleep. However, doctors don't know why this is happening. There are theories for such things but they aren't considered proven. Doctors also don't know what might increase rem or deep sleep because it's also not well proven but there are things that have shown to be at least sometimes effective in studies. Things are not taught to doctors to use for treatment until it has shown a certain level of consistent results in groups of patients. Currently much of what is known about sleep and sleep disorders is only discussed among researchers trying to prove the theories, consistently repeat the results of some study that showed a certain substance helped, and come up with consistent treatments.

Doctors are mostly limited to being taught one option and typical insomnia medications can only suppress the symptom for awhile so it's less noticeable. That's why instead of a list of sedating substances I gave you a list of some common underlying causes or triggers of sleep disturbances and some of the safest options that help those particular causes. If the insomnia is not just a few very short term episodes then don't concentrate on how to drug yourself into sleep. Concentrate on reasons why you might not be sleeping and you might actually solve it forever instead of just sedating it into tolerable for awhile.

After constant insomnia for more than 8 years and many nights of only 4hrs sleep with sometimes going 3-5 days without sleep (urgent care never believed me when I said that) I ended up spending $1,000s out of pocket (US medical care) at an integrative health doctor to run blood tests that are not normally done. It even included some tests not fully approved by medical groups as valid or considered by most doctors to provide useful information.

Doctors didn't know what to do with that information so I looked into theories and the latest insomnia research until I accumulated so many studies and medical journal articles I quit trying to find anything in my bookmarks. I've probably been through supplements in the 100s As well as a doctor willing to prescribe the most off the wall med requests if I could give any logical argument or at least one study why it might help.

I have permanently improved my situation by a considerable amount but I have not reached the point I sleep great every night. Unfortunately what helps one person doesn't help another because insomnia is a symptom of a wide variety of causes. I can't just give a list of things to take or do that always fix insomnia because it will work for maybe 1 in 100 people. A list of things that make me worse will improve sleep for some other people.

Maybe the increase in telehealth will make it easier to find doctors knowledgeable in specific things or at least ones willing to work with patients and discuss theories with those that don't respond to the standard options. Maybe doctors will also start actually using the steadily improving telecommunications systems to discuss with each other and share information instead of generally relying on only their own medical school knowledge and personal experiences with patients.