My sleep is just awful at the moment. For weeks now I get less than 2 hours sleep a night. I am currently taking Sertraline for some issues I have. I have been on this for a couple of years now.
I go to bed because I am nodding off on the sofa but as soon as the light goes off in the bedroom it comes in in my head.
I have tried listening to music/podcasts, warm bath, Lavender oil, sleep pillow sprays, warming chamomile eye masks, milky drinks, gentle exercise, you name it I have tried it.
I tried taking Nytol and nothing, Kalms night and nothing and was prescribed Zopiclone which on a dose of 7.5mg, still did nothing. The Dr won't prescribe me a higher dose as he said they are not meant for long term use.
I am getting desperate now. Last night I had 1 hour sleep and then have to get up and go do a full day at work. I am at my wits end right now.
The lack of sleep is affecting my mood and I get very emotional very easily, I'm moody with my partner, I have no energy or motivation at all. My skin is dull and my eyes are burning with tiredness.
Can anyone offer me any advice?
Thanks.
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Stormtrooper4
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From your previous posts, it sounds like you have so much going on in life and I can't imagine what you are having to deal with on top of going to work so I'm not surprised your sleep is affected. My heart goes out to you.
Your mind must be racing so maybe that's what needs to be calmed? Are you being supported by your work, partner, family, GP in that respect?
Do you have someone you can talk to in confidence? Is that something you could consider?
It's OK to have some time out for yourself no matter how long or short that is. Having a breather may help?
I am so sorry you're going through this. I have gone through something similar. I can tell you the more you worry about the lack of sleep, the more you will not sleep. It becomes a vicious cycle. You have to get to a place where you think to yourself if you sleep great, if you don't oh well. You will survive. It really stinks to not sleep., And you don't feel well, but it will not kill you and you will eventually sleep better. Make sure you get some sunshine everyday to help regulate your circadian rhythm. Walk for about a half hour a day. Write down all the things you are worried about and set them aside, And tell yourself when you go to bed You cannot think of the things you wrote on that paper until the next day. Make sure your room is cool, And keep the same bedtime every night. Once you can stop worrying about Sleeping so much it will get better. It takes time but I promise you it will get better. Hang on. Do your best to not obsess about it. Do your worrying during the day, And allow yourself to not Think about problems in the evening. And above all, Pray to God to help you get through this time. Jesus will sustain you. This is not permanent, It will get better.
I think the comment here about sleep apnoea is very poignant as I went through a very similar process and it took years for them to find it. I couldn't however get on with the CPAP but I use a body cushion which keeps me from sleeping on my back it's actually a maternity pillow and it works really well actually. I still have some central sleep apnoea but usually when I'm stressed it's much more reduced and the obstructive sleep apnoea is definitely prevented by the pillow. I think I had it quite bad as well. I wanted to suggest something as well though because for years in the early times I went through this they missed an iron deficiency. Clinical iron deficiency is not true iron deficiency it's just when you're radically low and could die. You can be dramatically deficient in iron way before that and the best way I can describe it is looking at the ferritin levels and having a full iron blood check which they do specially. So from memory I think anything below 22 is clinically deficient but anything under 100 means you are under the appropriate healthy level of iron. It's hard to get decent iron though without a prescription and doctors are not always supportive if you are over 22 but under 100 but I cannot underestimate to you how effective that was in recovery for me. I still have to manage blood sugar as well and it definitely been a complicated journey that took years but I wanted to share my own part so you could perhaps take or leave what helps you. I also went through the menopause but it didn't affect me as much as the other things here. So it's worth a shot as it's a miserable existence without good sleep but I really do think the apnoea thing and the iron things are too very key areas that you should try. If you're in any doubt and you don't have hemochromatosis I would try taking a decent maintenance dose every day for a good while which won't take you over the dangerous levels. It's perfectly safe and you can see if it made a difference but I slept like a baby on it for a good long time. Before that I was going for a month at a time without any sleep night or day and the suffering was unimaginable.
Have you ever considered Hypnosis? I have a CD for relaxation and insomnia. They can be very helpful. I have a few for relaxation and anxiety. Well worth a try. Glen Harold has a voice I like. I bought mine from Amazon.
If your thoughts won't shut up trying writing it all down or I use penzu online diary that can be accessed from any device with internet. If you are not too sensitive to electronics and it's best to always use dimmed, blue screen filters shortly after sunset or several hours before bed.
Did your sleep change within the 3 weeks after you started sertraline? SSRIs are named because they increase the amount of serotonin in the body and brain. For most this is a good thing and generally it is accepted by most medical organizations that raising serotonin only improves sleep. However, serotonin is the main alerting, "it's wake up now time" neurotransmitter. It should get broken down into melatonin when you have low enough exposure to light but not everyone's body is efficient enough, has a delayed response to light reduction, or is sensitive to light and the use of room lights and electronic screens prevents the drop in serotonin.
Too much melatonin can also be bad for sleep. Although generally people fall asleep better with higher melatonin. They just tend not to get deep sleep and wake easily, repeatedly, or feel like they never actually fell asleep despite losing track of time because they are only in stage 1 sleep the whole time.
SSRIs actually cause me agitation, restlessness, complete inability to sleep, and anxiety I don't normally have instead of improving anything. Even excessive sunlight exposure such as when camping or certain supplements known to raise serotonin can decrease my sleep quantity and quality as well as cause negative effects on emotions and cognitive function. Melatonin gets me stuck partially aware of my surroundings but also dreaming. Almost as if I'm hallucinating. The first time I tried taking it as a teenager I heard the cat meow in the hallway and then worried whether I'd closed my bedroom door and thought I was seeing the cat walk in my room where I had my gerbil cages. I then got stuck in sleep paralysis and couldn't do anything about it. I finally managed to come up with idea of telling my body to clap my hands and I thought I was fully awake at that point. I walked across my room, reached for the open door, and nearly fell in my fish tank because it was closed. Further experiments periodically over the next ~20 years of severe insomnia did not produce any better results when raising serotonin or melatonin by any method.
Despite the claimed high safety and low side effects SSRIs and other serotonin or melatonin increasing meds and supplements can have some odd, extreme, and opposite side effects in certain groups of people compared to what studies all determined they should.
Milk is bad for sleep. The reasoning in the past for it may not apply if not drinking raw milk and it tends to have a stronger negative impact on digestion that makes it harder to sleep. Probably at least 90% of the effect of all those other things you mentioned along with it is mental. It only works if sitting down to drink tea or enjoying pleasant scents in a comfortable environment helps you mentally and emotionally to calm down and relax. If it's just another chore or a desperate attempt to sleep instead of concentrating on what relaxes you then it won't work. Any effect those things have beyond psychological is negated by your failure to relax.
Some people even find going for a run before sleep helps. When I was younger and in better shape I used to alternate jogging and walking for 2-3miles across the farm fields around my house within 30mins of going to bed. When I started having health problems I found myself constantly pacing the house when I should be sleeping until I started taking belsomra and now use dayvigo. I also got diagnosed with ADHD partially because I decided to finally ignore the advice to avoid caffeine and realized it was quite calming to me. I had figured out the exact quantity of a can of caffeinated soda to drink quickly when it got to be 2-3am and I hadn't fallen asleep yet. Never failed except for the getting up to pee about 15mins later but then I'd fall right back to sleep again. I started using dopamine based supplements often marketed for daytime energy and longer gym workouts before bed so my psychiatrist/neurologist decided to test that theory.
Prescription stimulants knock me out. Serotonin keeps me up. Total reverse of what every doctor will tell you but plenty of people work that way even if they don't have severe enough symptoms to meet the criteria for ADHD. Dopamine is normally considered a stimulating neurotransmitter that makes people alert and hyper but it actually has more down regulating or relaxing receptors than serotonin does and plays a major part in sleep. Too low of dopamine has nearly identical symptoms to excessive dopamine causing both those with normal levels who take supplements or stimulating substances and those with something like ADHD that causes at least some parts of the brain to be low in dopamine to have the same hyper, impulsive behavior with poor sleep timing, inability to sleep, inability to stay asleep, and often waking up after 4hrs. It gets overlooked by doctors that don't understand the complexities of sleep/wake triggers.
It's not the first thing I'd suggest since it's not typical but when you've tried the typical suggestions you start thinking outside the box. One doctor once called me a walking pharmaceutical experiment. I spent 5+ years sleeping 4hrs a night, frequently didn't sleep for 1-3days, and once went to the ER after not sleeping for 5 days because my general doctor was no longer comfortable prescribing me strong enough medication. Really don't think they believed me. I eventually had to start thinking waaaaay outside the box for what works for me instead of for everyone else and ended up throwing out most of the advice doctors had given. I do best if I'm active before bed, eat well before bed (hunger or thirst spikes cortisol which triggers wakefulness), take things that raise dopamine enough, control light exposure, and sometimes watch tv before or in bed. A book triggers my imagination and nothingness is the absolute worst so a dimmed tv screen works for me.
Light is the most consistent trigger. I have been living with the whole house on timed lights with screens dimming and turning on blue screen filter so they tint red for about 8 years now. It got easier with new smart leds that you can put in a regular ceiling fixture and set a timer on them with your phone. I used to have to install light strips on the ceiling. The difficulty is that it's only effective if you find lights that are close enough to daylight and extremely bright. You have to aim for as close to noon day sun as you can. Most use light therapy boxes instead or some diy equivalent so they don't have to light the entire room. Leds have also made it cheap enough to light a whole room though beyond the expense of multiple built in timer, daylight spectrum, high powered led bulbs.
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chronic insomnia for 19 years 
Melatonin and antidepressants Mirtazapine and Trazadone
Continuous bad dreams affecting sleep
New medication - 10mg Amitriptyline
Sleep is complicated or perhaps not so much
