[Colin657522]

Hi all, I was reading back on the posts here to see if I could find someone experiencing the same night time issues as myself. Here’s what happens for me;

I go to sleep at 10pm. I wake at approximately 4:30am, often with a rapid heart beat usually immediately after lucid dreaming. I do my best to keep calm and breathe slowly. I’ll often get out of bed and relax on the couch until I feel tired enough to fall asleep again. The trouble is the double sleeps keep me absolutely zonked tired, and sometimes it feels better to just stay awake and do my best with the day. This has been ongoing for the last 8 years and has had a big bearing on my quality of life.

Falling asleep is not an issue and initially I wondered if I was experiencing night time panic attacks during REM sleep. I’ve recently gone through a sleep clinic and it showed two things; during deep sleep I have no apnoea events/ during REM sleep I experienced 16 AHIs per hour. Clinically, I would not be diagnosed with sleep apnoea. Although it did indicate I was sensitive to oxygen desaturation.

Incidentally, I’ve tried using a CPAP machine for over a month and found myself exhausted from waking up multiple times a night. It’s a different kind of exhaustion from my normal exhaustion waking at 4:30 am.

I’m 34, a mouth breather. I don’t snore. The question now I’m wondering is this physiological or psychological? I’ve read that emotional issues/depression can cause awakenings.

It’s a bit frustrating and I’ve almost resigned myself to continuing life with the sleep I can get in that 10pm to 4:30am window. Has anyone experienced this before and resolved it?

Cheers,
Colin

[Martin Reed]

That sounds difficult, Colin. I can’t say for sure whether what you’ve described is physiological or psychological. Waking during the night is a normal part of sleep, but if the awakenings are caused by something like sleep apnea then treatment can help. CPAP can be hard to tolerate and ongoing experimentation with pressure settings (and different devices) can help.

When you wake around 4:30 AM, have you tried staying in bed instead of getting out of bed? Resting still offers restorative value, if sleep doesn’t show up. And, trying to make sleep happen or trying to control our thoughts and feelings (for example, trying to make “calm” happen or trying to push away worry, fear, or anything else) can draw us into a battle that makes sleep more difficult and is likely to consume more energy.

I hope there’s something useful here.

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[Colin657522]

Hi Matt,

Thanks for the reply.

Over the last year I’ve been pursuing different avenues to resolve it. It’s mad how I make it through most of the night but the wake up time is so routine. There’s no longer any clocks in my room. I don’t look at my phone but it’s always in the latter part of the night. I decided to give myself a break from the CPAP machine until the new year. I needed a bit of a break.

To be honest I do have a bit of an inner battle when I wake up. Past experiences have shown me that I usually won’t fall asleep if I stay laying down. I often feel an elevated heart rate. I feel warm and very alert. I have tried sitting up and just breathing until I yawn and then I lay down on the pillow again. Sometimes I fall asleep. A lot of the time I resist the idea of leaving the bed. But past experiences have shown me as well that moving to the couch helps me wind down again so I’m ready to sleep.

It’s strange in that I feel quite calm at the moment when I wake up. I’m don’t feel anxiety. Maybe I’ve resigned myself to accepting that this is just something that happens. This past week I had 3 nights (Tuesday, Wednesday and Thursday) where I consistently woke and struggled to fall back to sleep. I feel like the last two nights I vaguely remember waking but managed to make it through to the morning.

A good night sleep feels quite elusive at the moment.

[hiker]

Hi Colin, I am wondering if it would be helpful to explore further whether physiological aspects are in play.

I am a little confused why you are using a CPAP at this point. I would think you have seen a sleep medicine specialist if you have had a complete sleep study, and that the physician would have recommended a CPAP only if you had received a sleep apnea diagnosis. I use a CPAP, but I have apnea. I am surprised you would even get authorization, including insurance coverage, for a CPAP and supplies without such diagnosis. I certainly would not use one without a doctor’s recommendation. Am I missing something here?

Second, panic attacks. At least in my experience, I would experience difficulty breathing to the point where I thought I was on the verge of suffocating–in other words, major in-your-face panic. But you describe being calm at the point of awakening. This is not to negate what you are going through, but I am thinking a mental health professional might be able to rule out panic attacks once and for all. And if indeed you are suffering from something closely related, short-term, as needed medication could help. Since this would be prescription, it might help to see a psychiatrist, ARNP or other professional authorized to prescribe.

You mention depression. Unfortunately (maybe fortunately to be able to write this!) I know firsthand about this as well. It can lead to early morning awakenings, and sometimes it can be a bit hard to detect, without obvious signs. Or perhaps with a layer of anxiety on top of it, so it doesn’t present as the stereotypical dark, no-energy, maybe even suicidal feelings. Again, a mental health professional could address this with antidepressants.

Sorry this is so long, but I guess we have had some similar experiences. So there is one more, and that’s the rapid heartbeats. This might not be driving the insomnia directly, but I can certainly understand how you would be anxious about it. A cardiologist can typically run tests to see if there is anything to it. For me, it is atrial fibrillation (a-fib), which is dangerous if untreated but is no big deal with medication.

Whew, enough of all that. If it turns out you come out with a gold star on your physical exam, and of course still wondering where in the hell the insomnia is coming from, it may have started because of some life stress, and even if that passed, the insomnia decided to hang around. This is sleep anxiety: >>> I am getting more and more obsessed about not being able to sleep, which is making me exhausted, and now I can’t think straight, and around and around. This one I haven’t found doctors to be a whole lot of help. They are good at medical engineering and maybe they will chuck some pills at you that work for a little while, but that’s about it.

I have gone on too long here, so suffice to say that slowing down and being aware of how anxious you are can help. Way easier said than done. And like Martin says, it doesn’t mean giving up or sucking it up or accepting this is your fate. It does mean stop trying to make sleep happen, and believe me I know you want it to happen. Martin goes into this in detail in the course.

The next time you see a baby or little kid conked out in mother’s arms, know they didn’t put any effort into it.

Take care, you are not alone in this.

[Colin657522]

Firstly, thank you so much for all the above information!

To be honest I didn’t question the CPAP recommendation after the sleep study. It was explained to me that if I factored in my overall sleep I wouldn’t be diagnosed with sleep apnoea however there were two reasons behind the recommendation. 1) I’m a side sleeper but when I would change position to my back whilst asleep it resulted in oxygen desaturation to lows of 88% and I would have an awakening event soon after. 2) There was a high number of AHIs during my REM sleep. I’m not sure how it works out here in Australia but I was happy to give it a shot to resolve my issues. Unfortunately, it didn’t.

Yeah I definitely don’t experience panic attacks like you described. It’s hyper alertness but I’m always pretty calm. There could be an underlying low mood issue. I feel like it comes hand in hand with my poor sleep. Definitely, I feel a bit miserable some days when I’ve had a really bad night’s sleep but it’s all on a scale really. If I have had a bad but not terrible night’s sleep I manage to push through and remain pretty optimistic. To be honest, I hadn’t considered speaking to a psychiatrist before but maybe you’re right I ought to rule it out as a key contributing factor.

I hadn’t considered speaking to a cardiologist either. Can I ask did you experience heart related issues at night as a result of this condition as well? I think I should rule this one out as well. I’m quite active (run twice a week and use the gym) and I don’t recall experiencing any worrying heart related symptoms during the day. Being a mouth breather however for years I certainly have experienced getting breathless easily even when my body physically feels fine.

It sounds like you have been through the mill as well trying to resolve your sleep issues. I’m hopeful that I can improve the situation even just a bit. It’s hard going trying to juggle life’s responsibilities and not having the same recovery at night as the next person.

In any case you have given me a lot of fruit for thought. Thank you for being so generous with your time and for sharing your experiences.

Cheers,
Colin

[Chee2308]

Hi Colin,

I wonder why nobody mentioned that sleeping 6.5hours per night is actually a very healthy amount imo. Also, if rapid heartbeats present as some kind of a medical problem, then why aren’t these happening in the period from 10pm to 430am when you happen to sleep the most soundly and only “decided” to bother you after 430am after you have had your most restful and potentially most restorative sleep.

[hiker]

Hi Colin—-re your question about my own heart issue

No, it is unrelated to any insomnia I have had. I have never experienced any symptoms and it doesn’t impinge on exercise or anything. The afib was discovered when I was getting general anesthesia for routine surgery.

I never give it much thought, frankly. Though when I take my pulse, I can tell it is way out of rhythm. I take a blood thinner because untreated means significant risk of stroke.

I mentioned only to include it in a general physical to rule out any physiological causes of insomnia. A cardiologist should be able to tell you if you have afib, some other heart issue, or maybe it’s nothing of consequence.

[Colin657522]

Thanks for the insight again on the a-fib. I’m 100% taking on board your advice. Best to rule out the physical side of things first!

[Colin657522]

Hi Chee,

To be fair the sleep specialist at the sleep clinic did tell me that I was getting a reasonable amount of hours of sleep but the problem for me is that it’s never restorative. I’m permanently exhausted when I wake up. There’s permanent lines of tiredness under my eyes. I’m groggy and struggle during the day with brain fog and coherent thinking.

The logic shared by the sleep technician was that during the deeper stages of REM sleep toward the latter end of the night the muscles naturally relax and potentially my airways are being blocked causing my heart rate to accelerate.

All I know for sure is that my Apnoea-Hypopnea Index skyrocketed in REM sleep during my sleep study. I wake with a rapid heart beat about 6 hours into sleep (sometimes earlier) and it’s been ongoing for years. As far as I’m aware the REM sleep is when the restorative aspects of sleep happen and I don’t seem to be able to make it through for a full night’s sleep.

Cheers,
Colin

[Chee2308]

Hello Colin!

I can only wish you the best of luck and hope you find your remedy soon.

• This reply was modified 3 weeks, 5 days ago by Chee2308.
• This reply was modified 3 weeks, 5 days ago by Chee2308.

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