Severe insomnia

This topic contains 8 replies, has 3 voices, and was last updated by LCF 2 hours, 21 minutes ago.

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  • #30657

    ✘ Not a client

    I’ve had bouts of insomnia since I was a child of 6-7, but it was only ever an occasional thing until I hit menopause.  Since then it’s been horrific.  While I was working, about 20 years ago, my GP put me on Lorazepam 1 mg, and I used it happily for 15 years with no side effects.  When I retired I came off it, and then the trouble started for me.  I was able to sleep right away, but often I’d wake up after an hour or two.  It’s progressed now to the point where I often don’t sleep at all.

    I’ve tried everything, and I mean everything.  Low-dose antidepressants worked for a while, and then they stopped abruptly and have never worked since.  Progesterone therapy worked for a while, and then stopped.  The natural remedies worked for a while, and then stopped.  My current doctor has given me some sleeping pills for when I absolutely have to sleep, but I can’t live this way. Most nights I sleep 0-2 hours.

    I’m dealing with a partner who is dying of cancer, and I am his emotional support and will be his caregiver.  I have to sleep.

    I tried SRT earlier this year and became so ill I had to stop.  Is this the wrong time for me to even consider SRT?



    Martin Reed
    ★ Admin

    Sorry to hear about your struggle with sleep, LCF.

    Can you tell us a bit more about the sleep restriction therapy you tried? How many hours of sleep were you getting and what was your prescribed earliest bedtime and latest out of bed time?


    ✘ Not a client

    My sleep restriction therapy (it’s euphemistically called sleep consolidation therapy here) was the basic one:  don’t lie in bed awake for more than 20 minutes, keep a diary, get up at the same time each day, don’t take naps.

    My initial sleep window was 6 hours; from midnight to 6 am.  In the whole 5 weeks I don’t think I slept more than three hours in a night, and even then it wasn’t three contiguous hours, it was broken by an hour or two being awake.  A few times I had to break down and use a sleep aid because I can’t drive on the amount of sleep I get.  Most nights I got between 0-2 hours, which is about what I get now.

    The only way I can survive at all is to use sleep aids a couple of times a week; otherwise I wouldn’t be able to function at all. I’m trying to stay positive for my partner, but it’s almost impossible on no sleep.  My exhaustion also comes with nausea and dizziness, which means most days I’m afraid to drive.

    Of course, I also fear my future.  I imagine another 25 years of life like this, and frankly, it wouldn’t be worth living. That doesn’t help, I know.

    (By the way, the avatar your site chose for me is very apt; it looks like I feel).

    • This reply was modified 1 week ago by LCF.

    ✘ Not a client

    I know you said you have tried hormone therapy, was that progesterone and an estrogen patch? That helped me some after menopause, maybe you need your dosage tweeked?

    I too am a caregiver of an adult disabled child and unfortunately an emotionally abusive spouse that has kidney failure. My insomnia started from a side effect of medication, but my home life has exasperated the situation. I had to take a sleep aid last night, I’m upset because I was doing very well for 4 nights.

    I spoke with a therapist and she said I put to many performance requirements on myself – you may be doing the same being a caregiver to a critically ill spouse. Maybe for a while ask God to fully support and take care of your spouse, or seek respite care, something to ease your caregiving so you can take care of yourself. My sleep doc told me to keep the last hour before bed, only to myself, my time. Dim the lights, take a warm shower, do gentle, relaxing things. He gave me a whole bunch of things to do, which ended up being stressful. So far the most calming activity before bed for me is coloring. I have a couple books and about 50 colored pencils. And also getting exercise during the day even on only 2 hours sleep makes me feel a bit better.


    ✘ Not a client


    Thank you for your kind reply.

    Yes, I am on both estrogen and progesterone and my levels are in the normal range. A high dose of oral progesterone had me sleeping like a rock for 18 months, even after my partner’s diagnosis — but one night it didn’t work, and that was that.  For good.

    I practise good sleep hygiene — and was overjoyed to see that the new Kindle device has a warm backlight so I can read before bed without worrying about blue/white light affecting my sleep. I have a regular bedtime and try to get up within half an hour of 7:00 am every morning.

    My partner doesn’t require any special kind of care right now.  My concern is that my lack of sleep leads to depression, and right now we’re focused on having as much fun as we can, so depression really gets in the way. I’m his emotional support, and that’s what’s suffering because of my insomnia.

    I am two different people.  When I sleep you can’t hold me back — I’m like the energizer bunny.  But after a week of 2 hour nights, I can’t even get dressed.


    Martin Reed
    ★ Admin

    Most people with chronic insomnia have great sleep hygiene! Sleep hygiene is known not to fix chronic insomnia.

    When you followed a sleep window of midnight to 6:00 AM for five weeks, did you make sure you didn’t go to bed before midnight, not nap during the day, always get out of bed by 6:00 AM, and always get out of bed during the night when you couldn’t sleep, every single day (without fail) for those five weeks?

    If so, how long ago did you try these techniques, and were you being regularly supported by a therapist or coach? Was it explained to you why these techniques can be so helpful or were you expected to simply blindly follow those directions? I think a key to success is understanding why individual CBT-I techniques can be so helpful (and how they work) and having adequate support and guidance throughout implementation.


    ✘ Not a client

    I went through the CBT in March/April of this year, about a month after having a night in the local sleep clinic to rule out apnea.

    It was a five-week course.  I kept a sleep diary on line. I had a weekly “coaching” session, which was really just a review of my on-line sleep diary plus a few pretty basic relaxation techniques

    I went to bed at midnight without fail, got up at 6 without fail, I never stayed in bed if I wasn’t sleeping, and I have never been able to nap, so that wasn’t an issue for me either.  As the days went by I became more and more anxious, I was constantly nauseated and dizzy, and by the end of the first week I no longer dared to drive.  I had to cancel a dinner party we had planned because there was no way I could cook for eight people and sit and be sociable with them. After a week I was also loathe to go into my bedroom at all.  My asthma became so pronounced I had to back on my puffer full-time after nearly a year of not needing it.

    The most sleep I got on any night was three hours, but not in a three-hour block. Also, my pattern has always been to fall asleep quite quickly and then I wake up after a couple of hours.  Because of the requirement that I had to get up if I wasn’t asleep within 20 minutes, I just couldn’t go to sleep at all, I was so worried about it.

    The other thing is that once I get up, my heart starts racing and won’t stop. I don’t have heart disease, but I do have low blood pressure, which can do this.  So every time I got out of bed, my heart would start racing and pounding, and then of course there’s no going to sleep with that going on.

    In the end I think I must be one of the 20% who aren’t helped by these techniques.



    ✘ Not a client

    Sounds like your underlying issue is anxiety, so maybe the structure of Sleep Restriction was too much for you. Have you tried any forms of meditation, like progressive muscle relaxation or listening to guided meditation? I’ve found many decent mediation practices on YouTube and I swear there were days when I was so stressed and sleep deprived that if I didn’t listen to  one of these I’d probably be sent to a 5150 mental health lockdown unit.

    My sleep doctor recommended the practice of Stimulus Control first before Sleep Restriction. Martin has the info on SC here under “resources”. I practiced it for 3-4 weeks and then had a very decent week of sleep. That week I decided to take back my bedroom, (it was suggested I sleep away from my spouse for a while) I got an assortment of ear plugs to try to block out my husband’s Bi-Pap, bought some new crisp sheets and took a warm shower before bed each night. Then I had a setback for 3 days due to some stressors like job interviews and arguement with spouse, but thanks to the support here, last night was a little better falling asleep at midnight (after getting out of bed 3x) waking up at 5am with my husband’s alarm. I do not have a “sleep window” but try to fall asleep between 9:30pm-10pm knowing I will probably wake up around 5am. For me its so much less stressful than knowing I have to stay up until a certain time.

    Like with you there are days I could not drive, and I realize that for this time in my life I am also adding stress by seeking a full time job, when really a part time job would be better for my sanity. Hopefully your friends who you would like to have over for dinner will understand and support your situation. Last week was my birthday, my adult daughter wanted to take me out but the thought of making a plan was stressful, so I just told her I call her the morning of my bday and see how I feel. Without the stressor of a dinner reservation I slept really well and the day of my bday we were able to go out and enjoy ourselves. Maybe your friends can be a bit spontaneous with you.


    ✘ Not a client

    Right now, because of my husband’s situation, I am suffering from anxiety, of course, but the original problem really started 20 years ago, when I hit menopause.  Combined with my Hashimoto’s Thyroiditis, which went undiagnosed for decades, my endocrine system is a mess and no amount of dose tweaking seems to help.  Even when my thyroid numbers are optimal, I still have obvious physical symptoms.   And of course nobody really knows all that much about female hormones because we aren’t tested before menopause, so our individual optimal levels are unknown.

    I would say that my insomnia is about 60% medical and 40% anxiety at the moment.

    A couple of years ago I worked with a therapist who had me doing 20 minutes of meditation daily.  She swore it would help me sleep, but after a year of practice I gave up.  It did make me feel better in the moment, but as a sleep aid it was a bust.

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