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Edgar, with due respect, I think you are overreacting to someone’s opinion/someone’s post. I mean, you can leave the forum if you wish (or if you think it would be better for you), but I wouldn’t let one person’s opinion dictate what you do or do not do.
Hi Edgar,
I remember your story and replying to you on another thread and I wanted to update you on what has happened with me in the hopes that what I say might be helpful.
Like you, I have been suffering from “early awakening insomnia” and specifically, I would wake up after 4 or 4.5 hours and not be able to fall back asleep.
I was on two sleeping pills, one in the beginning of the night (I couldn’t fall asleep without one) and one in the middle of the night that I took when I got up in the middle of the night. Long and short of it, I discovered as I have been tapering off both of them, that the sleeping pills themselves were actually perpetuating the early morning awakening problem. My problem started in 2016 when I was suffering from a physical health issue that made it difficult to sleep as well as going through some very stressful life events. I imagine that if I had done nothing, that the insomnia would have disappeared after the initial factors that caused it abated, in other words, within months. Instead, I was put on this stupid medication regimen, which caused it to last 4-5 years. I’m still not out of the clear yet — I still awaken every night in the middle of the night, but I am increasingly falling right back to sleep when I do awaken.
Here is my advice— it seems like you have multiple things going on that is contributing to your poor sleep. I am no psychiatrist nor have I, even as a layperson, talked to you extensively, so I don’t know if you have OCD. I do know, from what you have described, that you in the very least, have a considerable amount of sleep anxiety. You also have a problem where you seem to need both Valium and/or alcohol in order to fall asleep, and you’ve admitted that you take Valium after your early morning awakening in an attempt to get more sleep.
So I think you need to tackle this from multiple angles. You need to get a handle on the sleep anxiety, but keep in mind, as my example illustrates, that decreasing the anxiety is a necessary but not necessarily sufficient factor toward restoring normal sleep. You probably also have to address the substance abuse issue –it’s been shown that both benzodiazepines and alcohol contribute to highly fragmented sleep.
You are probably at this point physically dependent on the Benzos so I would suggest you search out a physician that has the knowledge necessary to assist you with tapering off the Valium (as well as the alcohol). It is also necessary to shift your thinking — you will, as I did, as you are tapering off the medication and alcohol, experience some very bad nights — even nights of zero sleep. However, you need to shift your thinking and think about not what would be comfortable and get you possibly more sleep in the short run, but what would improve your sleep the most in the long run. I realize, that that must be extremely anxiety provoking (anticipating zero sleep nights) esp. when you are working full-time.
That is why I wanted to get back to you now, because as I recall, you are a teacher???? Maybe you could get a start on this process in the summer so it won’t be as difficult or anxiety-provoking as it would be when you have a heavier work schedule.
Just a heads up about Seroquel.
Seroquel is not a sleeping pill; it is an antipsychotic that is usually given for psychosis or at times, bipolar disorder. Now doctors can prescribe drugs for off-label uses (read: uses not listed above, outside of psychosis and bipolar) and in recent years, there has been a disturbing trend among psychiatrists to offer antipsychotics like Seroquel for insomnia, since it is also a tranquilizer and will make you drowsy.
However, the drug also comes with the possibility of serious side effects and can (esp. with prolonged use) cause disfiguring movement disorders (you can look up on youtube tardive dyskinesia, tardive dystonia, akathisia, etc.)
If you have a severe psychiatric disorder, then the benefits of the drug can possibly outweigh the risks; however, if you are taking the drug primarily for sleep then there are other, safer alternate drugs out there for that particular purpose and there are also alternative treatments to addressing sleep-related issues (like for example, CBT-I).
This message is not meant to contradict your psychiatrist ! But what I’m finding is that there are a number of doctors out there (chiefly psychiatrists) that are prescribing this drug for sleep WITHOUT informing patients of the risks of taking this drug and the fact that it is not a sleeping pill, but an antipsychotic.
So let me say reading the replies, that I both agree and disagree with some of the them.
See, I believe that benzodiazepine/sleeping pill addiction is both a real thing and is a real physical problem (in addiction to a psychological one and therefore, fixing your thinking alone isn’t necessarily enough).
Moreover, the way you’re using the Valium could be actively contributing to your sleep problem (I say “could” because obviously I’m not your personal physician and I am not qualified to make a specific claim). However, I have had your kind of insomnia for 4+ years (except that I wake up after an average of about 4 hours and instead of Valium, I take sleeping pills both at the beginning of the night and the middle of the night when I awaken.)
From working with my current sleep physician and my own research on sleep, here is why I believe using an anxiety or sleeping pill in the fashion you’re using it could complicate your sleep problem:
1) Sleep is very habitual. By taking a benzodiazepine or a sleeping pill frequently or every night in the middle of the night to fall back asleep, you are actually training your brain to wake up in the middle of the night in order to take the pill.
2) As Martin said, even without taking a benzo/sleeping pill in the middle of the night, sleep maintenance insomnia/early morning awakening insomnia can be challenging to treat because your sleep drive is lower in the middle of the night than it is in the very beginning of the night (of course this is a true for both normal sleepers and insomniacs)
3) Lastly, not only is your sleep drive lower after 5 hours than it would be at the beginning of the night, but you could be training yourself to become physically dependent on a benzo/sleeping pill in order to fall back asleep again (ie: literally, you could get to the point where you are like me and need to be knocked out by a pill in order to fall asleep again and that, combined with point 2, could create an insomnia that is much more difficult to treat).
I’m going to write more later when I have more time and tell what I’m doing to try and tackle my insomnia, but I just wanted to give you food for thought.
