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Hello Pike and welcome to the forum! As I think you realize, nobody here is qualified to give you advice on your medication — I would suggest raising your concerns with your prescribing doctor.
You mentioned that you often wake at 4:00 AM or 5:00 AM and then find it hard to fall back to sleep before getting out of bed to start your day around 6:45 AM. What time do you usually go to bed at night?
—If you are ready to stop struggling with insomnia you can enroll in the online insomnia coaching course right now! If you would prefer ongoing phone or video coaching calls as part of a powerful three month program that will help you reclaim your life from insomnia, consider applying for the Insomnia Mastery program.
The content of this post is provided for informational and educational purposes only. It is not medical advice and is not intended to diagnose, treat, cure, or prevent any disease, disorder, or medical condition. It should never replace any advice given to you by your physician or any other licensed healthcare provider. Insomnia Coach LLC offers coaching services only and does not provide therapy, counseling, medical advice, or medical treatment. All content is provided “as is” and without warranties, either express or implied.
Everything you’ve described is quite common among people with chronic insomnia, Veteran!
You said you’ve tried every method over the years — does that include cognitive behavioral therapy for insomnia (CBT-I)?
CBT-I techniques can be really helpful since they get to the root cause of the problem — they help tackle the thoughts and behaviors that perpetuate sleep disruption.
I am encouraged that you are able to recognize you can always get through the day, regardless of how you sleep — might there be anything you could do during the day to improve the quality of your days and shift attention away from sleep?
—If you are ready to stop struggling with insomnia you can enroll in the online insomnia coaching course right now! If you would prefer ongoing phone or video coaching calls as part of a powerful three month program that will help you reclaim your life from insomnia, consider applying for the Insomnia Mastery program.
The content of this post is provided for informational and educational purposes only. It is not medical advice and is not intended to diagnose, treat, cure, or prevent any disease, disorder, or medical condition. It should never replace any advice given to you by your physician or any other licensed healthcare provider. Insomnia Coach LLC offers coaching services only and does not provide therapy, counseling, medical advice, or medical treatment. All content is provided “as is” and without warranties, either express or implied.
Many people with chronic insomnia, quite understandably, believe that there might be a chemical imbalance in the brain or that there is a medical condition that is perpetuating their sleep disruption.
The fact of the matter is that, when it comes to chronic insomnia disorder, sleep disruption is perpetuated by our sleep-related thoughts and behaviors (one of which might be a concern that there is a medical cause of our insomnia).
So, if medical issues have been ruled out, I’d suggest looking into cognitive behavioral therapy for insomnia (CBT-I) since that will help address the thoughts and behaviors that perpetuate sleep disruption.
I have yet to come across anyone who has found their chronic insomnia was permanently cured by a supplement or vitamin, or that a chemical imbalance was to blame for their sleep issues.
I hope this helps!
—If you are ready to stop struggling with insomnia you can enroll in the online insomnia coaching course right now! If you would prefer ongoing phone or video coaching calls as part of a powerful three month program that will help you reclaim your life from insomnia, consider applying for the Insomnia Mastery program.
The content of this post is provided for informational and educational purposes only. It is not medical advice and is not intended to diagnose, treat, cure, or prevent any disease, disorder, or medical condition. It should never replace any advice given to you by your physician or any other licensed healthcare provider. Insomnia Coach LLC offers coaching services only and does not provide therapy, counseling, medical advice, or medical treatment. All content is provided “as is” and without warranties, either express or implied.
I’d suggest raising your concerns about that morning grogginess with your prescribing doctor — perhaps they can modify the dose, change the timing of when you take the medication, and/or explore a different treatment option.
Have you looked into an alternative to medication, such as cognitive behavioral therapy for insomnia (CBT-I)?
—If you are ready to stop struggling with insomnia you can enroll in the online insomnia coaching course right now! If you would prefer ongoing phone or video coaching calls as part of a powerful three month program that will help you reclaim your life from insomnia, consider applying for the Insomnia Mastery program.
The content of this post is provided for informational and educational purposes only. It is not medical advice and is not intended to diagnose, treat, cure, or prevent any disease, disorder, or medical condition. It should never replace any advice given to you by your physician or any other licensed healthcare provider. Insomnia Coach LLC offers coaching services only and does not provide therapy, counseling, medical advice, or medical treatment. All content is provided “as is” and without warranties, either express or implied.
I have worked with so many people who can trace the initial trigger of their insomnia to parenthood! The fact of the matter is, there are probably as many initial triggers of insomnia as there are people in the world — but long-term sleep disruption is only sustained by a change in the way we think about sleep and by a change in our sleep-related behaviors.
These thoughts and behaviors perpetuate sleep disruption because they can reduce sleep drive, disrupt the body clock, and increase arousal.
So, with all this in mind, anything we can to do build sleep drive, strengthen the body clock, and lower arousal is likely going to be helpful!
Based on your experience of waking and then finding it hard to fall asleep, I’d suggest exploring whether the amount of time you usually allot for sleep is appropriate (is it close to your average nightly sleep duration, or are you often allotting a lot more time for sleep than you usually spend asleep?). Having a sleep schedule that is similar to the amount of time you usually spend asleep can help build sleep drive and reduce nighttime wakefulness.
To help with the nighttime arousal, you might find it helpful to just get out of bed whenever being in bed doesn’t feel good and doing anything you find relaxing and enjoyable instead. If conditions start to feel right for sleep again, you might then return to bed — and repeat the process as necessary. Not only does this give you a more appealing alternative to remaining in bed when being in bed doesn’t feel good, it also prevents you from reinforcing a negative association between the bed and unpleasant wakefulness.
I hope this helps!
—If you are ready to stop struggling with insomnia you can enroll in the online insomnia coaching course right now! If you would prefer ongoing phone or video coaching calls as part of a powerful three month program that will help you reclaim your life from insomnia, consider applying for the Insomnia Mastery program.
The content of this post is provided for informational and educational purposes only. It is not medical advice and is not intended to diagnose, treat, cure, or prevent any disease, disorder, or medical condition. It should never replace any advice given to you by your physician or any other licensed healthcare provider. Insomnia Coach LLC offers coaching services only and does not provide therapy, counseling, medical advice, or medical treatment. All content is provided “as is” and without warranties, either express or implied.
Recognizing that sleep-related thoughts are perpetuating sleep disruption is a huge insight, Edgar — since it proves that your sleep system isn’t “broken”, that your insomnia isn’t unusual, and that working on those thoughts will likely prove to be helpful!
I think you’ll find it really helpful to work with a trained CBT-I therapist to help explore and tackle those thoughts and reduce the amount of anxiety and worry they seem to generate.
In the meantime, you might also find it helpful to make sure you are engaged in daytime activities you enjoy and find enriching, rewarding, and engaging. This can help shift focus away from sleep, reduce fatigue, and help you explore how capable you might be during the day, even after difficult nights of sleep.
Just adding “good stuff” to our days can be a really powerful way of lowering arousal.
You’ve got this, Edgar!
—If you are ready to stop struggling with insomnia you can enroll in the online insomnia coaching course right now! If you would prefer ongoing phone or video coaching calls as part of a powerful three month program that will help you reclaim your life from insomnia, consider applying for the Insomnia Mastery program.
The content of this post is provided for informational and educational purposes only. It is not medical advice and is not intended to diagnose, treat, cure, or prevent any disease, disorder, or medical condition. It should never replace any advice given to you by your physician or any other licensed healthcare provider. Insomnia Coach LLC offers coaching services only and does not provide therapy, counseling, medical advice, or medical treatment. All content is provided “as is” and without warranties, either express or implied.
Unfortunately, I cannot suggest or recommend anything other than using your CPAP as prescribed, Bob. If you haven’t already done so, you might want to raise your concerns with your doctor and/or discuss different masks/pressure settings/alternative devices. It can sometimes take a while to find a CPAP solution that is easily tolerated.
—If you are ready to stop struggling with insomnia you can enroll in the online insomnia coaching course right now! If you would prefer ongoing phone or video coaching calls as part of a powerful three month program that will help you reclaim your life from insomnia, consider applying for the Insomnia Mastery program.
The content of this post is provided for informational and educational purposes only. It is not medical advice and is not intended to diagnose, treat, cure, or prevent any disease, disorder, or medical condition. It should never replace any advice given to you by your physician or any other licensed healthcare provider. Insomnia Coach LLC offers coaching services only and does not provide therapy, counseling, medical advice, or medical treatment. All content is provided “as is” and without warranties, either express or implied.
As you pointed out, after five hours of sleep, sleep pressure is diminished and this means that not only is sleep needed less but it can also be more difficult to fall back to sleep, especially if the arousal system is activated.
The arousal system is typically activated whenever we put pressure on ourselves to sleep, put effort into sleep, strive for sleep, or worry about sleep. When sleep drive is strong enough, it can overpower the arousal system. When sleep drive is low (for example after getting five hours of sleep), the arousal system can win and temporarily suppress sleep.
So, with all this in mind, we can see that your sleep drive system seems to be working as it should be — when it’s strong, at the start of the night, it’s able to overpower the arousal system and sleep occurs quite easily. When sleep drive is lower (after five hours of sleep) then the arousal system is back in charge and this can make falling back to sleep quite difficult.
It might make sense, then, to see what you might be able to do to weaken the arousal system in addition to building sleep drive through the implementation of a sleep window. This might be done, as suggested earlier, by doing things like:
* Not putting pressure on yourself to sleep
* Eliminating sleep efforts
* Not striving for sleep
* Exploring the sleep-related thoughts that seem to generated worry and anxietyIt can be helpful to remind yourself, too, that the techniques you described (such as getting out of bed when being in bed doesn’t feel good) are not intended to generate sleep — they are simply intended to create better conditions for sleep to happen (they do this by addressing the behaviors that typically perpetuate sleep disruption).
So, when you get out of bed during the night — for example — you are doing this simply to give yourself a more appealing alternative to remaining in bed when being in bed doesn’t feel good, and to prevent you from reinforcing a negative association between your bed and unpleasant wakefulness.
If you can’t nap during the day, this suggests that either you aren’t sleepy enough for sleep during the day (most people with insomnia are fatigued during the day rather than sleepy — just as you described) and/or arousal is making it hard to nap. So, there’s nothing particularly unusual when it comes to being unable to nap during the day.
As you pointed out, Valium (especially when combined with alcohol) doesn’t seem to be working — and that’s not unusual because those things don’t tackle the thoughts and behaviors that perpetuate sleep disruption.
The ironic thing when it comes to taking medication is that it rarely has a good long-term outcome on our sleep — if we take a pill and sleep, we believe the pill generated sleep and this erodes confidence in our natural ability to sleep. If we take a pill and don’t sleep, we believe something is wrong with our sleep and this increases arousal!
It sounds as though you have a great grasp of the behavioral techniques that can improve sleep — you might find it helpful to work with a therapist trained in CBT-I (if not already doing so) to help address the cognitive (sleep-related thoughts) side of the equation since it sounds as though that could be where the opportunity exists for you to weaken the arousal system and make sleep a bit easier!
I hope this helps!
—If you are ready to stop struggling with insomnia you can enroll in the online insomnia coaching course right now! If you would prefer ongoing phone or video coaching calls as part of a powerful three month program that will help you reclaim your life from insomnia, consider applying for the Insomnia Mastery program.
The content of this post is provided for informational and educational purposes only. It is not medical advice and is not intended to diagnose, treat, cure, or prevent any disease, disorder, or medical condition. It should never replace any advice given to you by your physician or any other licensed healthcare provider. Insomnia Coach LLC offers coaching services only and does not provide therapy, counseling, medical advice, or medical treatment. All content is provided “as is” and without warranties, either express or implied.
Welcome to the forum, Anil! I would suggest discussing your concerns with your doctor — you might also ask them if they feel you would be a good candidate for cognitive behavioral therapy for insomnia (CBT-I) to help address your insomnia while you are being treated for schizophrenia.
—If you are ready to stop struggling with insomnia you can enroll in the online insomnia coaching course right now! If you would prefer ongoing phone or video coaching calls as part of a powerful three month program that will help you reclaim your life from insomnia, consider applying for the Insomnia Mastery program.
The content of this post is provided for informational and educational purposes only. It is not medical advice and is not intended to diagnose, treat, cure, or prevent any disease, disorder, or medical condition. It should never replace any advice given to you by your physician or any other licensed healthcare provider. Insomnia Coach LLC offers coaching services only and does not provide therapy, counseling, medical advice, or medical treatment. All content is provided “as is” and without warranties, either express or implied.
Welcome to the forum, McDonagh. It sounds as though your insomnia followed a well-trodden path of there being an initial precipitating event (sleep difficulty due to stifling heat) and this sleep disruption changed your relationship with sleep, ultimately leading to sleep-related worry and anxiety, and perhaps the implementation of new behaviors in an attempt to improve sleep that only seemed to perpetuate the problem.
Often, directing attention and efforts towards the implementation of different sleep-related behaviors and working on new ways of thinking about sleep can help improve sleep for the long-term.
Since you do have a history of depression and have experienced a nervous breakdown, I would suggest talking to your doctor or therapist to see if they think that you’d be a good candidate for cognitive behavioral therapy for insomnia (CBT-I).
I hope this helps!
—If you are ready to stop struggling with insomnia you can enroll in the online insomnia coaching course right now! If you would prefer ongoing phone or video coaching calls as part of a powerful three month program that will help you reclaim your life from insomnia, consider applying for the Insomnia Mastery program.
The content of this post is provided for informational and educational purposes only. It is not medical advice and is not intended to diagnose, treat, cure, or prevent any disease, disorder, or medical condition. It should never replace any advice given to you by your physician or any other licensed healthcare provider. Insomnia Coach LLC offers coaching services only and does not provide therapy, counseling, medical advice, or medical treatment. All content is provided “as is” and without warranties, either express or implied.
Are you currently following any kind of sleep window, Jonas? If so, what is your biggest challenge with following that sleep window?
—If you are ready to stop struggling with insomnia you can enroll in the online insomnia coaching course right now! If you would prefer ongoing phone or video coaching calls as part of a powerful three month program that will help you reclaim your life from insomnia, consider applying for the Insomnia Mastery program.
The content of this post is provided for informational and educational purposes only. It is not medical advice and is not intended to diagnose, treat, cure, or prevent any disease, disorder, or medical condition. It should never replace any advice given to you by your physician or any other licensed healthcare provider. Insomnia Coach LLC offers coaching services only and does not provide therapy, counseling, medical advice, or medical treatment. All content is provided “as is” and without warranties, either express or implied.
Some things about sleep architecture that might be worthy of consideration here:
1. Unless our brainwaves are being measured, there’s no way to know for sure what stage of sleep we are in at any given moment
2. We have absolutely no control over sleep architecture
3. As we get older, we get less deep sleep and that is completely normalPeople with insomnia typically (and understandably!) monitor for sleep a lot more than people without insomnia and this increased state of vigilance can lead to less consolidated sleep, less restorative sleep, and the feeling that no “deep sleep” is happening — whether or not that is actually true!
What we can say with confidence is that someone is not going to get nothing other than N1 sleep indefinitely — this stage of sleep typically makes up a very small proportion of our total sleep duration and is extremely light. If someone is woken from N1 sleep, they will often report being awake rather than asleep.
N2 sleep is the “next deepest” stage of sleep. People will typically report being asleep when woken from N2 sleep. N3 sleep, often referred to as “deep sleep” occurs mainly at the start of the night and usually makes up the biggest proportion of sleep in the initial sleep cycle. The body is usually done with N3 sleep within just a few hours. People who wake during N3 sleep often feel a sense of grogginess or sleep inertia.
Ultimately, the body knows what it is doing when it comes to sleep stages. It’s not unusual for people to get no N3 sleep (especially older adults) but this doesn’t mean that someone is destined for non-restorative sleep at that point because there is more to restorative sleep than N3 sleep alone!
So, in conclusion, without a polysomnographic study, there’s no way of knowing for sure what sleep stages we are in during the night. Even with such knowledge, there’s nothing we can do to control sleep architecture since the body takes care of that all by itself. Finally, it’s probably impossible to spend the entire night exclusively in N1 sleep for any period of time.
As has been mentioned in this discussion, it’s often the hyperarousal associated with monitoring for sleep that is the biggest obstacle to more restorative sleep.
I hope this helps!
—If you are ready to stop struggling with insomnia you can enroll in the online insomnia coaching course right now! If you would prefer ongoing phone or video coaching calls as part of a powerful three month program that will help you reclaim your life from insomnia, consider applying for the Insomnia Mastery program.
The content of this post is provided for informational and educational purposes only. It is not medical advice and is not intended to diagnose, treat, cure, or prevent any disease, disorder, or medical condition. It should never replace any advice given to you by your physician or any other licensed healthcare provider. Insomnia Coach LLC offers coaching services only and does not provide therapy, counseling, medical advice, or medical treatment. All content is provided “as is” and without warranties, either express or implied.
I would ask that we keep posts in English, where possible! For those interested in a rough Google-powered translation of the above post, I’ve pasted it below:
Hi Cesare, I’m Italian too. I did cognitive behavioral therapy for insomnia after I started suffering from it in May. Now I’m much better and I can sleep well. If you have trouble sleeping I recommend you do it too.
—If you are ready to stop struggling with insomnia you can enroll in the online insomnia coaching course right now! If you would prefer ongoing phone or video coaching calls as part of a powerful three month program that will help you reclaim your life from insomnia, consider applying for the Insomnia Mastery program.
The content of this post is provided for informational and educational purposes only. It is not medical advice and is not intended to diagnose, treat, cure, or prevent any disease, disorder, or medical condition. It should never replace any advice given to you by your physician or any other licensed healthcare provider. Insomnia Coach LLC offers coaching services only and does not provide therapy, counseling, medical advice, or medical treatment. All content is provided “as is” and without warranties, either express or implied.
Welcome to the forum, Sally!
It’s not surprising to learn that you haven’t found sleeping tablets helpful — since no medication can generate sleep! Furthermore, as Scott suggested, sleep hygiene alone is not going to be helpful for chronic insomnia — so, again, no surprise you haven’t found that helpful, either!
The thing with sleep hygiene is it can actually lead to us implementing a whole host of rituals that increase sleep-related worry and arousal and it can reduce our quality of life by encouraging us to remove things we enjoy from our lives (such as caffeine) — all while not even helping us improve our sleep!
So, I would encourage you to enjoy that morning coffee again — and to look into cognitive behavioral therapy for insomnia (CBT-I) techniques!
CBT-I techniques are helpful because they address the thoughts and behaviors that perpetuate sleep disruption — something that no pill can do, and something that sleep hygiene certainly does not do by itself!
I hope this helps!
—If you are ready to stop struggling with insomnia you can enroll in the online insomnia coaching course right now! If you would prefer ongoing phone or video coaching calls as part of a powerful three month program that will help you reclaim your life from insomnia, consider applying for the Insomnia Mastery program.
The content of this post is provided for informational and educational purposes only. It is not medical advice and is not intended to diagnose, treat, cure, or prevent any disease, disorder, or medical condition. It should never replace any advice given to you by your physician or any other licensed healthcare provider. Insomnia Coach LLC offers coaching services only and does not provide therapy, counseling, medical advice, or medical treatment. All content is provided “as is” and without warranties, either express or implied.
This is a huge insight, Mandy — thank you so much for sharing!
If we have struggled with sleep for a long time, it’s very easy to go to bed before we are actually sleepy enough for sleep. We might do this with the logic that more time in bed will mean more time asleep (but the result is usually only more time awake) and we might do it because we have mistaken fatigue for sleepiness (fatigue is not the same as sleepiness).
As you also pointed out, it’s so helpful to avoid anything that might increase worry, concern, or anxiety before going to bed. We really want to be doing things that we find personally relaxing and enjoyable as bedtime approaches.
Thanks again for sharing!
—If you are ready to stop struggling with insomnia you can enroll in the online insomnia coaching course right now! If you would prefer ongoing phone or video coaching calls as part of a powerful three month program that will help you reclaim your life from insomnia, consider applying for the Insomnia Mastery program.
The content of this post is provided for informational and educational purposes only. It is not medical advice and is not intended to diagnose, treat, cure, or prevent any disease, disorder, or medical condition. It should never replace any advice given to you by your physician or any other licensed healthcare provider. Insomnia Coach LLC offers coaching services only and does not provide therapy, counseling, medical advice, or medical treatment. All content is provided “as is” and without warranties, either express or implied.
