Insomnia

[SooVeryTired]

Can anyone offer any help with regards to the terrible insomnia that I'm struggling with...

I'm 42 and in the last 12 months have been hit with a couple of bouts of insomnia. The first cleared quite quickly with 15mg per night of mirtazapine. The mirtazapine stopped being effective around October time and I've had chronic insomnia ever since. I get between 2 and 5 hours a night. If its 5 hours, its a broken 5.

I've tried EVERYTHING. This includes:

• Magnesium
• Phenergan
• Zopiclone
• Quviviq
• Amitriptyline
• CBD
• Weed
• Ashwaganda
• ...and much more

Nothing makes a dent.

I've been on hrt (2 pumps of Oestrogel and 2 Progesterone tablets a night for half the month) since early November. It's not made one bit of difference.

I had a lot of stress last year, so am focusing on stress management, including now being on 30mg of mirtazapine to focus on tackling anxiety rather than insomnia, doing CBTi, and doing yoga and healing therapies etc.

I fall asleep fine, but wake a few hours later and dont go back to sleep. Im not aware of worrying about anything when I wake.

I lift weights (in the morning) 4 times a week. I get lots of exercise and fresh air. I have 1 cup of coffee a day (very early), limited alcohol, and a great diet. I weigh myself every so often to check I'm not in a calorie deficit, in case that's spiking my cortisol.

I'm trying to remain calm, but am becoming increasingly depressed. I'm so exhausted, all I do each day is go through the motions.

Will this ever end?

How do I know if my hrt is right for me? I dont have any other symptoms of perimenopause.

Have you tried melatonin? You’d need to ask the GP to prescribe but it worked well for my daughter.

I have. I should have added that to the list.
I feel bullet proof in relation to all medicines and supplements. Literally NOTHING has any effect on me whatsoever.

Im the same op, it started when peri hit at a similar age.

I’ve just been reading about glycine, so I will buying some to try out.

Thanks. I take a 5-in-1 magnesium supplement that contains magnesium glycinate, but is this different?

I was on top of the world last summer - so happy, glowing and healthy. I feel like my life's over.

I could pay for a private sleep study, or see a private hormone specialist,but I dont really know how to access those resources and dont know if they're genuinely any good.

I feel like I'm out of options.

On my worst days, I tell my husband I no longer see a future. I've also become so frustrated with the situation on two occasions that I've hit myself in the face repeatedly and left bruising, and had to be restrained by my husband. I was a previously happy person.

Is there anything going on outside (or inside) that might be waking you up? The smallest sounds at night that I wouldn't notice during the day sometimes wake me up.
We have a milkman who comes about 3am and that wakes me up. Sometimes the heating coming on in the middle of the night (if it's very cold) wakes me up, or it could be the cat going outside - something like that.

No. I live somewhere quiet. Ive tried with ear plugs and without. I get the same amount of sleep no matter what I do. I also have been on holiday during this period and didnt sleep any better.

Im concerned this is with me for the long term.

Are you me, OP. You're not going to like what I have to say, but take it as a solidarity post. My problems with sleep or lack of, started ten years ago. I went from 7 hours a night to 2-5 of broken sleep. I had to give up my career because I just couldn't cope with the effects of the insomnia and associated anxiety. My brain was a mess, I felt my body surging with adrenaline when it was supposed to be winding down. I had no ' off' switch. I tried everything too to no avail. At my lowest point antipsychotics were introduced, but they didn't make me sleep either and I became even more tired during the day. I'm now on 30mg of mirtazapine which I started over a year ago. At first, they worked well and I was getting 8 hours but over the last few months I'm back to no sleep. The insomnia has changed too - I can now generally get off to sleep, but I'm wide awake after an hour and it takes ages to get back off. Three hours later I'm awake again, so have early waking. I'm constantly exhausted and this has been a decade of hell with no end in sight. The gp is at a loss - amitriptyline, imipramine, trazadone, melatonin, quitipine, olanzapine, and countless others just don't work. I'm also on hrt, but that does little either. My life has been taken over with insomnia. It's changed me as a person. I don't live anymore. Sorry, I don't have the answer but you're not alone.

Thanks for taking the time to reply.

I'm in a very dark place and dont know if I can go on any longer.

I understand OP, it's a hellish way to ' live'. People don't get how devastating it is, especially when you've seemingly tried every natural remedy and chemical intervention, to no avail. I eat clean too, massive walks daily, reduced caffeine intake, chamomile tea, magnesium, vitamin d supplements, iron tablets, anti histamines,breathing exercises.... So I get it, I really really do. Are there any meds on my list you haven't yet tried? Antipsychotics? They're a real last resort and come with risks, but they're worth it if they help. Just because they haven't done it for me, doesn't mean they won't for you. We can't function without sleep It's torturous.

So sorry you're experiencing this OP. Sending a hug.

Is your bedroom a haven? Do you have a good routine set in place that promotes good sleep hygiene? Things I found super helpful were:

No phones in the room
No screens an hour before bedtime
Warm light bulbs in bedroom
Reading before bed
SAME time for bedtime and wakeup every day. This routine is important

I was you two years ago, i went to a private GP they prescribed me Trazadone its for depression but also helps with sleep. they didnt give up on me. i also take magnesium which i know youve said you have taken. I am early 30s

I use a magnesium cream, @SooVeryTired - Sleep Butter by Feather and Down. I rub it in just before I put the light out, and then I listen to an audiobook - I like medieval, Plantagenet and Tudor history - it is interesting so it occupies my mind (otherwise my thoughts run round and round like a squirrel in a cage, and stop me sleeping), but not too exciting. I find the historian Dan Jones particularly soporific.

I take mirtazipine at bedtime, as well as a couple of paracetamol, which helps with the old age aches and pains that can disturb my sleep.

I do everything and more. I've done CBTi. Nothing helps.

Thanks. Ive not tried Trazodone but will mention it to my GP. He seems open to me trying most things.

Thanks. I feel my insomnia is severe and established enough that supplements just wont cut it now.
I do find an asmr video helps me to feel calm at bedtime, but I don't have racing thoughts when I wake. I'm literally just wide awake.
I also don't always feel that horrendous during the day - I can work hard at the gym, and do a decent enoygh job of my career. I have to go by how bad my eye bags and shadows are and how depressed I feel. Ill get a shock when I look in the mirror and have to face the fact that, yep, I got 3 hours sleep again last night.

Have you had your ferritin levels checked. Even results deemed as normal but in the lower range can cause insomnia.

Insomnia is awful and I really feel for you op.

I suffer bouts of it and know how awful it makes you feel. No words of advice unfortunately just solidarity to show you aren't alone

This may not help you but it did me. I took magnesium to help me sleep because it was recommended everywhere. However -in some people magnesium can have a paradoxical effect and it can actual exacerbate insomnia.

I found my sleep improved when I stopped taking it.

My GP told me to make sure the magnesium I take is magnesium glycinate.

I’m wondering this too as I’ve slept dreadfully since taking a magnesium glycinate supplement (for about three weeks now). I did take Trip gummies before that and they really seemed to help but wanted to avoid all the additives.

You have my full sympathy OP, this all sounds absolutely dreadful. This might sound silly or trivial and I apologise if so, but if you’re up for trying anything, I’ve been trying cognitive shuffling recently and it has got me back to sleep. Feel free to ignore!
https://theconversation.com/what-is-cognitive-shuffling-and-does-it-really-help-you-get-to-sleep-two-sleep-scientists-explain-256444

Have you tried increasing the Mirtazapine from 15mg to 30mg? I know a lot of people say that the lower the dose, the more sedative it is, but that wasn’t the case for me. I had horrendous insomnia just like you describe, it destroyed my mental health and was running my life. GP finally gave me 15mg Mirtazapine - I slept so well and felt like a new person, it was amazing. After 2 months I stopped sleeping again and I was devastated. Back to the GP, Mirtazapine increased to 30mg. I honestly didn’t think it would work, given that everywhere online says that Mirt is more sedative at lower doses, but within a couple of nights of taking the 30mg my sleep returned. I’ve been on 30mg for years now and sleep really well most of the time - honestly this medication was a life saver. Worth trying a dose increase maybe?

Apparently testosterone can have a beneficial impact on sleep. You may be very low OP. Its horrible though, my insomnia comes and goes in phases

I’m so sorry OP, I didn’t read your post properly and have just seen that you are already on 30mg Mirtazapine. I really hope it kicks in for you soon, it really helped me. Sending lots of support, I know how awful insomnia is x