Tips for managing hyperarousal insomnia and early waking at night

[Appleski]

I have been struggling with insomnia for the past year or so. I am perimenopausal and I am on HRT (Estrogen Patches, Utrogestan and Testosterone) The insomnia started a few years after I went on HRT. After trying various changes to my HRT, different supplements and medications I believe that my insomnia isn't hormonal or caused by anything specific other than hyperarousal that occurs if I wake up in the night.

I can fall asleep fine but if I wake up at 3 or 4 am that is it. I have been watching the sleep coach on youtube and after watching a few videos I actually started sleeping well but I'm having a set back. The past week I've been waking at 3 or 4 and that is me awake from then on. I can feel that I am in a state of hyperarousal i.e. essentially feeling upset and afraid of being awake at night. This pushes my nervous system into fight of flight mode and makes it nigh on impossible to sleep. If I am able to stay calm I might be awake for 20 minute or half an hour but I fall back asleep. I am sure those who have struggled with sleep will understand.

Unfortunately I don't think supplements or melatonin really work for this kind of insomnia and even many sleep meds struggle to control it. I try breathing exercises but they just seem to wind me up even more.

Does anyone have any tips on how to get over this kind of hyperarousal insomnia?

I have chronic insomnia. Magnesium glycerate, progesterone and melatonin don’t touch the sides. After hours when I eventually fall asleep I’m up again around 3 after only 3/4 hours sleep. When I wake up I’m not stressed, just feels like I’ve had enough sleep and lie there for 2-3 hours just waiting to get back to sleep or I can’t function the next day.

I too would love to know why this is happening to me it’s literally ruining my life.

I read for an hour as this stops my mind whirring and brings me to a calm state. I’ve tried all the tricks such as meditation, body scans, purposefully directing my attention to something more neutral etc but when I’m really hyper aroused they don’t work. I’ll try those things first but if it becomes apparent I’m too hyper aroused it’s better to turn my lamp on and read. I lose less sleep overall that way.

The other thing is to cool my body down if I’m over heated, so I’ll go to the bathroom and pad around on the cold floor, splash cold water on myself, which in itself is quite grounding and takes me out of my racing thoughts and into my body.

I’m reading in the hopes of a magic cure, as I have this too and it’s exhausting.
I read an article last year about how people used to sleep in two shifts - in the Middle Ages, I think - and they would get up and do stuff in the night. Somehow this made me feel better and I remind myself that it’s normal when I’m lying there at 4am and it makes me feel less stressed. I don’t get up and do stuff though. If I can, I rest with my eyes closed, often with white noise, but if not then I do sudoku as somehow it distracts my brain and I can sometimes doze off again. Solidarity

I really struggled with Utrogestan causing this type of sleep problem. I, reluctantly, switched to a Mirena IUS, scared it would be even worse and I'd be powerless to do much about it, and it has been life changing, my sleep is consistently better.

Amazing to hear this - I am awaiting an appointment for a Mirena and was also worried, especially given it's more of a faff to adjust than the pills so this is encouraging. Very happy for you too as it's awful having insomnia...

Solidarity. Like others going to bed at 9 helps with the general exhaustion, a reverse nine to five I read it called on here. Also the antihistamines occasionally I use. Branded as Sleep Aid.

I like Radio 3 Unwind in the night. No ads, quite reassuring. Also a bit of Mumsnet. Like you say, fighting it makes it worse, quiet acceptance is the rule. I like to think it's because post menopausal women kept an eye on the tribe for safety, after the young men did the late evening shift!

do you drink caffeine?

I gave up caffeine and although my sleep isn't perfect it went a long way to sorting out my sleep

as does exercises

a teaspoon of honey and salt helps me as its the loo in the night that really disturbs my sleep

ive also found going through Banana thinking of every word I can begging with b then a and then n and picturing these objects works - ive never gone passed the first a - I find this useful when I wake and am alert