Terrible insomnia and sleep anxiety, what will GP do?

[Xenomoth]

I’m suffering from terrible insomnia at the moment and associated sleep anxiety. I literally can’t sleep and last night was awake all night.

I am an anxious person anyway, and this has triggered panic attacks and worsening anxiety. I’ve had to call in sick to work today as I can’t face it.

I’m not sure really where to turn and am getting increasingly desperate. I have a GP phone appointment in a week and am wondering what they will suggest. Heavy duty sleeping pills aren’t going to be any good as I must be able to get up and go to work the next day.

has anyone experienced similar and have any words of wisdom?!

I'm glad to have found this thread. I have had insomnia for around 12 years since i was pregnant. Thinking I might be at the point of seeing the gp. I can't seem to cope with it anymore. I can get to sleep OK but I don't stay asleep. Generally asleep by 11-11:30pm, but I wake up around 3am for 2 hours or more and they wakeful sleep until 7am. I'm now very sleepy all day. I'm struggling to concentrate at work and nearly fell asleep in a meeting yesterday. Like I say, I could manage my weird sleeping, but not anymore. Hope you get something sorted. I'm very anxious about being fobbed off by the gp.

Have you had any therapy about this?

I feel like that would be a place to start - meds will only relieve the symptoms, they won't address the underlying problem.

Your GP may well prescribe you medication (anti anxiety and sleep) at first to break the cycle. However to manage this long term, meditation can be a real help. Have a look at the headspace app. This has helped someone very close to me to overcome exactly what you are experiencing.

I'm really sorry to hear that you're going through such a tough time with insomnia and anxiety. It's incredibly frustrating and overwhelming, especially when it starts affecting other aspects of your life like work. You're definitely not alone in dealing with this, and reaching out for help is a positive step.

By the way, do you exercise?

• Even simple fitness exercises will put a strain on your body, making your body tired and making you want to sleep. The main thing is not to exercise 4 hours before bedtime, as it will excite your nervous system and you will not be able to sleep.
• Also a good remedy is to take a walk for about 20-30 minutes about 3 hours before bedtime.
• Take a shower before going to bed, the warm water will relax your body and you will fall asleep easier.

Personally, these factors have helped me overcome insomnia and I find it much easier to fall asleep.

I do exercise and find that it helps my overall wellbeing, when I’m very anxious it can be hard to motivate myself though.

I’ve contacted a few therapists and hoping that it may help. I’d like someone who takes a mindfulness/cbt approach. But I also feel like I need someone quite direct who can talk some sense into me (@ringoffiire you're not a therapist are you?!)

I also sent the doctor a bit of a rambling and desperate message yesterday so will see what they say. I just don’t know why I’m doing this to myself. Everything in my life is good yet I seem determined to sabotage it with this obsession over sleep! Btw, for anyone who is interested there was a programme on insomnia on radio 4 yesterday. I’m going to listen to it later, it at least reassures me that it’s a common problem. Hope everyone slept well last night.

I actually saw a private gp online to get my amitriptyline (appointment within an hour) . I just couldn't wait. It was about £50 and she was lovely. Got a letter for my GP and now I don't need to pay.

I listened to a fascinating “Inside Health” on radio 4 a couple of days ago on insomnia. Interestingly, all the experts agreed that there was no real evidence for medication working long term, but a lot of evidence for CBT effectiveness.

I didn’t hear the whole programme, but one thing that stuck with me was the idea of re-setting a poor sleep habit by vastly restricting your sleep for a bit, eg only going to sleep 3am-6am. Teaching your body to get its sleep in one block. Then you can work on extending that block, as your body relearns to stitch the sleep cycles together again. You’ll be v.tired, obvs, but you are anyway. I’ve probably relayed that badly so do give the programme a listen.

Mirtazapine is great for sleep and anxiety

I am having this on and off (thankfully not every night, though increasingly). I think I might be peri though and have a lot of other symptoms. I'm booked in for a call from a Woman's Health Clinic by GP at the end of the month and hoping to try HRT and see if it helps. The anxiety is huge and gets worse at night. I did have luck trying magnesium and zinc about a year ago when I had really bad insomnia, which might be worth a try before medication? It reset my sleep in a month and was all good for about a year.

GP may prescribe Zopiclone, even if short term. It helps to reset the system technically but there'll also need to be changes with your routine, sleep hygiene and it may be worth tackling your mental health as a whole too. Tackling the basis of the insomnia is usually the first step. Are you on any medication for anxiety?

Even if you have to take occasional sedatives, you should still be able to get up and going in the morning. The grogginess shouldn't last.

I’ve been on amitriptilline for the past 6ish weeks, initially started for headaches but I have terrible anxiety too so has helped both!
I’ve also been having some vivid dreams which I’d put down to the medication. I really think it’s helped me and I’ve only been started on 10mg so don’t feel the grogginess the next day as long as I take it around 9pm.

I think the main problem is I have an intense fear of being awake all night and the consequences of this

Yup. You're in an anxiety cycle. You dread not being able to sleep so you don't expect to sleep and therefore you don't and you get more anxious about it.

Have you tried accepting that you're not going to sleep but you are going to lie down, relax, do nothing for several hours? It's something we all look forward to doing on holiday but don't consider that we do it for about a third of every day.

It’s often only the stress we create by pressuring ourselves to fall unconscious that stops it from happening. If we go to bed perfectly content that we will be awake all night but at rest, at peace and relaxing doing nothing, then the resulting reduction in our cortisol (stress) levels more often than not will allow us to naturally fall asleep.

I listen to the podcast nothing much happens

Then while I'm listening I tell myself my body is getting some rest lying down and I don't need to sleep, I should stay awake and listen

Works about 70% of the time, the rest of the time I take Kirkland sleep aid

You are right it is an anxiety loop. Very much so. Thing is, I try to tell myself that it doesn’t matter and I am resting but I just can’t believe that and then I get another surge of anxiety and adrenaline. Fact is, work is horrible when I’ve not slept and I just feel so so odd and anxious the next day. I then worry that I will never sleep properly again and that this is just my life now. If I don’t have work the next day I can calm myself down ok.

I’ve contacted the GP three times about this now and they’ve said they will call me back in THREE weeks! Not helpful. I’ve tried contacted a few private counsellors but not sure if I need a counsellor, psychotherapist, or psychologist. Anyone got any insight on which would be more appropriate in my situation?

Thanks so much for everyone who has posted tips, solidarity and listened to my rambling. It’s really helping me.

It is a horrible loop and you feel very emotionally vulnerable when it is constant. I felt like I was always over reacting but unable to stop myself. Is it worth getting bloods done to check for any deficiencies before assuming it is work anxiety? Often we need more D and B vitamins and folate/ferratin/iron deficiencies can cause anxiety and depression quite quickly.

Oh my god I have been where you are. It’s hell. Listen up. All the sleep hygiene shit does nothing when you’re in an anxiety spiral about sleep. Sleeping pills will make it worse. What saved me was this online course called the Sleep Coach School. You need to reframe your beliefs about sleep, and learn how to not try and control it. Honestly this course changed my life. I sleep so much better now. There’s loads of free videos on YouTube and I did a month long course on their app for about £50 I believe. You will get through this and you will sleep again, trust me!

Can you remember when and why this started? Sometimes there's a part of the mind that hasn't got the memo that nighttime is for rest and recuperation and carries on working - generating thoughts and memories which spike your adrenalin; it needs to be told to stop. Remedial hypnosis can help, happy to send you a list of practitioners if you like.

I’m in the same boat. Gp prescribed me mirtazapine but I’ve heard you put weight on with it so it’s still in the cupboard. I take phenerghan most nights. At first I was taking 20 mg but felt terrible in the morning so I’ve started halving the tablets and that seems to be enough to get me to sleep and don’t feel too awful next day

@Upinthenightagain just curious, do you work? Do you manage ok if you do? I actually have one quarter of a Nytol and it seems to work (possible placebo effect) the full two tablet dose was truly terrible the next day, however it does make me sleep.

@ButtCheeks I just looked up the sleep coach school and it looks amazing but unfortunately they must have put the price up as it’s nearly £300 now. Shame as it looks really interesting.

I would recommend you look at the sleepio app and complete the sessions. Whilst obviously not quite as good as a face to face therapist, it's an evidence based CBT for insomnia app that offers 6 virtual "sessions".

Edit: looked it up and it's now free to people in England or Scotland via NHS
Edit 2: when I say evidence based, I previously worked in a closely related field and sleepio has a really good evidence base. It works for a lot of people, especially those who complete it and implement the suggested techniques.

Thanks, I will take a look now

Those of you who have mentioned Phenergan, where are you getting it from? I haven't been able to get it in any of the pharmacies near me for ages.

It looks like it might have been. I used to buy it as brand name sominex.

According to mumsnet davina recommended Kirkland sleep aid in her menopause book. I got some imported from America. Its decent. I think my body is resistant to nytol now.

I completely feel your pain! Something that has helped me is sleep patches. I got mine from Kind and just use them every now and then when things are bad. You not meant to use them too often, so I flip between those and nytol (the one a night ones). I listen to radio 4 comdies (i find pod casts to interting) to help me drift off. I also just get up some nights and watch TV - 9 times out of 10 I fall asleep on the sofa.

Magnesium has worked wonders for me.