insomnia, please tell me what else I can try

[lovelygirl17]

I've been struggling with sleep for more than I decade. First few years it was the kids that kept me awake every night. Eventually they started to sleep through the night and I couldn't wait. Just to discover that I didn't have the ability to sleep any more. This was about 5 years ago. I was riddled with anxiety and the worst of my demons came out at night. I never have trouble falling asleep, I'm knackered every night. But I started to wake 2am most nights no matter what, feeling anxious and wired and ready to start the day. Sometimes I managed to go back to sleep around 5 am, sometime I didn't. I used to blame my stressful job but I'm not sure anymore. I was prescribed antidepressants for my anxiety. Citalopram made me so sleepy, unfortunately mostly during the day that I struggled even more at work. I switched to Flouxetine (it has helped in the past) but this time it just didn't do anything anymore. Over the years I tried, magnesium, melatonin, new pillow, new duvet, weighted blanket, vitamin B, mindfulness, yoga, regular reflexology, acupuncture ,not looking at screens, having a regular bedtime, getting some exercise and some gave some relief but always short term only. For the last two years things have deteriorated, I'm hot and sweaty at night then I'm freezing cold and wide awake of course, I was still anxious and made me miserable during the day. The kids started to suffer, my husband and my work too. Most days I feel I'm unable to function. I went to GP suggesting it might be perimenopause. It has taken me several appointment over the course of two years to get hrt prescribed. My sleep was deteriorating fast at this time, 2 days before I started the patches, I was awake from midnight, banging my head on the wall and wanting to die. Then I put my first oestrogen patch on and I had the two most wonderful nights of the decade. I was so happy! From day 3 the situation however deteriorated and when I put the conti patch on, it went awful, I wasn't anxious anymore but deeply depressed. Still woke up after an hour sleep each night, sobbing my heart out and this didn't stop in the morning, it carried on during the day. I couldn't sleep or nap during the day either but on rare occasions, like once every 10 days I would get an ok day to keep me going, the rest is awful. Trying to get into touch with GP but it's almost impossible. Despite telling them that I lost my willingness to live, I haven't managed to speak to anyone for the last 3 weeks. Last night I was so bad that I decided to walk to a&e in the middle of the night, I was wide awake all night and couldn't stop crying. They gave me sleeping pills (Zopiclone 3.75) to break the cycle. They said I had to be careful because they were very potent. Now, I hate to say but I've taken one and it had no effect. Went to bed at 10:30pm, fell asleep, woke at midnight and sitting up ever since, wide awake. I'm going insane. So anybody, has any suggestions or just sympathy then please share. It's affecting everybody in my family now, I feel that I'm only upsetting them and there is zero happiness left.

I'm so sorry to have no further practical suggestions but you certainly have my sympathy.
This sounds extreme. Extremely bad. Much worse than 'just' insomnia alone. I don't know how you have continued to function. Is there an alternative to zopiclone that the GP can prescribe? Can you get a referral to a specialist? Keep going to the GP as I imagine there are NICE protocols that have to be followed in terms of escalating any treatment or referrals.

I'm sorry that you are experiencing this. My only tip is I just decided to stop letting it get to me. I'm still awake. I might not sleep at all tonight. I just decide to power through the knackeredness. Then it doesn't wind me up so much and I can sleep the following night.

I have no answers I'm afraid,but am here in sympathy.this is my 4rh year as an insomniac.i fell asleep at midnight,awake 230,3rd night running I've only had a couple of hours.
Regular bedtimes etc done nothing.i just try and suck it up.i do know stressing over it makes it worse

is anxiety still part of your insomnia, OP?
What treatment R u getting for anxiety/

It’s sounds more extreme than insomnia.

Push for a sleep clinic?

There are so many different HRT’s, GP to review as to whether this one is making situation worse?

Really sorry you’re suffering. Lack of sleep is torture. And it’s a vicious cycle when you can’t sleep because you even go to bed worried that you’re not going to sleep, then you don’t sleep.

Look for sleep clinics in your area, and go back to the GP with some information

I'm a v long term insomniac - waking around 3.
Thankfully I don't work now as retired.
I would say that trying to keep on the go in the evenings might help. I'd started slumping in a chair at 7.30/8 and watching (dozing) at the tv til dragging myself to bed. I think my body thought 7.30/8 was my 'bed' time so was waking me 7 hours later.
Read a book. listen to audiobooks. Find nice things to do rather than lying fretting.
I found with Zopiclone that about ?15 mins after taking it I would get this feeling of relaxing of muscles. I could turn over and get to sleep then. Didn't work so well if I missed that.
I took it for years - limited to 6 a month or so. Stopped now as doc says i shouldn't have been on it so long.

This sounds horrendous. I turned the tv off at 2am this morning and fhink i may have had two hours sleep . It seens a regular pattern now that maybe i may have one or two nights ok sleep that helps get me through the week. HRT has helped a bit but not massively , i have also upped the dose recently.. i have found exercise does help but its a vicious circle if i fall out of the pattern, kids ill, busy at work etc, then finding the energy / motivation to start it up again. However i dont have your levels of anxiety / low mood so am able to bob along most days . I am finding GPs not great and refereal times for anything are horrendously long. I wonder if you have the funds whether booking yourself a private GP that may have a specialism in menopause/sleep disorders. They can make referrals back into the NHS, you may get a more holistic assessment and more that a 5/10 minute appointment. Please also contact mental health services , although your health issue may be physical in origin it is resulting in pyschological distrress and you need some support in that area while you get to thr bottom of this extreme insomnia.

Your symptoms sound similar to mine! Go back to your GP and make a fuss. I am in surgical menopause and can't take hrt. I have similar problems. There are alternatives, which I will shortly start working through after the consultation I had with an endocrinologist this week. The GP might not know about them. Get a referral. I am starting with gabapentin, to control hot flushes and hopefully, consequent insomnia and mood problems.

I'm an OK sleeper but my mum, sister and daughter are not, so I'm going to copy and paste a note I have on my phone of a technique that helped my daughter.

Our main issue was night wakings rather than bedtime, daughter would wake at 1:30am like a clock and not go back to sleep, sometimes at all. We found she needed to go to bed later for quite a long time then gradually move bedtime earlier in incremental steps. There is a technique used on insomniac adults where you work out how long you can sleep in a block without waking (xhrs), work out what time you need to get up, and don't go to bed until xhrs before then. We did that. My daughter would sleep 6hrs then wake. We decided that morning was 6am. So if she'd have been an adult she would have stayed up till midnight for a week or more, aiming to sleep 12-6, then started creeping bedtime forward. We did 10pm bedtime though.

Just rereading that it's not the best note is it, but you should be able to find it online. I think it's called sleep restriction technique.

Have you tried phenrgan? (Not sure how you spell it)

Also a small dose of amitriptiline?

I am on amitriptiline for nerve pain at a low dose and it really has helped my sleep and my anxiety.

OP.I'm a hypnotherapist.I work with a lot of people with sleep problems. My clients have one of my audios to listen to in bed. I'm happy to email it to you if you want to try it.no charge - just pm me.

I'm so sorry OP, that sounds awful.

I'd definitely push to review your HRT. The fact it worked for the first two nights suggests there is something hormonal going on there. You may need to tweak it?

Other than that, have you tried a SAD lamp first thing in the morning? Apparently exposure to light first thing in the morning has a big influence on how we subsequently sleep at night.

I'm sure you have - but just putting it out there have you had your bloods done re thyroid? I was diagnosed hyperthyroid - heart racing, palpitations, anxiety, sweats and insomnia were some of my symptoms. I was convinced was peri or menopause but wasn't and it was bloods that showed it, basically my body was in overdrive. Either way hope u can get it sorted x

Following on from the PP, it would also be worth checking for anaemia, which can cause sleep issues.

I’m so sorry you’re going through this. My mother has suffered terribly with insomnia and hasn’t found a solution.
Like you I had many many years of broken sleep due to my child with special needs.
When that improved and I started to feel human again menopause kicked in. I wake up every single day a about 3:45 and can’t go back for at least 2 hours. It is horrible.

What I’m planning to do is go to a private consultation with a clinic that has a menopause specialist. I am convinced that with the correct hrt dose this should be fixable! I don’t care about the cost at this point I just want to get this sorted.

I had the same problems. I am now taking three magnesium glycinate before bed. It took me a while to get used to them. They gave me vivid dreams at the beginning, but not anymore. If I wake up and cannot go back to sleep, I take another one. I suggest to start with a lower quantity. Good luck!

Have a read around cortisol causing you to wake in the night.
And I would echo what pp said, try not to get het up about it, which I know sounds stupid. But really, lying there getting upset about it won’t help.
Try and relax, and remember that resting is good too.
Try and put all thoughts out of your mind, actually push them out and just see black. This is what I try to do when I’m awake in the night. Doesn’t always work but at least I’m trying something.
Have you tried an Epsom salt bath in the evening for magnesium and relaxation ?
And do you do any exercise ?

I take Amitryptiline.

Some people can sleep on a low dose, but l had to go quite high for any effect.

I’ve had sleeping pill from the drs that don’t work but for some reason nytol one a night which you would think wouldn’t be as strong knock me out.
I have to take about two hours before bed at 8:30
Or 9 though as they make me drowsy next day so taking them earlier gets them out of my system by 9 ish when I need to be more functional

You say you are on conti patches? These contain synthetic progesterone rather than bio identical which may contribute but in addition I had to up my dosage of oestrogen as my sleep would improve for a short time then insomnia would reappear.

Maybe worth trying separate HRT ie Evorel patches at a higher dose and a single daily dose of utrogestan and see if that helps. though @lovelygirl17 it’s horrible going through this.

Perhaps switch to gel/spray oestrogen with separate utrogestan progesterone? You can increase the oestrogen dose this way. Speak to whichever GP has most interest in HRT at your surgery.

Mirtazapine

Another insomniac here, I have the Mirena coil and use Oestrogel. The best thing that helps me is to stay up as a late as I can, then I may get a chunk of sleep. Zopiclone helps for one night but the next is worse so I’ve ditched those. I had the strongest 7.5mg dose. I had to make it work, I felt an odd feeling and then had to say myself let it work, don’t think and it would take about half an hour but then did work.
Two of my friends can’t sleep either one takes hay fever medication and that helps a bit and the other a co-codamol at bed time . This is obviously addictive but that’s how desperate she is.

Do you get enough exercise during the day? At least 1 hour of vigorous exercise (sweating) helps a ton with sleep.

I could have written your post op, the losing the will to live is awful. I have lost count of the amount of times I’ve almost fallen asleep at work, and I’m a therapist so not ideal
I’ve tried everything going and variations of them as well, best short term was double the dose of promethazine but I’d be groggy in the morning. My GP would only give me two weeks and one further week after I told them I was now resorting to 6mg melatonin knocked back with two gins at bedtime.
Exercise some not a jot of difference.
However I very recently changed the time I took my thyroxine and now her 2-3 good nights sleep, that’s from about 2am- 7 a week, other than that I’m wide awake until about 4 then up for work at 7.30. I actually can’t wait to retire in 12 years so o can sleep whenever w want.
Sorry I have no useful advice