Anyone else have this insomnia issue?

[Furryfeet]

Sorry about the long post. Ideally I'd like to hear from anyone who has come through similar experiences to give me encouragement or anyone who just wants to share their own circumstances. (Btw I'm 45; been on Evorel 100 patches for about 8 weeks, upped to 150 3 weeks ago + cyclical utrogestan + 37.5mg venlafaxine for 5 weeks + 10mg amitriptyline started v recently)

I am continually perplexed by the way I have lost the ability to sleep and my sleep is at the same time really bad AND erratic. The thing that aggravates me most is that I've lost count of the number of times I've tried something new to help sleep and it's worked and I've thought 'Brilliant - I've cracked this' and then it's stopped working after 2 nights max.

For example I noticed for several months I was sleeping longer and more soundly on the nights my dh had ended up falling asleep downstairs on the couch, so he offered to sleep on the sofa for a week as an experiment to see how it benefited my sleep... 3 nights of great sleep for me and then it just stopped working. Same when i took taurine - first 2 nights slept like a baby but not since. First night of amitriptyline knocked me out for 8 hours and then the next night I was awake within 30 minutes and only got back to sleep again from 3-5:40am, CBD oil was similar. I've tried CBTi and hypnotherapy but they just seem like expensive chats.

I seem to sleep for little more than 3 hours a night with maybe 1-2 nights a week of a magical 7 hours, but I never know which I'll get. To make it more confusing, dh thinks I sometimes think I'm awake when I'm actually asleep. I thought about getting a smart watch to track sleep but think I'd probably just get even more obsessed with it.

The thing I find the hardest is the sense of not 'knowing myself' any more. I have been off work for a while with anxiety, low mood and insomnia after a fairly full-on stint of homeworking during the pandemic (which was when certain peri symptoms emerged). Some of my physical symptoms have gone and part of me would love to go back to work and feel part of that world again (and in fact I'll have to return soon anyway), but it's hard to tell how working will impact on my sleep and wellbeing. My managers have been pretty supportive in terms of asking me all about what might support me, but it's actually hard to know what would help when I've been feeling so weird for so long.

I find melatonin works for me if I take it every night, before ten thirty, for a week. It doesn't leave me drowsy the next day.

But after a week I'm back to "normal". Every time I think I've got it under control it goes wrong again.

Do afternoon naps help you? We are programmed to sleep in the afternoon as well as night time so might be worth a try.

@ladygindiva tbh it's only been 2 days on Amitriptyline - day 1 I took it at about 10:30pm and was knocked out. Then last night I did the same and was asleep from 11:30pm for about 45 minutes - I was desperately frustrated so I took another 10mg at about 1am. This was probably too late at night but I do stupid things at that time : )

@Furryfeet I had a thought...don't know if it's helpful at all. But...you are a HUGE dose of estrogen.

I've never heard of anyone using a 150mcg patch( assume you are doubling up with 2 patches.) It's roughly the equivalent of 4mgs as a tablet or gel and the usual dose for those is 1 or 2mgs.

Have you had your estrogen levels tested and is there a reason why your dose is so high? Are you doing this via your GP or a specialist?

It's just that as estrogen is the energy-giving hormone, I wondered if you had too much and that was the root cause of your issues.

Would you consider seeing a hormone specialist privately to try to get some guidance?

Try taking 2 at 10pm

If this is referring to amitryptaline my experience is I take it about 8pm for a 10pm sleep ( I have a child who likes waking at around 530). But I agree an increased dose may work.

I can't remember the last time I slept all night. I'm 50 and wake at least once a night but usually twice. I don't feel like I need the loo but assume that's why I woke so get up for a wee after trying to go back to sleep for a few minutes. My dd went missing for three weeks and I slept two hours a night while she was gone. Some days I want to cry I am so tired. I don't drink alcohol, go running five times a week, walk the dog 1-2 times a day and take 5-HTP at bedtime as well as spraying sleep mist on my pillow some nights. I'm more tired not than when I had a new born, a nearly two year old and a four year old.

I haven't experienced this directly but can imagine how it could... I was 'gifted' 12 Circadin tablets (the slow release melatonin) and last time I tried one a few weeks ago I had a lovely natural, long sleep. I had considered taking 1 a week and hoping that it wouldn't wear off that way. But I'm too young to get it on prescription so I don't want to use them up fast. I will ask the sleep clinic about scheduling melatonin as they can prescribe it and hopefully they'll have something to advise about the tolerance thing. I don't understand how it's meant to be prescribed for insomnia over 55 yrs over 13 weeks when it seems to lose it's potency so soon.

I have been there, even on a family holiday which cost a packet, I didn't sleep at all every other night, the other nights fit ful, every day I was like a zombie. I then took up exercise every single day no matter how tied I was, and I mean a good 45 mins to an hour a day along with taking on a highly stressful job that took my mind off of bed time ( I used to dread it and get what i can only describe as fire in my belly thinking I would be awake all night) and slowly i have started to sleep. I am now in my late 50s. If i drink a lot or eat sugar I still sleep rubbish, but nothing like the year of hardly any sleep. Get active, cut the sugar, and get up the same time every day regardless of whether you have slept or not. Go back to the offices, it will help i promise, you will get there. It's hell on earth and i really sympathise.

I get up at 7.30 each day.
I've usually been awake for hours by that point...on a bad night from 2.45am.
I try to get my 10000 steps in but tbh even on days I'm more physically active it doesn't help.
I try to read before bed as it relaxes me me but I'm just too tired atm - I just can't concentrate.
I'm so miserable :(

Don't drink or smoke
Do 16:8 eating window
(I could cut down on sugar though)
1 cup of coffee each morning
I'm honestly not sure what else I can do

This is a really good point @JinglingHellsBells (although my sleep was crap before the increase to 150). I had a consultation with the Newson crew but felt a bit short changed. I emailed them a timeline of my symptoms ahead of my consultation so there was very little the Dr had to do on the day for her £285 but say 'you're definitely peri'. Then she gave me a 'schedule' to increase from 50 to 100 to 150 but no timescale. She said that I could email her for advice on increases before my 3 month follow up but seemed to change her mind and cooled off after 3 emails, stating that if I wanted further advice I would need to bring my review meeting forward (in other words pay through the nose). So I just increased based on my GP's guidance which is far from ideal, but at least my GP is nice, free and is herself perimenopausal so it's the best bet I have : )

You could try Kirkland's Sleep Aid, it knocks me right out.
Do you listen to ASMR stuff? It might work.

I will try this... thanks @ChiswickFlo . I was on mirtazapine for a while and got in the habit of taking close to bedtime so I think my instinct was to take amitryptaline quite late, but I have noticed many take it earlier in the evening.

Interesting that you're suggesting return to work! It's funny that when I first disclosed my symptoms to my manager and his manager, they both said 'You can't function on that amount of sleep, go home and rest' and I was so tired, with such a low mood, I just went ahead with that suggestion but in some ways I regret taking that advice because it misses the reality of what it is to be a woman in mid-life. It's not like I can retire for sleep reasons and I hate being in the house all day.

Sorry to hear you're feeling like this... and as you post hints, the stressful family events don't stop for us. Hope you and dd are ok now...

@chiswickflo try cutting out the sugar and if awake get up at 6am, it is light now, if you are in uk, and make bed time 10pm, I tried everything and sugar is defo a no no regardless of time eaten. It is like mental torture though and I really do sympathise, I wouldn't wish it on anyone.

I’m another one suffering this, I occasionally take a phenergan tablet, which helps me to fall asleep, but then I wake after a few hours. Melatonin doesn’t work on me either, it’s a nightmare and I feel constantly knackered. I’m on everol 50 patches and just been prescribed fluxotine.

Could you advise what type of ear plugs? I bought some of the mouldable ones recently but don't think I was using them right

@Phyllis321 I tried ASMR and again it was one that worked for 1 night (lovely while it lasted!) - never heard of Kirklands but can't hurt to try I suppse

Good point, i use ear plugs too, foam ones from boots.

@Furryfeet My advice (having used HRT for 14 years through an excellent private gynaecologist) is that you go back to square 1 and start by thinking about your dose.

I know that some drs at Newson are very keen to keep increasing the dose but it's fairly unique to them ( as far as I know). I've never gone above 3 pumps of gel which equates to about 2.5 mgs, and I only did that for a few weeks when my flushes/ sweats came back for a short time.

Some women report being 'wired' on high doses of estrogen and I'm wondering if your experience is simply down to too high levels.

You really ought to have some blood tests to see how much you are absorbing rather than adding more and more, willy nilly.

The other thing is that Utrogestan is a sedative and many women find it helps them sleep, BUT the balance between estrogen + Utrogestan is important and too much of one can negate the other.

Why not do something you've not thought of and cut your dose down to a 50mcg patch and see how that feels?

The only thing that helps me stay asleep is progesterone. I take it separately to the estrogen. I used to wake up after 45 minutes and be so desperate for sleep, and it would take hours and hours to fall asleep again.
I paid through the nose to the Marion Gluck clinic in London, all done online, but they knew their stuff and sorted out my thyroxine levels as well. After three days I started sleeping. That was five years ago. Now I get my body identical hormones on the nhs. If I'm a bit slack taking the progesterone in the evenings I start waking up again and staying awake.

Reading some of the posts, here I am surprised at some posts that describe poor sleep, which I'd regard as normal!

I found hrt helped, as I'd had problems going to sleep.

Now, I wake at least once or twice a night, (never ever sleep right through) and wake early-ish around 6am. If I've had a good 7 hours, I find that's enough.

Please don't think I'm minimising severe insomnia, which is horrible, but I don't know anyone in their 50s or older who sleeps right through the night like younger people.

I've been on HRT for 6.5 years since a full hysterectomy. One pump of gel on each thigh in the mornings. I would definitely get a bit hyped if I had any more - although I sometimes feel I'm not getting quite enough.

I take a large dose of magnesium every day - and I reckon it helps with sleep. It's a Newson Health one and I get it from emmasnutrition.com. It's got lots of B vits in too.

@JinglingHellsBells While I’m reluctant to make any changes at the moment (due to there being so many variables) I would like to get my hormone levels tested to see what’s really going on. It’s just a matter of knowing where to go for this and what to ask for. I’ve spent so much money on ‘wellbeing’ lately I need to be careful with what I invest in