1. < Sleep Health

Frequent awakenings, no restful sleep. Need guidance

Posted by chopperdave @chopperdave, Dec 11, 2024

So for the last (almost) 11 years I have suffered from frequent awakenings and lack of restful sleep. I sleep maybe an hour to an hour and 15 minutes at a time before waking up, sometimes as little as 30 minutes. And in the morning I still feel tired.

Over the years I have seen probably a dozen different doctors across multiple disciplines (psychologist, psychiatrist, pulmonologist, neurologist, etc.). Every form of therapy and type of medication they had me try has had no effect. I still wake up all the time and am still exhausted in the morning.

For therapies, I have tried neurofeedback, TMS, hypnosis/subliminal messaging, light exposure, meditation, and sleep restriction. For medications...it's too many to list and I honestly don't even remember them all. But it's essentially all standard prescription medications, OTC options (like Benadryl), CBD/THC, and even an injectable peptide like Sermorelin. I tried to get a prescription for a sodium oxybate, but without a diagnosis of either narcolepsy or idiopathic hypersomnia (of which I have neither) I don't qualify for one. Benzodiazepines do help reduce the number of awakenings but I still do not get any restful sleep.

I did a sleep study a few years back which showed my awakenings in the hypnogram, but no cause for it. They ruled out sleep apnea and limb movement, but weren't able to actually pinpoint the problem. My current doctor said the amount of time I was spending in each stage of sleep was within "normal" parameters, but obviously it's not what's normal for me since I'm still tired. And unfortunately he said they are out of ideas at this point.

Anyone have any ideas on what I can do? I'm back at square one and trying to find a treatment/medication/doctor/anything to help get me going again.

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chopperdave | @chopperdave | Dec 29, 2024
In reply to @sleepcoachjohn "Hey chopperdave. I'm curious, how much sleep are you actually getting a night? Do you think..." + (show)
@sleepcoachjohn

Hey chopperdave.
I'm curious, how much sleep are you actually getting a night? Do you think you might be suffering from insomnia?

Jump to this post

Well insomnia is a general term for any undiagnosed sleep disorder, so yes I technically have insomnia. But beyond that no one knows what my issue is.

Last time I did a sleep study (several years ago) I was getting around 5 hours of actual sleep. The problem was not enough of it was deep sleep, so I never felt rested. That and the frequent awakenings.

REPLY
chopperdave | @chopperdave | Dec 29, 2024
In reply to @projfan "There is a CBTi approach that you might want to consider if you haven't tried it,..." + (show)
@projfan

There is a CBTi approach that you might want to consider if you haven't tried it, called sleep compression. This is a good description: https://www.med.upenn.edu/cbti/assets/user-content/documents/btsd--sleepcompression-bsmtxprotocols.pdf. It's supposed to be done while working with a therapist, but it's easy enough to try on your own.

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I've done that (I call is sleep restriction in my OP). Tried it several times under the guidance of a psychologist. It kind of works as long as my time in bed (TIB) is kept short (5-5.5 hours), expanding by 15 minutes every two weeks. As soon as I get to about 6 hours TIB all of the interruptions come back. Seems like a breaking point for some reason.

And even though I had fewer awakenings at 5.5 hours TIB the sleep wasn't quality so I was even more tired than usual when I woke up

REPLY
1 reply
projfan | @projfan | Dec 29, 2024
In reply to @chopperdave "I've done that (I call is sleep restriction in my OP). Tried it several times under..." + (show)
@chopperdave

I've done that (I call is sleep restriction in my OP). Tried it several times under the guidance of a psychologist. It kind of works as long as my time in bed (TIB) is kept short (5-5.5 hours), expanding by 15 minutes every two weeks. As soon as I get to about 6 hours TIB all of the interruptions come back. Seems like a breaking point for some reason.

And even though I had fewer awakenings at 5.5 hours TIB the sleep wasn't quality so I was even more tired than usual when I woke up

Jump to this post

Interesting. I finally gave up on it myself, because I kept falling asleep during the day while sitting up and reading. And as you say, the quality of my sleep suffered. I'm sure it works better for some people than it did for us. Still might try it again in the future, but not until some other problems stabilize.

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turandot | @turandot | Jan 5 7:57am
In reply to @gloaming "Have you ever had a full overnight polysomnography? Was sleep apnea ruled out? REM disordered sleep?..." + (show)
@gloaming

Have you ever had a full overnight polysomnography? Was sleep apnea ruled out? REM disordered sleep?
https://www.mayoclinic.org/diseases-conditions/rem-sleep-behavior-disorder/symptoms-causes/syc-20352920
Otherwise, I feel it must be psychosomatic. With all the diagnostics run on you, it's either an emotional distress of some kind, or unresolved/put to bed problems that you might need to face before you let yourself sleep properly. It's just a guess, and I have no formal training, no coaching experience in this area, no advanced reading because I suffer from the same problem(s). I sleep quite well, just not long enough. At least about 90 minutes less than the experts say a typical adult needs. In fact, none of the now-adults in my family, not my father, nor my three siblings, sleep more than 5.5-6 hours.

When I need a better sleep to reset a bit before the next four-six days of short sleep, I take 2.5-5mg of melatonin at bedtime, or I'll try up to half a 7.5mg tablet of zopiclone. I haven't done the zopiclone in 18 months because I got over a really bad spell after 10 months of poor sleep due to the diagnostics and follow up ablations (two ablations) to stem persistent atrial fibrillation. Now, melatonin at bedtime, about twice a week (only), works pretty well, say at a B- to A- level of success, again because I do it so seldom that it retained its potency on my system.

How are your relationships? Anything niggling that, if you were (more) honest, should be nipped now or raised between you and at least one other person to put to rest once and for all? Finances okay? Are you trying to avoid saying no?

Do you get out for a brisk walk at least three times a week, and for at least three miles, more better if you have the time and energy? Exercise to the point of at least 130 BPM for anyone under 60 is both restorative and soporific in nature.

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Could it be undiagnosed allergies? Also electronics give me mild headaches. Watching and using too late in the evening disturbs my sleep. Must turn all off at least two hours before bed. Then I’m able to sleep. Also no food two hours before bed.

REPLY
1 reply
chopperdave | @chopperdave | Jan 7 10:46am
In reply to @turandot "Could it be undiagnosed allergies? Also electronics give me mild headaches. Watching and using too late..." + (show)
@turandot

Could it be undiagnosed allergies? Also electronics give me mild headaches. Watching and using too late in the evening disturbs my sleep. Must turn all off at least two hours before bed. Then I’m able to sleep. Also no food two hours before bed.

Jump to this post

Well I still live in the same area as I did before this problem started so I don't think it's allergies. And before this problem started I could use electronics right up until bedtime with no ill effects. I don't do that anymore (I turn them off an hour beforehand) but it doesn't seem to matter.

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1 reply
gloaming | @gloaming | Jan 7 10:58am
In reply to @chopperdave "Well I still live in the same area as I did before this problem started so..." + (show)
@chopperdave

Well I still live in the same area as I did before this problem started so I don't think it's allergies. And before this problem started I could use electronics right up until bedtime with no ill effects. I don't do that anymore (I turn them off an hour beforehand) but it doesn't seem to matter.

Jump to this post

Dave, allergies develop as we age. This has been well understood for several decades, and when I learned of it, I was flabbergasted. How can a healthy aging person finally start to get allergies?!?!? Well....it happens....

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cindisue | @cindisue | 6 days ago

chopperdave, I sympathize with you and pray you find something that works for you soon. Have you tried over the counter Unisom with active ingredient Doxylamine Succinate? It works very good for an over the counter sleep aid. Also, you say you've tried benzos....I'm wondering which ones you've tried. Flurazepam was an extremely good med for insomnia/sleep issues, but then went off the market. It's supposed to be coming back under manufacturer Chartwell and Rising. I take Lorazepam with Amitriptyline nightly. I've finally found what works for me and couldn't be happier. These 2 meds work together to stop the anxiety and racing thoughts at bedtime and also help so much at getting back to sleep when I wake up. Don't give up! I did alot of my own research and recommend people do the same. The website Drugs.com is very helpful. It will tell you all the meds used for sleep issues or any issue you want to research. That's how I found Amitriptyline. It's an older med that's been around a long time but doctors these days don't prescribe it because they, for some reason, want to push these new SSRI's and SSNI's.... examples are Zoloft, Lexapro, Duloxetine, etc.... some work for some people, but most have alot of side effects. Good luck to you.

REPLY
1 reply
cindisue | @cindisue | 6 days ago
In reply to @gloaming "Have you ever had a full overnight polysomnography? Was sleep apnea ruled out? REM disordered sleep?..." + (show)
@gloaming

Have you ever had a full overnight polysomnography? Was sleep apnea ruled out? REM disordered sleep?
https://www.mayoclinic.org/diseases-conditions/rem-sleep-behavior-disorder/symptoms-causes/syc-20352920
Otherwise, I feel it must be psychosomatic. With all the diagnostics run on you, it's either an emotional distress of some kind, or unresolved/put to bed problems that you might need to face before you let yourself sleep properly. It's just a guess, and I have no formal training, no coaching experience in this area, no advanced reading because I suffer from the same problem(s). I sleep quite well, just not long enough. At least about 90 minutes less than the experts say a typical adult needs. In fact, none of the now-adults in my family, not my father, nor my three siblings, sleep more than 5.5-6 hours.

When I need a better sleep to reset a bit before the next four-six days of short sleep, I take 2.5-5mg of melatonin at bedtime, or I'll try up to half a 7.5mg tablet of zopiclone. I haven't done the zopiclone in 18 months because I got over a really bad spell after 10 months of poor sleep due to the diagnostics and follow up ablations (two ablations) to stem persistent atrial fibrillation. Now, melatonin at bedtime, about twice a week (only), works pretty well, say at a B- to A- level of success, again because I do it so seldom that it retained its potency on my system.

How are your relationships? Anything niggling that, if you were (more) honest, should be nipped now or raised between you and at least one other person to put to rest once and for all? Finances okay? Are you trying to avoid saying no?

Do you get out for a brisk walk at least three times a week, and for at least three miles, more better if you have the time and energy? Exercise to the point of at least 130 BPM for anyone under 60 is both restorative and soporific in nature.

Jump to this post

Yes...walking an hour a day helps sleep alot!

REPLY
chopperdave | @chopperdave | 3 days ago
In reply to @cindisue "chopperdave, I sympathize with you and pray you find something that works for you soon. Have..." + (show)
@cindisue

chopperdave, I sympathize with you and pray you find something that works for you soon. Have you tried over the counter Unisom with active ingredient Doxylamine Succinate? It works very good for an over the counter sleep aid. Also, you say you've tried benzos....I'm wondering which ones you've tried. Flurazepam was an extremely good med for insomnia/sleep issues, but then went off the market. It's supposed to be coming back under manufacturer Chartwell and Rising. I take Lorazepam with Amitriptyline nightly. I've finally found what works for me and couldn't be happier. These 2 meds work together to stop the anxiety and racing thoughts at bedtime and also help so much at getting back to sleep when I wake up. Don't give up! I did alot of my own research and recommend people do the same. The website Drugs.com is very helpful. It will tell you all the meds used for sleep issues or any issue you want to research. That's how I found Amitriptyline. It's an older med that's been around a long time but doctors these days don't prescribe it because they, for some reason, want to push these new SSRI's and SSNI's.... examples are Zoloft, Lexapro, Duloxetine, etc.... some work for some people, but most have alot of side effects. Good luck to you.

Jump to this post

Thanks for the input.

I've done the OTC stuff and I've tried Lorazepam before. The thing with benzos is that while they reduce the number of awakenings I have, they don't improve the actual quality of my sleep so I still wake up tired.

However, I have not tried Amitriptyline (much less with a benzo like Lorazepam) so that is something I will bring up with my doctor. Thanks for mentioning them!

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