2:30 am wake-ups: What do you do?

@celia16 If you are having insomnia, I would try it. It's not an instant fix though. You have to start at a low dose and work up to the maintenance dose which is 4.5mg/day for most people. After that it can take 1-2 months to notice improvement. The only side effect I notice is vivid dreams (not nightmares). It's not covered by insurance and you have to get it from a compounding pharmacy. It costs me $115 for a 90 day supply.

In the meantime, you could try melatonin. I still take 2mg before bed. I also take 200-250mg magnesium glycinate, which helps relax muscle and can help with falling asleep. Good luck, I hope it helps.

@daisy17 LDN when used for sleep alone is off label and considered experimental so there is not much research on its effectiveness. Funny when I asked my new doctor about it she said she would not give it to me for sleep. When I saw a second doctor and asked about it he said for me to take higher dose gabapentin for my fibromyalgia and it should help with sleep. Frustrating to say the least. Now trying vagus nerve stimulation. I get roughly 4 hours of sleep most night with two awakenings. Get up go to bathroom back about every hour to hour and a half until I finally give up and just get up and find something to do.

@daisy17 , I actually have no trouble getting to sleep. I easily fall asleep at a pretty early time….between 9-11 pm. Rarely can I stay awake past 10. But, I will awake in 3-4 hours and sometimes struggle to get back to sleep. This happens about half the time. I have improved greatly from where I used to be. I used to struggle to get to sleep and was wide awake until 3-4 most days.

I do take magnesium, but never saw that it helped me with sleep. I’m going to start HRT soon and am told that will help with sleep. I probably will try the LDN.

@roxiesmom13 That is frustrating and makes me a bit angry. Why would a doctor push higher doses of gabapentin when it has so many side effects and can lead to dependence and addiction instead of letting their patients try LDN to see if it helps? Also, with gabapentin, patients often develop a tolerance to it over time, so higher doses may be needed to achieve the same effect.

As far as LDN being "off label", Trazadone is prescribed off-label for sleep issues as are many other drugs.

I didn't know you had fibromyalgia. I developed it in 2021 after I got Covid and that's when my insomnia started. So I originally started taking LDN for my fibromyalgia pain but found it also helped my insomnia. LDN reset my body or something because my pain and sleep issues went away. It was a godsend for me.

I had to go to a pain clinic to get my prescription but found out my PCP also prescribes it. If you also have fibro with your sleep issues, I would recommend finding another doctor who would prescribe LDN for you. It doesn't work for everyone, but helped me so much. Here's an article about how it helps fibromyalgia: https://www.verywellhealth.com/low-dose-naltrexone-ldn-for-fibromyalgia-cfs-716070

@daisy17 Glad you found something that worked for you both with fibromyalgia and sleep. My insomnia started in my twenties and I am now 79 and they have tried five different sleep meds. Fortunately the gabapentin has not caused side effects or addiction. I frequently stop it then restart after a few months. Insomnia intensified after I lost my husband so that’s why they tried trazadone but the loss of balance at my age was really a concern. Hugs and thanks for your feedback.

I wake up around that time, and its hard to get back to sleep , the brain starts thinking. drives me crazy, then I seem to drop asleep late afternoon. I have thought of getting up at 3am, sometimes I have to as a manic ( I'm bipolar ) session hits. but not always. Thank heavens I dont live in a block of flats.

I got 10 hours last night! I got up twice to use the bathroom but went right back to sleep. Felt great today! Fully rested. Had a great workout at the gym too!

One piece of whole grain wheat toasted bread with peanut butter and jelly, 1/2 glass milk, wait 10 minutes and I sleep rest of night.
few tips I have learned from my doctors and personal trial and error over the years.
No napping during the day, it ruins your sleep drive for the following night.
No interactive electronics after 8pm. TV or read ok.
Dont eat any carbs after 7pm, doctor indicated this stimulates your body into the night (this means crackers, chips, sugar etc) Pepperoni and cheese ok, just no crackers. Cottage cheese ok. Fats are fine, just NO carbs.
Try a as warm a bath as you can early getting out before 9pm. This would help me relax on my running days.

I know this frustration very well but getting up and doing other things isn’t helpful for me. I’m now using the breathing technique that I read has helped others. It was also recommended in the calm app which I have used out of desperation. The technique is simple: 4-7-8. Breathe in to the count of 4, hold for the count of 7, and breathe out to the count of 8. Keep repeating and your heart rate and respiration will slow down allowing you to get back to sleep. At least it’s working for me now.
One other thing I started trying this week is to start drinking water (liquids) earlier in the day and stop drinking liquids between 5:00 and 6:00 pm. And, no caffeine after 3:00 pm. (I try to drink 60 oz) The result was that 3 nights this week I didn’t wake up to go to the bathroom. I still woke up but not having to get up and using the breathing technique I was able to get back to sleep quicker. I have come to the conclusion that it’s not just one thing that is the game changer… it’s a combination of things. I have also been trying to incorporate a bedtime routine with soothing music and some relaxing exercises on the bed and no screen time for 1 hour before bedtime. Hope something from this will help. 🤗

@smithneedssleep I feel the same way about getting up and doing other things. Nothing like that will make me sleepy again. I am doing an online CBT-I course, and they say that waking up around 3 pm is just part of the "sleep architecture" of humans, going back to caveman days. It was a protection-defense mechanism. They also recommend breathing, or thinking of a very pleasant memory, or trying to "rescript" the dream that you just woke up from, so you can go back to it (you change the ending of the dream). They also say it is OK to lay in bed awake, as long as you tell yourself it is just to rest. Do not force sleep.