67 year old who wakes up at 2:45am +/- daily and then up.

Hi @sleepwell67 ---Truthfully, there is no magic pill to help anyone sleep as the long-term solution. And, "sleep medications" ALL come with their own set of problems.

I had insomnia for a while related to restless leg syndrome. There were nights at its worst when I only slept an hour and a half.

For me, getting my restless legs under control was key, but I also had to work on a way to change bedtime from something scary and unpleasant (because I had become so anxious about not being able to sleep).

I went to two different sleep psychologists while my restless legs were really bad and much of their advice was helpful--all the "sleep hygiene" stuff (dark room, cool temperature etc etc).

At the same time, I also do some things not recommended (such as reading in bed, just before I go to sleep) because it makes going to bed something positive (for me). I also have an electric blanket, so there isn't the jarring of cold sheets. I turn this off after I get into bed but crawling into a warm bed is an inviting thing for me. (My husband also has come to enjoy this--our electric blanket has dual controls).

For me, my subconscious became so anxious about sleep it needed to be addressed in my subconscious. This took time. I had to coax it back into more normal behavior. The restless leg experiences taught my brain to be afraid of sleeping and it needed to be convinced I could sleep successfully (which, by the way, I am now.)

My advice is for you to seek out a sleep expert doctor and not take your problem to a primary family practice or internist doctor whose "easy answer" would be prescribing medication. A "sharp" sleep psychologist might also be helpful for you.

I found insomnia to be a BIG problem--the most painful experience of my life. It makes sense to seek help for sleep problems--but the right kind of help. Medication, ultimately, can be going from the frying pan into the fire. Make sure you hold-out for the right kind of help--not the prescription kind. And, overcoming sleep issues --truly getting better--can't be quick. That isn't the way brains work.

People training for a marathon need to build up to doing the entire 26+ miles. During the initial phase of training, they don't return from a run upset because they weren't immediately able to go that entire distance. They understand that training is a process and each stage prepares for the next.

Retraining our brains is like this. It is about consistently doing (and thinking) the little things and building a structure of behavior over time. The end result can't be immediate, but all the small steps will get you there.

Do you live where there are medical and psychological services available with good practitioners? Since you are on this Mayo forum, maybe you can see someone whose specialty is "sleep disorders" through them.

Best of luck to you, sleepwell67! Please post your progress so others can learn from you!

Thank you so very much for your time and compassionate suggestions...

I have requested a sleep study , not a regular cpap test... Had apnea before.

You are correct , as this sleeplessness has built up over time the solution may take the same.

Be and stay well! Thank you!

I have similar symptoms. It’s improved quite a bit with time and especially since I started using a portable AC unit at night. Sometimes, I can get 8-9 hours straight! But, usually I will awaken 2:30-4:00……but I usually am able to return to sleep. I haven’t tried meds. I wear an insulin pump and have to be alert enough to awaken if it alarms me.

I suspect my issue which started in 2023 (post covid) is rooted in anxiety. I’ve experienced a lot of stress, anxiety and disruption in my life since then relating to health and personal and family issues. I believe that if my stress is reduced, I’ll return to my former ideal sleep schedule. I am working towards that goal. I eat a tight diet and work out daily. I may return to talk therapy. That helped me for about a year with my anxiety. Good luck!

First easy solution, chamomile tea.
For anxiety and slew of other things, I have been pursuing Neurofeedback sessions. Completed 24 of 40 sessions.
Two things gone are brain fog and anxiety. I am present, my sub-conscious doesn’t swing between past or future thoughts for than a few mins. Its like someone put a stiff rubber band in my brain.

I have had ADHD, anxiety for most of my life, and now, its an amazing feeling, to be present and content. Lot less emotion in conversations.

Neurofeedback... I will look into this... Is this a electrical impulse device??
Thank you!

Best and be and stay well!

Here is the place I go, not an electrical impulse device, but I do have one of those too, called Alpha Stim. Did Alpha first, then Neuro.
I struggling from brain fog due to cancer medication, Tamoxifen. Since I still work, the fog was affecting my job so my therapist suggested Neurofeedback and wow, its an awesome experience. And without any medications, like depression, anxiety or stimulants if you have ADHD.

Links -
https://alpha-stim.com/
https://www.neurobehavior.com/

I am 71. I have what I call "old lady insomnia." I noticed many years ago an online friend from Canada would email late at night[orearly in the morning] and talked about waking up, not being able to sleep etc. She was a good 10-15 years older than I. Sure enough, as I've aged I have trouble staying asleep. No trouble falling asleep. I can wake up anywhere from 2-4 am. I will lay in bed until 4 if I've woken up earlier than that. Sometimes I have actually fell back to sleep. Sometimes if I feel quite alert, I will read in bed for a bit 30-60 minutes and can occasionally fall back to sleep. At 4 am or just prior I will get up.

There is some research that says that human beings have a cortisol dump around 3:00 a.m. I also wake up around that time but I am able to go back to sleep. I do take 50 mg. of Trazadone every night and I also have Long COVID that causes severe fatigue. I have always needed more sleep than, say, my brother. Even as a child. Sounds like you are taking good actions to try and get some assistance.

Last night was a good one! Went to sleep easily and slept a solid 8 and 1/2 hours! I wish I could figure out how to get that consistently.

I take magnesium glycinate from a company called Pure Encapsulations. You need to be sure you are taking enough. My doctor said to start with 1 or 2 capsules. If that doesn't work, go to 3 and if that doesn't work, go to 4. I have been taking 4 capsules, 120 mg per capsule and that has worked or a long time and then I started waking at night. So recently I switched to another brand because what is also needed is to be sure the body is absorbing it.
The brand I have been using now is called Adapt Naturals and it is called Bio-Avail Chelated Magnesium, 300 mg per capsule and I take the 2 recommended, which gives you 71% of daily value. Magnesium is something most people do not get and is needed.
Adapt Naturals is a company founded by Chris Kresser who is an expert in functional medicine.