Clockwork early morning insomnia, possibly from overtraining
Hi all! New to this great forum and hoping someone here can help me.
I’m a 38 year old guy, 6’4″, 178 pounds. I’ve been having incessant early morning insomnia for months, and am struggling to pinpoint the cause. I should clarify what I mean by early morning: I’m a night owl, and have gone to bed at around 2:30 AM for at least the last twenty years. (There was a period of a couple years when I was working on Asian time and had to go to bed even later (4:30 to 5:00 AM), but I’m back to my druthers of 2:30 AM.) My body seems to function best on about 7.5 hours of sleep, so if my circadian rhythms are in tune, I go to bed around 2:30 AM and wake up around 10 AM with a song in my heart and hope for the day, but I can function reasonably well on about 6.5-7 hours of sleep *provided that I wake up around 10*. (Waking up at my normal time seems to be more important than going to sleep at my normal time.) But since last summer, I’ve been waking up around 8 AM every morning, and with a BANG – not gradual, groggy wakeups, but with a surge of energy and a pounding heart that casts me impossibly out of sleep in an instant.
My initial self-diagnosis was that this was some consequence of overcardio and undernutrition. For most of my late 20s and early 30s I was pretty fit, doing HIIT cardio sessions for about 90 minutes a day, 4-5 days a week, and everything was dandy. Work and marriage kept me couchbound for my mid-30s, however, and I grew chubby, sulky, and TIRED – like the less I moved, the more worn out and depressed I got – and I couldn’t live with the person I was becoming. For New Year’s 2019 I resolved to get back into shape, so I resumed the HIIT and radically cleaned up my diet: no sugar, no caffeine, and no flour or refined grain. (I’m also a vegan of 15 years and a teetotaler who’s never had alcohol more than once or twice a year at any age.)
Anyway, I felt GREAT, and unfortunately started to overcook the training, letting my normal 90 minute sessions spiral outward into 180 and even 240 minute grindfests. I was obsessed with reclaiming a six pack, and underate, underhydrated, and overtrained, ignoring all the warning signs of system collapse. I stopped losing weight, even though I was eating less and working out more, and a few DexaScans revealed that I was putting on body fat in general and visceral fat in particular month after month despite a total lack of sugar intake and a mammoth calorie deficit. I also had what I’d call permanent dude PMS, getting irritated by seemingly everything and taking all sorts of trivial slights deeply to heart, and I was fantasizing about food, especially junk food, every night.
Sometime in the summer of 2019 I started to have the sleep disturbances, but they were intermittent at first: some mornings I’d wake up at 8 and struggle, but I often could get back to sleep, and even when I couldn’t, I’d be fine the next night. Then, in September, my beloved cat, who I’d had for a decade and was the last pet of mine from my bachelor days, was suddenly diagnosed with malignant lymphoma and given six weeks to live. From that day on, I was up at 8 AM every day, no matter what, and couldn’t get back to sleep under my own power no matter what I tried. Since then nothing has changed. If I go to bed at my normal time, I’m up at 8 AM with what feels like an adrenaline rush, and if I go to bed earlier I wake up earlier and *still* have the 8 AM adrenaline rush (or whatever it is) when I’m out and about in my morning routine. The morning wake up is so jarring that sleep vanishes completely, and the idea of just breathing and going back to bed is laughable. The insomnia feelings don’t kick in for several hours, but then inevitably hit me like a truck.
I tried doxepin for several months and it did help me sleep. I’d still wake up at 8 AM with the same horrible energy burst, but the doxepin would overpower it and drag me back down till my normal 10 AM wake up. Unfortunately the doxepin stopped working, but it was obviously treating the symptoms, not the cause, so it was always going to be a band aid and I kinda knew its day would come.
Two other notes:
* My testosterone is much lower than it used to be. In 2018 (before the overtraining) it was 493 ng/Dl, now it’s 290. My sex drive/libido is basically zero – the machinery still works, but I never want to turn it on. This has been the case since last summer – about when the insomnia started to creep in – and has not improved in any way. I’d love to get my testosterone back, and feel like the insomnia must be related somehow, but I can live without it if need be. The insomnia is a much more pressing issue.
* I’ve tried a lot of the holistic supplements (Seriphos, holy basil, kava, ashwaghanda), thinking that I was suffering from high cortisol, but none of these has worked, and if anything they’ve each had the OPPOSITE effect: they seem to give me heart palpitations and some physical unrest/agitation. Seriphos is particularly rough: if I take it before bed, as most naturopaths suggest, I wake up about three hours later and can’t fall back asleep for love or money. Kava used to be one of my favorite relaxants, and now it makes me feel like I’m one step closer to a heart attack – tight chest and shortness of breath. (Not nearly extreme enough to require a doctor, of course, but still bad.)
My endocrinologist at Kaiser won’t run any tests on me beyond a catchall blood panel because “my testosterone is still in the normal range”, no matter how crazy the loss of libido is, and my “TSH level is normal so any thyroid-related insomnia is impossible”, a statement which seems flatly contradicted by a lot of the medical literature I’ve looked into. I need a better doctor and a place to start – can anyone help? At this point I’m ready to bestow half my kingdom – which amounts to a used car, a couch, and a medium sized TV, but hey 😀 – on anyone who can save me from this.