Frequent awakenings, no restful sleep. Need guidance

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.

Good morning @chopperdave. I’ve been where you are for 5 years including sleep studies, sleep specialists, meds etc. so I understand how it affects your life. I will be 71 next month and was told by a sleep specialist that this type of sleep disruption is “normal” for about half of those over 65. About half my friends in that age group have unsatisfactory sleep so that statement seems to be true. Seems that hormone imbalances/declining hormones are significant factors in sleep. Are you on any medication or supplements at this time? I find that the older I get, the more sensitive I have become to side effects. Supplements that are somewhat stimulating such as Rhodiola or Alpha Lipoic Acid even when taken in the morning seem to affect my sleep that night. Have you been tested for Vitamin D, B12, iron and ferritin levels? All other lab work OK? Do you refrain from looking at screens such as smartphones, laptops etc at least an hour before bed? Do you turn off your Wi-Fi at night and leave your cellphone out of your bedroom at night? Lots of studies published in this regard. Have you tried prolonged release melatonin such as Douglas Labs brand? Do you refrain from any caffeine after morning? Even caffeine in the morning can affect some people’s sleep that night. My mother started experiencing insomnia in her early 50’s if she drank any caffeine (chocolate included) or consumed any sugar or too many carbs after 6:00 at night. I’m the same way except now, the small amount of caffeine I may consume has to be in the morning only. And as mentioned by @gloaming, do you get any exercise outdoors during the day? There is a great book “Spark- The Revolutionary New Science of Exercise and The Brain”
I hope this may have given you some things to think about.

You mentioned trying full spectrum hemp supplementation. Or did you? The quality of and amount of cannabinols can make a difference. I would retry that route and go for at least 33 mg of cannabinoids and with 17 Delta 8 THC per serving. Let’s assume you live in a state where you can buy this like Tennessee. I get no buzz or high from my nightly tincture and It has cut down dramatically my mid-night wake ups.

Thanks for responding.

Yes, the sleep study I referenced in the OP was an overnight in-lab study. They ruled out apnea and limb movement, and saw nothing that looked abnormal on any of the charts. On the hypnogram it shows me reaching REM sleep, but when I come out of it I got to fully awake instead of maybe stage 3 or 4 sleep. I point this out to doctors that it seems odd but none of them think its abnormal. Sometimes I don't even reach REM before waking.

I've tried melatonin in the past but it has no effect. I've gone as high as 15mg and still nothing. I have not heard of Zopiclone though. That may be one I have not tried.

I've always been an introverted person. I am currently single and mostly keep to myself. I don't really have any obvious stressors that bother me during the day and I'm pretty good at blanking out my mind when I go to bed.

The issue started when I forced myself to be more social by joining a meetup group and just diving in to meeting strangers. The night after the first meetup is when my sleep was off, and it's been that way ever since. I haven't done anything social like that since then, but the problem persists. Maybe it's still social anxiety, or maybe it has evolved to something else. I don't really know sadly.

For exercise I do weightlifting 4 times a week. It's a struggle with the fatigue but I force myself to do it.

Thanks for the input!

I'm still on the "younger" side (currently 40) so I don't think I've reached the age yet where meds start affecting me differently. In fact most have no effect on me at all.

I see my doctor for my annual physical every year which includes broad spectrum bloodwork. Everything comes back normal. I have had specific tests for vitamin levels and iron and those are fine too. I even got tested for multiple STDs (just in case) plus Lyme disease. Nothing.

I don't drink coffee or alcohol and I don't smoke.

The last hour before bed I dim the lights, turn everything off and relax. If I have to look at a screen they are all setup with blue light filters. My bedroom does not have a TV in it so I could make sure it's specifically associated with sleep and nothing else.

I'll take a look at the book though. Thanks for the pointer.

I'm no weed expert so I honestly can't say if the stuff I tried was a good enough dosage or not. I'll check out the specific amount you mentioned to see if it helps. I have no tolerance for marijuana so hopefully it's not too much. I live in California so it should be easy for me to find. Thanks!

I have mid sleep awakenings too. They used to be multiple, but now I’m down to one. Occasionally, I’ll get a full 6-7 hours. My trouble started when I had several other things going on. I had post covid syndrome, dental trauma, and Vitamin B12 deficiency. So….not sure of the culprit. Several doctors and my therapist told me that once a pattern of awakening gets established, it’s difficult to break. We really need a reset to get it back to normal. I’ve tried a lot of things, including one med that does help, but isn’t designed to be taken long term so I don’t rely on it.

Mine is improving due to resolving certain conflicts in my life. The more issues I resolve, the better my sleep seems to go. Now, I’m falling asleep early and awaking early morning. Usually getting at least 6 is success for me. Seven is celebrated.

Have you had your B12 checked?

Thanks for the input. All of my bloodwork is normal