COnvince me to see a sleep specialist (bonus for local Chicago recs)

I’ve been an insomniac for years - I don’t have trouble falling asleep, I have trouble staying asleep. It comes and goes in spurts - when I’m in a bad spurt, I wake up after 4 hours or so and can’t get back to sleep. (Tonight, for example, I went to bed at about 10:30, woke up around 2, and haven’t been able to get back to sleep. Boy, tomorrow - I mean today - is going to be fun. The Fitbit thinks I slept 2 hours and 8 minutes, and it may actually be right.)

It tends to flare up when I’m stressed (usually, but not always). This week someone I know from childhood (younger sister of a close HS friend) died after a brief but intense struggle with breast cancer, less than 6 months from diagnosis. It’s peak crazy period at work, and I have multiple bosses, most of whom are completely disorganized and one of whom has ADD (for real, actually diagnosed), and none of whom bother coordinating with each other to see what workloads actually are, they just throw stuff at me. But they don’t want me to work overtime when I’m swamped, because then they would have to pay me, but that’s a much longer rant. I’m trying to clear my desk off because I’m supposed to have my first 2 consecutive week vacation since 1994 right after the end of the busy season, but they just keep piling work on me. There is a huge pile of files that have been sitting next to my desk for months waiting to be closed, but I haven’t had the time to do it, I have no help doing it (although management keeps telling me they want me to minimize the amount of admin time I spend, but do not provide alternatives), and there’s nowhere else to put them. The clutter makes me bonkers.

Both my parents are also insomniacs. I know I grind my teeth in my sleep, because my dentist tells me so (and made me a mouth guard, which has some pretty deep grooves in it now). I have some respiratory issues (nasal polyps I never did anything about 20+ years ago, mild intermittent asthma). I’ve tried various meds to sleep (Rozerem, which did squat, and a brief round of Ambien XR, which knocked me on my ass, because it was right before they reduced the recommended dosage for women by half). I’m not fond of taking drugs to deal with basic bodily functions, but what else can I do?

My doc doesn’t like prescribing things like Ambien because they are habit-forming, and advises Benadryl, which is handy for my allergies anyway, which also tend to flare up when I’m stressed. Melatonin helps sometimes, but apparently not tonight - I’m tired to the point of dizziness, but can’t turn my brain off. I follow all the standard sleep hygiene advice - only 1 cup of coffee a day, no caffeine after noon, don’t read or watch TV in bed, etc. It doesn’t work reliably. Exercise levels seem to have little to no effect. The Fitbit thinks I’ve been averaging around 6 hours of sleep, even when I am in bed with the lights out and am not conscious of being conscious for 8 - 9 hours, which makes me think I don’t sleep very well.

So I need to sort all this crap out before it makes me insane. Am I missing anything? Any other professional I should consult?

I’d suggest going to a sleep clinic and a specialist if you haven’t already done that. Not sure from your OP if the doctors you have seen are specialists or more general.

Poor sleep is rated about as bad for your health as smoking a pack a day (or something like that).

Do a sleep study if warranted. There are take home ones (I did that) and fully wired overnight in a clinic (my daughter did that). I used to think I had caffeine headaches. Turns out with a CPAP machine both my caffeine headaches and afternoon sleepiness instantly went away (and thos symptoms return if I skip one night).

There are herbal solutions or melatonin that seem to be pretty hit and miss. Some work for some people.

Assume that you have also tried the standard routine of sleep at a set time, get up before sleeping in past a certain time, no caffeine after noon, etc.

Anecdotal, but a fair number of people find listening to podcasts to be pretty good to help you fall asleep or fall back asleep. A good droning voice, a topic that isn’t riveting. The “stuff you should know” podcast works wonders for me.

A trick with ambien I learned is that half an ambien puts you to sleep half as long. A quarter works for 1/4 the time (seems like 1/4 may not be enough to cause sleep for some people). When I wake up in the middle of the night, know I won’t be going back to sleep for a while, yet really need sleep that night, then i find a 1/4 ambien will put me out if I’m lying there in bed quietly. But now it’s a rare night when the podcast doesn’t put me to sleep, and a 30 minute podcast can take 4-5 nights to listen all the way though.

Read this book. It’s short, not woo-woo, and it will convince you. Written by a dentist. He’s not selling any products. Read the reviews.

Thanks, guys. I have not seen a specialist or had a sleep study, and I don’t think it’s in the cards, time-wise, until we get back from vacation, but maybe I will check out that book in the meantime.

Valerian root seems to really make me sleepy if taken an hour before bedtime. Before I used to not really feel sleepy, or take far too long to fall asleep.

Try the podcasts. It’s recommended by many sleep doctors and anecdotally seems to work for a high percentage of people including me. You can use earbuds if it is going to be irritating to anyone sleeping in the same room.

The book is called “The 8-Hour Sleep Paradox,” and it talks about how a restricted or narrowed airway (throat) can cause sleep apnea, and this condition means that you virtually never fall into the deep, restorative sleep that your body needs. The author’s wife was in great health, ate right, exercised, etc., but was always tired and draggy. When she had a sleep study done, she found out that her sleep was disturbed dozens and dozens of times during the night because of a narrowed airway. She never woke UP, but her body was constantly bringing her from deep sleep into a lighter sleep to kick-start her breathing. When your body is not getting adequate oxygen, it’s an emergency and all systems go into action to make sure you keep breathing.

The author, as I mentioned, is a dentist and he said that now he checks for narrowed airways in his patients. It can sometimes be corrected with a mouth guard of some kind… a c-pap device isn’t always needed.

He himself had a sleep study done and was told that his “score” was within normal limits, but after what his wife went through, he had it done again and found out he was suffering from sleep apnea, too. (How often have people been told by their medical provider that their readings are “normal,” but they really do have something wrong…don’t get me started on that.)

When he finally got the problem corrected, he said he now wakes up totally rested, relaxed, energized, ready to take on the day— which was never the case before. Let’s fact it: maximizing oxygen delivery to all parts of the body and its systems is the name of the game. When that’s not working right, bad things happen.

Anyway, just read the book. It’s an incredible eye-opener (or should I say “throat-opener”).

My mom used to take valerian root when I was a kid, and just the smell made me gag. Is it available in any format besides that nasty-smelling tincture?

I don’t have problems falling asleep at night, just sometimes getting back to sleep again after waking up in the middle of the night. The Fitbit thinks I sleep pretty calmly for the first 4 hours or so, and get pretty restless after that.