I have a colleague, a 49 yo woman, who has been suffering from chronic insomnia for the last 12 months. She says she has never been a good sleeper, but since this time she has seldom gotten more than three hours of sleep a night. She somehow manages to get through the day more or less normally, but I am worried about the long-term toll of insufficient sleep.
She has seen several doctors who have suggested relaxation techniques, exercise, etc, but nothing is helping. She has also tried melatonin and CBD oil with little noticeable effect. Barbiturates like Zolpidem seem to help, but they are very addictive. Her doctor has just prescribed this new drug Daridorexant which is supposed to be less habit-forming. Let’s see.
I hope she will eventually find a solution, but in the meantime, I thought I would ask around here. What are your thoughts and experiences on chronic insomnia?
“No eating four hours before bedtime” was a game changer for me. I still have problems getting back to sleep if I wake up in the middle of the night, so “staying” asleep is the most important part.
There are many possible causes for insomnia. I would ask her, is there any difference between the circumstances surrounding your life now as opposed to the circumstances surrounding your life before this chronic insomnia began? If there is, then she may be fortunate to discover the answer right away.
I have been on Ambien for 20 years.
I now cannot sleep without, but was sleeping very little before starting.
So no real harm.
It was my last resort, but it lets me lead a normal life.
Christina Applegate has been very public about her insomnia for many years. Despite her success and ability to afford the best medial attention, she hasn’t been able to solve her problem despite her best efforts, at least according to the last stuff of hers that I read. I’m so glad you found a solution to yours!
I have some insomnia. I’ve tried trazadone, ambien, and melatonin. All left me with a “hang over” in the morning, making me really tired when I woke up.
I recently was given a muscle relaxant for some back pain. It makes me a little drowsy and helps me get to sleep, but doesn’t carry over to the morning. It’s not great, but it does help some days. My GP is ok with me using it off label as needed, for now.
She can also experiment with some binaural beats sleep videos on YouTube. These are just 8-10 hours of New Agey drone music that pegs a frequency conducive to sleep.
this is worth considering as I believe she usually gets home around 8 pm and may be eating dinner late
I did ask her about that, and she couldn’t find any clear association. But something must have happened to make the insomnia start
That is interesting to hear. What did your doctor say? I have taken Ambien (Zolpidem) a few times and I love the stuff. It gives me great sleep and I don’t feel anything the next day. Benedryl, Unisom, etc give me horrible hangovers, but Ambien never does.
Yeah, I have been hesitant to ask her about that, but it seems to me to be the most plausible explanation
I suspect not. I think she has been only doing what her doctor recommends and did not mention these. But, in addition to the hangover effect, aren’t these addictive too?
Hmm. I looked at the site @DavidNRockies linked to and was intrigued by the idea until the very end when they said that the meta studies showed basically no significant effect
FYI, this is my first time doing the multiple quote thingy!
How much does Ambien affect your behavior? I’d want to do it too, except that I know one acquaintance who used and started going crazy and dismantling things and behaving worrisomely at 1 AM.
I have generally fallen asleep OK but wake up early and often.
My recent habit is to take a melatonin and benadryl before bed. I’m not sure I need the melatonin, but the benadryl keeps me groggy enough to keep sleeping through the night.
I also listen to something overnight. Used to be a “sleep program” podcast called Sleep With Me, now I listen to The Ancients, a podcast about archaeology and ancient civilization. The key to me was to have something interesting enough that I can focus on the content rather than random thoughts, but not so interesting that I feel compelled to stay awake until the end, and that doesn’t have loud sound effects or people laughing hysterically.
If I’m awake too early, NPR does the trick for me. There’s something about hearing something that I should know about, but not critical enough for me to jump out of bed for. Sometimes I’ll catch the first sentence and the last sentence of Sunday’s The Puzzle, missing the answer from last week.
A few years ago my wife was having chronic insomnia. It’s hard to overstate how much this affected her quality of life. Many days she did little besides work and nap, and she felt terrible for most of her waking day. Her doctor recommended a program developed at Harvard Medical School called Cognitive Behavioral Therapy for Insomnia. She had excellent results. It’s a 5-week program, but she was sleeping better within a few days, and had returned to an essentially normal sleep pattern within 2 or 3 weeks. She says she also doesn’t stress about sleep anymore, because she knows that if she starts to have sleep difficulty, she can return to the CBTI tools to get her sleep back on track.
She should probably talk to her primary care doc about a referral to Sleep Medicine. There may be a reason to do an in-the-lab sleep study.
There are also any number of conditions that can cause or exacerbate poor sleep. She should have a thorough going over by a primary care/internal medicine provider if she hasn’t already.
One thing is that her perception of how much sleep she’s getting may be incorrect. She may be drifting in and out of sleep through the night. To her it may feel like she only slept for 3 hours, but she may have actually been sleeping more than that. It may have not been a deep sleep, but she may have been in a light sleep state. Her conscious brain may not be correctly registering the time spent sleeping properly. If she’s able to carry on normally, then she may actually be be getting more sleep than she realizes. It’s kind of like the conscious brain is paused during short sleep segments. It thinks it was awake for 1 hour straight, but really it was kind of awake for maybe 10-15 minutes of that hour and in a sleep state the other time.
An example of this is when you fall asleep on a plane. You might not get into a deep sleep state, but you get into a deep restful and light sleep state. When you wake up, you may not have a good idea of how long you were in that rest/sleep state. Even though it doesn’t feel like she slept through the night, she may be getting the restful benefit of that kind of sleep.
Worrying about sleep can make the problem worse. If she’s thinking she has to get to sleep or else she’ll be a mess, then the stress will really wake her up. But if she can just be relaxed about it and realize her body may drift in and out of sleep to get the rest it needs, she can wake up relaxed and refreshed even if she doesn’t think she slept through the night.
This may not be uncommon. My wife sometimes complains to me that “I hardly slept last night”, but I remember that whenever I woke up (all too frequently, being an elderly male with a prostate, so bathroom trips) she was always sawing wood quite soundly.
Are there any easily available monitors that can record sleep patterns fairly reliably?
