Insomnia again!!!!

[Shazamataz]

Hi guys,

Along with my anxiety I've had real issues with insomnia these past months. Am on Mirtazapine which is supposed to be sedating but it hasn't helped.

At my last psych appointment we decided to give melatonin a try and I had nearly two blissful weeks getting at least 8 hours a night.

One of the issues that developed was having a loud pounding heart when I lie down, sometimes but not always racing quite fast as well but not high enough to be tachycardic. So I also started taking my beta blocker at night which stopped this for those two weeks.

I was feeling hopeful and starting to feel human again but now 4 nights in a row have barely slept at all. Pounding heart has returned (despite the beta blocker) and even zopiclone won;t send me to sleep.

3 hours, 3 hours, 4 hours and last night I did not go to sleep at all, had times where my heart was pounding as high as 98 beats a minute.

When I was getting sleep my anxiety was hugely improved. A lot of my anxiety has become about sleep and fatigue for the obvious reasons of months of terrible nights.

Feeling desperate and scared of going backwards. Any words of wisdom?

[23fish]

I was advised to take betablockers before bed so that the morning ones took effect more quickly. I found they increased my insomnia significantly, so that might be a factor in yours. Remember the pounding heart is a sign of a strong heart, and 98 bpm is not that high (normal resting heart rate is between 60 -100 bpm). Have you tried putting music or a podcast on so you have something to listen to. It might take your mind off your heartbeat.
Hope you get some sleep tonight x

[Shazamataz]

Thanks fish,

The beta blocker is a double-edged sword really it seems. For two weeks its completely stopped the heart pounding which is what keeps me awake and I was getting a good night's sleep. I didn't know they can CAUSE insomnia?

I usually go to bed and watch something on my tablet and was managing to fall asleep with that but I seem to have hit a blip in that regard. Even when I woke up which I do often my heart was fine, it's just started back in the past few days. I'm not scared about it as I know it's not dangerous but it certainly isn't helpful with sleeping. It's like someone in the neighbourhood playing music with a loud bass or something. Also I expect when one's heart rate is that high, it's impossible to relax.

Might try leaving it (the beta blocker) tonight and see what happens.

This is all so frustrating! It's a holiday today and despite being winter the weather is great and I feel too tired to enjoy it.

---------- Post added at 12:30 ---------- Previous post was at 12:25 ----------

Yep, I've just read bisoprolol (the beta blocker I'm on because my thyroid is a bit dodgy and the GP thought that was giving me a fast heart rate) can cause insomnia as well as anxiety and depression. Not idea for someone with anxiety and depression!

[MyNameIsTerry]

Sorry to hear you are struggling again, Shaz. :hugs: Insomnia is a real pain in the back end, you just end up pinning your whole day on how you feel rough and sleep becomes far too important so it just gets harder and it's very unpleasant from what I remember of my bouts of this.

I can remember hearing my pulse in my ears when lying on my side too. It would keep me awake but as I started to get less anxious in general, I found this was another one of those lesser symptoms that just went away, the same with heightened sense issues like with light, noises, etc.

Insomnia is a common side effect of that med so could your GP swap you to another one without this side effect? Thyroid meds can be a problem with anxiety, has that side been ok though?

Another thought could be the stress & sleep disturbance over your dog being neutered. I found something stressful could do that to me back then and it could take a few days of more to settle down as I was just more anxious than normal. Do you feel you are more anxious over everything? Probably a silly question with the lack of sleep.

I take it the Melatonin was a short term fix to correct your sleep cycle? But you can get Melatonin into your diet which some have found useful for sleep from what I've read. There was an article in The New Scientist about sleep hygiene and it was referencing a sleep study using Montmorency cherries, which are known to contain Melatonin, and it mentioned how Melatonin supplements have a very short half like so can be limited in helping but the cherries seemed to have a longer effect which was thought possibly due to being more bioavailable.

I've been meaning to look the study up since those cherries are useful for some physical issues, one of which I may have or at least symptoms similar.

[Shazamataz]

Sorry to hear you are struggling again, Shaz. :hugs: Insomnia is a real pain in the back end, you just end up pinning your whole day on how you feel rough and sleep becomes far too important so it just gets harder and it's very unpleasant from what I remember of my bouts of this.

I can remember hearing my pulse in my ears when lying on my side too. It would keep me awake but as I started to get less anxious in general, I found this was another one of those lesser symptoms that just went away, the same with heightened sense issues like with light, noises, etc.

Insomnia is a common side effect of that med so could your GP swap you to another one without this side effect? Thyroid meds can be a problem with anxiety, has that side been ok though?

Another thought could be the stress & sleep disturbance over your dog being neutered. I found something stressful could do that to me back then and it could take a few days of more to settle down as I was just more anxious than normal. Do you feel you are more anxious over everything? Probably a silly question with the lack of sleep.

I take it the Melatonin was a short term fix to correct your sleep cycle? But you can get Melatonin into your diet which some have found useful for sleep from what I've read. There was an article in The New Scientist about sleep hygiene and it was referencing a sleep study using Montmorency cherries, which are known to contain Melatonin, and it mentioned how Melatonin supplements have a very short half like so can be limited in helping but the cherries seemed to have a longer effect which was thought possibly due to being more bioavailable.

I've been meaning to look the study up since those cherries are useful for some physical issues, one of which I may have or at least symptoms similar.

Thanks, as always Terry for all your insights. Yep, when insomnia hits, sleep becomes all you think about and so that creates anxiety which, in turn, causes insomnia. I've just gotten myself a little freaked as had a couple of weeks where I felt I was starting to get on top of things.

I can only take bisporolol as a beta blocker as I have asthma so the other ones aren't safe. I only started taking it at night as a bit of an experiment after a couple of bouts of waking with a pounding heart and it seemed to have helped. When I told the GP I was doing that she said it could cause crazy dreams but didn't mention insomnia. She's good but I suppose she doesn't know everything.

I'm a bit scared NOT to take it at night now, although last night in particular my heart was pounding loud and fast all night despite taking it. It's a tricky one.

I'm not on any thyroid medication as my levels are normal apart from TSH. I have a nodule that's been there for years and it's just a case of keeping an eye on things. My GP insists this could be causing me a lot of my issues but the specialist disagrees. They call it 'subclinical hyperthyroid'. A bit of reading, however shows it CAN be symptomatic. It was because of this I was put on the beta blocker in the first place as I had a constant elevated heartrate that sat in the early 90s.

I have melatonin for 3 months. Apparently that's standard practice here. It also seemed to help temporarily but maybe it was a placebo effect?

However, you are bang on about the dog. I wasn't worried about him per se as we have a very good vet. I think, though, that since I'm off work and have become accustomed to not having a schedule as such (I have things I need to do but not on a tight time frame), the knowing I had to set an alarm and be at the vet at 8 am was enough to stop me sleeping the night before. Then I was a bit shocked when they told me he was not allowed in water or at the beach for TEN DAYS! And had to be walked on lead. Having two dogs, this makes things tricky for a number of reasons. We usually only go places where they can run around. So anyway the last three days I've taken him and Lola out seperately and have had to leave him with friends to keep an eye on him because of the stitches and because of circumstances (him being the youngest child essentially) he has never ever been left on his own.

So, yes, I think just an extra thing has been enough to set me off again. He's happy as a clam and his stitches look good so I WILL be taking him to the beach in the next few days, that being our 'local'. It's just too hard otherwise.

I'm pretty sure when he last had stitches after getting attacked by a schnauzer I was only careful with him for a couple of days and he healed up well.

Anyway, enough about that. Tonight I will do my best to not be anxious about sleeping. Fingers crossed!

PS. I'm having concerns about sleep and worry that something in my brain regarding sleep has simply 'broken'. I know I am catastrophising but one's thoughts are harder to control on no sleep. I don't think I have ever not slept at all for a whole night. You can't 'break' your sleep mechanism can you?

[MyNameIsTerry]

No, and I think you are saying (and asking) all the same things we all do. I remember Crystal on here and her sleep was totally messed up for a time after some meds and she was worried just like you. But she got much better and her sleep came back. But she still has wobbles with it if something has stressed her out or if she has to get up for something. Sleep cycles will reset themselves or change but I can't see you can break them in the sense you just stop having natural sleep cycles. I think people who worry about that end tend to veer towards diseases causing real sleep problems and we are talking mega rare stuff there so please don't allow your anxiety to entertain that one.

Gregcool's insomnia started from his hyperthyroid meds, I remember him saying.

Exercise helps, it's proven too, but it's a real chore slogging through the day let alone that. Walking your dogs is giving you something, just do what you can and add things bit by bit if you can too to see if it helps. But I know how horrible I felt and just wanted to sleep all day and then couldn't anyway! It's so frustrating.

I was like that too for a while but I started getting enough to push through. What I ended up doing, which was not really intended as it was my OCD causing it, was to get too little sleep for months and I found my thoughts about sleep changed. I didn't intend to do this. Before this happened I was still a little tender about sleep and a rough night could make me suffer the next day even though I had got past my insomnia and be fighting my way back from the relapse for a couple of years.

I just sort of got used to it. I accepted that things just go on and you get things done. It was easier though because I had been moving forward and I doubt I would have seen any benefit earlier when I was so easily triggered by so much.

Sleep is one of those things that you need to not care about. I guess it's a bit like how we say not to tell your mind to stop something happening because it will invest more effort in worrying about that and you suffer for nothing as it may never have happened. For instance, telling yourself not to think about that white bear...you just end up thinking about it.

It's a pain when they have ops. Our dog was born with a cyst on his belly but the vet waited to do that at the same time as the neutering. We had to keep him under surveillance as he didn't like the socks and would try to scratch. Then a couple of years later he was attached by one of those Bordeaux dogs. He was shaken up & down and it took all 3 of them to get the jaws off him. Luckily no real punctures or damage so he was just shaken for a few days but then raring to go again. My parents don't suffer from anxiety but they didn't sleep that night as it shook them up.

There are a range of beta blockers that are seen as safer for asthma sufferers including the one you are on. So, perhaps it would be worth looking at the side effect profile of them to see if insomnia is more of an issue with certain ones? (atenolol, metoprolol, betaxolol, nebivolol, acebutolol seem to be mentioned)

[Shazamataz]

Thanks for all that Terry,

Good news is that last night I didn't take the bisoprolol (saved it for morning) and I didn't have any heart pounding. I had a pretty restless night but managed about 6.5 hours so that's a big improvement.

Will check out the other beta blockers but there's a chance they aren't funded here. But if I stop taking it at night and don't have any more pounding heart situations then that might be a it. Before I changed to taking it at night I was having pounding heart sometimes but it wasn't every night.

Of course I may have also slept because I'm less worried about Zico. He doesn't need the plastic cone anymore as he doesn't seem to be licking at his stitches so that's one less thing to worry about!

I can also take the dogs out together today. We have a lot of sports grounds nearby where you are allowed to walk dogs but they are pretty much off limits in the weekend due to winter sports but nobody will be playing on a Tuesday morning!

Will definitely work on the not caring about sleep but it's sure a challenge when you are exhausted!

---------- Post added at 09:13 ---------- Previous post was at 09:09 ----------

Interestingly I will add that pounding heart can be a side effect of bisoprolol. It's only been happening fairly recently and I've been on them 2-3 years now but maybe it's just developed? Or it could be thyroid. Whatever it is I sure don't want it to continue!

[MyNameIsTerry]

Yes, perhaps it's just the timing with it. Only trying will tell there.

If the heart pounding has started only after started that beta blocker then it makes sense it's a likely cause of it and trying it like this is a good way to try and work that out.

If it goes, I think that's enough. If it continues, then you can keep investigating whether it's the beta blocker, thyroid, etc.

If it only came on though during a time of increased stress on you, I would be thinking that to be a major factor, if not the actual problem. So, it will be interesting to see how your sleep goes now things are getting a bit more back to normal

[Shazamataz]

I've had the heart pounding issue on and off for months now so it's hard to tell what it is. Most likely anxiety. But if the bisoprolol causes insomnia it could indirectly cause the pounding heart IF it's an anxiety symptom for me.

It's difficult because I feel everything I experience is now put down to anxiety, at least by my psychiatrist, and that's a big load to carry when I DO have actual health issues as well. It's difficult to separate the two but I do worry that something could be ignored because I have anxiety and that must be what is causing it.

Feel a bit shit that something as simply as getting the dog fixed could cause stress. I suppose I need to be kinder to myself after the few months I've had.

Today has been pretty rough, I expect because I still have a lot of proper sleep to catch up on.

Thanks so much for the input. You are always so helpful and wise, Terry.

[MyNameIsTerry]

But sleep is still a sensitive subject for you so things that may interrupt it are on your list of triggers, for the moment. So, the vet and then him whining keeping you awake just start the process off.

Learning to get beyond all that stuff always takes time and repetition but it will come.

Sometimes getting loads of sleep makes you feel sluggish & knackered, then too little makes you feel the same but with nausea. It can feel like a no-win at times.

Always glad to help, if possible, Shaz. :flowers:

[Shazamataz]

But sleep is still a sensitive subject for you so things that may interrupt it are on your list of triggers, for the moment. So, the vet and then him whining keeping you awake just start the process off.

Learning to get beyond all that stuff always takes time and repetition but it will come.

Sometimes getting loads of sleep makes you feel sluggish & knackered, then too little makes you feel the same but with nausea. It can feel like a no-win at times.

Always glad to help, if possible, Shaz. :flowers:

Yes sleep is a very sensitive area for me. I swear the SSRIs at the beginning of the year ruined my ability to get any sleep!

Last night I lay in bed for two hours with the radio on and constant hot waves of anxiety coming over me. I decided to just ride it out instead of getting up and down too prove those heatwaves won't do me any harm.
'
That said, by 1 am I gave in and took a zopiclone and managed to sleep til 4, took another half and slept til 6. Not nearly enough sleep so starting the morning very rough but doing my best not to give into it. REALLY nauseous and out of sorts.

I need to walk the dogs this morning and have psychologist this afternoon. I think I am running out of appointments as he is leaving at the end of the month and no mention of me being handed over to anyone else so that's anxiety-provoking in itself!

At least I didn't have a full blown panic in the night, that's something right?

[MyNameIsTerry]

When it's like this, Shaz, you've just got to take it hour by hour until things calm down. Be kind to yourself and wary of overdoing things.

You've proven that what happens one night doesn't happen another. The rest is just anticipation because it could happen. This will calm down as the anxiety reduces.

It took me a while to get over stuff like that.

[Shazamataz]

When it's like this, Shaz, you've just got to take it hour by hour until things calm down. Be kind to yourself and wary of overdoing things.

You've proven that what happens one night doesn't happen another. The rest is just anticipation because it could happen. This will calm down as the anxiety reduces.

It took me a while to get over stuff like that.

Thanks Terry

I accidentally posted on this thread this morning instead of my new one - oops!

That said it's still relevant as the sleep seems to have set me off. A couple weeks back with the dog situation I didn't sleep and felt really rough but the anxiety symptoms weren't this bad. Today has been right back to how I felt when I started the SSRIs. And unfortunately the thing that makes me anxious is not sleeping and/or being alone at home which are not things I can wait to pass.

Urgh!

PS there's no chance of me overdoing anything as am struggling to do anything at all.

[MyNameIsTerry]

What I mean is that they pass on their own over a period of time. So, whilst you can't wait as you are in that situation now, if we have a big shock we can find it takes a few days and then it naturally declines. A bit like when you do exposure therapy how anxiety levels go way up for a time first.

When you had your dog done (poor chap) you had a spike from it but it settled down after a period of time. This has been a much bigger event and resulted in higher anxiety that than did so it may take a bit longer to just ease away a bit.

There might be a link in with the Diazepam reduction too. I know some of the other people on here who have had to withdraw have said that they found it ok to reduce from the higher levels but it was reducing the very small levels towards the end that were hardest. You really need people with those experiences to help you there but it's a possibility and maybe this means a certain amount of time before it just seems to reduce again?

[Shazamataz]

What I mean is that they pass on their own over a period of time. So, whilst you can't wait as you are in that situation now, if we have a big shock we can find it takes a few days and then it naturally declines. A bit like when you do exposure therapy how anxiety levels go way up for a time first.

When you had your dog done (poor chap) you had a spike from it but it settled down after a period of time. This has been a much bigger event and resulted in higher anxiety that than did so it may take a bit longer to just ease away a bit.

There might be a link in with the Diazepam reduction too. I know some of the other people on here who have had to withdraw have said that they found it ok to reduce from the higher levels but it was reducing the very small levels towards the end that were hardest. You really need people with those experiences to help you there but it's a possibility and maybe this means a certain amount of time before it just seems to reduce again?

Terry, you deserve a medal for all the time you put into helping everyone on here!

Yes, the attack I had on Wednesday night really set me back and potentially the diazepam reduction has caught up with me. It's good for me to have it in my head that this will pass. It's hard to believe because of how bad it feels and earlier in the year it didn't pass on its own but then it settled quite a lot with the Mirt, or maybe it was just time? Who knows?

I won't reduce the diazepam any further for a while to see if things settle. I'm only on 1.5 mg a day now. Such a shame it doesn't help any more :(

[MyNameIsTerry]

Thanks for your kind words, Shaz. I think we all deserve medals on here. We've certainly got the battle scars.

I remember how bad my setbacks hit me. I was in tears over them and that happened plenty before I got a handle on things. It's very much a lessons learned process with what appear to be failures at first. I try to see as professor Mark Williams explains starting Mindfulness in his book. He says everyone will fail at first and that it is ok and expected since it's a skill.