Detailed question on Insomnia/Anxiety

[Ins0mniac]

Dear Insomniacs, I was wondering whether or not one of would be able to give me some advice or possibly have an answer to some of my questions.

I'm a 22 years old male, 1,72m and 84kg. I was wondering whether or not I would be able to beat insomnia, caused by anxiety (initiated by a major panic attack), without taking any perscription medication.

I've been suffering from insomnia for 3 weeks now and it seems to get better, as I'm no longer paranoid on forcing myself to sleep. Symptoms that I've had before mostly dissapeared (such as depersonalization, brainfog, extreme palpitations, even panic attacks themselves, and more).

Although I still have trouble getting enough sleep. I usually go to bed at 22:00 and lie there till 2:00 untill I finally doze off for aprox. 2 hours, try to sleep again and after another 4 hours I get another 2-4 hours of sleep and so on. I even have times when I wake up more than 10 times.

I have lost my appetite and I've lost 7 kg in 3 weeks. I even have to force myself to drink water. Sometimes I get heartburn and acid reflux, but these go away after drinking more water. I'm taking magnesium, vitamins D and B.

Another point is the fact that I can't recall myself having a dream. I don't even remember falling asleep or waking up. Once I was looking at the clock it was 2:17 and 3 seconds later I've looked back and it showed 4:00. I used to dream alot and had no problem falling asleep and dreaming, eventhough I had an extremely stressful and depressive 4 years before I got insomnia. Could it be that my brain is shutting itself down with force, in order to rest and keeps all energy for restoring my body rather than producing dreams?

The Cardiologist did a Electocardiogram, Echocardiogram, Stress-Echo, all were normal. I've done bloodtests, normal urine tests and tests on faeces, all were normal. The Neurologist told me to do a 24-hour urine test for hormonal imbalance (adrenaline/noradrenaline/...), I'm still waiting for results. I have pre-hypertension, but it might be caused by anxiety. I'm also doing an EEG and a full sleep-study next month.
The Psychiatrist just perscribed me some medication for getting more sleep, although I don't want to get hooked on drugs at all and they might cause rebound-insomnia.

I'm no longer in a "zombie" state as I was initially, I can function (although not as good as I once did) and I still feel tired all the time (even after sleeping). Is this an indication that I'm not getting any or not enough REM sleep? If so, what can I do to get more REM sleep and get a healthy sleep-pattern (or reset my "biological clock")?

Thanks in advance!

[gypsylee]

Hey there,

What did the psych prescribe, out of interest?

Try deep breathing. I don't mean to fall asleep (although it could help), I mean do it during the day and see if you stay asleep longer. There's a thread started today by PanicCured and in my reply I wrote how it helped my sleep during a nervous breakdown.

See, when we're really anxious the body thinks sleeping isn't a good idea because that's when a bear could come and eat us. Eating is similar because it uses energy (hence we get sleepy after a big meal). When the nervous system is on high-alert these activities are a no no because it doesn't know the difference between now and times when we could get eaten by animals. That's very basic but you get the drift.

Deep (diaphragmatic) breathing tells the nervous system it doesn't have to protect us from bears :) so we are allowed to sleep for longer than a few hours (or at all) and we are allowed to eat. It's the key link between the mind and the body.

All the best to you,
Gypsy :)

[aml0017]

What gypsy said. Insomnia is a common issue with anxiety. You may have some degree of trouble with sleep until your anxiety is under control, you just have to accept that for now. It does suck to not get enough sleep but in the end the lack of sleep is not going to kill you. Worrying about the fact that you won't be able to sleep makes it even harder to fall asleep, and it becomes a vicious cycle. Meds can help you sleep but they can backfire, make you feel groggy and out of sorts, and you may become dependent on the effects (or the drug itself) to sleep normally. I do take some benadryl on nights when i am really anxious but I don't like to do it every night as it makes it harder for me to sleep naturally. I take 25 mg at about 9 pm then go in my room and read a book, then take another 25 mg when I start to feel relaxed around 10 pm. Some people can't handle benadryl, i find it gives me at least 5 hrs of sleep when I just can't turn my mind off.

Try to relax before bedtime, start at 9 pm or so. Take a nice hot bath/shower, have a snack, don't run around the house cleaning and getting stuff ready for the next day. Drink some decaf tea or cocoa. When it comes around bedtime, go in your bedroom to prepare for bed but don't pressure yourself with looking at the clock constantly. Keep yourself distracted from your anxious thoughts. Just read a book or watch tv or something that relaxes you and accept the fact you may or may not fall asleep soon. It will happen when it happens. Once you get into this routine and you let go of the fear of not being able to sleep, it should get better.

[Ins0mniac]

Thanks for your advice, gypsylee and aml0017!

The psychologist prescribed Zolpidem and Xanax, although I won't take them anyways. He also gave me one Temesta Expidet 2,5mg pill to get some sleep that very same day (since I was awake for 3 days). I used this pill and got 2 hours of sleep, untill I woke up feeling worse than I did before going to bed. I wouldn't advice anyone to use this drug.

I usually keep myself calm and relax. Sometimes I take 2 tablets of "Sedistress". "Sedistress" consists of "Passiflora incarnata L. 200mg". It helps alot with mental stress and slows your thinking down. With this homeopatic medicine I'm able to get atlest 5 hours of sleep (eventhough I wake up numerous of times), yet it's still hard to fall asleep.

Today I've tried to fall asleep for over 6 hours untill I finally slept for 5 hours straight. I think this medicine is gradually helping me, or it might be a placebo-effect.

Seems like the only way to beating anxiety, is becoming completely fearless.

Thx again :)

[aml0017]

Glad you are getting some relief, even if it is a placebo effecgt. There is something about anxiety I think that just prevents your body from going into that deep, restful stage. Even with meds, I will sleep a couple hours then wake up. when I fall back to sleep I dream a lot and have sort of waking dreams where I react to stimuli around me in my dreams. Like I will be half awake and will hear cars passing outside or my dog will move around and the sensations will somehow incorporate into my dreams. I don't know if this happens to you. It is not restful but it is better than no sleep at all.

I have never been a heavy sleeper at all, even when I am not anxious. I have put on some weight over the years (emotional eating) and I find it has gotten worse. I have never been tested but I do wonder sometimes about sleep apnea due to being overweight. I know the constant interruption of breathing will prevent people from getting deep restful sleep. Some people have it even if they are not overweight, ie people who snore a lot. I have always slept better when I was healthier and thinner, and got daily exercise.

[Dragons]

I have similar issues with sleep. Most of the time I sleep well, but then there will be a random few days/weeks where I just find it impossible to sleep. Last night, for example, I went to bed at maybe midnight and couldn't fall asleep until around 3 AM ... I had to get up at 8 but kept waking up randomly in the night. I think it's partly due to stress, it being the end of the semester and all––I don't know if you're also a student, but maybe either that or something else is stressing you out? I sometimes take melatonin, although it's kind of a crapshoot; sometimes it works and sometimes it doesn't. I've also found that wearing a sleeping mask seems to help. My room is pretty dark already but some light does get in through the curtains and I think that disrupts my sleep a bit.

[Ins0mniac]

aml0017, I've actually had that before I've got insomnia. I think that's just a part of 'depression'. I remember when cars used to pass by I would incorporate those exact same sounds it in my dreams, like racing. If I hear someone talking while sleeping, my brain would incorporate that same dialogue and visualize it somehow. It's really strange. It's like being 75% asleep and 25% awake.

Nowadays, I don't recall having any dreams whatsoever, so I guess I couldn't tell anymore how it felt exactly. Also, I tend to wake up to any minor noise in my surroundings. If a door or something shuts, I tend to wake up in a 'panicking' way. After that I won't be able to fall back asleep. Today I've tried to sleep for 5 hours and got 3 hours of sleep (perhaps less), after that I've woken up because some ***hole was yelling outside.

I've gained alot weight over my 'student life' 4 year period at University. I was constantly stressed, and used 'food' as a way to make me 'feel better'. I've messed up my "biological sleep-clock", because of the random hours of classes (sometimes at 6:00, sometimes at 20:00,...). I usually tried to 'nap' in between classes in order to feel more 'energized'. I guess I just burned out completely. After classes I would often play competitive video-games, in the hope of reducing stress, but it just increased stress for me. Anyways I took a year off from University, in order to solve my 'mental' problems in the hope that I would be able to finish my courses after a year of rest. After that I've gotten addicted to gaming, felt it was getting harder and harder to fall asleep, became completely depressed,... untill I've had a panic attack and got all these "Anxiety/Depersonalization/Insomnia/..." problems to deal with now.

Only thing that would make me 'happy' used to be sleep, now I don't have that anymore. Getting enough sleep has become the most stressful problem I've ever had to deal with.

PS: What type of work-outs do you do? Alot of cardio? It's a shame that I have Asthma, I usually 'gas out' after running more than 100m. I tried walking alot in the park and stuff, it clears my mind from distractions and personal problems. Perhaps I should do that more.

[Ins0mniac]

Dragons, You should watch out at 'overworking' yourself for school. Make sure you make some personal spare time to deal with your emotional/physical health. Go outside and socialize, hang out with friends, become more 'positive' in life, ... I used to supress my emotions and neglected my physical health, from eathing unhealthy and studying 12 hours a day. All of it piled up, untill it bursed open with a panic attack and now I'm constantly in 'anxiety-mode', which is the main reason it's nearly impossible to get decent sleep.

I don't know much about Melatonin, but I've tried 5-HTP once (before my insomnia kicked in). I've gotten a full 9 hours of sleep, but it gave me horrible vivid nightmares that I couldn't wake up from (being eaten by a bunch of zombies lol).

[aml0017]

It seems for a lot of people anxiety can start to rear its head in the teens, but you are young and don't have too many worries so it is not so bad. But there is something about college/university that just sends it all into overdrive. I am 33 now so I haven't been in school a while but that is when it all went into overdrive for me. I had my first panic attack freshman year over a test, and it was all downhill from there. I had such extreme anxiety over grades, I would break down in the bathroom before every test, and afterwards as well. I isolated myself and stopped going out with friends, just stayed in my dorm room all the time. That is when I really started eating emotionally and putting on some weight. When I was in class taking a test I would plan in my head what food I would eat after to make myself feel better. After school was finally over my anxiety improved but I still ate as a response to stress and the weight kept coming. I have lost over 150 lbs total probably since then, but always put the weight back on as soon as it gets stressful.

I am still fighting the weight but I usually find I can get in the exercise mode fairly quickly. Mostly cardio for now since I haven't done anything for a while don't want to overdo it. I do the treadmill at the gym mostly, also rowing machine and elliptical. Maybe 30 minutes or so at my target heart rate. Don't worry too much about how far you go or how fast, just get your heart rate elevated for a period of time, at least 20 min or so. Take your heart rate at rest and then walk and once your heart rate is elevated to a comfortable range, just maintain it for a while, go slower or faster as necessary. There are online calculators to find target heart rate but you may have to adjust for your asthma. Just take it slow. I find the sense of accomplishment is more helpful than the physical exercise sometimes. On days I don't go to the gym, I walk my dog in the park or along the bayou behind my house. Nature is very calming I find, obviously you do too. You should go to the park more, even if it is just a stroll or to sit down and eat lunch, whatever.

[Ins0mniac]

I just realized that I haven't 'dealt' with the (perhaps) most important 'anxiety symptom', which is excessive 'googling'. Once I get sometype of a wierd feeling in my body, I just google the symptoms and often think of the worst type of disease. The other day I found something called 'Fatal Familial Insomnia', which is spammed all over the net in the media/blogs/... Therefore I though I was quite common. Ofcource they 'forgot' to mention that only 100 people in the world ever had this disease, that the person who has this disease can't get beyond the first stage of sleep (5-10min of sleep), needs to have a mutated prion (which is inherited from ancestry) and needs to have a parent who suffers from the same disease. They did it on purpose, just so that paranoid insomniacs like me would read it non-stop and worry about it (the more views, the more these 'bloggers' get paid). Once I figured this out I was at ease, since I'm able to get more than 5-10min of sleep and my parents don't have it. Yesterday I found out something even more 'interesting' called 'Sporadic Fatal Insomnia', which is a non-inherited mutation of 'Fatal Familial Insomnia'. To cut the story short it had all the symptoms I have, without all the needs of 'FFI'.

Does anyone know how to stop being 'paranoid' on googling?

[aml0017]

I don't even know what to tell you about the excessive googling, I have that issue too. Not even about health stuff, just everything. It is a compulsion, like you are trying to find that one thing that will relieve your mind, and even if you find it, you keep looking it up for reassurance. That is of course unless you find something that is NOT reassuring, which is bound to happen. I finally stopped because yesterday I woke up and my phone would not come on at all (true story), I may have broken it. I do have access to internet at work but no computer at home so without my phone I have barely googled anything for over 24 hrs. It is a relief I must say.

Before that, I would ban myself from google for like one hr. I even turned off my mobile data so even when i forgot and reached for my phone to search for something I was cut off and reminded that I shouldn't. Once I broke the cycle i found it got better. Google can be helpful but after a while you keep getting the same info repeated over and over and you are not really learning anything new.

[Ins0mniac]

Update:

After 2 weeks I seem to be doing better ("sleep-wise"). I think that my sleep-pattern and biological clock are adjusting themselves, by shifting my sleep earlier. A week ago I've had my first set of dreams, 3 nightmares. All of them happened during the first REM-stage (5-15min of REM after aprox. 90 min. of other 3 sleep-stages). Yet I still couldn't sleep more than one stage at a time (max. 1.5-2 hours of sleep), without waking up. Although, I was glad not to lay in bed for 6-8 hours untill I would doze off for 2-5 hours max. Sleep occured at nighttime. I went to bed at 22:00, fell asleep somewhere at 2:00-4:00 (woke up from a abrupt nightmare - most vivid dream), 6:00-7:30 (woke up from a abrupt nightmare - medium vivid dream), 9:00-11:00 (woke up from a abrupt nightmare - least vivid). This same pattern happened the day after. The next day something strange happened. I fell asleep quickly, aprox. at 00:00, and I remember having a beautiful extremely vivid dream where everything felt and looked real (the colors were extremely bright, and I felt extremely happy). Then I something felt odd, nothing in this dream felt 'real', I realized in my dream that I was dreaming, and I diden't know or couldn't wake up from it. (When my anxiety kicked in, in my dream) I suddenly though that my 'real body' was either dying or in a coma. At this point I jerked myself up and woke up screaming my loungs out, and had a full blown panic attack (bloodpressure 160/107 and pulse 103). That day I promised myself to have a full sleepstudy done (EEG, Polysomnography, all other sleep-labo tests...) as quickly as possible. I made an appointment with a second Neurologist, the head Neuro-Psychiatrist and other specialists (Neurologists, ...). He told me that I should take 'sleep-medication' - mainly Benzodiazepines or others like Zolpidem/Zolpiclone... I refused to start taking any type of medication that would alter my brainchemistry, not only because they would give me alot of problems in the future (rebound insomnia/anxiety/depersonalization, dependency, addiction, all kinds of physical/mental side effects,...). I know all this because my sister works in a pharmacy and she is totaly against the use of these type of drugs (unless it is as a 'last-resort') and both of my parents who are surgeons completely agree that I would do more bad than good in the future (so it isn't worth the temporary relief). He said that it's necessary to take me out of this 'vicious cycle' (of Anxiety - Physical symptoms - Fobias - Insomnia). He was concerned about my constant head pressure/tingling/headache feeling, and ordered an immediate CT scan of the brain (which came out negative for any type of Neurological problems). Later my father (who used to be a orthopedist, pediater and surgeon) diagnosed me with inherited (from my mother) Osteochondrosis in the neck and spine. The stiff neck is what caused all of my headaches. I used to 'crack' my neck alot before to relief myself from this pain so nobody ever figured I had a problem (eventhough I allways had bad posture - leaning head forward - when sitting and walking). However after 'googling' more about the side effects of neck cracking (snapping the carotid arteries and having a brain aneurysm) I stopped even twitching my neck too fast. The Neurologist agreed to put me on the priority list to undergo a sleep-study on the 6th of January, mainly because my private doctor forced them to, although the head Neurologist is a collegue of my sister. Other clinics told me to wait for 3 months atleast... The sleep on the next days was at mixed hours, sometimes I would doze off at 12PM, 2AM, 4AM, ... Although I did get alot more sleep and woke up less often. I was even able to sleep to a full uninterrupted 7 hours, but I was snoring like crazy (something that I never did before). The past week, since my sleep has been getting better, my headache started to be less painfull, I felt less tension/tingling in my head, had overall better mood, could control my 'panic attacks' more, ... The 'chest' feelings however became more extreme. My father thought the daily supplements might had caused my heart to beat stronger than before, mainly the dose of Magnesium 1000mg (normal daily Magnesium intake should be is 340mg/day). I stopped taking supplements completely and I diden't feel the need to take them in the future, since by getting more sleep, my appetite came back. The 'strong heartbeat' diden't stop however (I could feel my heart beating so strong that my body and my vision would shake), the pulse stayed normal (my normal resting pulse is 60-64), although my bloodpressure could rize up to 150-97. This symptom is persistent when I feel: Anger, Fear or strong Anxiety (like having a test done or awaiting results). I was confused by this, but thought it to be temporary, as the headache feelings I've had. Then all of a sudden I could only sleep upright, when lying down I would immediately feel shortness of breath, faster heartbeat... When leaning to the left I would feel my pulse radiating through my body and I would see a pulse in my vision (shaking of my vision). When leaning to the right, I would get these wierd biting/spasms/needle picks on the left side of my heart (above the nipple) and bubbling feeling/wierd sensations/wierd sounds 2cm under my nipple (either the stomach or an intestine). After going back to upright position I would feel all other symptoms dissapear quickly and feel my heart (far left side of my chest) flutter/tingle (without pain). I made an appointement with another Cardiologist. She did all the usual tests EKG, Echocardiogram, Ultra Sound machine, all 4 different sounds of the pain arteries (Phonocardiogram), she looked at my past blood tests and told me all is fine. Although I will mention to her that I have slightly high Calcium 2,58mmol/L (normal: 2,15-2,50), borderline LDL-cholesterol 100mg/dL (normal:<100), low HDL-cholesterol 31mg/dL (normal:>=40), just to clear out the possibility of plaque buildup (Atherosclerosis). Eventhough I took the bloodtest month and a half ago and I used to eat fastfood and GMO crap. Now I eat low amounts and only 'healthy' food, I already lost 9kg in 1,5 months (I'm now 81kg and 172cm). My total cholesterol and tryglicerines are normal, I don't have hypoglycermia and CRP is <5 mg/L (ideal is <3, normal is <10). My parathormone is at 36ng/L (normal: 8-53), so I don't have a thyroid disfunction. Eosinofile (white bloodcells that fight off allergies) are low 0,08 10E9/L (normal: 0,1-0,5), because I have chronic asthma and had no triggers (now during winter they should skyrocket as weatherchange is a major trigger for me). Hemoglobine was slightly high 16,8 g/dL (normal: 12,9-16,4), mainly because I used to drink less water. I did fail to complete the Stress-Echo on a bycile, I almost fainted. The Cardiologist told me my heart peaked (max. rate) at only 75Watts. A normal person of my age (22years old) - not even sportive - should get 220Watts. This showed that my physical condition was horrible, I sat on my ass for over 2 years (University/Gaming/Eating/No Vacations/No Exercize). She put me on a Heart-Monitor for 24hours, of which the results will be examined with a CT Anginogram. Because I have problems with my lungs (I had Pertussis when I was little, it eventually became Chronic Asthma/Bronchitis) and I'm not allergic to Iodine she opted for me to undergo a CT Pulmonary Anginogram in 2 days to see if there are pulmonary emboli. If everything is good, I must start exercizing (slowly building up). I still don't know my 24hour Urine test (for Adrenaline/Noradrenaline/...), I need to consult with my doctor to get them next week. I'm glad I got second-opinions, even if it is simply for reassurance. Although a seeing a third Psychiatrist wasn't the best experience I've had, the first one told me to 'drink warm milk before bed' (useless), second perscribed a bunch of sleeping pills (zolpidem/xanax...), this one tried to perscribe me anti-depressants (celexa). Allways refuse to take pills, they treat the symptoms not the core problem that creates these symptoms.

If anyone (who has the same type of condition) got any questions, ask away.