Hello 3am

Hello 3am said no sane person ever, after having over a month of waking up at that time and then being unable to get back to sleep no matter what time they nodded off.

This is the hideous situation I have been in since the end of October. Initially I believed my waking up at 3am was due to being excited about my forthcoming birthday in November. When this came and went and I was still not sleeping past 3am I was at a loss to explain it. Why 3am? Why nearly every night? Even if I have had a few nights where I have slept past 3am I have still woken up at 4:30am - 5am. It gone beyond a joke now.

Due to this early waking I am incredibly tired, on top of my normal level of fatigue. It doesn't seem to matter what time I fall asleep when the clock strikes 3am I am awake. The worst night was when I dropped off a little after 9pm only to wake at 11pm. I truly wanted to cry that night. I feel as if I am stuck in a sleep pattern I can't correct and it makes it a very long day when it starts at 3am.

I am averaging between 4-6 hours a night, this simply isn't enough for me to function. My dysautonomia symptoms are going haywire, breathing, heart rate, temperature control and digestion have all started to go wonky. It is getting to the point where I am dreading going to bed because it really isn't going to be worth it. Nothing is keeping me up or preying on my mind. I have no problem at all dropping off to sleep I just can't stay that way. 

The condition is called Middle of the night Insomnia or Sleep Maintenance Insomnia. It is called sleep maintenance insomnia or middle of the night insomnia as sufferers report being able to drop off to sleep with no issues but they simply can not stay asleep either having frequent prolonged awakenings during the night or like me wake up at 3 or 4am and are not able to get back to sleep again. I have to admit this is much worse than the bout of insomnia I had in 2011, where I would go three days without sleep and then sleep for 13-16 hours. This type teases you by making you believe every night this must be the night when you will sleep all the way through and then you wake up and discover it is 3am again.

Whilst researching this blog post and looking for advice to help myself I did chuckle when the articles stated someone with Sleep Maintenance issues has problems getting back to sleep with it usually taking them longer than 20 minutes. I wanted to scream I don't go back to sleep at all!!! Not one of the articles addressed those of us who wake up and stay that way. They also trotted out the same advice all of which I have been doing or have been aware of for years 1) sleep in a cool room,  2) No caffeine after 2pm - I don't stick to that one as it is waking up not getting to sleep that causes the issue, 3) Having a good bedtime routine, 4) getting up if you haven't fallen asleep within 20 minutes, 5) using relaxation CD's. All of which I have tried at various points over the years either altogether or individually nothing works.

Many of the articles I looked at also talked about the various reason why people suffer from insomnia. Anxiety insomnia is something that most people will suffer from at some point in their life. Have you ever not slept before an important event such as taking an exam or getting a test result? Anxiety insomnia becomes an issue when everyday worries stop you sleeping for at least 3 nights a week. This can signal that the person may be suffering from generalised anxiety disorder. Mental health and sleep are intrinsically linked. Many people with depression find that either they can't sleep or they want to sleep all the time. I am not currently suffering from any mental health issues - I say currently because I have suffered with them in the past and it is highly likely I will in the future. 

This is a great article looking at why it is believed we need to sleep and what causes insomnia Brain Basics, Understanding sleep. Although it talks about smokers waking up early due to nicotine withdrawal, I can tell you that the last thing on my mind when I wake up at 2/3/4 am is a cigarette! It is usually why??? Why have I woken up again at such an early time?

Other suggested causes of insomnia were obesity - causing sleep apnea, caffeine / smoking or other stimulants consumed too close to bedtime, poor sleep hygiene, chronic pain or medications with the side effect of insomnia. None of which were causing my insomnia, my pain at night has been reduced since starting physio / Pilate's and only very rarely does my pain medication cause insomnia and when it does it is the type of insomnia where I can not drop off to sleep. I can not find a cause for the bout of insomnia. What I have found is that the circadian rhythm and the autonomic nervous system work together (it is believed although much more research is needed for basic info use this link ) so perhaps this is why I am currently suffering from sleep maintenance insomnia?

For sleep maintenance it is suggested getting more sunlight later on in the day to try to sort out your circadian rhythm. The circadian rhythm is a biological process that rises and falls throughout the day and plays an important part in sleep disorders. It can be thought of as your own internal clock and it informs the body of when sleep is needed and when you need to be awake. Many sleep disorders are caused by there being an issue with the person's circadian rhythm and day light plays a massive role in regulating this. I was unaware until I started researching my blog piece that some people who are blind suffer badly with insomnia due to no light reaching their retinas. Due to my situation of being pretty much housebound I do not get exposed to daylight on a regular basis. So should the insomnia situation continue I will certainly look into investing in a light box to see if that helps.

Last night I managed to sleep from a little after 20:30 until 05:15am. I did have many periods during the night when I was awake for a few minutes mainly due to toilet trips. I consume vast amounts of fluid over night (we are talking litres) which my own pet theory is that I am trying to boost my blood pressure overnight. Every ones blood pressure drops overnight but due to my screwed up autonomic nervous system it drops too low causing sweating, confusion on waking, dizziness etc. When I woke up at 2am my heart sank but after going to the bathroom I went straight back to sleep. I woke again at 3am, 4:30am but managed to roll over and resume sleeping. I am excited but I know one night of decent sleep does not a sleep maintenance insomnia cycle break.

I hope that last nights breakthrough wasn't just a product of being sleep deprived for so long. If it was it will mean I am back to square one tonight and that thought fills me with dread. Yesterday I had got to the point was hallucinating from my lack of sleep and was more clumsy than normal. It was very difficult to focus on anything and throughout the day I felt like I was having an out-of-body experience.

Unfortunately the cycle resumed the following night with last night being the worst it has been for a long time. I have been up since 01:30am and its beginning to feel like the film Groundhog day. I am seeing my gp in the next few weeks so I think you can guess what we will be discussing!