Insomnia getting worse (and women's talk)

[Night Elf]

Hi everyone. I haven't been here in a while although I've peeked in to see what's going on. I miss this board with all it's awesome insight and help. I am curious about personal experiences by other women my age, 40's - 50's who are in or have gone through perimenopause. I've had insomnia for over 15 years so I can't blame it completely on perimenopause but I'm wondering if it made it worse. Every time I try something, it works for 3 - 5 days and then becomes a sugar pill it seems like. My current plan is taking 330 mg magnesium, 10 mg melatonin and one 3 mg Lunesta tablet at bedtime. I can sleep anywhere from 1 to 3 hours, although most nights it's about 1.5 hours. Then I get up and read a while and then take a 50 mg Trazodone and sleep another 1 - 2 hours. My best sleep is between 8:00 am - 11:00 am. I'm averaging 5 hours a night/morning and am up before lunch. I go to bed at the same time, 10:30 pm because I'm super tired and have discovered my bedtime has no bearing on when I wake up. Whether I go to bed at 11:00 pm or midnight, I sleep 1.5 hours and wake up. 

So I'm frustrated beyond belief. I have a bedtime routine with no screens. Occasionally I read my Kindle but even now I'm trying to get away from that and read only print books. I don't read anything exciting. I take my meds at the same time each night. And I'm up by 11:00 am most days, 11:30 am if I decide to just lie there and feel sorry for myself that I'm not  getting enough sleep.

As for other symptoms, I miss occasional periods but that's it. No night sweats or hot flashes. No mood swings. And I'm 54 years old so I feel like I should be well into symptoms by now. The longest I've gone without a period is 5 months which was heavenly but then my body decided it wasn't ready to let go completely. I had someone recently ask me about hormone replacement therapy but I don't think I'm a good candidate because I don't suffer from anything except lack of sleep. 

Is my experience abnormal? I'm thinking of making another appointment with an actual GYN MD rather than just a PA, and see if I can get some answers. Last time he laid it out for me in easy terms but nothing has changed since then and it's probably been over 2 years since I've seen him. I had just started skipping periods. Wow, I didn't realize I've been dealing with that for so long. It doesn't bother me. Well, I'd like to be done completely but my periods are relatively easy so they cause no suffering.

Any words of encouragement? I'm not complaining that I'm not suffering from traditional symptoms. I'm just curious why my body seems to be in no hurry to move forward with this process.

Edited July 14, 2022 by Night Elf

[KSera]

12 minutes ago, Night Elf said:

I had someone recently ask me about hormone replacement therapy but I don't think I'm a good candidate because I don't suffer from anything except lack of sleep. 

Lack of sleep is a big deal, and HRT was the first thing that came to mind reading your post. I don’t know how I feel about it overall, but if I was sleeping that poorly, I would try it. 

[Jean in Newcastle]

Is your melatonin the sustained release kind?  If not, I would get that. 

[MercyA]

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Edited July 14, 2022 by MercyA

[Tap]

I would schedule two appointments. One with an OBGYN. Have them test your FSH levels and that should indicate if you are in menopause or not. Women in my family have historically gone thru menopause late, and so far at 50, I am the same. My numbers are no where near menopause yet.  Skipped periods can be caused by several things (including exhaustion), so a visit to the doctor is prudent. They can also talk to you about HRT and if it is appropriate for you.

Two. A sleep study and sleep specialist visit (not just a pcp giving you the results). You need to know if there is a physical reason you are not sleeping. Apnea and RLS are very common causes, but there are others as well. They may be able to help you pinpoint what is actually wrong, and treat it. 

You are on a heavy cocktail of sleep meds. Is a doctor overseeing this combination? I would want to see a sleep specialist to help you figure out a med combination that is more effective for you. Taking such high doses of Melatonin with the others is concerning to me. Trazodone and Lunesta is an unusual combination. One or the other is fine, but together is definitely uncommon. 

((((hugs)))))

 

[Arcadia]

I went into menopause “early” due to chemo. Have been an insomniac all my life. Menopause didn’t change my insomnia pattern though. I need to be either very physically tired or mentally tired to sleep. While I tend to sleep best after sunrise, I do usually fall asleep after midnight and wake up around 7am on weekdays, 9am on weekends. My doctor did prescribed Dormicum for me when I was in my 20s to help me fall asleep earlier but it didn’t help. 

[Night Elf]

4 hours ago, Tap said:

I would schedule two appointments. One with an OBGYN. Have them test your FSH levels and that should indicate if you are in menopause or not. Women in my family have historically gone thru menopause late, and so far at 50, I am the same. My numbers are no where near menopause yet.  Skipped periods can be caused by several things (including exhaustion), so a visit to the doctor is prudent. They can also talk to you about HRT and if it is appropriate for you.

Two. A sleep study and sleep specialist visit (not just a pcp giving you the results). You need to know if there is a physical reason you are not sleeping. Apnea and RLS are very common causes, but there are others as well. They may be able to help you pinpoint what is actually wrong, and treat it. 

You are on a heavy cocktail of sleep meds. Is a doctor overseeing this combination? I would want to see a sleep specialist to help you figure out a med combination that is more effective for you. Taking such high doses of Melatonin with the others is concerning to me. Trazodone and Lunesta is an unusual combination. One or the other is fine, but together is definitely uncommon. 

((((hugs)))))

 

I have mild sleep apnea and sleep with a cpap machine. My sleep doesn't change whether or not I use it which is frustrating.

My psych doctor has me on this med combination. She doesn't think the supplements help as they've never helped before but I am desperately trying everything I can to get sleep. That combination worked great the first few nights and I slept two sleeping periods, waking only once in the night. But the past 2 nights I'm back to sleeping 1-1.5 hours in my first sleeping period, being up until 6:00 - 7:00 am and going back to bed to sleep another 3 - 4 hours.

She suggested I take both at the same time but I'm the one who decided to stagger it because taking them at the same time is wasting them. Together, they do not keep me asleep any longer than they do individually, but if I save one for later, I'm guaranteed to get at least another 1-1.5 hours.

I do think I should email my sleep doc and ask for a second study. The first was a fluke as I actually slept a solid 9 hours that one night. I was so mad because it wasn't representative of my normal sleeping pattern. But they discovered mild sleep apnea and blamed my lack of sleep on that. But the cpap hasn't helped so I'm wondering if there is something more.

[Night Elf]

3 hours ago, Arcadia said:

I went into menopause “early” due to chemo. Have been an insomniac all my life. Menopause didn’t change my insomnia pattern though. I need to be either very physically tired or mentally tired to sleep. While I tend to sleep best after sunrise, I do usually fall asleep after midnight and wake up around 7am on weekdays, 9am on weekends. My doctor did prescribed Dormicum for me when I was in my 20s to help me fall asleep earlier but it didn’t help. 

I've never heard of that medication. I've tried numerous meds. The worst was Ambien. I was eating when I shouldn't have been, and having conversations with my family while under its influence only to wake up the next day and have absolutely no memory of any of it. 

[Night Elf]

5 hours ago, KSera said:

Lack of sleep is a big deal, and HRT was the first thing that came to mind reading your post. I don’t know how I feel about it overall, but if I was sleeping that poorly, I would try it. 

Ok, I didn't know that. I'll make an appointment asap.

[Scarlett]

My best friend was an insomniac from the age of 12.  She said one night she was sleeping all night like always and the next night it all changed and she she never slept again. She and I both believe this happened around the time she started getting her period. 
 

I have known her since we were 11 and ( 45 years or so) and she has tried a lot of things.  I know for years she took 10 mg of melatonin and I remember her telling me the doc had prescribed that to her and it was a high dosage.  She avoided taking sleeping pills because she just did not want to go down that path.  Her best sleep has always been about the time other people get up too….like 6-10 or whatever. 
 

She is 57 now and she sleeps better….I think it has to do with going through menopause. She thinks it too.  
 

So I would start with your gynecologist.  So sorry.  Insomnia is no joke.  Lack of sleep for long periods of time is very very serious imo.  I think doctors have never figured this out exactly.  

[Toocrazy!!]

I am so sorry you’re not sleeping. That is so rough! Hormones can certainly wreak havoc on you. I hope you find some help. 
These are very basic suggestions you’re probably way past, but I’ll throw them out in case. 

first was advice to me- stop eating and drinking 3 hours before bedtime. This allows for sugar to stabilize and food digested. For me, I can really only sip water after that too or I’ll wake too Often to go to the bathroom. This made a big difference for me. 
second - my son is on melatonin and his dr said to only take it in gummy form, they work better for release. He did notice that was the case. 

[mom31257]

I'm sorry! I have had some sleep issues, too. I'm post menopausal, and I have found that I don't need a ton of sleep anymore. I do well as long as I can get at least 6 hours. It sounds like you are needing more than you are getting. Calcium has seemed to help me and dh sleep longer and better, so I would try adding a calcium/D pill to the magnesium. I'm assuming you avoid caffeine. 

Maybe your circadian rhythm is off. I think getting outside for bright sunlight very early in the day is supposed to help reset that. Maybe take a few days and force yourself to get outside at 7 AM and then stay up all day to see if you can reset it. 

[elegantlion]

I had a hysterectomy in 2020. I'm mid 50s. My insomnia is pretty much gone. I was waking up at 3 a.m. several nights a week. Some of the things I do/have done to help me sleep are:

• light stretching before bed
• Watch ASMR video  - I know this violates the no screen rule, but it does help me sleep. I watch on my phone. 
• make sure room is not too dark. I do not sleep well in a completely dark room. I use a nightlight on my phone. 
• make sure temperature is correct - I need airflow. I also use an air purifier on night setting. 
• sleep in comfortable pjs (generally cotton). I sleep on my side and roll over several times in the night. 
• sleep with comfortable (temperature & texture) sheets/comforters. Right now I just have a light cotton sheet as a blanket. When it's cold, I use a heavier comforter with some weight. 
• SO has insomnia. He uses audiobooks to help him sleep. 

 

edit: also going to be at the right time seems to make a difference. SO goes to bed early, like 8:30 or so. If I don't stay up until 10 p.m., I am more likely to have trouble sleeping through the night. 10 has always been the sweet spot for me, even as a kid. 

Edited July 14, 2022 by elegantlion
adding more information

[ScoutTN]

Acupuncture can help with sleep issues sometimes. Very helpful for stress. A good practitioner will want to know what medications you are on. 

Edited July 14, 2022 by ScoutTN

[Junie]

1 hour ago, mom31257 said:

Maybe your circadian rhythm is off. I think getting outside for bright sunlight very early in the day is supposed to help reset that. Maybe take a few days and force yourself to get outside at 7 AM and then stay up all day to see if you can reset it. 

I agree with this -- I think your circadian rhythm is off.

It sounds like you're going to bed at 10:30 pm and getting up at 11 am?  Your body is probably getting all of the rest that it needs -- you just need to get it to rest at a better time for you.

Right now it seems like you are devoting 12 hours of your day to sleeping and/or trying to sleep.

By staying in bed so late, you are training your body that this is okay.  I think that you should get up earlier and stay up later so that you will be actually tired when you go to bed.  And for a while you will probably feel tired when you get up.  But if you continue with this, it will hopefully train your body to actually sleep.

 

[Arcadia]

3 hours ago, Night Elf said:

I've never heard of that medication. 

Its also called Midazolam or Versed. Mine was in tablet form in asia.

https://medlineplus.gov/druginfo/meds/a609003.html
“Midazolam is in a class of medications called benzodiazepines. It works by slowing activity in the brain to allow relaxation and sleep.“

[Kassia]

Have you had your hypothalamus checked?  That affects sleep, appetite, mood regulation, etc.  Mine doesn't work right and I have so many issues that are related to the hypothalamus.  

[Night Elf]

2 hours ago, Junie said:

By staying in bed so late, you are training your body that this is okay.  I think that you should get up earlier and stay up later so that you will be actually tired when you go to bed.  And for a while you will probably feel tired when you get up.  But if you continue with this, it will hopefully train your body to actually sleep.

 

I fall asleep naturally, without meds, around 9:30 - 10:00 pm. I just don't stay asleep more than an hour. The latest I can seem to make myself stay up is 11:00 pm but it's extremely difficult. So imagine that I wake up by midnight. I'm then wide awake and nothing will allow me to go back to sleep, not even another sleeping pill. So I get up because two doctors have told me not to stay in bed if I'm not sleeping. So I come out the living room and read. Or I'll put on music and write in my diary or color. I don't get sleepy again until about 7:00 am. So if I don't go to sleep then and sleep until 11:00 am, I'd be getting less than 2 hours sleep. And I really did try to stay up one time and fell asleep repeatedly all day. It was terrible. I was totally useless, lethargic and achy. I didn't sleep any better that night either. I've just not wanted to repeat that. My therapist wishes I wouldn't sleep in the mornings either but she has no answer as to what I'm supposed to do if I wake up at 12:00 - 1:00 am after getting only a couple of hours of sleep. 

[Night Elf]

I am outside every day for an hour. I take two 30 minute walks, one at 4:00 pm and one at 7:00 pm. I also do a 10 - 15 minute dumbbell workout. I've got a personal trainer who is yet one more person who is telling me I need to be sleeping. It's frustrating. I appreciate all of your suggestions. 

I got a response from my sleep tech already. He says they don't treat insomnia. The sleep study I did showed I had mild sleep apnea and the data they're getting from my machine on a daily basis has shown those apneas greatly reduced, so the cpap is doing it's job. He told me to call Behavioral Health for insomnia. Well, my psych doc is the one who has prescribed the sleeping pills so she is the only one treating me. 

[alisoncooks]

So this may not be helpful, but I suppose you can’t have too many tools in your toolbox…

I’ve found the technique called “cognitive shuffling” useful when I’m struggling to fall asleep. https://www.vogue.co.uk/beauty/article/cognitive-shuffle-sleep-method/amp

[Night Elf]

12 minutes ago, alisoncooks said:

So this may not be helpful, but I suppose you can’t have too many tools in your toolbox…

I’ve found the technique called “cognitive shuffling” useful when I’m struggling to fall asleep. https://www.vogue.co.uk/beauty/article/cognitive-shuffle-sleep-method/amp

Interesting. I've done something similar. I just go through the alphabet and think of words so I might say A is for apple, arrow and ant. B is for ball, baby and basket. and just keep going. Usually I get bored and my thoughts wander but I do eventually fall asleep if I'm tired. Another thing I do is prayer. My therapist told me to pray for everyone I've ever met in my life and when I run out of them, start praying for random people or happenings. Again, I get bored and my mind wanders. The problem with my mind wandering is it usually involves high anxiety thoughts which do not help me fall asleep. Instead I feel agitated and angry and then to shut off my mind, I get up and distract myself with reading or music. *sigh*

[Toocrazy!!]

I’ve been listening to this podcast lately and he has some interesting things to say and interviews a lot of people. He’s done several on sleep with one particular expert, and I think the episodes are linked here. Perhaps you’ll find something useful here. 
 

https://hubermanlab.com/toolkit-for-sleep/

[Night Elf]

1 hour ago, Toocrazy!! said:

I’ve been listening to this podcast lately and he has some interesting things to say and interviews a lot of people. He’s done several on sleep with one particular expert, and I think the episodes are linked here. Perhaps you’ll find something useful here. 
 

https://hubermanlab.com/toolkit-for-sleep/

Thanks! I'm looking at it now.