Sudden, odd case of insomnia--help me sleep!

February 3, 2013 12:39 PM

My doctor's office is closed today but I am in desperate need of a good night's sleep tonight. Weird adrenal "fight or flight" response kicks in every time I'm about to hit REM.

I've been fighting a bit of a head cold, and one night last week I had a mild case of sleep apnea due to my nasal congestion that jolted me awake. Scared the crap out of me, and it's been difficult for me to sleep since. I have anxiety issues and have been under a good deal of stress in general (particularly in the past few weeks), so this bout of insomnia is tipping things over the edge. I've been averaging maybe 2-5 hours a night and I am just plain exhausted at this point.

I have my regular bedtime routine, nothing unusual. I take a hot shower and relax, but right as I'm drifting off, a shot of adrenaline zaps me awake. It's like my body is terrified of going to sleep. This keeps up all throughout the night. I took 0.25 mg of Xanax one night and that helped a little, but I don't feel like that is strong enough (my prescription is for 1-2 0.25 pills as needed so I could potentially take more).

During the day, I am a little more anxious than usual. I have GAD, panic disorder, and a case of hypochondria, but generally I've always been able to sleep at night without anything like this ever happening. My mind is racing with worst possible scenarios (losing my mind due to sleep deprivation, having a heart attack, dying in my sleep) and I am dreading nighttime. I need need NEED to stop Googling my symptoms because it's making me more nervous. I'm otherwise completely healthy, pretty sedentary, average BMI, no heart issues, no issues with snoring or sleep apnea or asthma.

How do I cope until I see my doctor? I know YANMD, but could it really be just anxiety that's causing this? How can I just get one GOOD night of sleep with this feeling going on?

posted by andariel to health & fitness (14 answers total)

Valerian extract and melatonin really helped me with anxiety related sleep issues that weren't resolving themselves (I had to get up at 5:30 to commute to school, and was awake until 3am due to a feedback loop of anxiety about not sleeping and having to get up early and being stupid at school). I took 30 drops of valerian in a mouthful or two of water, and 250 mg of melatonin and finally was able to sleep. Other things that helped were eating dinner a bit earlier and then taking a walk out in the cold before a warm shower.
posted by oneirodynia at 12:50 PM on February 3

Could you try zzzzquil? I was having a hell of a time sleeping a few weeks ago and that restarted my body after only 3 nights of use. I don't need it anymore.
posted by These Birds of a Feather at 1:03 PM on February 3

If possible, do a ton of exercise between now and bedtime...even better if you never exercise...ask me how I know!

Then I second the valerian and melatonin suggestion above. Valerian roots (possibly from your local immigrant neighborhood supermarket's tea section) will work if you can't get the drops. Just make tea out of them (smells like the feet of some kind of animal).
posted by skbw at 1:08 PM on February 3 [1 favorite]

I have this happen to me from time to time, although I have never taken Xanax or a similar drug.

Perhaps avoid any and all caffeine after 12pm?
posted by KokuRyu at 1:16 PM on February 3 [1 favorite]

In europe they give Benedryl for sleeping if I cannot sleep I pop one.
posted by ibakecake at 1:17 PM on February 3 [1 favorite]

This would be a great time to listen to a progressive relaxation tape or podcast, or to some of these lovely bedtime stories.
posted by Corvid at 1:53 PM on February 3 [1 favorite]

One non drug remedy that helped me was a sleep mask. It somehow helps signal "Sleep Time Now" for me.
posted by sweetkid at 2:01 PM on February 3

just to be sure - you're not taking anything (stimulants, decongestants) for the head cold, are you?
posted by lokta at 2:06 PM on February 3

This keeps up all throughout the night. I took 0.25 mg of Xanax one night and that helped a little, but I don't feel like that is strong enough (my prescription is for 1-2 0.25 pills as needed so I could potentially take more).


Why don't you take your prescription at face value? I mean, it's for anxiety. Anxiety is keeping you from sleeping. You said it helped a little, but didn't feel like it was strong enough. It says you can take more. Why not take the second Xanax as written on the prescription?

I'm pretty familiar with anxiety-based insomnia, and the problem is, your critical thinking skills tank as sleeplessness increases which makes you even less capable of rationally managing the anxiety. Sleep is the thing that will allow you to exit that loop.

When I'm in the midst of the kind of freak out you're describing, I take a sleeping pill because at a certain point I'm unwilling to mess around. Maybe when you see your doctor, he or she can prescribe one, but in the meantime as long as you're using the prescription according to the way it was written, I'd go for taking the medicine to combat anxiety for the anxiety.
posted by A Terrible Llama at 2:08 PM on February 3 [2 favorites]

Maybe your body is going into panic mode because you can't breathe when you hit REM sleep? Insomnia can be caused by breathing problems.

Agreed that you should just take your Xanax. Along with it, try wearing a Breathe Right strip and using a decongestant spray (don't use the OTC sprays for more than a few days as they cause a rebound effect; when you see your doc you can ask for a Flonase prescription). Do you have a humidifier? That might help make your bedroom air moister so you can breathe better.
posted by Rosie M. Banks at 2:57 PM on February 3

Try arranging yourself so you're sleeping kind of propped up, which will help with any congestion-related breathing problems.
posted by rtha at 3:22 PM on February 3

Decongestant or perhaps some benadryl type antihistamine would probably work quite nicely. Most sleeping pills available without a prescription would include the antihistamine component. I would normally recommend sudafed for decongestant but the adrenaline ingredient might not help you sleep so well.

I tend to get your reaction, which in my case is a hypnogogic reflex, when I try to go to sleep lying on my back. It's a lovely animal brain reaction as my prefrontal cortex shuts down, back to the days when we used to fall out of trees. It's definitely worse if I haven't had enough sleep recently or have higher amounts of stress about something.

http://en.wikipedia.org/wiki/Hypnogogic_jerk
posted by hobo gitano de queretaro at 4:01 PM on February 3 [2 favorites]

Benadryl is really a good solution for this. It might dry you out a bit too much--a humidifier will help with that. It may also help to sleep on your side, so at least one nostril clears out. A neti pot is also a good way to clear things out temporarily until you drift off.

I would avoid Afrin or the like unless you are incredibly desperate--that stuff causes rebound congestion on me instantly. It is such a bear to wean off.
posted by elizeh at 8:19 PM on February 3 [1 favorite]

This is a side note but nasal congestion doesn't cause sleep apnea.

I'm hoping that fact might help ease your mind since it seems like the incident that triggered your anxiety was that you were having trouble breathing through your nose due to being stuffed up and congested. Although that can certainly make it feel harder to breathe, it does not cause apnea (which literally means you stop breathing) because you can just breathe through your mouth when your nose is stuffy.
posted by treehorn+bunny at 10:04 PM on February 3