I've got the opposite sleep problem!

August 14, 2008 9:12 PM

Instead of not being able to get up in the mornings, I have a problem with waking up TOO early. Typically I go to sleep around midnight-1:00 am (it's when I start getting tired) but for the last 2 months or so I've been waking up anywhere between 5:00 am to 7ish, and my alarm doesn't go off until 8:15.

Usually it's when I wake up because I have to go to the bathroom (and I don't drink anything before bed) but once I wake up I'm awake awake. If I try to close my eyes and fall back asleep, it's useless. I'm still getting 5-7 hours of sleep a night but this happening every night is catching up with me.

Stuff that might be important:
I was diagnosed bipolar about a year ago. I'm on Wellbutrin (300mg) for the depression and Lamictal (200mg) for the manic behavior.

I just recently lowered my Lamictal to 150mg because it's giving me (I think it's responsible) digestive problems.

I am between psychiatrists because my last one didn't listen to me at all (so any meds adjusting I'm doing is on my own, I know, terrible idea).

I drink no coffee at all. I do drink a can of diet soda a day, usually, but it's no later than 2 in the afternoon. And that's been the case for months before these problems started.

I've never been one to sleep in. I think the latest I've slept in years is 9:00 a.m.

I have a medicinal marijuana card. I was smoking it fairly frequently for a period of time after a long depressive episode, and I began to realize it really helps stabilize my moods. My swinging is way less frequent and extreme. And it also helps me fall asleep at night, which can be a problem for me too.

Every sleeping pill I've run into helps you FALL asleep, not stay asleep. I'm a morning person so I'm not terribly worried about drowsiness - I have a lot of energy. But what meds to turn to? Or is there something else I can't think of (Non-medicines and the like).

Thank you!

posted by dithmer to health & fitness (19 comments total)

My husband has managed on 5 hours a night for most of our lives together EXCEPT when he exercises strenously during the day, in which case he falls asleep earlier (10ish) and wakes at his normal time 5 or 6, instead of going to sleep at 1 and waking at 5 or 6. Alcohol has been a hindrance as has weight gain (resulting in sleep apnea).
posted by b33j at 9:19 PM on August 14, 2008

How's the lighting situation where you're sleeping? I sleep pretty well through most things, but with the way the sun comes into my room once I'm awake and notice how much light is there I can't go back to sleep. And that's through wooden blinds closed all the way and up, as opposed to down.

I have no idea when sunrise is where I live, so I have even less of an idea on if this could even effect you. But if it is, find a way to close those windows up so that no light is getting through.

And I read somewhere that you have to go to the bathroom when your bladder is only a small percent full. Maybe you could try not getting up to use the bathroom.
posted by theichibun at 9:29 PM on August 14, 2008

ditto what theichibun said about lighting. I moved to a new apartment last year and never got completely light-blocking window coverings because I guess I didn't need to, as we were headed into winter and the sun did not get too bright until I was already up and moving in the morning.

But, the bedroom window faces the rising sun, and as we came into summer I noticed I was lying awake for the last 1-2 hours of what should be my sleep time, after I would get up to go to the bathroom and sometimes I'd wake up even without needing to get up.

Now I have some coverings that block almost all the light, and I even have an eye mask for those extra-sunny mornings. That usually does the trick for me and I will sleep until my alarm goes off. Don't know if that's the case for you, but it really could be that simple.

You don't need to buy expensive curtains to test it. Just hang some thick/dark blankets as an experiment, or something similarly crazy just to make the room as pitch black as possible. Use a long tshirt to wrap tight around your head as an eye mask.

Good luck!
posted by inatizzy at 10:10 PM on August 14, 2008

From painful personal experience: any disruption in your sleep pattern when you have bipolar is serious. It is both a sign of a possible oncoming episode as well as a trigger (if you have a few nights of bad sleep for whatever reason).

Unfortunately I have the reverse problem (GOING to sleep, but usually can STAY asleep) so cannot give any on point advice.

But in general, get a psychiatrist or some medical adviser that you trust!! And even if you don't like your medical help you need them to regularly monitor your blood levels! This ensures that medications stay in useful range without becoming toxic and also helps spot emerging problems in other areas...

If they are worth their salt they will listen to your sleep problems, as well as other problems, and help you with an overall strategy. In my case, we must monitor my thyroid which can seriously impact sleep and weight gain.
posted by DetonatedManiac at 10:17 PM on August 14, 2008

My sleeping pattern is like yours, but I usually take a nap of one to two hours in the late afternoon or early evening, and for me this works out to enough sleep to feel just fine. However, because this has only started happening to you in the last two months, at a time when you are fiddling with your meds on your own and have no ongoing professional care, I'd have to strongly (strongly!) echo DetonatedManiac - don't have a fool for a doctor, kid! Find a better psychiatrist who will take this into account in your overall treatment.
posted by taz at 11:39 PM on August 14, 2008

Could you perhaps tackle it from the other direction, and start going to bed earlier? My experience has been that "when I get tired" can move pretty easily, but "when I wake up" tends to be more static (6-7 AM in my case). Maybe go to bed at 11 for a couple of weeks, even if you lie awake for a while, and see if that shifts your sleep patterns a little earlier?
posted by five toed sloth at 11:48 PM on August 14, 2008

My mom is bipolar and has the same problem. Her doctor suggested taking melatonin supplements to help stay asleep, and she claims that it makes a difference.

But I agree with everyone else -- find a new doctor before you start taking any supplements or pills.
posted by puffin at 4:23 AM on August 15, 2008

If you think lighting might be the problem, try this eye mask. I can't sleep without complete darkness, and this is the best mask i've found so far to achieve that. Luckily, it's cheap too!
posted by ukdanae at 4:45 AM on August 15, 2008

You really, really, really shouldn't be adjusting the dosage of your meds by yourself. Just call your doctor, explain the situation and that you want to decrease (insert drug) because (insert reason) and see what they say.
posted by sero_venientibus_ossa at 4:54 AM on August 15, 2008

I had the same issue (minus the bipolar component). I chalk it up to getting older- started when I was 31. I did two things to adjust to it:

1- realize that it's (biologically) normal to be awake during daylight. Embrace that, and just get up and start your day.
2- So to sleep earlier.

I feel WAY better being a day person.
posted by gjc at 6:46 AM on August 15, 2008

I think this is a common issue that has nothing to do with bipolar or meds etc. I'd just make use of the time, since you're "awake awake." It's generally quiet and peaceful during those hours - bicycling or jogging is awesome because virtually no one's on the road. A lot of people meditate or do yoga when they first get up and find it makes them feel peaceful all day. Can you take a nap when you get home from work to "catch up"?
posted by desjardins at 6:49 AM on August 15, 2008

With sleep issues, having trouble staying asleep can be a sign of anxiety. I do not know how this overlaps/interacts with bipolarness at all. I second that calling a doc about the change in meds, if you haven't already, is a good start. When I have been waking up too early, I often start taking benadryl before I go to sleep. It makes me just a little muzzyheaded [melatonin works the same for me, for what it's worth] so it's easier to fall back asleep when I wake up to pee in the morning. There are no real problems with long-term use so it's better than sleeping pills. I also found that lying in bed with my eyes closed, even when I felt totally awake, would often result in me falling back asleep, I began to trust that more and it began to work more regularly. Good luck, sleep disturbances are no fun at all.
posted by jessamyn at 7:12 AM on August 15, 2008

Blah this response is long. OK:

It's quite possible lighting could be a problem. I've always had trouble sleeping during the day, but maybe all of a sudden it's gotten more difficult? Unfortunately sleeping masks never stay on me! :)

Yeah, I know, I'm quite crap for changing my meds. It's just that this psychiatrist, not only absolutely not listening to me in the least (I told him I wanted sleeping pills, he insisted on prescribing yet another mood stabilizer despite me insisting that that part of my life is just fine) he's kinda inappropriate. He once told me that I looked like I should be in Playboy. Pretty much since then he's made me uncomfortable. He doesn't do blood work - he pretty much just talks over me, writes a prescription, and then shuttles me out of his office in less than 10 minutes. $125, please! I'm working on finding a new one but offices never call me back! I did still go to this guy about a week ago, but I was at a good point with the meds and I knew this would probably be the last time I saw him so I decided not to bother, since bringing things up with him is difficult.

In the same vein, I do know decreasing the meds could also be a factor. But these silly sleep problems were happening long before I did that. Only then, the problem was waking up in the middle of the night at 3-4 am and not being able to go back to sleep for two hours or so. Yeah, he didn't listen to me about that either.

And I lowered the Lamictal because, well frankly, I've been having constipation issues for almost a year now - around when I started the Lamictal. I saw a commercial for another anti-depressant that mention constipation could be a side effect of these meds, so I looked it up, and sure enough. It's really been concerning me as of late - I'm trying to up on the fiber, and since I lowered the dosage it's gotten a little better. I have discussed this with my parents, who are both physicians, and they advised I tried stool softeners which I was taking everyday without great effect. Hopefully this is something I can address with a new MD.

Last but not least (goodness I feel like I'm being defensive) I've tried going to sleep earlier, and also tried crawling back in bed and trying to close my eyes. But one of my problems is (and has always been since I was young) that I have a very speedy mind. As in, I can't ever stop thinking stuff. My mind races. It's why the few attempts at yoga I've made have gone so poorly. :)

Unfortunately I can't take a power nap or the like when I get home because I don't get home from work until around 8:00 pm. So, dinner, then watching tv for a bit, then bed. At the moment I'm making the best of it as much as I can, with doing crafting projects in the morning when I wake up. Unfortunately exercising outside isn't much of an option because I live in Los Angeles, in a part of the Valley where honkings and cat calls are happening from the moment I step outside. And because I am a morning person, my energy levels are for the most part ok all through the morning. But if I'm waking up so early, and losing so many hours of sleep, shouldn't it have caught up with me by now? So that I would actually be tired enough that this wouldn't happen?

Thanks for all the answers though. The only reason I respond in such length is because it's great to have suggestions from other people, and I want to provide as much info as possible. It's super helpful to hear from other people that actually listen to me more than my doctor. Silly doctor.
posted by dithmer at 8:00 AM on August 15, 2008

A thought on the racing mind. Ms. Ricketts has described that same issue. She can't really sit still and just think about nothing. She manages a large theatre and there is always something to worry about. We have found something that has helped, however. Audiobooks. Seriously. She lays down at night to listen to the book and watch it in her mind and Boom. Asleep in 5-10 min. It takes quite some time to get through a book when you're asleep so quickly, so it isn't even that expensive. Heh.

I also agree about the light. It certainly can't hurt to try and keep your room as dark as possible.
posted by Wink Ricketts at 9:01 AM on August 15, 2008

(I'll cross post this on the other sleep question)

Here is something that might interest you. I came across it on boing boing a while ago.

The short and skinny of it.....
There is a researcher named Seth Roberts who is well known for self experimentation. He was an early riser, but found that if he held off on eating until 11AM, the problems were significantly reduced. The idea is that early waking is an anticipatory behavior. If you habituate your body to early morning nourishment, your body will wake up up even earlier to get ready for the incoming food. He has also found supportive results from other studies.

In addition, he found (surprisingly) that changing lighting did NOT have the anticipated effects on rising patterns.

I've seen anecdotal evidence from people who claimed skipping breakfast has worked for them. While i haven't tried this myself, I've been a long time breakfast skipper and have had no problems with early rising.

If you are a breakfast eater (or are getting any sort of calories prior to what might be considered early lunch time) you might want to consider delaying breakfast for a couple weeks and see what happens.
posted by NormandyJack at 9:07 AM on August 15, 2008

i should also note there are other things you can do that he mentions in the paper (first link). the breakfast thing didn't work 100% and its effects wore off over time.
posted by NormandyJack at 9:14 AM on August 15, 2008

You could try reading a book while in bed. Must be a long piece of work like a novel. I'm not sure whether it works with after having just waken up, but it's worth a try.
posted by curagea at 10:30 AM on August 15, 2008

Yeah, I know, I'm quite crap for changing my meds. It's just that this psychiatrist, not only absolutely not listening to me in the least (I told him I wanted sleeping pills, he insisted on prescribing yet another mood stabilizer despite me insisting that that part of my life is just fine)

It's also possible that he is listening to you. Early morning awakening is one of the classic signs of depression. My guess is he's trying to treat the cause of your sleep problems by adjusting your meds rather than giving you sleeping pills which be treating a symptom of the larger problem. If that is the case there is obviously a communication problem since you should have an understanding of what he's doing and why.
posted by sero_venientibus_ossa at 1:49 PM on August 15, 2008

Waking up at least two hours before you intend every morning is a symptom of melancholic depression. Please find a new psychiatrist - if you're in the SF Bay Area I can give you some recommendations.
posted by granted at 12:06 PM on August 16, 2008