Coping with sleeping 4 hours per night?
July 7, 2020 3:51 AM   Subscribe

Since lockdown started my sleep schedule has been out of whack. In the last week this has become fully fledged insomnia/sleep deprivation. I can fall asleep just fine most of the time, but after (on average) 4 hours, I'm awake again. Insomniac mefites, give me your tips on coping until you find a cure!

Details: I'm 31, fairly healthy (we'll get on to this), AFAB.

I've never really had issues with sleep until this year, around the time lockdown started (which was March for me as I'm a student and my university locked down hard), when I found my sleep schedule sliding later and later, combined with waking up regularly around 3/4 hours in for a little while. These waking up times have become longer and longer until I just stopped being able to get back to sleep again. It's like my body is just "OK, let's start the day", except it's 5AM.

During the day I don't really feel excessively sleepy/foggy, just sort of achy and flu-y more than anything, as well as very thirsty. The sleep deprivation has also fucked up my digestive system and I feel low-key nauseous a lot and have lost my appetite. I actually wouldn't be worried at all (I know some people actually try to achieve this style of sleep as a lifestyle) except that I can feel it taking a toll on my body.

Additional note: I had bloodwork done fairly recently for an unrelated issue and the results show my SHBG levels are messed up in some way (either too high or too low, I'm not sure how to read the results -- I have an appointment to talk to my GP about it tomorrow and figure it out), which Dr. Google suggests might be a range of things which have insomnia as a symptom. I understand that this type of insomnia tends to suggest anxiety but I'm inclined to believe the issue is physiological rather than psychological.

I have tried/am trying: valerian tablets (didn't seem to make an appreciable difference); cooler/darker room; no screens an hour before bed; leaving the bed when awake; listening to sleep apps/audiobooks/podcasts; cutting out caffeine.

I am going to try: a sleep mask to block out light; talking to my GP; booking an appointment with a therapist.

At the moment I'm looking for ways to cope with this thing until I can find a root cause (though suggestions are welcome if this sounds familiar to you?), and reassurances that this is normal and happens a lot. Assume I've read most of the guides on how to have healthier sleep hygiene etc. Is there a diet you'd recommend for when you're balancing an upset stomach + trying to get healthier sleep? A type of herbal tea that worked for you? A podcast you'd recommend? Lay it on me!
posted by fight or flight to Health & Fitness (24 answers total) 21 users marked this as a favorite
Best answer: Something I found that helped me a LOT was magnesium. That's supposed to help you stay asleep after you've fallen asleep, and that was the problem I was having.

It wasn't an insta-fix - my doctor explained that it would take my taking it daily to build it up and then maintain it, and that might take a week or two to get to the level I'd need. And I found that happened with me too - but what also happened, during that week or so that it was building up, was that I started noticing that even on the nights when I was still waking up early, was that those four hours of sleep were a better quality four hours of sleep. That's what ultimately convinced me that it was still working.

I don't have any trouble sleeping now - I have a lot less stress, fortunately - but I still have a jar of magnesium supplements in case I need to dip back into it for a while.
posted by EmpressCallipygos at 4:00 AM on July 7, 2020 [4 favorites]

Best answer: Have you tried taking an afternoon or early evening nap? (Assuming you have the time in your schedule, of course, time when you're not required to work or study or care for family.)

I've been having something similar happen to me since COVID restrictions started, sleeping an hour or two less than normal at night, which often means waking up much earlier in the morning. So a lot of days I'll lay down in bed in the afternoon with a book, maybe with some relaxing music on, and even if I don't feel particularly sleepy, I'll often wind up dozing off for an hour or two. I wind up with a "normal" (for me) total of hours asleep, just split into two sections.

IOW, for me, "don't feel sleepy" doesn't mean I won't sleep for at least a bit if the opportunity presents itself, and I definitely won't feel sleepy if I'm up and about and doing things. Maybe see if you can grab an opportunity to just lay down for a while during the day, see if you wind up taking a nap.
posted by soundguy99 at 4:42 AM on July 7, 2020 [1 favorite]

For me personally, earplugs and eating my last meal as early as possible help with sleep quality. (Also sleep temperature, but you've mentioned that.)

You might try doing an elimination diet to see if anything you've been eating has an effect.

Benadryl isn't recommended on a regular basis but could be worth a try here for at least a night or two of deep sleep.

Those mornings when you've woken up too early, do you stay in bed or get up? I'd try staying in bed until the waking time you're aiming for, and spend that time doing relaxation exercises with deep breathing. (Because if you can't sleep, you might as well get your body and mind as close to a sleeping state as possible, and give your body a few extra hours of muscle relaxation.)

Napping during the day is also good if you can do it. If you can't, at least lie down for half an hour and breathe slowly/deeply.
posted by trig at 5:09 AM on July 7, 2020

I have been you! (well, sort of.) I've had sleep issues for awhile and typical sleep advice has mostly not helped me.

In addition to a cool/dark room I need a fan blowing on me (YMMV on this, my air conditioner is not the best), I eat something calorie-dense before I go to bed (high fat/high protein, like cheese or big spoonful of peanut butter) because sometimes a drop in blood sugar contributes to waking up. But the biggest thing for me has been realizing that due to biorhythms or whatever, I just need to go to bed earlier, especially in the spring and summer. I've played with it and if I go to bed at 1am I'll often wake up at 5am. But if I go to bed at 11pm, I *also* wake up at 5am, and six hours of sleep is way, more tolerable than four hours. Giving in (or trying to take the perspective that my body is just doing what's right for it) and getting up and having a cup of coffee and reading at 5am has helped with this, because then I'm more likely to feel tired and ready to go to bed at 10pm (or earlier).
posted by needs more cowbell at 5:30 AM on July 7, 2020 [2 favorites]

Best answer: Also came to recommend Biphasic and polyphasic sleep which is basically trading the 8hr sleep 16hr awake for a split schedule of 4hr sleep 8hr awake 4hr sleep 8hr awake. AKA a good afternoon nap.

I sorta have the opposite problem, being an old and only sleeping about 5 1/2 or 6 hours a night normally (and waking up after 3hr most nights)... during covid with nothing better to do and no real reason to get up I've been trying to catch the 8-9hr of sleep that everyone raves about. So I just wake up after about 6hr and just lay there and calmly daydream and sometimes fall into another sleep cycle. Sometimes I don't sleep and just lay there for a couple of hours just pondering things, making up fantastical stories or some such. So that's another vote for just lay there and stay a bit meditative and calm and think about things unrelated to the real world, you have the time to spare away from the world, maybe you get some more sleep. Slight warning, at least for me, the dreams that come from that extra not-really-tired but sleeping anyway sleep get a bit weirder than normal.

Not sleeping as much might be a bit normal in these times depending. Theory goes that sleep is recuperation and letting your mind do some cleaning and organizing of new experiences. If you're not doing that much new, there might not be as much of a need for the sleep you'd need when everything was normal.
posted by zengargoyle at 5:34 AM on July 7, 2020 [4 favorites]

I don't have a lot of advice for getting better sleep because I've been an insomniac my entire life and it's pretty bad right now. I do find that sometimes Vitamin D helps.

Living underslept is something I'm used to, though. I crave carbs during the worst times, so making sure you eat good food is important. I have caffeine only in the morning 99% of the time (occasionally I'll have a coffee with a friend in the afternoon during normal times, just because I truly love coffee). I will sometimes let my boss know, depending on the boss, if I've had a truly rough night, just in case I am accidentally irritable. I've learned to function quite well, but I do avoid driving or doing anything dangerous after a no-sleep night.

The real key, in my experience, is not judging yourself for not sleeping and saying OK I MUST SLEEP TONIGHT because that's not gonna happen if you're under pressure.
posted by wellred at 5:48 AM on July 7, 2020 [3 favorites]

Fellow sleep-maintenance insomniac here. Boy, do I feel you! I'm sorry you're going through this.

When I was at the stage you're at, I did the GP rule out (glad you're doing that). In my case, it really was psychogenic. My GP sent me to a behavioral health psychologist, who said that it wasn't going to get better until I'd dealt with the source of my stress, and that once I did that, the insomnia would resolve slowly. He was basically right. It's been a year now and neither thing is totally resolved, but both are much better.

In the worst months, after a particularly bad night, I would focus on making it through the hours from 1-3 pm, which were the hardest for me (sometimes I would be so tired I felt like I was dissociating). Going for walks helped. Eating crunchy vegetables helped (I credit a MeFite for this).

As for preventive measures, I've noticed that days where I spend a bunch of time with a friend tend to precede good nights, although of course that's trickier to arrange now. Another MeFite also pointed me to mindfulness meditation around the time my insomnia started. At first when I tried it, it mostly resulted in naps, which is the kind of failure that looks like winning ;).

Sleep hygiene stuff: Seconding earplugs. When I wake up, I get out of bed, grab a glass of ice water, go to another room with a dim light, and read. Sometimes that helps me get sleepy again.
posted by eirias at 6:01 AM on July 7, 2020 [1 favorite]

This has been me, too, since COVID hit. About the only thing I've been able to semi-rely on is popping a tylenolPM right before bed. That seems to push my sleep out to something closer to 6-7 hours. Sometimes more, depending on how sleep-deprived I am.
posted by Thorzdad at 6:26 AM on July 7, 2020

I had this problem earlier in lockdown, and what fixed it was getting more exercise.

My situation changed such that I went from being sat inside on the computer all day, to being outside doing physical labour much of the day and cycling a few miles a day, and my sleep snapped back to normal within days.
posted by automatronic at 7:31 AM on July 7, 2020

My doc told me this is caused by a cortisol spike that naturally happens in the very early morning, and that when you're stressed it can be strong enough to wake you up and keep you up.

I use trazadone occasionally to help get good quality sleep (it's not addictive like valium, etc), along with magnesium supplements. You can also try melatonin, just keep upping the dose until it works for you through the night.
posted by ananci at 7:35 AM on July 7, 2020

Response by poster: Thanks for the answers all. It's reassuring to know I'm not alone in wacky sleep patterns.

I'm definitely going to talk to my doctor about magnesium. The advice about trying to chill out about sleeping/not sleeping is also great -- I have been obsessing about it probably a bit too much (save me from the insomnia forums where everyone is convinced they definitely have a rare prion disease). Acknowledging that this might just be normal for a little while, that it's not going to do any lasting harm, that it may or may not be serious and it's gonna be all right even if it is, and it's okay to just have a normal day, is already making me feel better. <3
posted by fight or flight at 7:54 AM on July 7, 2020 [2 favorites]

If you're going to talk to your doctor about magnesium, some more detail for you about what worked for me: I take just the regular OTC supplements from the drug store, in the highest possible OTC does. Meaning: if the bottle says to take "one to three pills daily" I'd take three daily and not like ten or something.

Personally I go with a supplement that is a combo of calcium, magnesium, and zinc, since I think calcium and zinc help your body process magnesium. (Also, calcium is good for you too, so hey.)

So you don't need to be looking into, like, shots or anything, just regular vitamin supplements like you'd get over the counter.
posted by EmpressCallipygos at 8:07 AM on July 7, 2020

I take a 60% RDA magnesium oxide pill prior to going to bed and it does seem to help with sleep. One thing to be aware of is it absolutely loosens up my stool. This isn't exactly a bad thing because I trend on the opposite end of that particular spectrum, but can be alarming. I hear that the more expensive magnesium citrate has better uptake and can be better tolerated digestively, but I have no first-hand experience.
posted by Dmenet at 8:37 AM on July 7, 2020

Best answer: I could have written this a number of years ago. What resolved the situation for me was MUCH better hydration. Pro tip: don't ramp up your intake after 8 p.m.
posted by kate4914 at 8:56 AM on July 7, 2020

Best answer: Sorry if this isn't helpful, but the pandemic lifestyle has definitely exacerbated my insomnia. My approach has been to... give up. I've started a personal project (learning to flatpick fiddle tunes on guitar) that I pour my "being restless and pissed that I'm not asleep" time into now. I still feel like I ought to be sleeping more, but I can absolutely crush Billy in the Lowground and Arkansas Traveler now. At least I don't ALSO have stress/guilt/sadness about failing to sleep.
posted by Ignatius J. Reilly at 9:55 AM on July 7, 2020

When are you going to bed? After a couple of years of bad insomnia post-kids, I just realized that while yes, stress was definitely contributing to me being up at 5 am every day, it’s also that my body just wants to wake up at 5 am.

My solution was aim to go to bed early. Like super early. 9pm is a not infrequent bedtime for me and now I get 7+ hours almost every night. If I go to sleep at midnight I’ll still wake up at five so I don’t go to bed at midnight anymore.
posted by lydhre at 12:05 PM on July 7, 2020 [2 favorites]

I was also going to suggest going to bed earlier. That way you might be able to squeeze in six hours before you wake up.
posted by mai at 12:38 PM on July 7, 2020 [1 favorite]

Best answer: Hello Fight or Flight,

I’m a therapist who has worked in the sleep field since 2008 and I believe I may be able to provide some useful information.

First, I want to say that I’m sorry to hear you’re experiencing problems with your sleep. Your story is unfortunately quite common right now. COVID19 has had a massive impact on how people are sleeping ranging from people who had previously been chronically sleep deprived starting to get into the habit of getting more and more sleep during the lockdown, to people like yourself, who had been previously sleeping fine but now find themselves struggling with getting a decent nights rest.

Second, I am glad to hear you are working with your physician and wish you good luck with your trip tomorrow. I’ve found that its preferable for a patient to come see me after working with their MD or a sleep doctor so that they can rule out any physiological issues.

I’m also very encouraged to hear that you have a future appointment with a therapist. That said, it has been my experience that although many therapists advertise that they treat sleep problems very few are actually trained to do anything other than basic sleep hygiene. Of those who do provide more than sleep hygiene, it is not uncommon to find a therapist who will argue that the sleep issue is related to an underlying problem like depression or anxiety and who will then treat that with the assumption that fixing the underlying problem will resolve the sleep issue. Although treating other issues can be extremely helpful for clients, all of the data suggests that this usually does nothing for insomnia.

When looking for a therapist to treat insomnia you want see someone who is trained in Cognitive Behavioral Therapy for Insomnia (CBT-I). Although there is a vast amount of documentation on therapy being useful for insomnia, with a few rare exceptions, all of it relies on CBT-I. You can find a CBT-I trained therapist here or here.

Most of the recommendations you are likely to hear for insomnia are either a placebo or the result of coincidental reinforcement similar to how baseball players have rituals they adhere to every time they go to bat.

Dietary magnesium is unlikely to cure insomnia unless you have an actual magnesium deficiency (your doctor should help you figure this out).

Valerian root almost never provides consistent sleep improvement.

Marijuana can be helpful, there is data that shows it increases the likelihood to fall asleep but there are also studies that show large amounts can impair sleep, and it can have side effects like changes in how much REM sleep you get.

Alcohol may help you fall asleep, but you will find yourself waking up more often as its effects wear off and it also will change your sleep architecture.

Melatonin, an unregulated chronobiotic hormone (who knows what you actually get), changes when you are sleeping, not how much sleep you are getting and can screw up aspects of your biological clock.

I also want to note that I do not recommend naps if you hope to sleep at a regular hour that night (unless you are struggling to stay awake, in which case a nap is preferable to driving drowsy (Think of DROWSINESS when driving as RED ALERT that you need a nap!). Napping depletes the bodies homeostatic sleep pressure and will result in you not being able to fall asleep later until later that evening.

Although there are people who successfully live with bi-phasic or polyphasic sleep, the data suggests that sleeping outside of the window of opportunity created by your circadian rhythm and homeostatic sleep process is analogous to eating junk food instead of healthy nutritious meals.

TLDR See your doctor, work with Sleep Doctor or a CBT-I trained therapist as your GP recommends.
posted by Jernau at 1:27 PM on July 7, 2020 [8 favorites]

NOTE ON MELATONIN: I do not recommend melatonin for the reasons I explained above but that said, the ideal dosage of melatonin according to an MIT study was .3 milligrams. That's right 0.3mg not 3mg or 5mg or 10mg or 20mg.

You can get sick on a melatonin overdose. DO NOT KEEP UPPING THE DOSAGE TILL IT WORKS.
posted by Jernau at 1:48 PM on July 7, 2020 [2 favorites]

Best answer: I'm struggling with the same problem. I was just reading that exposure to natural light outside can help (especially in the evening, if you're waking up too early). I'm going to try going for a walk both early in the morning and just before dusk.
posted by pinochiette at 3:02 PM on July 7, 2020 [3 favorites]

I had this problem a few years ago. One day I just started waking up at 5am, and no matter what I did or how late I stayed up, I woke up at 5am.

After a couple of weeks of this, I decided to start exercising in the morning. This was the BeforeTimes, so I went to the pre-dawn Pilates class at the studio down the block. I also started doing early-morning hikes. This did not help me sleep later, but it did help me go to sleep earlier, which allowed me to get a decent night's sleep. And I got much fitter, which was an added bonus.

It was several years before I stopped waking up at 5am every morning; YMMV.
posted by rednikki at 9:09 PM on July 7, 2020 [1 favorite]

Response by poster: Typing this after a more or less sleepless night, even with chamomile tea + my new sleep mask/Bluetooth speakers + Calm app combo.

Thanks again for all of the advice -- if anyone has any recommendations for CBT-I that's not based in the US that would be useful (even the apps I see recommended online are there). Although I'm still not sure whether it's worth making major changes to my lifestyle yet until I can determine if this is temporary or not?

Frustratingly it seems like so much advice about this online directly contradicts other advice. I see some saying "all sleep is good sleep" and others forbidding any naps at all. Will have to wait and see what my GP advises, if anything.
posted by fight or flight at 10:51 PM on July 7, 2020

Honestly, it might come down to trying it both ways for a fixed period of time, taking notes on the results, and seeing if either way makes you feel better or worse. A lot of things aren't one size fits all, though recommendations often are.

One thing that might be useful is to look at how your lifestyle has changed since lockdown. Besides increased anxiety, you might also be getting less physical activity, eating at different times, even experiencing stress at different times of day, etc. If so, playing around with those variables or trying to recreate your pre-lockdown schedule might help.
posted by trig at 4:07 AM on July 8, 2020

The behavioral health psych I worked with had me keep a two week sleep log when we were deciding whether to do CBT-I. In my case we decided that even though the insomnia felt awful, it was not bad enough to warrant that level of intervention, so we started elsewhere first. From his perspective if I was getting at least 4 hours on a good number of nights I was going to be fine. My typical week at the time had at least one night <2h, and usually one full night of good sleep, and a typical night was 4-6 hours.
posted by eirias at 5:17 AM on July 10, 2020

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