2AM Wake-up call
February 19, 2021 5:25 AM Subscribe
For the last several weeks, I have been dealing with sleep fragmentation. I reliably wake up around 2-2:30 AM and can't get back to sleep for a couple hours. This means that I get somewhere between 4-6 hours per night, except for weekends where I make up my sleep debt by hardly getting out of bed at all. I start feeling human again by about Sunday afternoon, just in time for the cycle to repeat itself. List of things I've tried inside. If you have had this, what worked for you?
OK before I get to the list of failed remedies, I want to say very clearly upfront that I know sleep fragmentation is distinct from sleep-onset insomnia. If you have something that worked for your sleep-onset insomnia, by all means share it, maybe it will work for me or for someone else who reads this. But I am most interested in hearing from people who have sleep fragmentation (aka interrupted sleep).
Things I have tried and failed:
- avoiding alcohol most nights (I will have a glass of wine with dinner, 2-3 nights a week, seems to make no difference)
- breathing exercises
- caffeine avoidance after 10am
- steady sleep schedule both weeknights and weekends; wind-down routine starts at 8:30pm, in bed by 9, read a paper book for 20-30 min until I get sleepy enough to sleep
- no screens in the bedroom other than my phone, which has a blue light filter activated after 10pm
- podcasts about boring topics
- melatonin tabs (this worked great the first night, possibly a placebo effect, but the next few nights failed even though I tried various combinations of both bedtime + on arousal, only at bedtime, only on arousal)
- temperature control (thermostat, weighted blanket)
- get up and walk around until sleepy (the problem with this is that I am physically exhausted but mentally chirpy, sort of like an overtired child.)
Things I am not interested in:
- CBD/cannabis
- sleep study (might consider once covid calms down -- I don't fully trust the quality of the home studies -- but I've never been told I snore, and my STOP-BANG score is 1 for "fatigue" [yes I know STOP-BANG has limits])
- Ambien, Klonopin, or other prescription sleep aids
OK before I get to the list of failed remedies, I want to say very clearly upfront that I know sleep fragmentation is distinct from sleep-onset insomnia. If you have something that worked for your sleep-onset insomnia, by all means share it, maybe it will work for me or for someone else who reads this. But I am most interested in hearing from people who have sleep fragmentation (aka interrupted sleep).
Things I have tried and failed:
- avoiding alcohol most nights (I will have a glass of wine with dinner, 2-3 nights a week, seems to make no difference)
- breathing exercises
- caffeine avoidance after 10am
- steady sleep schedule both weeknights and weekends; wind-down routine starts at 8:30pm, in bed by 9, read a paper book for 20-30 min until I get sleepy enough to sleep
- no screens in the bedroom other than my phone, which has a blue light filter activated after 10pm
- podcasts about boring topics
- melatonin tabs (this worked great the first night, possibly a placebo effect, but the next few nights failed even though I tried various combinations of both bedtime + on arousal, only at bedtime, only on arousal)
- temperature control (thermostat, weighted blanket)
- get up and walk around until sleepy (the problem with this is that I am physically exhausted but mentally chirpy, sort of like an overtired child.)
Things I am not interested in:
- CBD/cannabis
- sleep study (might consider once covid calms down -- I don't fully trust the quality of the home studies -- but I've never been told I snore, and my STOP-BANG score is 1 for "fatigue" [yes I know STOP-BANG has limits])
- Ambien, Klonopin, or other prescription sleep aids
I have intermittent problems with waking up around that time. I didn't see it in your list so in case you haven't tried it: more exercise.
When I was biking and walking a lot every day it was less of a problem. When I WFH and don't get out, I have to have a specific exercise regimen. The best I ever sleep is when I've been physically working hard for long periods. I can't do that every day, but I can get in 20 min of semi-intense exercise. I like medicine balls and shovelglove, but I'm sure anything that burns some energy could potentially help.
posted by SaltySalticid at 5:35 AM on February 19, 2021 [7 favorites]
When I was biking and walking a lot every day it was less of a problem. When I WFH and don't get out, I have to have a specific exercise regimen. The best I ever sleep is when I've been physically working hard for long periods. I can't do that every day, but I can get in 20 min of semi-intense exercise. I like medicine balls and shovelglove, but I'm sure anything that burns some energy could potentially help.
posted by SaltySalticid at 5:35 AM on February 19, 2021 [7 favorites]
I sympathise, this is so hard. My sleep fragmentation improved when I started going to bed later (11:30 or midnight), I was finally tired enough to sleep through the night.
posted by third word on a random page at 5:43 AM on February 19, 2021 [6 favorites]
posted by third word on a random page at 5:43 AM on February 19, 2021 [6 favorites]
I sleep soundest on days when I've done some moderate-to-intense cardio, say for a half hour or longer.
posted by Theiform at 5:46 AM on February 19, 2021
posted by Theiform at 5:46 AM on February 19, 2021
I would really encourage you to consider the sleep study once the pandemic calms down a bit. It sounds like you've gone through most of the self-help stuff to try and you're in need of another set of eyes and, more importantly, some data.
For what it's worth, I've been there - I rarely snored, so while I was tired all the time and waking up feeling like crap, I didn't seek out a sleep doc because it didn't occur to me that I could have a sleep disorder. (Spoiler alert: I did, specifically UARS, which among other things can lead to waking in the middle of the night and insomnia.)
When I eventually got there, I did have to suffer through the at-home sleep test first because my insurance required it (you're right, they're not helpful unless you have a bad to severe case of classical apnea). Fortunately, I had chosen a good sleep doc who keeps up to date on all the other possible sleep issues, including UARS, and he got me in for an in-person sleep study that diagnosed what I actually had going on.
In my case, the case of my UARS wasn't something that at-home measures could fix. I'm incredibly glad I went to the sleep doc and got the information that let me actually deal with the underlying cause.
posted by pie ninja at 5:59 AM on February 19, 2021 [1 favorite]
For what it's worth, I've been there - I rarely snored, so while I was tired all the time and waking up feeling like crap, I didn't seek out a sleep doc because it didn't occur to me that I could have a sleep disorder. (Spoiler alert: I did, specifically UARS, which among other things can lead to waking in the middle of the night and insomnia.)
When I eventually got there, I did have to suffer through the at-home sleep test first because my insurance required it (you're right, they're not helpful unless you have a bad to severe case of classical apnea). Fortunately, I had chosen a good sleep doc who keeps up to date on all the other possible sleep issues, including UARS, and he got me in for an in-person sleep study that diagnosed what I actually had going on.
In my case, the case of my UARS wasn't something that at-home measures could fix. I'm incredibly glad I went to the sleep doc and got the information that let me actually deal with the underlying cause.
posted by pie ninja at 5:59 AM on February 19, 2021 [1 favorite]
Clarification question: You said at the start this has only been a few weeks? And you've tried all those things? If so perhaps you've not given anything sufficient time. Or, there's something going on in your life that you're worrying about, which you need to deal with.
Other than that, I'm here to second or third the idea of regular exercise. The lazier I am about that, the worse I sleep.
posted by beagle at 6:16 AM on February 19, 2021 [2 favorites]
Other than that, I'm here to second or third the idea of regular exercise. The lazier I am about that, the worse I sleep.
posted by beagle at 6:16 AM on February 19, 2021 [2 favorites]
I have this kind of insomnia too. It's frustrating in that a lot of tips are not geared toward it.
Re: podcasts, I realize this is subtle, but have you tried listening to podcasts (or audiobooks) that you DON'T find boring? For me, part of the utility of this strategy is that because I find them interesting, I'm less angsty so I don't ruminate and keep myself up--it's basically "well, I'm doing this thing that I enjoy and that stimulates my mind enough to keep it from ruminating, so if I don't fall asleep, that's kind of fine too." I use sleep headphones (flat speakers embedded in a stretchy headband) and a timer to turn the podcast off after a certain amount of time; both of those things feel like useful components for me.
posted by needs more cowbell at 6:16 AM on February 19, 2021 [6 favorites]
Re: podcasts, I realize this is subtle, but have you tried listening to podcasts (or audiobooks) that you DON'T find boring? For me, part of the utility of this strategy is that because I find them interesting, I'm less angsty so I don't ruminate and keep myself up--it's basically "well, I'm doing this thing that I enjoy and that stimulates my mind enough to keep it from ruminating, so if I don't fall asleep, that's kind of fine too." I use sleep headphones (flat speakers embedded in a stretchy headband) and a timer to turn the podcast off after a certain amount of time; both of those things feel like useful components for me.
posted by needs more cowbell at 6:16 AM on February 19, 2021 [6 favorites]
Two things that have helped me with waking up in the middle of the night are cortisol pills before bed, and a snack with protein before bed. Good luck!
posted by walkinginsunshine at 6:30 AM on February 19, 2021
posted by walkinginsunshine at 6:30 AM on February 19, 2021
For me this is related to anxiety/sorrow levels - I will reliably wake super early if I'm really sad or stressed. Has anything changed for you in that area? I've only been able to deal with it by targeting the stressor or grieving through the sorrow.
posted by london explorer girl at 6:34 AM on February 19, 2021 [7 favorites]
posted by london explorer girl at 6:34 AM on February 19, 2021 [7 favorites]
I have some variation on this problem. My troubleshooting steps are 1 - go to the bathroom. I never feel like I have to pee, but somehow, I always do need to go. If that doesn't work, 2 - go find somewhere else to sleep. For me, it's a couch. Once I'm in the "correct" sleeping environment and comfortable, I usually drop off within a few minutes.
I've also had nights where I went to sleep in bed, transferred to the couch after a few hours, and then had to transfer back into bed. It seems very arbitrary, but it does the trick for me.
posted by snerson at 6:45 AM on February 19, 2021 [11 favorites]
I've also had nights where I went to sleep in bed, transferred to the couch after a few hours, and then had to transfer back into bed. It seems very arbitrary, but it does the trick for me.
posted by snerson at 6:45 AM on February 19, 2021 [11 favorites]
White/brown noise reliably keeps me asleep and/or helps me fall back to sleep quickly if I wake in the middle of the night.
posted by cooker girl at 6:47 AM on February 19, 2021
posted by cooker girl at 6:47 AM on February 19, 2021
I'm in the beginning of a similar journey of trying to fix my own fragmented sleep. Its stil very early on, but I've had a couple of really good nights sleep with a weighted blanket! I haven't been sleeping with it on the bed, instead I just chill on the couch before bed with it and then to bed as normal.
posted by cgg at 6:48 AM on February 19, 2021
posted by cgg at 6:48 AM on February 19, 2021
Since the pandemic, I've been sleeping MORE but I've also been waking up more. Like I go to bed to read at 930-10pm and I wake up at 2 or 3, pretty reliably, but I do get back to sleep. IDK if any of this will help, but one thing it helps me to know intellectually is that waking up in the middle of the night is completely evolutionarily normal. People used to not have artificial light after dark, or it wasn't good light, so they would go to bed earlier, wake up for some period of time in the middle of the night, and go back to sleep til sunup. So it's possible nothing is WRONG per se, it's just a thing that happens.
When I wake up, I read a bit on my paperwhite, do meditations, pet the cat (who enjoys the mid-night snuggles) and generally just try to relax and not punish myself for being awake at the "wrong" time. White noise helps.
posted by Medieval Maven at 6:48 AM on February 19, 2021 [4 favorites]
When I wake up, I read a bit on my paperwhite, do meditations, pet the cat (who enjoys the mid-night snuggles) and generally just try to relax and not punish myself for being awake at the "wrong" time. White noise helps.
posted by Medieval Maven at 6:48 AM on February 19, 2021 [4 favorites]
Nthing anxiety/stress as a trigger for this for me at least, as well as sometimes low blood sugar. I usually try to get up, have a small snack (piece of string cheese, usually), and wait it out with a sleep podcast or music. It sucks, I hope you find relief soon.
posted by miratime at 6:50 AM on February 19, 2021 [1 favorite]
posted by miratime at 6:50 AM on February 19, 2021 [1 favorite]
Response by poster: Thanks all, keep 'em coming!
(Lack of) exercise is a really good point; I get home too late to be able to walk/run outside safely right now, but I have an under-desk elliptical I could be more consistent about using during at least part of my workdays.
Also, yes to anxiety/stress because ... *waves hands at everything.* I've been able to take a couple days off here and there since March 2020, but having a proper vacation/being able to get away is way overdue. Alas.
posted by basalganglia at 6:54 AM on February 19, 2021 [1 favorite]
(Lack of) exercise is a really good point; I get home too late to be able to walk/run outside safely right now, but I have an under-desk elliptical I could be more consistent about using during at least part of my workdays.
Also, yes to anxiety/stress because ... *waves hands at everything.* I've been able to take a couple days off here and there since March 2020, but having a proper vacation/being able to get away is way overdue. Alas.
posted by basalganglia at 6:54 AM on February 19, 2021 [1 favorite]
This was happening to me for a while when I was super stressed at work, and my very specific solution (it may not work for you) was kind of like snerson’s. I would go downstairs to the recliner to avoid waking up my husband, then I would start reading a long article in The New Yorker, positioned so that I had minimal disruption to fall asleep from there. It took maybe 10 mins to fall asleep and then a few hours later I’d wake up just enough to go back to bed until the alarm.
posted by hellogoodbye at 6:55 AM on February 19, 2021 [1 favorite]
posted by hellogoodbye at 6:55 AM on February 19, 2021 [1 favorite]
I wake up in the middle of the night in spurts and have for years, so I'm not sure I've 'cured' it at all but here is what helps:
1. I try not to stress about being awake. This is really hard, but I find it helps the most. I try to take it as reading time - I either go out of the room and read a book (I share a bedroom) or read on my Kindle Fire as low as I can take the contrast, and light reading.
2. Protein snack before bed helps. No caffeine after 11 am and preferably decreasing it (I'm an addict otherwise I'd eliminate it)
3. Exercise, over an hour of it, preferably outdoors, preferably before about 3 pm (ha ha in the winter.) Even if I can't do that sometimes a workout before bed helps (but it can wind me up - I aim for something like Pilates.)
4. Part of my waking is related to joint pain so sometimes I take an ibuprofen in advance.
5. Mine is definitely anxiety related.
And finally sometimes I do a hard reset - I only recommend this if you are desperate and can spare the time, but I'll stay up until I've been waking up, so stay up until 2 am, and then usually I can sleep in but I don't let it go too late - 9 am at the latest. It makes for a day where I crash at the end of it but often that will help.
posted by warriorqueen at 6:56 AM on February 19, 2021 [3 favorites]
1. I try not to stress about being awake. This is really hard, but I find it helps the most. I try to take it as reading time - I either go out of the room and read a book (I share a bedroom) or read on my Kindle Fire as low as I can take the contrast, and light reading.
2. Protein snack before bed helps. No caffeine after 11 am and preferably decreasing it (I'm an addict otherwise I'd eliminate it)
3. Exercise, over an hour of it, preferably outdoors, preferably before about 3 pm (ha ha in the winter.) Even if I can't do that sometimes a workout before bed helps (but it can wind me up - I aim for something like Pilates.)
4. Part of my waking is related to joint pain so sometimes I take an ibuprofen in advance.
5. Mine is definitely anxiety related.
And finally sometimes I do a hard reset - I only recommend this if you are desperate and can spare the time, but I'll stay up until I've been waking up, so stay up until 2 am, and then usually I can sleep in but I don't let it go too late - 9 am at the latest. It makes for a day where I crash at the end of it but often that will help.
posted by warriorqueen at 6:56 AM on February 19, 2021 [3 favorites]
Cognitive behavioral therapy for insomnia, particularly sleep restriction. Please see a sleep doctor - there's a lot they can help with even without a sleep study.
posted by medusa at 7:00 AM on February 19, 2021 [2 favorites]
posted by medusa at 7:00 AM on February 19, 2021 [2 favorites]
For what it's worth, I've been sleeping in 3-4 hour chunks for years with many hour breaks in between. I'm not sure it's a bad thing. The hard part has been convincing myself to be either productive or relaxed during the middle-of-the-night time when everyone else is sleeping, rather than wasting time on things that I don't care about. "Is this actually a problem" is a question worth considering. (I realize you very likely have and it may well be, in which case, ignore me.)
posted by eotvos at 7:10 AM on February 19, 2021 [1 favorite]
posted by eotvos at 7:10 AM on February 19, 2021 [1 favorite]
Things I am not interested in:
...
- Ambien, Klonopin, or other prescription sleep aids
I also wasn't interested in those, but it turned out to be the only thing that worked for my chronic sleep interruption. I think a major part of why it helped was that it takes away the stress of "uh uh, what if I'm stuck awake for hours? I'll be so tired tomorrow!" which was frustratingly keeping me awake.
Like you say, this isn't the path you are desiring and I hope that one or more of the other suggestions people have made solve your issue completely.
posted by Dip Flash at 7:15 AM on February 19, 2021 [1 favorite]
...
- Ambien, Klonopin, or other prescription sleep aids
I also wasn't interested in those, but it turned out to be the only thing that worked for my chronic sleep interruption. I think a major part of why it helped was that it takes away the stress of "uh uh, what if I'm stuck awake for hours? I'll be so tired tomorrow!" which was frustratingly keeping me awake.
Like you say, this isn't the path you are desiring and I hope that one or more of the other suggestions people have made solve your issue completely.
posted by Dip Flash at 7:15 AM on February 19, 2021 [1 favorite]
I find that a slice of toast or oatmeal will help me get back to sleep until daylight.
posted by effluvia at 7:17 AM on February 19, 2021
posted by effluvia at 7:17 AM on February 19, 2021
I started waking up at 4am and never getting back to sleep about half way through June. I am certain this was pandemic anxiety related. It continued til November when I decided to get some Tylenol PM, which conked me out but made me feel heavy in the morning when I did wake up. So I switched to Advil PM and don’t have that feeling anymore. I don’t take it every night, but if I have something early the next day that I need to be particularly well rested for, it keeps me asleep til my alarm goes off. Most other days I now sleep through the night without it, but my stress levels have also gone way down. Before I took medicine, I would try to bore myself back to sleep by not looking at my phone (I keep it face down so I can’t even check the time) and making up fake dreams to think about. It worked most of the time.
posted by oomny at 7:27 AM on February 19, 2021 [1 favorite]
posted by oomny at 7:27 AM on February 19, 2021 [1 favorite]
I have segmented sleep and use that time to catch up on the news. It doesn't really bother me. The only time it has ever stopped was when I have had to stop drinking coffee for unrelated health reasons. Maybe consider cutting out coffee and caffeine drinks altogether.
posted by Toddles at 7:33 AM on February 19, 2021
posted by Toddles at 7:33 AM on February 19, 2021
Get up earlier and exercise for 45 minutes before breakfast and work. If you exercise late in the day it can mess up your sleep. When you wake up in the middle of the night go pee without turning on any lights then get back into bed and close your eyes. If you don't go back to sleep quickly listen to music and keep your eyes closed.
If all else fails, consider trying diphenhydramine/benadryl, it's cheap and over the counter. It works for some people but not for others. When I use it straight, not mixed with advil or tylenol, I wake up with no side effects whatsoever.
posted by mareli at 7:34 AM on February 19, 2021
If all else fails, consider trying diphenhydramine/benadryl, it's cheap and over the counter. It works for some people but not for others. When I use it straight, not mixed with advil or tylenol, I wake up with no side effects whatsoever.
posted by mareli at 7:34 AM on February 19, 2021
I wake up most nights, and generally use the bathroom (often it seems to be just needing to get up and move a bit vs. having to pee) and then fall back asleep pretty quickly. I don’t check the time and that helps me not to stress about it. Sometimes it takes a while to fall asleep again, and I lie in bed and try to think about how cozy I am - lying in bed relaxed is still restful even if I’m awake. Exercise during the day helps. Sometimes I’m cold and a hot water bottle does the trick.
If I’m having muscle pain / tension, I’ve used valerian before bed, and it knocks me out all night, even at less than the recommended dose. I don’t intentionally use it for a sleep reset, but having one solid night of sleep does get me back on track if I’m over tired.
posted by momus_window at 7:54 AM on February 19, 2021 [1 favorite]
If I’m having muscle pain / tension, I’ve used valerian before bed, and it knocks me out all night, even at less than the recommended dose. I don’t intentionally use it for a sleep reset, but having one solid night of sleep does get me back on track if I’m over tired.
posted by momus_window at 7:54 AM on February 19, 2021 [1 favorite]
I've had this problem a few different times for the past decade or so.
1) Reduce stress. (Likely not an option now, but it does help).
2) Coffee curfew is now 1pm for me.
3) Temperature. If it gets too warm, I wake up. I used to have a housemate who would get up pretty early for her long commute -- and turn up the thermostat at the same time. So I'd wake up too.
Now, I live in AZ, and in the summer, a duvet is too hot; instead I got a weighted blanket that is designed to be "cooling" (really it's just "less warming"), and that does a pretty good job of keeping me asleep.
4) Accept it. Sometimes, this happens. If you can arrange your day to allow for it, you'll stop fighting, which will help with the stress if nothing else. Of course this might be as comical as "reduce stress" depending on your life and schedule.
Good luck. I always feel like an infant who can't sleep through the night when this happens, but know that you're not alone.
posted by nat at 8:03 AM on February 19, 2021
1) Reduce stress. (Likely not an option now, but it does help).
2) Coffee curfew is now 1pm for me.
3) Temperature. If it gets too warm, I wake up. I used to have a housemate who would get up pretty early for her long commute -- and turn up the thermostat at the same time. So I'd wake up too.
Now, I live in AZ, and in the summer, a duvet is too hot; instead I got a weighted blanket that is designed to be "cooling" (really it's just "less warming"), and that does a pretty good job of keeping me asleep.
4) Accept it. Sometimes, this happens. If you can arrange your day to allow for it, you'll stop fighting, which will help with the stress if nothing else. Of course this might be as comical as "reduce stress" depending on your life and schedule.
Good luck. I always feel like an infant who can't sleep through the night when this happens, but know that you're not alone.
posted by nat at 8:03 AM on February 19, 2021
I've had some luck with a light therapy lamp ~30 mins a day, about 3 hours after I wake up. I also meditate 30 minutes a day which helps keep anxiety under control.
posted by Dmenet at 8:17 AM on February 19, 2021
posted by Dmenet at 8:17 AM on February 19, 2021
Part of me hates to recommend this because it counters some excellent advice but what’s worked for me is playing two dots on my phone. I put a calming audiobook on with a half hour sleep timer (calming in this case means I’ve listened to it 5+ times and the reader has a soothing voice) and then I play two dots. It’s a low stake game that I don’t care about beyond finding it soothing, in about 5 minutes my brain is quiet and in 10 I stop playing and fall asleep soon after. It’s the only thing that’s reliably gotten me back to sleep.
posted by lepus at 8:21 AM on February 19, 2021 [2 favorites]
posted by lepus at 8:21 AM on February 19, 2021 [2 favorites]
The best solution I’ve found in years of dealing with insomnia: Count down from 50, but you must only think about the numbers. If your mind darts off to something else, you start over. It turns off the “come out and play” that your mind wants.
The mind has a mind of its own. In the middle of the night, you need to steer it away from All The Things it wants to focus on. Your body needs sleep. Your mind needs to shut up.
Don’t turn on a light or pick up your phone. Keep your eyes closed, get comfortable, do a few deep breaths, then the countdown. I always have to start over a few times, but I don’t think I’ve gotten to zero yet.
posted by sageleaf at 8:22 AM on February 19, 2021 [2 favorites]
The mind has a mind of its own. In the middle of the night, you need to steer it away from All The Things it wants to focus on. Your body needs sleep. Your mind needs to shut up.
Don’t turn on a light or pick up your phone. Keep your eyes closed, get comfortable, do a few deep breaths, then the countdown. I always have to start over a few times, but I don’t think I’ve gotten to zero yet.
posted by sageleaf at 8:22 AM on February 19, 2021 [2 favorites]
I had this consistently for about a year, I think? I was always waking up around 2-2:30AM and being awake for 2 hours... then it started getting earlier and earlier, and one night I woke up around 12:30AM and was just in complete despair. I talked to my doctor about it at my annual exam and he asked me what time I was going to bed, and about my parents' sleep habits. My dad is deceased but my mom has been a lifelong ~5-6 hours a night sleeper. So he suggested I keep a sleep diary (I didn't), and also suggested that I just start going to bed later because maybe I don't actually need as much sleep as I'm trying to get. So I did that. I think I started staying up until maybe like midnight on work nights instead of going to bed around 10:30 or so. And I'm not sure if that's the exact moment that the 2AM wakeups stopped, but they stopped, and have not returned.
And just as a data point -- I had a sleep study done years ago because I never feel "refreshed" when I wake up, but the sleep study didn't find anything. Although I hardly slept the night with the stupid machine on, so I have no idea how it had any useful data to go on...
posted by jabes at 8:23 AM on February 19, 2021
And just as a data point -- I had a sleep study done years ago because I never feel "refreshed" when I wake up, but the sleep study didn't find anything. Although I hardly slept the night with the stupid machine on, so I have no idea how it had any useful data to go on...
posted by jabes at 8:23 AM on February 19, 2021
To add to my previous comment -- when my doctor asked me about it, he specifically said, "Are you falling asleep during the day at work? Are you able to function?" And I was able to function on the sleep I was getting even with the 2 hour morning wakeup (I mean, I was tired, but I was functioning fine). So going to bed later night only be a good suggestion if you're functioning on the fragmented sleep you're getting now.
I hope you get some relief. This is a tough thing to deal with.
posted by jabes at 8:26 AM on February 19, 2021 [1 favorite]
I hope you get some relief. This is a tough thing to deal with.
posted by jabes at 8:26 AM on February 19, 2021 [1 favorite]
I was routinely waking up at 2 a.m. and falling asleep again around 5:30/6 for ages until I figured out I needed way more hydration. More than seems reasonable. Don't know why, but it works for me. Hope it helps you too. Pro tip: load up throughout the day, ease off after dinner, or you'll be awake for a different reason.
posted by kate4914 at 9:07 AM on February 19, 2021 [1 favorite]
posted by kate4914 at 9:07 AM on February 19, 2021 [1 favorite]
walkinginsunshine, when you say "cortisol pills," what does that mean? I've never encountered them.
posted by needs more cowbell at 9:20 AM on February 19, 2021 [1 favorite]
posted by needs more cowbell at 9:20 AM on February 19, 2021 [1 favorite]
This is normal for me but I have the wake-period down to often less than 15 minutes now (I'm gonna have to get up and pee if I wake up, so it's at least 3 minutes). The things I do:
- Take magnesium 1 hour before bed (it can have a laxative effect, so you want that to be done before you hit the pillow). You sleep better AND are less prone to low-level muscle tension, restless legs, or cramps.
- When I wake up, after I'm back from the bathroom (nightlight only), I tell myself a story about getting into the most amazing bed I can think of in that moment. The world is your oyster here, you have no budget, and safety is handwaved away - if you want a bed suspended by balloons over Central Park on a perfect clear 64-degree night, you can have it. In this story you are extremely comfortable, your climate is perfect, your body is expertly cradled, your blankies are exactly the right weight. It's a form of meditation - not too interesting, but interesting enough to prevent most monkey-mind, and it keeps your focus on sleeping.
- If I can feel after 10-15 minutes that I'm not shutting back down, I take a chewable Children's (half-dose) Benadryl, which for me starts to kick in within minutes and isn't so powerful I can't wake up 3-4 hours later.
- - if I'm really struggling with jumpy brain, I play Bejeweled Classic (lightning version, personally) until the Benadryl fully gets me drowsy.
- Change any narratives about this wake-up that create anxiety. This was key to the whole thing for me, because I used to get angry and upset and that definitely meant I wasn't getting back down soon. I think about all the stories about historical segmented or polyphasic sleep and remember that this is a pretty normal thing to happen and I'll just lay here and rest for a bit until I get back to sleep and it'll be okay and it won't suck in the morning.
Very occasionally I do put on an audiobook, if I'm really agitated. I have a book on my phone narrated by Shoreh Aghdashloo that I have never successfully listened to awake and never make it all the way through 15 minutes on the Audible sleep timer.
posted by Lyn Never at 9:35 AM on February 19, 2021 [1 favorite]
- Take magnesium 1 hour before bed (it can have a laxative effect, so you want that to be done before you hit the pillow). You sleep better AND are less prone to low-level muscle tension, restless legs, or cramps.
- When I wake up, after I'm back from the bathroom (nightlight only), I tell myself a story about getting into the most amazing bed I can think of in that moment. The world is your oyster here, you have no budget, and safety is handwaved away - if you want a bed suspended by balloons over Central Park on a perfect clear 64-degree night, you can have it. In this story you are extremely comfortable, your climate is perfect, your body is expertly cradled, your blankies are exactly the right weight. It's a form of meditation - not too interesting, but interesting enough to prevent most monkey-mind, and it keeps your focus on sleeping.
- If I can feel after 10-15 minutes that I'm not shutting back down, I take a chewable Children's (half-dose) Benadryl, which for me starts to kick in within minutes and isn't so powerful I can't wake up 3-4 hours later.
- - if I'm really struggling with jumpy brain, I play Bejeweled Classic (lightning version, personally) until the Benadryl fully gets me drowsy.
- Change any narratives about this wake-up that create anxiety. This was key to the whole thing for me, because I used to get angry and upset and that definitely meant I wasn't getting back down soon. I think about all the stories about historical segmented or polyphasic sleep and remember that this is a pretty normal thing to happen and I'll just lay here and rest for a bit until I get back to sleep and it'll be okay and it won't suck in the morning.
Very occasionally I do put on an audiobook, if I'm really agitated. I have a book on my phone narrated by Shoreh Aghdashloo that I have never successfully listened to awake and never make it all the way through 15 minutes on the Audible sleep timer.
posted by Lyn Never at 9:35 AM on February 19, 2021 [1 favorite]
I get this kind of insomnia too. I'm sorry, I know how much it sucks! When I wake in the middle of the night I listen to guided relaxation sessions or "sleep stories" (very soothing stories that I have on my Calm app) right away. This tends to calm the weasels in my head enough so that I can fall back asleep sometimes. I also keep a glass of water mixed with Valerian tincture to drink when I wake up at 2 AM. If all else fails, my best strategy that I save for the really bad times is turning around and sleeping with my head at the foot of my bed. I have no idea why this works but it does, usually like magic!
posted by WalkerWestridge at 9:42 AM on February 19, 2021 [1 favorite]
posted by WalkerWestridge at 9:42 AM on February 19, 2021 [1 favorite]
I get this if I don't eat a snack right before bed, and the only thing that lets me fall asleep is getting up and getting a snack in the middle of the night if I do wake up. The more I exercise, the more this is true. But exercise + snack gives a good night's sleep. Sometimes a high protein snack works best, sometimes a high carb snack.
posted by lab.beetle at 10:13 AM on February 19, 2021
posted by lab.beetle at 10:13 AM on February 19, 2021
Eating a stick of string cheese and a few banana pepper rings right before bed is surprisingly helpful for me. Probably something to do with stabilizing my blood sugar.
posted by Serene Empress Dork at 10:41 AM on February 19, 2021
posted by Serene Empress Dork at 10:41 AM on February 19, 2021
I get both sleep onset and sleep fragmentation insomnia, and the sleep fragmentation is definitely particularly tricky. Sometimes I find I just need to break myself out of the cycle. If you're willing to try non-presecription sleep aids, I find the unisom made with doxylamine succinate (not diphenhydramine) works really well for a short term, need to get a few nights of solid sleep. I'd start with 12.5 mg (half a pill) because it can actually be quite effective.
As has already been mentioned, I also sometimes find I just need to start going to sleep later. If I go to sleep at 10 pm, I'm more prone to waking up at 2 or 3 am. If I go to sleep at 11 pm, I usually sleep until 5 or 6 am. This will depend on when you have to get up/how much sleep you need. I find 6 hours is usually fine for me.
Exercise/tiring myself out with a lot of work also sometimes helps with this.
A lot of times, it just seems like my sleep cycle gets thrown off so that my brain is suddenly like "3 am, time to wake up" and if I can break out of that pattern for a few nights, I'm usually okay (for a few weeks at least).
posted by litera scripta manet at 11:34 AM on February 19, 2021
As has already been mentioned, I also sometimes find I just need to start going to sleep later. If I go to sleep at 10 pm, I'm more prone to waking up at 2 or 3 am. If I go to sleep at 11 pm, I usually sleep until 5 or 6 am. This will depend on when you have to get up/how much sleep you need. I find 6 hours is usually fine for me.
Exercise/tiring myself out with a lot of work also sometimes helps with this.
A lot of times, it just seems like my sleep cycle gets thrown off so that my brain is suddenly like "3 am, time to wake up" and if I can break out of that pattern for a few nights, I'm usually okay (for a few weeks at least).
posted by litera scripta manet at 11:34 AM on February 19, 2021
I've had sleep fragmentation as well. Fell asleep no problem, woke up at 4am like clockwork every night. This went on for... months? I think?
It happened at a time when on top of my usual stress level (hospital doc with teaching responsibilities) I also experienced personal sorrow.
My suggestion will sound completely nonsensical but, what helped me was installing an app called Sleepcycle on my android phone. You put it by your bed as you go to sleep and it tracks your sleep and wakes you up with gentle music when your sleep is at its most shallow within a desired wake-up time period. It makes zero sense that it helped at all - but it helped. I did not use any of the extra features like white/pink/whatever noise, just the tracking feature. It gave me a score every morning for how good my sleep was and asked me what my wake-up mood was. I still marvel at this whole thing. Still have it on my phone even though I don't need it now. I feel better just having it there.
posted by M. at 11:34 AM on February 19, 2021
It happened at a time when on top of my usual stress level (hospital doc with teaching responsibilities) I also experienced personal sorrow.
My suggestion will sound completely nonsensical but, what helped me was installing an app called Sleepcycle on my android phone. You put it by your bed as you go to sleep and it tracks your sleep and wakes you up with gentle music when your sleep is at its most shallow within a desired wake-up time period. It makes zero sense that it helped at all - but it helped. I did not use any of the extra features like white/pink/whatever noise, just the tracking feature. It gave me a score every morning for how good my sleep was and asked me what my wake-up mood was. I still marvel at this whole thing. Still have it on my phone even though I don't need it now. I feel better just having it there.
posted by M. at 11:34 AM on February 19, 2021
What time do you need to wake up? Because I’m just kind of a bit confused about going to bed at 9:30, waking up at 2:30 and then being up for a few hours before being able to go back to sleep. I mean, if you don’t need to wake up at 5:30am, try going to bed later.
You also mention your phone set to do blue light at 10pm, a half an hour after you should be asleep. You might want to just put it in another room or across the room so it’s not a distraction or temptation to grab if you wake up in the night.
Nthing exercise. As a parent, it’s obvious that the kids nap and sleep better when they’re more tired out.
You don’t mention when you stop drinking liquids in the evening, but maybe try to stop earlier in case it’s needing to pee which is doing it.
I tell myself that if I’m going to get up that I need to do work. That makes me more inclined to go back to sleep.
Maybe it’s worth trying to record the sound in your room and maybe the temperature as well, to see if something is happening (garbage truck or furnace kicking on) which is waking you.
posted by cali59 at 12:20 PM on February 19, 2021
You also mention your phone set to do blue light at 10pm, a half an hour after you should be asleep. You might want to just put it in another room or across the room so it’s not a distraction or temptation to grab if you wake up in the night.
Nthing exercise. As a parent, it’s obvious that the kids nap and sleep better when they’re more tired out.
You don’t mention when you stop drinking liquids in the evening, but maybe try to stop earlier in case it’s needing to pee which is doing it.
I tell myself that if I’m going to get up that I need to do work. That makes me more inclined to go back to sleep.
Maybe it’s worth trying to record the sound in your room and maybe the temperature as well, to see if something is happening (garbage truck or furnace kicking on) which is waking you.
posted by cali59 at 12:20 PM on February 19, 2021
Put me in the camp of "this stressed me out at first but now I love it." I use this time to read easy, chill books. I read them on my phone in dark mode, with super-low contrast, in a position where I don't have to move to turn pages and can fall asleep without moving at any moment. I love my nighttime reads!
Another thing I've used when I don't want to read -- bedtime stories for adults on YouTube. (I have the no-ads subscription to YouTube, so it will keep playing audio when I turn off the screen.)
posted by nosila at 12:29 PM on February 19, 2021 [1 favorite]
Another thing I've used when I don't want to read -- bedtime stories for adults on YouTube. (I have the no-ads subscription to YouTube, so it will keep playing audio when I turn off the screen.)
posted by nosila at 12:29 PM on February 19, 2021 [1 favorite]
I find that getting up and sitting somewhere other than bed helps, especially if I can allow myself to get a bit chilled - climbing back under the covers and warming up is magical for helping me fall asleep.
I try to read, but more often watch fluffy tv or make music playlists while I sit up, usually for an hour or two. I try to hydrate too - I like hot water with lemon if I think to make it.
posted by Otter_Handler at 2:55 PM on February 19, 2021
I try to read, but more often watch fluffy tv or make music playlists while I sit up, usually for an hour or two. I try to hydrate too - I like hot water with lemon if I think to make it.
posted by Otter_Handler at 2:55 PM on February 19, 2021
Response by poster: What time do you need to wake up?
6:15. I can and often do hit snooze a couple times till 6:30 but then I'm discombobulated getting ready in the morning. At work from 7a-6p or 7p, M-F. No opportunity to nap at work (I'm a physician, we don't do "breaks" or "lunch," especially not these days; this is actually about the cushiest job I can imagine in my field because I don't have clinical responsibilities on weekends and am almost never on overnight call).
While I do appreciate the notes about pre-industrial sleep patterns (i.e. there is nothing intrinsically wrong with this pattern), the reality is that I live in 2021 and have to be cognitively intact for my entire workday. Right now, I wouldn't want to be my own last patient of the day.
The "are you functional" question is interesting, because we as a species are very bad at self-judgement about how much sleep deprivation affects us cognitively -- by the time you're aware of a problem, you're way in the hole. Personally, I'm very aware of my sleep debt weekly build/weekend discharge cycle, which probably doesn't help. I know just enough to know too little about sleep!
Anyway, thanks for all the suggestions. I've downloaded some of the apps and will try them out!
posted by basalganglia at 3:18 PM on February 19, 2021
6:15. I can and often do hit snooze a couple times till 6:30 but then I'm discombobulated getting ready in the morning. At work from 7a-6p or 7p, M-F. No opportunity to nap at work (I'm a physician, we don't do "breaks" or "lunch," especially not these days; this is actually about the cushiest job I can imagine in my field because I don't have clinical responsibilities on weekends and am almost never on overnight call).
While I do appreciate the notes about pre-industrial sleep patterns (i.e. there is nothing intrinsically wrong with this pattern), the reality is that I live in 2021 and have to be cognitively intact for my entire workday. Right now, I wouldn't want to be my own last patient of the day.
The "are you functional" question is interesting, because we as a species are very bad at self-judgement about how much sleep deprivation affects us cognitively -- by the time you're aware of a problem, you're way in the hole. Personally, I'm very aware of my sleep debt weekly build/weekend discharge cycle, which probably doesn't help. I know just enough to know too little about sleep!
Anyway, thanks for all the suggestions. I've downloaded some of the apps and will try them out!
posted by basalganglia at 3:18 PM on February 19, 2021
I'm similar to what a lot of people have said - stress causes it. Sometimes it's stress over a situation I don't even realize I'm concerned about, but when the situation resolves, I sleep like a baby for awhile.
The way I go back to sleep is mind exercises - mostly memorizing things. I can recite all the 50 US States in alphabetical order, recite their capitals, and now I'm working on being able to recite the capitals in alphabetical order. Prior to that I memorized a couple of very long poems. Or I play the alphabet game, with categories. A is for Anteater. B is for Box Turtle. C is for Cougar. Counting down is good too, vividly picturing the numbers.
Also what someone said about petting the cat - just focusing 100% on making him happy and giving the absolute best head scratch - seems to be relaxing, or releases dopamine or something.
posted by bluesky78987 at 4:56 PM on February 19, 2021 [1 favorite]
The way I go back to sleep is mind exercises - mostly memorizing things. I can recite all the 50 US States in alphabetical order, recite their capitals, and now I'm working on being able to recite the capitals in alphabetical order. Prior to that I memorized a couple of very long poems. Or I play the alphabet game, with categories. A is for Anteater. B is for Box Turtle. C is for Cougar. Counting down is good too, vividly picturing the numbers.
Also what someone said about petting the cat - just focusing 100% on making him happy and giving the absolute best head scratch - seems to be relaxing, or releases dopamine or something.
posted by bluesky78987 at 4:56 PM on February 19, 2021 [1 favorite]
I've had this on and off over the years. I have found that what works best for returning to sleep is to get back in bed - because there's always a bathroom trip involved - with a conscious sense of aaaahhhhh. I make a big deal out of snuggling back under the covers - like really think about how good it feels, how warm my bed is - and then I write a short story in my head. I never know what it's going to be about or where it's going. I keep repeating the opening lines until I can think of something to add.
Sometimes, I write a fake letter to an advice columnist. I focus on problems that would be interesting and/or funny for readers and stay away from anything dire or emotionally loaded. Basically, I'm reading myself back to sleep but I'm both author and reader. It's super effective, even if I've never actually put anything down on paper.
Oh, and never look at the clock!
posted by MissPitts at 7:06 PM on February 19, 2021
Sometimes, I write a fake letter to an advice columnist. I focus on problems that would be interesting and/or funny for readers and stay away from anything dire or emotionally loaded. Basically, I'm reading myself back to sleep but I'm both author and reader. It's super effective, even if I've never actually put anything down on paper.
Oh, and never look at the clock!
posted by MissPitts at 7:06 PM on February 19, 2021
Your blood sugar drops naturally around that time, which triggers a release of cortisol to stabilize it. If you're already stressed, or if you got a big flush of it bc your blood sugar was particularly low, its gonna wake you up.
Eat a small protein snack just before bed. Warm milk is a bedtime tradition for a reason.
If you're still waking up, do a relaxation exercise like slowly scanning down your body and relaxing each part in turn. I'd that doesnt work, seconding nosila's recommendation for low stakes reading.that you can fall asleep while doing.
And do keep in mind that this sleep pattern is super common -- there are plenty of references to 'first sleep' and 'second sleep' in older literature. The onset of the 9 to 5 job has done away with this, but it's still part of how our bodies are wired. Try to be gentle and patient with yourself about this.
posted by ananci at 8:42 AM on February 20, 2021 [1 favorite]
Eat a small protein snack just before bed. Warm milk is a bedtime tradition for a reason.
If you're still waking up, do a relaxation exercise like slowly scanning down your body and relaxing each part in turn. I'd that doesnt work, seconding nosila's recommendation for low stakes reading.that you can fall asleep while doing.
And do keep in mind that this sleep pattern is super common -- there are plenty of references to 'first sleep' and 'second sleep' in older literature. The onset of the 9 to 5 job has done away with this, but it's still part of how our bodies are wired. Try to be gentle and patient with yourself about this.
posted by ananci at 8:42 AM on February 20, 2021 [1 favorite]
Home sleep studies are actually pretty much the standard - most insurance companies will only cover in-facility studies if a home study has been done and there's evidence that the issue is more complex than what they can diagnose using the home study data.
Not trying to push you towards if if it's really not what you want - but it's likely you will have to do one even if what you ultimately want is a more in-depth study, so doing one now anyway would get that hurdle done and best case, you don't need further study for a diagnosis and effective help.
posted by augustimagination at 6:42 PM on February 20, 2021 [1 favorite]
Not trying to push you towards if if it's really not what you want - but it's likely you will have to do one even if what you ultimately want is a more in-depth study, so doing one now anyway would get that hurdle done and best case, you don't need further study for a diagnosis and effective help.
posted by augustimagination at 6:42 PM on February 20, 2021 [1 favorite]
I was exhausted all the time and my GP prescribed a sleep test. A CPAP has pretty much sorted things out for me.
Wishing you restful nights.
posted by intrepid_simpleton at 10:49 AM on February 21, 2021
Wishing you restful nights.
posted by intrepid_simpleton at 10:49 AM on February 21, 2021
Advil PM
As a note to others visiting this thread: Be careful about this. The sleep-inducing ingredient is diphenhydramine, AKA Benadryl. You can buy it separate from Advil or Tylenol as a standalone generic in the drugstore, but read up on its side effects etc. I used it for several years very regularly but decided the risks of using it long term were not worth it.
posted by beagle at 5:40 AM on February 22, 2021 [3 favorites]
As a note to others visiting this thread: Be careful about this. The sleep-inducing ingredient is diphenhydramine, AKA Benadryl. You can buy it separate from Advil or Tylenol as a standalone generic in the drugstore, but read up on its side effects etc. I used it for several years very regularly but decided the risks of using it long term were not worth it.
posted by beagle at 5:40 AM on February 22, 2021 [3 favorites]
Cardio and time-release melatonin work a treat for me.
posted by MarnieSrpings at 3:49 PM on October 29, 2021
posted by MarnieSrpings at 3:49 PM on October 29, 2021
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I always wake up mid sleep. It's been a a normal part of my healthy sleeping cycle for more than five years. Treat it like it's no big deal and you'll fall into a better rhythm with it.
posted by phunniemee at 5:30 AM on February 19, 2021 [1 favorite]