Link between 'non-restorative' sleep and nightmares?
July 20, 2008 1:52 PM   Subscribe

For the past twenty years or so (I'm 36 now) I have had trouble sleeping. Not really with falling asleep or staying asleep (even though I have had episodes where that was a problem too) but the big problem is I NEVER feel rested when I wake up in the morning. 'Non-restorative sleep' is the term I found after a bit of Googling. Through the years I have tried to tackle this problem in all sorts of ways but haven't gotten very far. About ten years ago I spent a night at a sleep lab but they couldn't find anything wrong with me. Sadly I have gotten so used to the situation that it is not on my mind a lot but lately I've been thinking about what else I could try.

The most obvious reason why I always wake up tired, tense and at least slightly depressed is the dreams I have every night. No matter what I dream about it is always negative. No matter how great or happy I feel before I fall asleep, I always wake up feeling as if something bad has just happened to me. Even though I could describe my dreams as nightmares I do not recognize myself in the symptoms of the so-called 'Nightmare Disorder' (I do not usually have 'repeated awakenings', also my dreams are not superfrightening just kind of depressing and negative). I have tried changing my diet in a million ways (no dairy products, no sugar, no 'food combining' etc.), I have tried sleeping and anti-anxiety pills and exercise to tire me out before sleeping but nothing really worked (even though healthy food and exercise certainly makes me feel better during daytime).

Does anyone recognize him or herself in this? Any thoughts on what else I could try to get a good night's sleep?
posted by dinkyday to Health & Fitness (22 answers total) 11 users marked this as a favorite
This might sound a bit woo-woo, but try keeping a dream diary, and working out what each dream means to you. If there is a connection, maybe that would help you figure out a solution?
posted by Solomon at 2:00 PM on July 20, 2008

This sounds like me. I was tested and had pretty severe sleep apnea, although I don't fit the normal profile of someone with that. Have you been tested?
posted by jeanmari at 2:08 PM on July 20, 2008

Response by poster: OP here. No sleep apnea - the people in the sleep lab could not find anything wrong.
posted by dinkyday at 2:26 PM on July 20, 2008

What anti-anxiety meds did you take? Some of them (benzos specifically) affect your dreams, sometimes negatively, so they might be counterproductive.

Perhaps you're not waking up depressed because of your dreams, but having dreams like that because you're depressed? I would check in with a therapist, even if you're not depressed, you could probably use some help to cope with this chronic condition.

Have you had a thorough physical lately? Have you had your T4 level (NOT your TSH) checked?

Good luck.
posted by sondrialiac at 2:50 PM on July 20, 2008

I would have thought sleep apnea as well, but if they found nothing in t he sleep lab then I guess you're clear there.

I used to have MAD violent dreams every night, the kind that would wake me up because I would kick the wall or punch my bedpost or whatever (even broke a toe once). I ended up kicking those by meditating during the day - nothing too fruity, just breathing and clearing my mind. Therapy sounds like it may be an option for you, though I've never gone so I can't vouch for it for your condition.
posted by Pecinpah at 3:01 PM on July 20, 2008

"say good night to insomnia" was recommended to me by my neurologist, a sleep specialist. it's very helpful for a lot of types of insomnia.

are you sleeping enough? if you forgot to set your alarm, would you still wake up more or less on time for work. if not, you probably need more sleep.

i would do another sleep study and see a sleep specialist--perhaps that old one was a fluke.
posted by thinkingwoman at 3:32 PM on July 20, 2008 [1 favorite]

A lot can happen in 10 years, perhaps you should be re-tested. Also having depressing dreams and waking up depressed is a sign of, you guessed it, depression. Perhaps that the root of your issues?
posted by damn dirty ape at 3:44 PM on July 20, 2008

How overweight are you? Even losing 5 lbs can help with sleep issues.
posted by damn dirty ape at 3:45 PM on July 20, 2008

I take melatonin from time to time to push me over the edge a bit and force myself to fall asleep. A side effect is more intense dreams, but not necessarily more violent or upsetting. Maybe try it if you haven't. Maybe it will have positive side-effects for you.
posted by jimmythefish at 3:57 PM on July 20, 2008

Do you use aspartame as a sugar substitute? As strange as it sounds aspartame gives me vivid horrid dreams.

I switched to diet coke trying to lose some weight, within a week the dreams started. It was the same type of dreams I had when I took Paxil, my doctor switched me to Prozac and the dreams stopped. I checked with the pharmacist to see if they had changed manufacturer's of my generic Prozac. They had not, the only change in my diet was the diet coke. The pharmacist said aspartame was a powerful chemical and was not surprised to hear of the effect it had on me.

Aspartame side effects
posted by JujuB at 4:15 PM on July 20, 2008

That link is batshitinsane. Millions take diet coke with no problems. The list of symptoms is pretty much any symptom a human can possibly get. If you have chronic ear ringing then I seriously doubt its the coke.
posted by damn dirty ape at 5:56 PM on July 20, 2008

damn dirty ape, I had vivid bad dreams, not tinnitus.
posted by JujuB at 6:16 PM on July 20, 2008

Reading over your previous posts, I did not see whether the test positive for Lyme disease you got in January was confirmed, or whether you got any treatment for Lyme, but Lyme disease is notorious for night sweats and sleep disturbances generally.

By the way, if you do have Lyme disease, I'd tentatively guess the cold you couldn't get rid of last October might have been Lyme, and that means you could have had it for 3 months already by January.

Lyme disease becomes much more difficult to treat the longer you have it. I think you should find a doctor who specializes in it.
posted by jamjam at 6:26 PM on July 20, 2008

I can't speak to the nightmares other than maybe to suggest seeing a psychologist, but to combat the "non-restful sleep" I STRONGLY recommend trying a medication called provigil, if you haven't already. I take it for a different sleep disorder and it works wonders for daytime sleepiness and fatigue. It really has made a strong difference for me. It seems to work really well for some people and not at all for others, but it's definitely worth trying - see if your doctor can get you some samples, because the effect is pretty much immediate.
posted by btkuhn at 6:34 PM on July 20, 2008

Sleep lab, schmeep lab. Did you wake up from that sleep just as tired? Many people have a better sleep at the lab than at home. There might be less allergens, they might drink less, they might be out of a bad routine, whatever.... Sleep labs are flawed. The only true sleep lab is your own bedroom and almost none of the sleep labs will test you there, unless you ask.

Anyway, you would be surprised at how you might have issues and have no signs other that being tired during the day.
posted by caddis at 6:58 PM on July 20, 2008

Best answer: I had almost exactly the same symptoms, except that I did have problems falling asleep at night. Always had a feeling of weariness, like I was never getting enough rest.

Although I haven't been following this regimen to the letter and am feeling the side effects now, I've noticed that when I follow these three rules, my sleep has never been better:

1. No caffeine
2. No sugar
3. Plenty of exercise

The problem with all of this is determining to what extent 1 and 2 are necessary (100% abstinence is surely not necessary for everyone), and keeping disciplined enough to do those, along with 3.

I'm sure others do fine with more caffeine or sugar, but I had to go cold turkey for awhile to make a definite connection between those things and sleep. And man, did I feel awesome.
posted by SpacemanStix at 8:43 PM on July 20, 2008

Have you ever tried one of those sleep cycle watches? They could be bullshit, I really don't know, but they're marketed as providing more restful sleep.

When I have too much on my mind it seems like my brain just churns away all night long, I wake up feeling as though I had a long, pointless debate for the 6-8 hours I'd been asleep.

I've found that telling myself before I fall asleep to accept the fact that today is over and that I'll be better off taking care of whatever it is I need to do tomorrow, after I get the sleep that I need to have the energy to take care of whatever it is, which will only happen if I don't spend the whole night thinking about it while I sleep.

I have a no coffee after 3pm policy. I've found that breathing awareness mediation, in my case hodge-podge zen, has helped make the transition of falling asleep seem less weird and anxiety provoking. Not necessarily mediating before bed, just in general.
posted by JulianDay at 9:41 PM on July 20, 2008 [1 favorite]

If you haven't already, you could look into progressive muscle relaxation and breathing exercises, like diaphragmatic breathing / belly breathing. The idea would be to spend a few minutes on exercises like these before bed to get yourself really relaxed before sleeping. I also believe that training yourself to breathe through your nose all the time can help with sleep quality.
posted by tomcooke at 12:47 AM on July 21, 2008

Response by poster: Thank you all for your thoughts. It seems I have been pretty thorough because most of the things mentioned I have already tried.

I do have problems with depression and have been to more therapists than I care to mention. Thing is that I have felt often that my lack of energy has contributed greatly to feeling depressed (instead of vice versa). I am not depressed all the time (it comes and goes in waves) but the unrefreshing sleep and the bad dreams are a constant, even when I feel very 'up'.

I don't think I could be classified as 'overweight': 1.86 m / 83 kg (6.1 feet / 183 pounds).

I've taken Modafinil (Provigil) for a few weeks but it unfortunately didn't really have the positive effect I've read about.

Melatonin did not do anything for me either.

The anti-anxiety pills (Xanax, Valium, oxazepam) I only tried a few times (as in: less than ten times in total) so those cannot have been the cause of this.

'Say Goodnight to Insomnia' is on my bookshelf and is certainly one of the best/most interesting books I have read on the subject. The central idea is to get up at the same time every day (no exceptions in the weekend) and curtail your sleeping hours to the point where your body just HAS to sleep deeply. This really works, when I tried it I could fall asleep seemingly within seconds of my head hitting the pillow. And when the alarm went off I had no or fewer memories of terrible dreams. But it is very hard to stick to (especially on occassions when you get home late and you know you have to get up in three hours) AND I got very tired during the day. But it remains one of the most promising things I have ever tried and I was considering having another go at it.

The aspartame suggestion is interesting. I don't use a lot of it but it is in the breath mints I use and sometimes I drink diet drinks. No harm in cutting that out for awhile.

I am not a coffee / tea / cola drinker so caffeine is not an issue.

Sugar is an issue for me (love sweets and have noticed how food that makes my blood sugar levels spike also affect my mood/energy). However, I have been eating very healthfully for years now with only very short periods where I did eat a lot of sugar. But it won't hurt to start watching my sugar intake even more carefully from now on.
posted by dinkyday at 1:17 AM on July 21, 2008

The anti-anxiety pills (Xanax, Valium, oxazepam) I only tried a few times (as in: less than ten times in total) so those cannot have been the cause of this.

Its worth mentioning that people without sleep apnea can develop temporary sleep apnea while on tranquilizers. Tranqs makes my apnea much worse. They relax your throat muscles enough so that you have apnic episodes. They may help you fall asleep but they dont give you restful sleep. This is generally true of tranqs. A lot of this stuff can help you fall asleep but if your body clock is out of sync then you're just not going to get restful sleep.
posted by damn dirty ape at 8:07 AM on July 21, 2008

maybe a one-in-a-million shot, but you never contracted or were exposed to malaria, were you? anti-malarial drugs, as well as malaria, can cause short- and long-term fucked up/dark/scary/vivid dreams.
posted by whitewall at 9:07 AM on July 21, 2008

Best answer: I'd also recommend thyroid testing, blood sugar levels... routine lab work/blood work panel, just to rule out other medical causes. If you're near borderline with, say, thyroid, blood sugar, etc., your diet could be pushing you far enough to feel the effects, but not over the line which classifies you as "diabetic", etc... IANA/YD, of course, so ask him/her.

So, on that note, as spacemanstix wisely suggested, tweaking your diet (i.e. choosing whole grains over refined sugars/starches) and adding daily exercise can do wonders (exercise not just for physical health, but mental health as well, of course. ) You mention not drinking coffee, etc, but don't forget chocolate as a caffeine source.

And you're definitely not alone in the "Is it the depression or the tiredness?" chicken-or-the-egg situation. Compounding issues may warrant discussion of trying other stimulants besides modanifil to patch-up the tiredness while working on the other stuff, and hopefully eventually arrive at a better long-term solution.
posted by NikitaNikita at 8:23 PM on July 21, 2008

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