How does insomnia feel?

I want an example from someone who suffers from this nasty thing.
Does it feel like your "mind" is restless and that you just aren't trully tired for sleep yet.

Or simly just can't fall asleep or stay asleep
Anyone have sleep maintanence insomnia

I don't know what sleep maintenance insomnia is. I have the type that you fall asleep ok but wake up and can't get back to sleep again. My insomnia experience feels like my switch is turned "on" and sleep is simply impossible. If I lie in bed, trying to sleep more, I just thrash around and have obsessive thoughts. I think the obsessive thoughts are a symptom of the root issue, not the cause of the insomnia. I usually sleep 2 to 3 hours, wake up and get out of bed for a couple of hours and try to get more sleep later. Usually all my subsequent sleep periods are 2 hours at most. I am continually exhausted. It really sucks. I find that if I get more sleep the day before, I sleep better the next night. It is a positive snowball effect. But at my best I sleep 4 hours at a time. I wouldn't wish this on my worst enemy.

snuginarug wrote:I don't know what sleep maintenance insomnia is. I have the type that you fall asleep ok but wake up and can't get back to sleep again. My insomnia experience feels like my switch is turned "on" and sleep is simply impossible. If I lie in bed, trying to sleep more, I just thrash around and have obsessive thoughts. I think the obsessive thoughts are a symptom of the root issue, not the cause of the insomnia. I usually sleep 2 to 3 hours, wake up and get out of bed for a couple of hours and try to get more sleep later. Usually all my subsequent sleep periods are 2 hours at most. I am continually exhausted. It really sucks. I find that if I get more sleep the day before, I sleep better the next night. It is a positive snowball effect. But at my best I sleep 4 hours at a time. I wouldn't wish this on my worst enemy.

Sleep maintanance is what you have i guess, where you can fall asleep but wake up repeatedly and early and have trouble falling asleep.


I simply wake up about 4 times a night but i am able to sleep within 20 minutes each time....its just that its an arousal

I would not say I suffer from insomnia but I have had year where I did the best description I ever hear was from the movie fight club "When you have insomnia, you're never really asleep... and you're never really awake. With insomnia, nothing's real. Everything's far away. Everything's a copy of a copy of a copy."

when I go through a bouts of insomnia I feel like I am living in a dream. As far as being tired I was always tired but just not able to sleep sometimes for 3-4 days. My mind never switches of and I lose all prospective of reality and even though my mind is working overdrive simple memory takes such as remembering the day or time become hard I often finding myself standing somewhere wondering what I am doing for example I can be standing with the fridge door open and I have no clue why then I go sit down and remember I had got up to make a cup of coffee. Thankfully for me it has been a while since I have gone through this.

I was waking up every morning at three am so my doctor prescribed 10 mg of doxepin. It is not a sleeping pill but will make you sleepy and able to fall back asleep if you wake up. It does dry out your mouth though. The Doxepin has really helped me adjust to CPAP as well. I plan to wean off of it when my compliance
hours are all in and I own my machine. I am sleeping between 8 and 10 hours a night with a few wakenings for bathroom and mask leaks etc. but in general things are going well.

My insomnia is laying in bed for hours waiting for my darn brain to shut up so I can go to sleep. I can be very tired to the point of exhaustion, but as soon as I climb into bed my brain decides to go into overdrive. Its even worse if I am stressed/worried about something.

Cognitive Behaviour Therapy has helped immensely with insomnia, sleep hygiene is very important for me. A set bedtime, set routine helps my brain realise "oh, time to switch off". My biggest problem is sticking to a set bedtime, as I have now been given a bunch of shifts at work which have totally messed me up

I've periodically had various expressions of insomnia over the years, but the most relentless type was the years when I never felt sound asleep - always on the verge of being awake. I once described it like this... My pursuit of sleep is like a greased pig chase at the county fair - easy to grasp but nearly impossible to hold onto. Most of these years were due to my issues with PLMD. With my legs reasonably controlled I now sleep in blocks of 3 - 4 good hours of deep sleep, however every few nights I do get stuck with an overactive mind and it takes a while to cross that wake-to-sleep barrier.

I don't think there's any one way that insomnia feels for everybody who experiences it. But from a clinical point of view, "insomnia" usually involves a persistent problem with one or more of the following:

• an inability to fall asleep in a "normal" amount of time even though one is going to bed feeling sleepy. Usually the lengthy latency to sleep time also has to be "disturbing" or "bothersome" to the person in some kind of fashion. In other words, if it usually takes you 45-60 minutes to fall asleep every night, but that does not bother you---you wake up feeling rested and you don't get worried or bothered by the fact that your latency to sleep is so long, then it's not considered "insomnia"
• an inability to maintain sleep after initial sleep onset. This is often described as "tossing and turning" during the night rather than at the beginning of the night by the person suffering the insomnia. The problem might be one or two wakes in the middle of the night where it is very difficult to get back to sleep (as in it consistently takes you longer than 20 minutes to get back to sleep after a wake). Or this problem might manifest itself through many more, but shorter wakes throughout the night. With lots of multiple short wakes, it's reasonable to also add to a "definition of insomnia" that those multiple short wakes are NOT triggered by some undiagnosed sleep disorder like OSA or PLMD. In other words, we're talking about "spontaneous arousals" in the language of sleep tests here. Again, it's important to realize that a few short wakes where you can get back to sleep quickly and that don't leave you "exhausted" in the morning are not really considered "insomnia". Where do you draw the line between "a few short wakes" that are not enough to worry about and "lots of multiple short wakes" that are enough to worry about? One part drawing the line is the answer to "How do you feel when you wake up?" Another part is: "Are the wakes so frequent that it's difficult to get a full sleep cycle completed before a wake?"
• waking up too early in the morning and being unable to get back to sleep. You can get to sleep ok. And you don't remember any wakes until the one that's sort of close to morning, but still much earlier than you want to get up. And you can't get back to sleep. But you're also not rested enough to just get up and start your day.
• a tendency to worry about how little sleep you get on a nightly basis that feeds the problems with getting to sleep at bedtime OR getting back to sleep after a wake. This problem can be exacerbated by a tendency among many people to underestimate the actual amount of sleep they're getting during the night.

The problem has to be persistent in the sense of affecting at least 3 or 4 nights every week and over several weeks or months before a doc is going to suggest anything more than "Don't drink caffeine or alcohol too close to bed time."

As to what it feels like? I think that varies tremendously from person to person when they're in bed and trying to sleep. The critical thing from a clinical point of view, however, is that the "bad sleep" is bad enough to affect how the person feels and/or functions during the daytime. In other words, if you have a few middle-of-the-night wakes which are not being caused by something like untreated OSA or PLMD and the wakes are NOT bothering the person---in the sense that they feel rested upon waking and they have enough energy to get through the day, then wakes are not really insomnia.

It's also critical to distinguish between "bedtime insomnia" and "wake too early insomnia" problems and problems that are caused by circadian rhythm disorders. Sometimes "bedtime insomnia" is nothing more than a night owl trying to live on a morning lark schedule. Sometimes "wake too early" problems are nothing more than the body is really done sleeping for the night, and person is more of a morning lark than s/he thinks s/he is. The difference between circadian rhythm problems and insomnia seems to be that with circadian rhythm problems the body is not even sleepy during a major part of the time frame that you need (or want) to be asleep; whereas with insomnia, you get sleepy at an appropriate time, but being sleepy is not enough to lead to high quality sleep during the time in bed.

In my case for example, there seems to be both a bit of delayed sleep phase (DSP) and bedtime insomnia when the sleep is really bad.

When the DSP is the primary problem, I'm simply NOT sleepy at the time that I need to go to bed by in order to function at my day job. Next spring I have a 10:00 class. I will need to be up and functioning at home by 7:30 in order to get to work and prepare for that class on a regular basis. This means that I really ought to be in bed by 1:00 or 1:30 in order to get at least 5.5 to 6 hours of sleep. But left to its own devices, my body would rather sleep from 2:30 or 3:00 AM to about 8:30 or 9:00. And it would sleep pretty decently during those hours. In other words, when left to its own devices, my body simply does not get sleepy until about 2:30, regardless of how tired I am. So I have to teach (and constantly remind) my body and mind----mainly through the light box and a rigid wake up time) that it really needs to learn how to get sleepy an hour or so before it wants to get sleepy. (And once the schedule is established, as long as there's no backsliding on weekends, my body usually adapts and starts to get sleepy closer to my desired bedtime.)

When bedtime insomnia is the primary problem, I get sleepy at the time I need or want to go to bed. But once I mask up and lie down, instead of relaxing and drifting off to sleep, my mind winds up "waking up" usually through unpleasant sensory stimuli coming from Kaa (I feel my stomach getting bloated; the back of my throat is being tickled by the air; my nose is damp from the initial condensation in my nasal pillows; the nasal pillows are irritating nostrils; the straps are irritating the tmjs; the hose gets tangled as I try to settle down into a proper "robin ball" to get to sleep; and so on and so forth) OR my mind winds up "waking up" because the proverbial voice in the head won't shut up. In other words, I start thinking instead of falling asleep. And the "thinking" is usually about unresolved problems that I can do nothing about at night. In Dr. Krakow's language, I've got a "closure" problem. But regardless of why the mind wakes up, I've then got the problem that the body is sleepy and tired, and the mind just won't let go and drift off to sleep ...

Ruinednose wrote:Anyone have sleep maintanence insomnia

In the last year, sleep maintenance insomnia has been a new and disturbing problem for me. In the past, once I finally got to sleep, I usually slept "OK" in the sense of few wakes or no wakes that I remembered in the morning.

After starting PAP therapy, the sensory stuff from the machine (primarily aerophagia) did trigger a huge number of night time wakes. And back then, once I was awake, it was difficult to fall back asleep because I was physically so uncomfortable. Several pressure changes were needed to get the aerophagia under control, and after that was accomplishd, the rest of these "sensory stimuli" wakes were largely reined in through sleep restriction during the First War on Insomnia. The sleep restricted schedule forced my body to finally figure out a way of ignoring all the sensory stuff coming from the machine and mask and get to sleep and stay asleep in spite of it.

But since Nov. 2012, the more disturbing part of my sleep problems have been numerous short wakes that have left me feeling exhausted in the morning. As in 5-10 wakes in a 6-7 hour time in bed window. On a typical night, none of the wakes was very long---maybe 5-10 minutes at most. But on the worst nights, I wake up at least once or twice an hour. So it's difficult to get a full sleep cycle in. On the bad nights, I'm aware that I'm waking up frequently, but I don't look at the clock. I sometimes feel like I'm spending a lot of time tossing and turning in the middle of the night trying to get comfortable. I typically turn Kaa off and back on to make sure that aerophagia is not going to start or get any worse if I'm already beginning to feel like a stuffed goose. And I'll fall back asleep soon enough----if my mind doesn't kick in and start worrying about things that I can't do anything about. When that happens, everything gets worse, sometimes much worse. But the primary symptom when my sleep maintenance insomnia is at its worst is that morning comes and I really do not want to get out of bed because I feel exhausted. As in I feel no more rested than when I went to bed, and on the worst of the nights with sleep maintenance insomnia, I feel worse when I wake up. Sometimes I feel as though I was running a marathon in my sleep.

In the last month or so things seem to be turning around. The number of wakes has dropped dramatically. And with that, the longest sleep period has lengthened enough where I'm clearly completing a full sleep cycle between most of the wakes. On really good nights, I'll even have one stretch where I'll have enough uninterrupted sleep time to have probably completed two full sleep cycles.

In my case the sleep efficiency seems to be a critical numerical indicator of how well under control the sleep maintenance insomnia is: If the wakes are really few enough in number and short enough in length for me to wake up feeling well rested, then there's a high probability that the sleep efficiency is higher than 90%. On the mornings where I wake up feeling the worst, the sleep efficiency is more like 80-85%.

robysue wrote:waking up too early in the morning and being unable to get back to sleep. You can get to sleep ok. And you don't remember any wakes until the one that's sort of close to morning, but still much earlier than you want to get up. And you can't get back to sleep. But you're also not rested enough to just get up and start your day....
...morning comes and I really do not want to get out of bed because I feel exhausted. As in I feel no more rested than when I went to bed, and on the worst of the nights with sleep maintenance insomnia, I feel worse when I wake up. Sometimes I feel as though I was running a marathon in my sleep.

This nearly perfectly describes my 'flavor' of insomnia, except that even when I do get a longer stretch of sleep (7-8 hrs) I still wake up feeling awful. This has been true since I started on therapy a year and a half ago (pre-CPAP sleep was bad but in a different way). Now I go through my day feeling like someone who got forced awake in the middle of the night and expected to be fully functional. Or I wake up at first thinking I feel a little refreshed but within an hour or two I've crashed. I also have more chronic pain which goes along with a lack of deep stage sleep. Insomnia is indeed a monster.

do basic OTC medicine help ok on a short term use?

Ruinednose wrote:do basic OTC medicine help ok on a short term use?

They help some people, but not all people. Nothing seems to help all people who suffer from insomnia.

As far as whether OTC stuff is safe to use on a short term basis? Yes, if you follow the instructions carefully.

I've been a life long insomniac (I'm 35 now). In fact that's why I originally saw my sleep doctor this fall. The apnea diagnosis was a surprise. For me I have both maintenance issues and getting to sleep issues. I lay awake getting frustrated. During the day I feel like I'm buzzed. I'm just never quite with it. My memory sucks and I have a hard time with concentration. My wife will be telling me something, I'm looking right at her, and have to take a second and ask her to repeat what she said. She says it's just me being a man, and she's probably right!

I'm about half way through the book Sound Mind, Sound Sleep by Barry Krakow. It's a little bit hocus pocus at times (which to this scientifically minded guy is a bit tough), but I'm surrendering to the methods and am having good luck. It takes work but so far it is worth it.