MaxDarkside wrote:robysue wrote:sleep maintenance insomnia once the most critical stage of the War on Insomnia was over and the insomnia was largely on the run except for some persistent continued waking in the middle and later half of the night.
So you call persistent continued waking in the middle / later part of the nocturnal rest period "sleep maintenance insomnia", yes? I'm having that now and it's not quite but almost bothersome. It's just wake for a few moments, sleep for an hour, repeat, on an hour or two cycle.
Sleep maintenance insomnia is characterized by multiple wakes during the night that are accompanied by one or more of the following: a prolonged difficulty in getting back to sleep after many of the wakes; a vivid and conscious memory of most of the wakes; waking in the morning feeling unfreshed, tired, and like you got little or no sleep during the night; and daytime symptoms such excessive sleepiness, fatigue, and exhaustion that are not caused by other medical conditions.
The WAKES you are describing are NOT sleep maintenance insomnia. You are describing a
normal phenomenon of sleep. Most human beings do NOT sleep the night through without any wakes at all. They wake up periodically---usually after a REM cycle or changing from Stage 3 to Stage 2. And they go right back to sleep and
never remember waking up once morning comes. The wakes are BRIEF---a few minutes or so at most. And they are both few enough in number and short enough in length that they do NOT adversely affect the overall quality of the full night's sleep.
Your
reaction to these wakes (feeling as though the wakes are "not quite but almost bothersome") and the fact that you typically remember them is typical of a person who is finally beginning to get their sleep maintenance insomnia under control. According to the PA who worked so long with me,
these small number of "random" post-REM wakes are NOT a problem once they are few in number and no longer bother you.
Keep working on "Not letting these wakes bother you". You're at the stage where it's useful (although difficult) to quit worrying about them. So quit trying to track them and quit trying consciously to remember them all. Your goal at this point is not to eliminate the wakes; your goal is to eliminate your memory of the wakes. Best of luck in finishing this last task in battling the insomnia monster.
And just to clarify what I meant when I wrote:
robysue wrote:sleep maintenance insomnia once the most critical stage of the War on Insomnia was over and the insomnia was largely on the run except for some persistent continued waking in the middle and later half of the night.
The first, most critical stage of the War on Insomnia was to get my body to be willing to fall asleep within 5-10 minutes of climbing in bed and slapping the mask on AND to get my body to feel sleepy enough to go to bed by 1:30 AM every night. I needed that short latency to sleep because many of my sleep problems and my CPAP adjustment problems were related to and aggravated by the severe bedtime insomnia I had at the time. Lying in bed for even as little as 30 minutes or so with the mask on will trigger aerophagia and serious anger issues for me. Neither of which helps me get a good night's sleep even if my AHI = 0.0. (Side note: There's been some serious back sliding on the bedtimes recently; but at least when I do go to bed, I'm wanting to get in bed; and masking up no longer triggers the anxiety and anger and I am able to get to sleep quickly enough to help prevent the aerophagia.)
The time frame that I was writing about in this comment was after that first phase of the War had been won. I was consistently getting to bed between 1:20 and 2:00 and getting to sleep within 5-10 minutes of going to bed and I was consistently getting up right around 7:30 am with only a minimum amount of difficulty. But I was still having persistent wakes in the middle and later half of the night that were bothersome on many, but not all, of the nights; I was finding that getting back to sleep quickly after these wakes was still a hit or miss thing and there was always the fear that I would not get back to sleep; I still was regularly waking up in the morning feeling as though I was tossing and turning during the whole second half of the night a lot of the nights; and I still had pretty solid memories of each of the wakes in the second half of the night; and I was still dealing with excessive daytime sleepiness.
But things were on the mend and the insomnia was on the run: Because also at that time I could tell that I was just barely
beginning to not remember every single wake with clarity;
beginning to get back to sleep very quickly after most of the wakes;
beginning to feel as though the wakes were no longer being a major disturbance to the overall subjective quality of my sleep; and
beginning to wake up somewhat rested and refreshed on many days inspite of the sleep restricted schedule. Unfortunately I also had reached something of a plateau----things were no longer noticeably improving on a monthly basis---most likely because this was also in the middle of unsuccessful trials of two different migraine meds that aggravated my existing sleep problems The sleep doc's PA suggested that I try melatonin as a way of kick-starting the progress I'd been making over a about a three month period of serious CBT work rather than floundering around on the plateau of no additional progress.
And so I tried the melatonin. And as for the first couple of weeks, I really didn't notice much difference except that the memory of the wakes was growing a bit foggier and fainter. But I was also waking up with much more TMJ pain and actively chewing my way through a brand new TMJ guard that was less than a month old. And then---after being taken off the last of the migraine prophylactics and being fired by sleep doc#1 and being told by my dentist that he was no longer comfortable treating my TMJ issues because of just how quickly I destroyed the new night guard, the psychologist told me that melatonin can increase TMJ problems in some people and that maybe I should stop taking it. So I did. And the foggy memories of the wakes did not become less foggy. Instead, they continued to stay pretty foggy most of the time.
And now? During my second summer since starting the War on Insomnia on Dec. 31, 2010? Well, bedtime still remains a problem in the summer time. I'm a college professor and I don't teach in the summer. So my night owlish tendencies WANT to manifest themselves and I find it difficult with no-one to be held accountable to to maintain that rigorous wake up time/bedtime schedule that my body really wants, but that my brain does not want.
But the sleep maintenance insomnia issues? I can honestly say that while I continue to wake several times each night, I don't feel as though I've got sleep maintenance insomnia any more. More often than not, I only have vague memories of one or two wakes even when it's clear from the combination of Kaa data and Zeo data that I woke up at least 3-5 times (or more). I now routinely wake up, feel the tummy not quite comfortable, reach over and turn Kaa off and then back on to make sure my pressure is set back to 6/4 and snuggle back down and get back to sleep within two or three minutes judging from the wave form data and the Zeo data.
And I don't remember doing any of this in the morning. I only know the wakes happened because of the session data in Kaa. And the part of the Zeo data that seems more believable. (The Zeo seems to mis score a lot of my REM as WAKE.)
And the wakes that I vaguely remember? Usually it's caused by one of the following: Waking from a remarkable dream that the brain
wants to recall in the morning, so I'll wake up and focus on the dream in an attempt to get it into my memory; waking up very close to 7:30, even though I plan to sleep until 8:30 or 9:00 these days; waking up exceptionally HOT or COLD so that I have to do some major work in rearranging the covers just to get comfortable. None of those wakes and their faint memories really qualifies as
sleep maintenance insomnia any more.
