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How to normalise sleep pattern

snowathlete

Senior Member
Messages
5,374
Location
UK
like most I have sleep problems but one I think I should be able to get a grip of is when I am sleeping (or lying in bed trying) but it's been skewed for ages now. It's 2am I just got in bed and this has become normal. But it means I don't get up until midday.

I want to bring my sleep forward. Every time I try and make some progress but then fail again and I think I understand a bit about why now.

I have a bad day where my inflammation is very high and I tollerare it by distracting myself, but to lie down and relax I have to face it and experience it so I put it off till I am exhausted. Without really choosing to I am back to very late nights.

I'm hoping someone has some ideas...?
 

dannybex

Senior Member
Messages
3,564
Location
Seattle
Unfortunately it's really common. A lot of discussion on Healclick about this recently -- I would guess that 80% of patients felt "better" by evening, thus stayed up longer, couldn't go to sleep, etc..

Some have used UV-blocking glasses (they block blue-light) in the evenings, and also B12 has been shown to help with circadian rhythm:

https://www.google.com/?gws_rd=ssl#q=b12+sleep+rhythm
 

JPV

ɹǝqɯǝɯ ɹoıuǝs
Messages
858
I've had good luck with very low doses, 200-300mcgs, of melatonin. This is the amount recommended for delayed phase sleep disorder. Other conditions require different quantities...

The Role of Melatonin in the Circadian Rhythm Sleep-Wake Cycle | Psychiatric Times

I've tried melatonin numerous times over the years and I just wanted to stress that the low dose is what made all the difference for me. It's somewhat counterintuitive but moderate to high dosages just didn't work for me.
 
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SDSue

Southeast
Messages
1,066
I've tried many things and find that when I do actually get to sleep earlier than the wee hours, I fall into a deep sleep only to startle awake and hour or so later, and then I'm wide awake often until after sunrise.

If I go to sleep around 2 am, however, my awakenings are quite short in duration and I can string together about 7 hours of relatively decent sleep.

Thus, I'm stuck solidly in the 2 am crowd until further notice and will be following this thread, eagerly waiting for good ideas!
 

Sushi

Moderation Resource Albuquerque
Messages
19,935
Location
Albuquerque
For me it has changed slowly over the years. I used to stay up until 2 a.m. or 3 a.m. because that is when I naturally felt ready for bed. I also felt better and had a bit more energy in the evening. Now I get to bed by midnight and actually have more energy in the morning. I think this is the slow result of treatment.

Sushi
 

heapsreal

iherb 10% discount code OPA989,
Messages
10,099
Location
australia (brisbane)
I've tried many things and find that when I do actually get to sleep earlier than the wee hours, I fall into a deep sleep only to startle awake and hour or so later, and then I'm wide awake often until after sunrise.

If I go to sleep around 2 am, however, my awakenings are quite short in duration and I can string together about 7 hours of relatively decent sleep.

Thus, I'm stuck solidly in the 2 am crowd until further notice and will be following this thread, eagerly waiting for good ideas!

Same.
 

Kati

Patient in training
Messages
5,497
i am falling asleep much better with melatonin, which i have started over the summer. However I started with a big dose and found it got me quite constipated. And this fall I surprised myself falling asleep with the lights in, so I am now tapering down my sleep meds (I take 2different), to where I haven't been in a couple of years at least, and I am still tapeing down (to 1pill instead of 3 Zopiclone).

The other thing you may want to try is relaxation tapes or guided hypnosis (check out you tube) as you go to bed (say, by midnight).

The other thing that helps me is not being in my bedroom in the few hours prior to going to bed.

i hope it helps.
 

Woolie

Senior Member
Messages
3,263
I think melatonin has another benefit too - its an NF-kappa inhibitor, which is one of those inflammation-related substances which is often elevated in us. For me, though, it only works for 2 nights max then stops working.

If you want to consider a pharma approach: Don't think it works for everyone, but I've had great success combining zopiclone with low dose amitriptiline. The zopi is supposed to be a sleep initiator and the ami a sleep sustainer, so the two seem to work well in combination. I take 10mg of amitiptiline and half of a 7.5mg zopiclone pill a half an hour before bed, then if I wake in the early morning, I take the other half of the zopiclone. This keeps the zopiclone use to a minimum, and I haven't needed to increase it (keeps working). It gets me 9 hours' sleep which really helps with my daytime symptoms. I've found that after a break, I need to start slow on the amitriptiline, I start with 5mg or less for the first few nights and work up (else it makes me feel dopey the next day).

Oh, and usually I take a naproxen (an NSAID a bit like nurofen) with the bedtime meds, to manage inflammation - which seems to be the main thing that interferes with my sleep too.
 

barbc56

Senior Member
Messages
3,657
Sometimes, I think I can count on one hand the number of times I have awakened feeling refreshed.Exaggeration alert!

I have always been a night person, it's just the way I am. For years I struggled getting up at 5:30 for work, raising kids, etc. I always promised myself I would get to bed early but by seven PM I'd be wide awake. This was even before I got sick.

I will sometimes get on a regular schedule only to have the cycle gradually move forward until I am back in the same situation. I did start the blue light therapy about a month ago and it helped a bit but life got in the way, long story, and I stopped doing this.

I'm glad I saw this thread as after writing this, I am going to drag the light from my closet and put it on my nightstand.

Barb
 
Messages
2,568
Location
US
What I learned from years of trying:

I can't take melatonin and most sleep meds. I am using natural methods but if you can tolerate OTC sleep pills or sleep meds, they could be your ticket. GABA, L-theanine, and some other supplements help me, but give me nightmares. They are worth a try.

Avoiding blue light for a few hours before bed helps me. Sunlight within 15-30 minutes of waking in the morning helps. Get it within 5-15 minutes if you can, and I'm not sure but I think through a window isn't enough. It has to kind of hit your eyes and you can't have sunglasses on. A sunlight simulator helps but not like the real sun.

The light avoidance and sunlight isn't enough for me, but if you force yourself to do it for weeks, it can reset your pattern. But melatonin is a lot easier. If you are trying to reset your pattern I say it's a must to watch your D3 timing.

Avoiding vitamin D3 in the late afternoon, evening, and night helps. D3 is in most dairy and some dairy subsitutes. Taking vitamin D3 within an hour of waking helps.

I also feel it is important to watch your energy envelope closer if you are trying to reset your sleep wake pattern. I don't have the energy to explain in detail, but for me the amount of physical activity and the amount I pushed yourself in a day is very closely related to how sleepy I am at the end of the day, whether I need a nap, how much sleep I need to feel rested, and how much sleep I can get by on. So I would try to develop a pattern.

I also am very benefitted by having someone to wake me up on some days, and being sure to have good sleeping conditions where little will wake me before I'm ready.

Magnesium about 60-90 minutes before bed helps me, especially if I take more like 600mg instead of only 250mg, and don't take it during the day. Avoiding some other "wakeful" vitamins and foods helps a little.

I would carefully analyze what you are eating and drinking. For example I found even decaf tea can keep me awake for 5 hours. I feel many fruits and vegetables are "wakeful". If you aren't sensitive to meds and supplements, you may not be sensitive to food and other stuff like I am.

Brushing my teeth is a "wakeful" activity, especially if using peppermint toothpaste, so I have to plan more carefully and not brush soon before bed.

Deficiencies in vitamins could cause problems. Allergies that are not well treated could too. I cannot sleep unless I have my allergy pills.

I also need to eat enough food before bed. Sleep experts say not to, but there is a PR thread about many of us needing to have a full stomach right before bed.

Resistant starch (RS2) helps me the most. More than the above combined. It is not a magic bullet but my sleep times are horrible without it and the effect I get is consistent. I had sleep problems for 20 years and I still have them if I miss my RS2 for a few days, or go against too much of my other advice in this post.

You will have to see that big RS2 thread on here, or Google because I can't explain in detail.

It doesn't work immediately. It starts working for me only after about the 3rd dose. If it doesn't work for you, you may be "feeding an empty cage" or "feeding vipers".

I was so excited about RS2 because of how much it helps some people, and it was kind of disappointing I don't get more effect, however, maybe I'd get more if I could use higher doses and get more RS3 and RS1. I still take lower doses only.

I follow the instructions and don't take it daily, and watch what food you put into your gut with the RS2. As I said, it doesn't help me the first 2 days or more. Also when it starts working it helps set my bedtime but not fix some other problems.

When I take RS2, the effect is I get sleepy around 11pm. I wish there was more flexibility, in that sometimes I would like to choose to go to sleep at, say midnight. I can only go without and be up til 2-4am, or take it and be sleepy at 11pm, no matter what time I take it, and no matter if I am just breaking out of an afternoon wakeup.

Even with the RS2, it helps me to have a certain activity before bed, like reading some duller material. I am very bad at turning off my negative thoughts, so I need something to do right before sleep. Enough to keep some interest but not enough that I want to stay awake for it. Many times I have mistakenly used interesting reading material and been up until 6am.
 
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BadBadBear

Senior Member
Messages
571
Location
Rocky Mountains
RS2 has helped me a lot, too. Though I fall asleep early, I just don't stay asleep. RS2 helps me stay asleep much better esp. between 3-4 am when I'm usually awake. Like @SickOfSickness, I notice if I miss a couple of doses - I just don't sleep as well.

When my mind is zooming and I can't go to sleep, sublingual coenzymated B3 seems to help. DH is high functioning autistic, and it seems to help him get to sleep instead of lying awake for hours. Something about it tamping down methylation and assisting COMT functioning helps both of us (he is COMT-+ and I'm COMT++).
 
Messages
2,568
Location
US
This week I keep falling asleep early (with the help of RS2) but waking up. Someone posted in this thread how they will wake up if they go to bed before 2am. Whenever that happens to me, it's from switching my bedtime too much too fast. My bedtime was 4:30 am and then I began RS2 again, so bedtime became 11 pm. I think it's worth sticking with it, until you go to bed at 11 and sleep through the night.

When my mind is zooming and I can't go to sleep, sublingual coenzymated B3 seems to help. DH is high functioning autistic, and it seems to help him get to sleep instead of lying awake for hours.

I wonder if that depends on which COMT SNP has a defect? My experienced methylation coach did not mention B3 at all, and I have one COMT +/-.
 

snowathlete

Senior Member
Messages
5,374
Location
UK
Thanks for the input everyone.
I should have probably said in the OP that I have tried all the sleep hygiene stuff. Initially, my sleep was actually much worse than now, it was bad enough that the NHS agreed to a full sleep study after stuff like zopiclone didn't work. Prior to that I'd tried all the herbal stuff and melatonin - melatonin did help a little initially but it ultimately stopped working. Same as with the medication I was subsequently prescribed, worked really well at first, but over the years has become less effective. I don't really want to move onto another drug if i can help it. I'm still taking amitriptyline (40mg now) for sleep at the moment and my sleep is still better than pre-tretment (though not as wonderfully improved as when I started the drug initially). But it's the time I'm going to sleep that's the current problem - even if I dont sleep any better, if I could be more present with my family by being awake more when they are, that would be a big improvement in quality of life I think.

Naproxen doesn't seem to help me either unfortunately. I haven't tried it specifically for sleep, but took it night for back pain a couple of years ago.

I don't drink tea or coffee, but I do get a lot of caffeine from chocolate, so that is something I should probably cut out in the evening.

I'm interested in the gut effect on sleep. I tried resistant starch and that made no difference for me. I'm very focused on improving my gut but it's a mess after ten months of abx, so that may be a reason I got no response when others do. I'm not sure the huge doses discussed on the RS thread are wise though, personally, so I would not take those huge doses anyway. But in time I hope improved gut health may bring some benefits.

The suggestion of the day lights is something the sleep clinic also reccomended, though I never tried it. They were quite expensive when I looked before, but I might take another look at that.
 

Mary

Moderator Resource
Messages
17,377
Location
Southern California
Niacin has helped me a lot with sleep. I've never tried the co-enzymated form mentioned above, but will. I found that niacinamide and no-flush niacin do nothing for me in terms of sleep, it had to be the flushing kind.

Also, glycine can help with sleep. Gelatin is very high in glycine so I've been taking a packet before bed. Initially it caused a very strong detox reaction but that has tapered off. Also inositol helps some, but again that causes detoxing for me - but I think I can tolerate a small dose now.

Also, if you haven't already, get your cortisol levels checked. If they are high at night, it will cause severe insomnia that almost nothing will touch. Seriphos (phosphorylated serine) is very good for normalizing high cortisol, but you need to take it in the morning.
 
Messages
87
Location
Kaneohe, HI
This is new information to me, so bare with me while I rationalize this. When I feel more awake in the evenings, despite being tired all day, this is a sign of a Circadian Rhythm Sleep Disorder? I feel more energized at night, but I am still unable to sleep in if I stay up late (daylight wakes me up?). I also have problems adjusting my sleep schedule even the slightest bit. Can this even be treated as a sleep disorder? Or do we have to self-regulate like everything else CFS-related?
 

heapsreal

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Messages
10,099
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australia (brisbane)
Every so often i go through a period where my sleeping pills stop working, unless i increase the dose but i dont want to get caught in that trap. Sleeping tablets(benzos) do help me fit into a normal sleeping routine and in the real world.

So i am taking breaks from them like 2-3 days off before using a benzo etc and increasing this time if they still arent working etc. I still use antihistamines but find they dont help me fall asleep but do seem to help sleep quality when i do sleep. Low doses of seroquel like 25-50mg helps sleep initiation but it increases nerve pains in my legs and feet, so dont use it that often but it does help when im off benzo's and need some sleep desperately.

I am finding that my normal sleep cycle is 3-4am till 10am, the sleep is ok but doesnt fit in with the real world. I do have a couple of weeks off work so i dont have to fit into the real world at the moment. My sleep quality isnt too bad without benzos.

Melatonin doesnt seem to help with this funky sleep cycle and im also using phosphatidyleserine at night to help lower night time cortisol, at this stage this isnt helping the sleep cycle but i guess its a slow return to a more normal sleep cycle.

I have thought of getting up earlier and staying up but i just cant function much at all with less sleep than im currently getting.

i wish there was a way to improve gaba receptor sensitivity?????
 

Sherlock

Boswellia for lungs and MC stabllizing
Messages
1,287
Location
k8518704 USA
I am very bad at turning off my negative thoughts, so I need something to do right before sleep. Enough to keep some interest but not enough that I want to stay awake for it. Many times I have mistakenly used interesting reading material and been up until 6am.
The same for youtube videos. Not too interesting, yet not too dumb to be irritating - also not too short. There are even 'relaxing music' ones of many hours.
 

Valentijn

Senior Member
Messages
15,786
Melatonin works for me to reset my clock, but not for getting to sleep on a regular basis. I take it for a night or two shortly before my intended bed time, and that seems to work pretty well. Then I stop taking it, because it turns me into a zombie.
 

wastwater

Senior Member
Messages
1,271
Location
uk
I naturally seem to want to be awake between midnight and 6pm and have never been able to break this cycle,Ive yet to wake up feeling refreshed,not once in twenty years