TL;DR
I take 20 mg hydrocortisone daily and lately have been taking it before bed too. This helps me sleep through the night as (I think) it calms down my body and keeps it out of stress due to too low cortisol during the night. This helps (only) with my particular kind of insomnia: wake up in the middle of the night and lie wide awake for an hour and a half.
My usual insomnia goes like this:
- go to bed and fall asleep right away (my MAO A enzym is faulty so my melatonin doesn't get broken down. Instant
)
- wake up 5 hours later, clear mind, very alert. Can't relax, mind racing.
- wait 1,5 hours and things settle down and I can get two more hours of crappy sleep and wake up groggy.
- have had this sleeping pattern all my life. My brother and mother have the same (MAO A connection I think)
having done research and a sleeping study I now act under the theory that those first 5 hours consist of the first few sleep cycles and it's the amount of sleep that will keep me alive.
When the brain goes from Deep Sleep stage to REM stage there's a surge in neurotransmitters of the excitatory kind that my MAO A doesn't break down. In a later sleep cycle, say the 3rd, this causes me to wake up.
If I had to describe the kind of insomnia I have it'd be a noradrenaline/norepinephrine rush. Dopamine or a cortisol rush. This ties in with MAO A and a bodily stress response.
If I can stop that surge of neurotransmitters rising too high I sleep through the night and have a glorious 7,5 hours of sleep and wake up rested. And healing from my illness fast!
Lately I've been experimenting with taking hydrocortisone at night and thus far it helps prevent the rise. Perhaps because it lowers the stress by body experiences by overall low cortisol?
On nights that I don't take it and wake up and have to sit out my insomnia I take a little bit HC before I fall asleep again, to keep my body calm. And to get a jump on the early dosis, where I have to wait 45 minutes in my bed before it's metabolized and I can get up.
disclaimers: I have full adrenal problems and try to replace all cortisol needed. It's not just an aid for me.
I take a generic pill of 20 mg that I break into any pieces during the day. Cortef didn't agree with me much. I'm in Europe, a doctor prescribes me. I get a lot from
the site of this lady who has full blown Addison's Disease and is running marathons. She's liberal with her incidental dosage but she knows what she's doing. Liberal and sensible.