Waking up too early every morning. How to adjust sleep cycle?

[future_man]

I've had sleep issues as long as I can remember (I'm in my mid-40s now) and I've recently made some lifestyle, dietary, and supplement changes in order to address what appears to be longterm CFS.

Overall, I feel like these recent changes have been moving me in a better direction as I'm taking less supplements and have eliminated some of the stressors and things that were aggravating the condition.

However, one area which hasn't improved as much as I'd hoped is sleep. While I'm generally able to fall asleep better now (probably due to reduced caffeine intake), I'm not sleeping through the sleep and generally waking up before I'm fully rested.

I'm usually in bed by 10:30pm, asleep by 11pm or a little after, but then waking up around 1-2am to use the restroom, the again around 3-4am or 4-5am. When I wake up in that 4-5am range, there's a good chance that I won't go back to sleep without taking some kind of sleep aid. This amounts to about 5-6 hours of broken sleep leaving me unrested and adding to the next day's exhaustion.

After much research and testing, I've come to the conclusion that I have elevated nighttime cortisol (resulting in very low morning cortisol), so I've recently started experimenting with Seriphos supplementation. *I think* it may be helping to reduce the nighttime cortisol levels as I feel more even in the evening now, but I'm still waking up through the night to urinate and my brain/body thinks its time to get up around 4-5am every morning.

Due to family and other obligations, my bedtime is pretty much set around 11pm, which means that I would ideally need to sleep to at least 6-7am to get a good night's rest. The way it feels to me is that I've been losing at least two hours of sleep for months now.

I could go on and provide a lot more details, but rather than make this post too long, I thought I'd end it here and see if any one has similar experience or insight and and answer any questions.

Any help is appreciated.

John

 

[rosie26]

I know how you feel about losing hours of sleep each night. It's very concerning.
In the 12 years that I have had ME I think I have lost about 4-5 years of night sleep!

The only thing that has helped me is melatonin, this is a hormone tablet and not recommended in high doses. I started on 1mg an hour before bed and am now down to half a mg. If you do try, you need to make sure it doesn't react to any other tablets you may be on, so check with doctor first to make sure all is okay.

 

[SOC]

You should probably get a sleep study, if you can, to find out what's really wrong with your sleep cycle. Once that's figured out, there are some treatments available depending on the dysfunction.

I have had a sleep maintenance problem most of my life. I'd wake up 4-5 times at night and never got more than 5 hours total. Trazodone was a godsend for me. From very little real sleep to 8 straight hours of deep sleep almost overnight. It was wonderful! Unfortunately, lots of people can't tolerate trazodone, so it's not the ideal solution for everyone.

 

[Firestormm]

future_man

Morning

I decided I couldn't tolerate my wet sheets and the feeling that I had run a marathon or fought Ali any longer, and - as I often do now - decided to 'start my day'.

That was at 04.30. I'd been out of bed three times during the night. I undoubtedly did sleep. I know I did. But I too cannot maintain sustained sleep.

This has been a clinical feature of me for the 14 years since all of this diagnostic mess began. Indeed, as you know, it is largely a defining feature of our mutual condition: ME or CFS or whatever you want to call it.

Unrefreshing sleep, disturbed sleep, sleep disorder, sleep irregularity, over-sleep, under-sleep: Sleep is either an expression of something that is fundamentally 'wrong' or is causing/contributing to our other problem that is variously surmised as a 'lack of energy'.

When I began this journey, with a viral infection (my 'trigger' if you will), and given my history of viral infections, I concluded that the long periods of 'over-sleep' i.e. sleeping too much; was a sign that my body needed to heal.

But, if that theory is correct, how does one account for what I am experiencing in the 'chronic stage' of ME i.e. the disturbed sleep? I used to think that if you are ill your body needs more sleep, more rest, to fix the bits that were broken.

So I don't know what the heck is happening now. But something is. And I am still sick. So I don't get it at all.

I think I have done over the years as much as I can to try and improve my 'sleep hygiene'. For example, my bedroom is only for sleeping, if I need to rest I do it in the lounge on the couch; I try now to stay awake, if rested, until a reasonable bedtime e.g. 10-11pm and when I go to bed, I go to sleep, so I don't go and read - I do that in the lounge too.

I cut out caffeine and nicotine prior to bed. Indeed I don't do caffeine in the evening at all. I will sometimes, not always, take a hot shower before bed to try and loosen up the muscles and relax; I might play some soothing 'storm-music' if I am particularly unable to sleep.... etc. etc.

I do take a half a pill of Sominex at night, every night; but am on no specific sleep prescription. I am entering my first ever sleep study shortly - I also get 'seizures' and whilst with treatment these have declined noticeable in 14 years during the daytime: I still get them at night but it is hard to distinguish them from possible other 'interruptions'.

I'd like to get some data on what is going on with my sleep pattern at night, so that might be interesting. I'd like them to rule out other possible diagnoses like Apnea (a common missed diagnosis apparently).

So we'll have to see where it leads. But I really do think I have done as much as I could to combat this issue and it hasn't gone away.

Learning to live with it is very hard. Harder depending on your circumstances - especially if living with others or trying to hold down a job. I am now on my own and without employment - so that helps me cope.

There are lots of threads on the forum about sleep problems. I hope you manage to find something that helps. A sleep study could be worth pursuing if you haven't already tried.

I shall be trying to sleep later I suspect. I don't like sleeping during the day, but sometimes after a bad night, I don't think we have a choice

 

[Valentijn]

I decided I couldn't tolerate my wet sheets and the feeling that I had run a marathon or fought Ali any longer, and - as I often do now - decided to 'start my day'.

That was at 04.30. I'd been out of bed three times during the night. I undoubtedly did sleep. I know I did. But I too cannot maintain sustained sleep.

Is your heart rate elevated when you're waking up? I usually don't have this problem, but have had it the past week or two, and an elevated heart rate is keeping me awake/waking me up. For me it corresponds to a drop in oxygen saturation (down to 87-93%) when I've been laying down for a while.

 

[Firestormm]

Is your heart rate elevated when you're waking up? I usually don't have this problem, but have had it the past week or two, and an elevated heart rate is keeping me awake/waking me up. For me it corresponds to a drop in oxygen saturation (down to 87-93%) when I've been laying down for a while.

Only if I am 'awakened' by one of these damn 'terrors' or the seizures or an 'event'. It's not something I notice specifically upon rising, if that's what you mean, Val? It's usual for me to drag myself out of something I have been trying to gain control of, or coming round in a state, or simply giving up on trying to sleep. Or being woken by the sweat cooling on my body or sheets. Or the pain. Or being generally uncomfortable. Christ what a mess

 

[Firestormm]

future_man I did think of something else that I never considered before I was told about it, and that's that you need energy to sleep. Sounds weird, right?

Anyway, this could be a factor in our situation. So I have started to routinely (I didn't have this as a routine before) eating supper. I think diet is an important factor anyway with energy - routine meals - and one I personally struggle with - especially eating regularly and particularly breakfast - yuk!

Yeah, so a light supper a couple of hours before I got to bed. Bit of cheese and crackers for me. CHEESE!! Like I said I don't now have as much of a problem in getting to sleep - but maintaining it remains a BIG issue.

Also think about the 'ambient' temperature in your bedroom. I need to feel cool. So no heating on for me - ever. I'd have the window open if I could but ground-floor flat - I don't risk it. Am not in Kansas anymore - it's the big city for me; well not really but it is a town and not the country

Good luck

 

[rosie26]

It's usually some toast and milo an hour before bed for me.

The last 2 weeks since catching winter flu (which fortunately wasn't a nasty strain) I have been taking 1/4 cup of lemonade fizzy drink to my bedside table and sipping just before I lay down to sleep. Well, one night last week I sleep 9 hours, told everybody who would listen that day, can't remember when I slept that long before. It would have been more than 12 years ago. And have had quite a few good night sleeps this last two weeks. I am wondering about the fizzy drink !!! Or is it that I have been spending too much time on Phoenix rising and tired out. I know I am not resting as much as I should be really.

 

[Firestormm]

It's usually some toast and milo an hour before bed for me.

The last 2 weeks since catching winter flu (which fortunately wasn't a nasty strain) I have been taking 1/4 cup of lemonade fizzy drink to my bedside table and sipping just before I lay down to sleep. Well, one night last week I sleep 9 hours, told everybody who would listen that day, can't remember when I slept that long before. It would have been more than 12 years ago. And have had quite a few good night sleeps this last two weeks. I am wondering about the fizzy drink !!! Or is it that I have been spending too much time on Phoenix rising and tired out. I know I am not resting as much as I should be really.

I often like getting colds etc. because it means I sleep better For whatever reason it seems to calm that side of things down a bit. But, yes, I do experience those most welcome of nights when I get 5-6 hours of absolute bliss - still wake up though feeling like I haven't slept: but I can settle for that

 

[Firestormm]

I don't suppose anyone else feels like owning up to incontinence at night do they? Not something we talk about. Certainly gets me down when it happens. Not so much that it happens but not noticing that it has. Humph! Not all the time thank the gods but now and then. Shows I suppose that I do sleep deeply but maybe not for long. Sure hope my sleep study comes up with something more than we know already. Ah well. New sheets it is then. Buggaring bollocks. What a life

 

[future_man]

Hi all,

Thank you for the comments so far. I'm up again at 5am this morning after about 6 hours of so-so sleep. Could be worse, but I feel like I haven't had a full 7 or 8 hours of good sleep in months.

Firestorm, like you I think I've already done quite a bit in terms of sleep hygiene/practices. My bedroom temp is definitely on the cooler side even in the heat of the summer. The sleep study idea is an interesting one. It would be good to have some more data on this and some other perspectives. As an aside, I met with a new doctor yesterday whom is running some additional lab work to get a few more data points and rule out some possibilities.

The goods news is that I seem to be making some progress with my sleep patterns. I'm now generally going to bed easier with less supplementation and not waking up and having to pee quite as much. Here are the things that I think are making a difference:

1. No caffeine after 9am
2. 200mg Magnesium Glycinate before bedtime
3. 2 capsules of Seriphos before bedtime
4. A glass of water containing a 1/4 to 1/2 teaspoon of sea salt before bedtime
5. Light protein/fat snack before bedtime (too much sugar or carbs in the evening tends to cause blood sugar issues and disrupt my sleep)

I'm getting in bed around 10-10:30pm and usually falling asleep around 11pm. I'll usually wake up to urinate around 1am or so, and take two more capsules of Seriphos and another 200mg of Magnesium. I may wake up again to pee again, and if I do, I seem to be going back to sleep easier than before.

However, my brain/body seems to think that its time to wake up every morning around 4:30-5am regardless. As best I can tell, that is when my cortisol levels begin to naturally rise for the next day. Ideally, I'd be able to sleep until at least 6-7am considering how much quality sleep I'm actually getting through the night.

So my current plan is to continue trying to delay the cortisol release as much as possible through the night and push it closer to 7am. I'm also trying to go to bed earlier, but that continues to be a challenge with our family and work schedules.

A couple of side notes:

In the mornings I've been experimenting with a new-ish ritual. The first thing I do upon waking is to drink a large room temperature glass of water with a 1/4 to 1/2 teaspoon of sea salt, half of a fresh lemon/lime, and 1 tbs. of Apple Cider Vinegar (followed by a second glass of water to rehydrate and flush). I'm doing this primarily for detox reasons. I then take my dog out for a short walk around the block both for her, and to get some natural sunlight. I've also been experimenting with doing it barefoot for grounding and the sensory input.

I'm attempting to get a better anchor with the natural rhythms of light and dark throughout the day. In this same spirit, I've stopped wearing my sunglasses during the day to let more light in and emphasize the difference between the light of the day and dark of the night.

Lastly, here's a link to a recent podcast with Dr. Amy Myers talking with Dan Pardi, a sleep researcher. Some good info and perspectives in there.

http://www.dramymyers.com/2013/06/24/tmw-episode-10-sleep-expert-dan-pardi/

 

[Firestormm]

future_man thanks I will have a look at the link later

 

[MeSci]

Hope I don't bore anyone with this, but my low-grain/low-sugar/gluten-free diet plus l-glutamine, sodium bicarbonate, acetyl-l-carnitine, alpha lipoic acid, bone minerals and omega-3 supplement regime has improved my sleep considerably along with many other problems. I still have a few poor nights, which I think are due to over-exertion. I am fairly sure it's all down to leaky gut/acidosis, which can be exacerbated by stress, exertion and carbohydrates. The improved sleep coincides with calmer moods and less occurrence of feelings of high adrenaline either in sudden rushes or an underlying 'wired' feeling.

I do take mild sleep meds, which I alternate over an 8-day cycle and comprise paracetamol-plus-codeine, melatonin, diphenhydramine, chlorphenamine and promethazine. I combine the melatonin with paracetamol-plus-codeine, diphenhydramine or chlorphenamine.

A vital skill I've learned is how to stop thinking. I do it by focusing on vague shapes visible after closing my eyes. Thinking is a real sleep-killer for me.

Re incontinence, I wonder whether this could actually be due to polyuria - excessive urine production. This can either be due to insufficient production of the natural antidiuretic vasopressin, which can be corrected with the synthetic form desmopressin (also prescribed for bedwetting in children) or to something leading to a loss of electrolytes (minerals) in urine, which also increases urine production. I think that this 'something' is lactic acid. I get both types of polyuria, and take desmopressin for the first type. The second type doesn't seem to be treatable once it starts, but is probably preventable by avoiding stress, overexertion and too much carbohydrate.

 

[taniaaust1]

you could try "slow release" melatonin
..........

I feel like treating my POTS with florinef does help my body hold its fluids a bit better and get less peeing with that.

 

[future_man]

Hi MeSci, the stop thinking approach is interesting and something that I've worked with over time. I usually approach it by shifting my awareness more to my body and out of my head, and by sensing my limbs and extremities. I combine this with breathing exercises which seems to down regulate the more active part of my nervous system. Definitely seems to be a positive factor in all of this.

Can you tell us a little more about how you focus on vague shapes?

Also, I think I'm the second type regarding the frequent urination. I do seem to be producing a lot of urine (and losing electrolytes and minerals in the process), and I think it is related to some adrenal dysfunction and cortisol issues I've been trying to work out.

Tania, it's been a while since I've tried the slow release melatonin, and I think you're right that it may be worth a try again. It seems like I'm not producing or lacking something which is keeping me from getting enough deep sleep throughout the night.

 

[MeSci]

Hi MeSci, the stop thinking approach is interesting and something that I've worked with over time. I usually approach it by shifting my awareness more to my body and out of my head, and by sensing my limbs and extremities. I combine this with breathing exercises which seems to down regulate the more active part of my nervous system. Definitely seems to be a positive factor in all of this.

Can you tell us a little more about how you focus on vague shapes?

Also, I think I'm the second type regarding the frequent urination. I do seem to be producing a lot of urine (and losing electrolytes and minerals in the process), and I think it is related to some adrenal dysfunction and cortisol issues I've been trying to work out.

It's a bit hard to explain as my eyes may operate differently from yours, but it's easiest to do if you look at a light for a few seconds before switching it off. Then when you close your eyes you should still be able to see patches of brightness for a short time. I have found that if I just watch these, while breathing slowly and evenly, they continue until I drift off, which is qujite quick (a few minutes). They fade at first, and sometimes stop moving, but if you keep 'watching', new ones appear, and they move around, merge, and sometimes appear to turn into things that are recognisable or almost recognisable. I have to resist the urge to try to control them, or identify/analyse them, and stay calm whenever they make me feel uneasy, as it passes very quickly.

It took me months to master the 'art', and I previously watched kaleidoscopic videos to help me to get into sleep mode, but it's easier not to have to do this when eyes are tired.

I don't know if the way I have described this makes sense to others!

Mineral deficiency, notably magnesium, can impair sleep quantity and quality, so if you are losing electrolytes in urine it may be beneficial to supplement.

Prevention is better than cure, so if you can prevent the lactate build-up through diet, supplements and pacing this is the best policy, I think. It's certainly working for me.

 

[future_man]

It's a bit hard to explain as my eyes may operate differently from yours, but it's easiest to do if you look at a light for a few seconds before switching it off. Then when you close your eyes you should still be able to see patches of brightness for a short time. I have found that if I just watch these, while breathing slowly and evenly, they continue until I drift off, which is qujite quick (a few minutes). They fade at first, and sometimes stop moving, but if you keep 'watching', new ones appear, and they move around, merge, and sometimes appear to turn into things that are recognisable or almost recognisable. I have to resist the urge to try to control them, or identify/analyse them, and stay calm whenever they make me feel uneasy, as it passes very quickly.

It took me months to master the 'art', and I previously watched kaleidoscopic videos to help me to get into sleep mode, but it's easier not to have to do this when eyes are tired.

I don't know if the way I have described this makes sense to others!

Mineral deficiency, notably magnesium, can impair sleep quantity and quality, so if you are losing electrolytes in urine it may be beneficial to supplement.

Prevention is better than cure, so if you can prevent the lactate build-up through diet, supplements and pacing this is the best policy, I think. It's certainly working for me.

That does make sense. Thank you. I'll have to give that a try.

Mineral deficiency, notably magnesium, can impair sleep quantity and quality, so if you are losing electrolytes in urine it may be beneficial to supplement.

Prevention is better than cure, so if you can prevent the lactate build-up through diet, supplements and pacing this is the best policy, I think. It's certainly working for me.

I am supplementing with Magnesium and it does seem to help. I'm also taking celtic salt during the morning and at night and it also seems to be helping reduce the frequency of urination.

What influences lactate build-up in the diet?

 

[MeSci]

What influences lactate build-up in the diet?

Low-grain/low-sugar/gluten-free diet plus certain supplements reduces it (see my earlier post).

Also exertion and stress increase them.

So my prescription )) is

• Low-grain/low-sugar/gluten-free diet (maybe dairy-free too)
• Supplements, e.g. sodium bicarbonate and l-glutamine
• Avoid stress and over-exertion. These cause lactate build-up in brain and muscles and probably feed it back to the gut through a general acidifying process.

 

[future_man]

Ok, good. That sounds pretty much like the diet and protocol I'm on - with the exception of the sodium bicarbonate and l-glutamine. I'll have to look into those. Thanks!

 

[Beyond]

Holy Basil its a good option for high cortisol. Your nocturia could have a prostatic origin, so maybe adressing that would stop at least the wake ups related with going to the bathroom. Ah wait I just read your theory on adrenals! Yes I have read that people with adrenal dysfunction sometimes urinate a lot, just read it yesterday but cannot remember the details.

Melatonin makes me wake up at 3 AM with itching all over. Slow Release seemed to work better but didnt improve enough my sleep.

Yeah MeSci leaky gut its a major player in this damnation, not to be overlooked and often brings big improvement when healed. Glutamine its the basic leaky gut healer.