Depression and anxiety's impact on sleep maintenance

Discuss the effects of depression and anxiety on sleep, and sleep maintenance, with the Sleepio Community.

Posted 6 Aug 2012 at 3:46 PM
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  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    I posted a lengthy reply on your profile page.

  • Sleepio Member

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    Graduate

    For what it is worth alexburr, I have always understood that you should calculate your sleep efficiency based on the sleep window you have been given.
    So, for example, your SW is 11.30 to 6 and you fall asleep after 10 minutes and sleep until 2a.m. but then wake and get up to do something to help you get back to sleep ( reading, cooking, physical exercise etc) then get back into bed after 30 mins and fall asleep 10 minutes later until your assigned wake up time. Then you calculate time asleep as follows:
    Your allotted sleep window of 6.5 hours – 50 minutes ( 2 × 10 minutes to fall asleep both times + 30 minutes up out of bed) so total Sleep of 5 h 40m which will be calculated as a percentage of 6 h 30 m.

  • Sleepio Member

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    in reply to Sleepio Member
    Session 4

    I read it, and I appreciate it, Chickatee! My sleeping did recover for about two weeks, but it has taken a dive again. I'm not going to bed at around 10:30 and am wide awake usually at 3:00am. It's been super frustrating. I'm looking forward to seeing what sleep restriction can do for me.

  • Sleepio Member

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    Session 4

    Thanks, Ohforsomesleep. My problem seems to be that I just can't fall back asleep no matter what I do. I will feel physically exhausted, but my brain will be running a mile a minute. Even relaxation techniques will help my mind calm down a bit, but I just can't seem to cross the threshold over to sleep once I've woken up. It's very frustrating.

  • Sleepio Member

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    Graduate

    Hi alexburd88,

    I was going through something similar when I started Sleepio. I went to the doctor, who gave me Zolpidem (generic Ambien), which helped somewhat, but I came to Sleepio because I knew that wasn't a long-term fix.

    For me, the things that helped the most were:
    1) The “putting the day to rest” exercise and writing a to-do list for the following day, which you should get by week 3 or so. This made me think through my problems during the day instead of at night. If I think of a solution in the middle of the night, I write it down, then go back to sleep.
    2) Taking at least an hour for wind-down time. If I can't get my mind off my problems, I watch a good TV show or read a good book that will get my mind off of things. Once I find myself yawning and wanting to doze off, I know it's time to think about going to bed.
    3) Taking some time during the week just for fun. I had been focusing a lot on a stressful work situation and having very little fun, which I think led to the insomnia. Once I started taking time again to get out and enjoy myself, the sleep improved.
    4) My doctor told me to take a walk outside every day if possible in the sunlight if I could. This is good exercise, gets my mind off my problems, and the sunlight helps the body make it's own melatonin. The only time that worked with my schedule to do that was early evening (around 6:30 – 7 PM), which she said wasn't too late.

    I hope some of this helps. I still wake up in the middle of the night sometimes. I try to keep calm and not think about anything, and most of the time I can get back to sleep. After I got used to the new sleep restriction schedule, I spent less time awake in the middle of the night.

  • Sleepio Member

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    Session 4

    Thank you for all of the positive comments. I went through Session 3, and I honestly feel even more frustrated than I did before it. I only get about 4-5 hours of sleep a night. However, the professor wants me getting 6.5 hours of sleep a night. How am I supposed to do that when I can't sleep that long?

    The other frustrating part was not being able to identify with the insomnia he was speaking of. I have no trouble falling asleep at night. None. I just can't stay asleep. I usually go to bed around 10:30pm-11pm and wake up at 3:30am or 4am. Last night I went to bed at 11:30pm and was wide awake at 2:30am. I can never fall back asleep once I'm up.

    Ideally I would like to go to bed at 11pm and wake up at 6am- something I was able to do a year ago. What I'm thinking I should do is push back my sleep later- trying to go to bed at 1:30am or 2:30am to force myself to sleep in until 6:30am. Any thoughts?

  • Sleepio Member

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    Graduate

    Hi Alexburd88,

    I started out with a long sleep window also for weeks 1 and 2, then for week 3 it shrank to only 15 minutes more than the number of hours I was actually sleeping. I would find 6.5 hours surprising for the sleep restriction part of the course. Can anyone else speak to this?

    For quite a while, I was getting 4-5 hours per night. I don't think that's too unusual for Sleepio members. I agree staying up a little later may help you sleep later. Personally, I move my sleep window in smaller increments of about a half hour at a time.

    I'd recommend experimenting with the different techniques to see if any help you get back to sleep once you wake up. I I find if I keep calm and don't start thinking of what I have to do the next day, I have a better chance of getting back to sleep. Advice I was given by my husband was to think of a nice place you visited, such as a beach or hotel etc. In week 4, I received instruction on imagery, essentially the same thing.

    I hope your sleep improves!

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    alexburd88, yes I would definitely try going to bed later. If you want to sleep 11pm to 6am, but currently you sleep an average of 3 or 4 hours I would place your current duration in the middle of your desired window – and go to bed around 1pm. Bear in mind the idea that quality is more important than quantity. Being attached to a set period of 7 hours may cause anxiety, so I invite you to focus on getting better, not more, sleep. Good luck!

  • Sleepio Member

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    Graduate

    Hi Alexburd88. I imagine you must have been sleeping for at least 6.5 hours in weeks 1 and 2 to have been given this as a sleep window so it should be possible for you to do it again. I would imagine that the idea of 'forcing' yourself to sleep will be enough to prevent this happening. I have found out that just the very thought of how much sleep I might get can cause a bad night.

    You say you tried going to bed later at 11.30 but still woke early (or even earlier) so maybe that's not the answer. What do you do when you wake at 3.30 or 4am? I ask as this is the time I always wake (along with a few other short wakings before my get up time)? Do you do any relaxation, thought blocking, imagery in bed before getting up? If I were to get up this time and do anything remotely stimulating (even reading) I wouldn't be able to get back to sleep. Perhaps you should try paradoxical thinking have you learned about that yet) – lying in bed and trying hard with eyes open not to go to sleep. I know some people have found this works.

    It's very frustrating when you know you need more sleep but you are very early in the programme so give it time. Really this is the time to Try everything you are offered and see what works for you. I don't think many people get enough sleep in weeks 3 and 4 but eventually it all comes together and gradually you should increase your sleep. Try your hardest to forget about how much sleep you want/will get (easy to say I know!) and just follow the programme to the best of your ability. Lindsay

  • Sleepio Member

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    Graduate

    Hi Alex-- great input from the others.
    Here's another way to think of your 6.5 hr. sleep window when you are not presently sleeping that amount of time as it is. The Prof is not expecting you to sleep that long. But it's the longest block of time you are allowed to be in bed for now, until your sleep efficiency improves.

    That's great that you can usually fall asleep quickly. Since it's staying asleep that you're struggling with, you need to experiment with different approaches to dealing with that awake time, but nothing lengthy since you are trying to transfer that into sleep time. The tools the Prof has given for getting to sleep initially are a good place to start (i.e. progressive relaxation, autogenic training, and imagery).

    Just getting out of bed and sitting in the dark about 15 min. may be all you need to do. Mentally coaching yourself might be surprisingly helpful, by mentally telling yourself you don't need to wake up now, giving yourself permission, so-to-speak, to go back to sleep. Tell yourself that you CAN get back to sleep. Tell your active thoughts “no, not now, this is not the time”, etc. It may seem silly, but I've been amazed at times how this has helped me with my wakefulness in the middle of the night.

    If there's something genuinely on your mind during that time, in dim light, try briefly writing down your thoughts and concerns so they're out of your mind and on paper until daytime, the better time to deal with things.

    It could be a metabolism thing that may be remedied by an appropriate small, simple snack or warm beverage, though you don't want that to become a habitual thing in the middle of the night either. Do you eat or drink anything shortly before to going to bed?

    During the day, do you drink anything caffeinated? Even if it's early enough in the day, caffeine regularly in the system could be an interference to uninterrupted sleep. I've been experimenting with leaving coffee only for the weekends, and it seems to help. When it's out of my diet for a few days, sleep is better, and having it on the weekends has been fine.

    We are all puzzles to ourselves with these things aren't we? You'd think we could figure them out at little more easily than we do… if we ever do. I do hope you get some resolution with your situation. Keep in touch.

    Chickatee

  • Sleepio Member

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    Graduate

    Hi AlexBurd

    I have exactly the same problem that you do. I'm hopeful that you are making progress with your very early wakings.

    In my case, I've come to the conclusion that my early wakings are related to anxiety and depression. When I wake up my heart is racing and the relaxation exercises don't help much. I'm now on meds and in therapy so I'm hopeful that with those interventions too my sleep will improve.

    How are you doing now?

    ccjto

  • Sleepio Member

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    Session 5

    HELP! early awakening & anxiety… so my insomnia is initial sleep onset is fine, I wake after approx 3.5hrs sleep, when I wake my heart feels like it is beating hard and its that wakes me, relaxation techniques hardly help and I struggle to return to sleep. I know if I sleep >5.5hrs I can feel good. I have realised that some emotional time probably triggered my insomnia, then the insomnia-anxiety circle commenced. I believe that I must have some underlying anxiety that awakens me at night, by day I am not particularly depressed or anxious (except with sleep health, but I can do my best to control that once I have a set path to follow). At the start of the yr, I tried SR for 6 weeks, weekly average I got my sleep duration from 3.5 to 5hrs, albeit was very up and down. It was tough I got tinnitus and started to get some chest aching. I am confident that my body and heart are physically fine (all tests confirm too). I had to stop and relax everything. I have been on 1mg melatonin which gives me 5hrs sleep, enough to feel semi ok. I can see that I made some gains and im ready to give it another go, and I see that I must give it much more time probably 3 months+ before I would be happy with the sleep I achieve. So I have two options I can foresee 1) attempt CBTi again for a longer duration, maybe introduce some relaxing herbs to keep calm by day, and I mean legal ones. OR 2) take 15mg mirtazapine for 2-3mths, im sure ill sleep like a baby, with the hope that this breaks the anxious habit of awakening, then 1-2mths slow withdrawal whilst putting into place strict set sleep hours. I also have option of Celexa, but I think this could add to sleep difficulties. I can see positives and negatives of both, the medicine route could be a role of the dice if sleep well when on them, but everything returns when I stop, plus I get other unwanted side effects, could give me new problems. The CBTi route could work to exacerbate this night time anxiety, but overtime it may calm as sleep increases and I see the light! :) Opinions please?

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    My story is very similar – early awakening in the middle of the night after just 3-4 h of sleep, anxiety manifested by fast heart beating, nausea, hot waves, abdominal distress. I also feel good after 5,5 – 6 h of non-interrupted sleep (but it is extremely rare now).
    I tried antidepressants (prescribed by my doctor) one year ago. Its reduced the anxiety and frequency of night-time panic attacks but not resolved the problem of insomnia. Recently my physician recommended the sleep drug for me (Zolpidem) but I decided to try the CBTi first. Only if I will have no significant improvement after 1-2 months of CBTi – may be I will try medication.

  • Sleepio Member

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    Graduate

    Your situation sounds rather challenging, and I’m not sure I know how to help. I wonder if you might want to ask your question of the weekly expert. They have the education and experience to deal with many different issues. Best of luck to you.

  • Sleepio Member

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    Session 1

    Hello Sleepio Community,

    My name is Evan, and I'm healing from GAD, PTSD and Depression. I was wondering, if any of you had a diagnosis of one or all of these disorders as well, and how you believe it impacts your sleep?

    Let's share tips, and methods to help one another's sleep efficiency!

    All the best!

  • Sleepio Member

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    Session 2

    I have been diagnosed with anxiety/depression and currently going through marriage difficulties (my life is a mess) sleep is a real problem. I can go a whole night without or I can fall asleep (10-11pm) then wake up just a few hours later (2-3am). I am never able to get back to sleep once awake.

    I try following sleep health advice but it doesn't seem to help.. I came across Sleepio by chance and hope it will help..

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    Hell keehunt and welcome to sleepio. I suffered from insomnia for many decades, and was hooked on sleeping pills for over 10 years before finding sleepio. I had read many books seen several doctors, had a sleep study, etc, and everyone just kept giving me more pills.

    The first few weeks of sleepio were torture, but it slowly improved. I sleep well most nights, and only take sleeping pills in hotels or during jet lag situations. And even then, i take a much smaller dose than before.

    The science is solid, and the community is very supportive. If this worked for me, it can work for anyone.

  • Sleepio Member

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    Session 2

    Thanks I am only on week 1 at the moment, so its hard to see what I should be doing, I am also taking sleeping tablets otherwise I don't sleep – life being a mess for me at the moment.

  • Sleepio Member

    • 260 comments
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    in reply to Sleepio Member
    Graduate

    Just take it one day at a time, one week at a time. There’s a lot of great insight here, from weekly experts, the prof, and the community. You will learn a lot, and have the opportunity to try a variety of techniques to help you relax and welcome sleep.

    As for your sleeping pills, when you feel ready, work with your doctor to wean off them if that is what you want and if your doctor agrees. I took several months to wean off Ativan. I couldn’t sleep without it at first, but I very gradually reduced the dose and now I only take a little dose in hotels.

    You seem to have a lot on your mind. I’m sure you will get support and good advise here. Best of luck to you.

  • Sleepio Member

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    in reply to Sleepio Member
    Session 2

    Thank you Auntie Hoho, I plan to keep with the programme because I want to get well again and sleep forms part of that.

    Thanks for your comments.

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