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Interrupted sleep... waking to urinate/eat... ruining life. Help!
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Interrupted sleep... waking to urinate/eat... ruining life. Help!

Need some help badly.  About 4 years ago my sleep was badly disrupted by loud noise at the same time early each morning for several months (I was also fairly stressed at the time).  This woke me up early, after about 6 hours, and after a while I needed to urinate in order to get back to sleep.  The problem is, after things returned to 'normal', I still continued to wake (and still to this day!) during my sleep to urinate.  Things never went back to normal.  It has gotten worse since then, so that now this usually happens several times each night.  The first time is almost always after about 4 hours.  I used to be able to sleep perfectly for 8-10 hours straight, and felt great.  However, the past 4 years I can probably count on one hand the number of times this happened, and I am feeling worse and worse.  It's getting to the point where I'm unable to cope with anything anymore... I can't work, I don't have the energy to do anything.
I should also mention that after a while, the urge to urinate wasn't all that kept me up.  Eventually, I felt very hungry as well (as my stomach was empty when I woke) and needed to eat something substantial in order to feel 'full' again and return to sleep.  Due to this disruption, it takes me anywhere up to 2 hours to return to sleep (though it varies..  often it's immediate), and so I tend to be in bed about 12 hours a day just to get the minimum amount of sleep to function.  My eating habits are all messed up now because of this too.  When I wake I'm not very hungry as I have eaten during my sleep.  etc etc.

I have seen a doctor and they tested my blood and took a urine sample and didn't notice anything unusual.  The doctor suggested this is all due to depression/anxiety.  One doctor presribed me valium which really helped, but obviously I only take it when things are very bad, as I don't want to become dependent on it.  Another doctor (earlier) gave me endep (tricyclic anti-depressant), which he claimed would reduce my urge to urinate and help my sleep return to normal.  It didn't really do this though (at least the dose I was on - 20mg), although it did make it very easy to *return* to sleep after waking (usually minutes instead of hours).  Eventually I stopped taking it as it really wasn't the solution I needed, and it had other undesirable effects.  The doctor I see now has prescribed me cipramil in combination with valium (when needed).  Is this really the right solution for me?  I hear it is very easy to become dependent on cipramil (you can't just stop taking it) and the doc says it could be needed for up to 15 months.  This is a *long* time to take something which may or may not help me.  However at this point I'm willing to try anything.

Thanks all.
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11 Comments Post a Comment
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Avatar_m_tn
Hey Mark, looks like you're having a habit of shaking off old habits.

You're right not to rely on the meds, you will only become dependant and tolerant of them. You need to focus on changing your habits. Enforce new positive sleep habits and thoughts. Have you tried CBT or EFT? For more info, sign up for the free newsletter at http://www.howtobeatinsomnia.com

Drink plenty of water in the day- at least 10- 12 glasses. Keep hydrated and eat well during the day. Lots of fruit and veg. It's better to eat little and often rather than a few big meals in the day, this will help shake off those hunger urges.

Avoid drinking too much fluid in the evening and go to the toilet before you sleep. Also it is actualy possible to train your bladder to hold back urges to go to the toilet. During the day only go to the toilet when you really really feel like it. Don't over do it though.

Also consider herbal remedies like st johns worts as an alternative. This is used in many European countries to treat depression. Anyway here's more info http://www.howtobeatinsomnia.com

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Avatar_n_tn
Thanks for your reply sleep.  I have gained some very bad habits over the past few years but it seems impossible to shake them off.  I've tried eating less, more, drinking less, more...  with very little effect.  Sometimes it helps my sleep, but I still wake up during the night.  At the moment, the vast majority of my urinating is done during the night - during the day I hardly go to the toilet at all.  You cannot train your body *not* to wake up or feel like urinating... no more than you can tell yourself not to have a bad dream.  Sometimes only medication can help with that.  My doctor has suggested therapy so I will be starting that shortly.
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242516_tn?1368227505
Mark, sorry for your difficulty sleeping, that sucks!

Sleepycat has some good suggestions with not drinking in the evening and urinating before bed.  CBT and EFT have not proven to be effective in randomized clinical trials, which is the kind of evidence that doctors use to recommend a treatment or not.  Treating depression if present, is very important, but it would be dangerous to switch to an herb like st johns wort without the guidance of your doctor.

I'm glad you're starting therapy, that should help.  It's importatnt to find a doctor and therapist you trust and stick with them for a while to give their guidance a chance to help you.

Dr. Enoch Choi, MD
Palo Alto, CA
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Avatar_n_tn
Dr. Enoch - thanks for your concern and comments.  This is awful - I'm down to less than 3 hours of sleep per night.  I've lost considerable weight - I am 6'2 tall yet weigh just 147 pounds now. (I was 160 a few months ago).  Sometimes my body is all hot like I've got a fever when I get woken.  They're doing excavations over the road and those excavators are around 65 decibels - impossible to sleep through.  It starts very early in the morning.  That's putting aside the noise in my own house.  I have so little energy that I simply cannot work, exercise, or do day to day tasks.  I don't feel like talking or doing much of anything... I worry about driving because I fear having an accident, but I have no choice?  I worry about catching an illness due to my weakened state.  I HOPE this medication is going to start kicking in soon...  I'm up to the full dose of cipramil (20mg) and I'm trying to change my sleeping habits.. who knows.
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Avatar_n_tn
Two things jump right to my mind.  Have you had a sleep study done to rule out sleep apnea?  If you have a sleep partner, you may want to ask them if you snore or gasp while sleeping.  Frequent urination, waking and exhaustion were symptons I exhibited before they diagnosed me.

I assume that your doctor has tested you for diabetes, the flush and frequent urination could also be attributed to that.

Good luck.

R
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Avatar_n_tn
I have been tested for diabetes and it came back negative.  I forgot to mention that I'm in my 20s, so this was always unlikely.  I looked into sleep apnea and I do exhibit many of the symptoms, but I have no way of testing it.  Anyway, as I mentioned, up until around 2003, I slept perfectly...  can you just suddenly get sleep apnea all of a sudden like that?  Haven't done a sleep study .. sounds interesting, but I don't know if I could even sleep at all in that environment.  On days when my sleep is at its worst, I lose my appetite as well (hence the weight loss).  I'll only be able to eat a little as food will make me nauseas.  If I take a valium it helps (as I did the other night) but I can't rely on it because I don't want to become dependent ... and also the following day I often get a throbbing in my veins (mostly legs).  Probably because I do very little activity at present.
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242516_tn?1368227505
If you have symptoms of sleep apnea, a sleep study is helpful in determining if it's a problem for you.  You're right, valium is addictive.  It sounds like anxiety is a problem, if valium helps.  Time to go get counseling and ask your doctor for help!
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Avatar_n_tn
Mark- I just went through with the sleep study, and although it would seem that you should not sleep while wired up to machines, the technicians assure me that most people do.  I did, only for about five hours. It is really not uncomfortable at all. They found that  not only was I not breathing 20 or more times an hour, but my body's level of oxygen dropped to less than 30% of normal.  I too had leg and muscle pain upon waking, sometimes so painful that i needed to brace myself against the wall to stand.  The Dr. explained that our muscles need oxygen to function, the pain was from the muscles not receiving enough oxygen overnight.

I do not know if apnea can just happen, but I never had a problem until three years ago.  I suspect my apnea started then, it just took three years of being exhausted before a wonderful Dr. realized what was at the root of my problem.  I am using a machine that keeps my airway open(yes-it does take a little getting used to, but not so bad) and I feel like a human being again for the first time in forever.  If you insurance pays for a sleep study, get one done.  It was a life-saver for me!
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242516_tn?1368227505
ruthiefrog has a good idea in going to get evaluated for sleep apnea!
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Avatar_n_tn
Before sleeping at night please take a psyco doze. Just convince yourself by reading it again and again for 5 minutes in complete silence before you sleep that you can sleep well without any problems. You can do this for 1 month continuously. To make it more effective you can do the same excercise two more time. Morning and noon.
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Avatar_n_tn
If I read a textbook on sleep apnea, it would sound like you - and me. Sometimes sleep apnea just finally takes its toll and the symptoms become more pronounced. Or maybe meds cause it to worsen by relaxing throat muscles. Or maybe a slight weight gain caused it to occur. Who knows? But the extra hungry feeling is typical of sleep deprivation, and nighttime eating is not unusual either. 60 Minutes did a special on sleep a couple weeks ago and dealt some with the subject of appetite and sleep.

Sleep apnea can cause increased frequency of urination due to hormones secreted during apneas. If you get a sleep study, ask ahead of time if your doc can prescribe an acceptable mild medication to help assure you'll get enough sleep in.

Since you are young, and if you are not overweight, it may not be the first thing your doctor thinks of since you don't fit "the profile". It is often undiagnosed in those cases.

Even if it's not sleep apnea, whatever is disturbing your sleep will need to be identified. There's many sleep disorders.
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