Debilitating insomnia...

[ChrisThomas88]

I've suffered anxiety for the last nine months, with insomnia setting in the last six months. The insomnia started after a moment of acute marijuana toxicity - I suffered a bad trip and essentially the anxiety set in over anticipation of a similar occurance happening. The anxiety shifted towards hypochondria, where I thought I was suffering from numerous medical problems.

The anxiety was triggured due to a fear of my breathing ceasing during sleep. Although I conqured that issue, the insomnia appears to have become chronic.

I do manage to get between 4-8 hours sleep, but I'm unable to sleep before 6am without the aid of alcohol and I literally have to wait until I'm physically unable to stay awake to sleep.

The disorder is affecting numerous aspects of my life, including imparing my cognitive functioning during the day and heightening my anxiety due to both tiredness and the recurrence of the insomnia. It's also causing problems in my personal life - I fear my inability to sleep normally is leading my current partner to believe I'm less interested in her and I'm unable to hold down a basic 9-5 job.

I also tend to suffer severe panic attacks mid-sleep - I'll awaken and my heart will be racing along with a struggle to breath for a couple of minutes. I'll also be dizzy and disorientated afterwards, which make the insomnia worse on the following nights.

I have been prescribed Valium in the past and have also attempted to take Nytol, but in both instances I paniced at the looming prospect of sleep and the fact I knew I was medicated in those instances only worsened the panic.

The anxiety and panic attacks have become much more bareable over time, but the insomnia's worse than ever.

I've yet to consult my doctor, but in the event that I do, what would someone recommend? I know a sleep study would be essential for both knowledge on my sleeping patters and peace of mind that nothing strange is happening during my sleep. I don't know if CBT would work either - I always seem to take the information in but it's too difficult to apply when required. Medication also seems hard with my previous experiences.

[MMahon]

Anxiety and depression frequently cause insomnia.  All the symptoms you mention are quite common for these disorders and drinking alcohol only makes matters worse.  Insomnia was one of the major symptoms of my anxiety and depression.  I too would wake up in the middle of the night with panic attacks and life became a living hell.  
The suggestions given by the earlier posters should be given serious consideration, especially the CBT.   I would suggest you go see a psychiatrist and explain everything you did here to him.  He will guide you thru the treatment process.
I know it's hard to believe that anxiety and depression can cause what you are experiencing but rest assured they can and they can do far more if left untreated.  
Check out the anxiety and/or depression forum.  You'll read many stories like the one you posted here.  Good luck and take care.

[Dr Rajput]

Hi, your symptoms are suggestive of insomnia. It is important to categorize the type of insomnia, which can be done after noting detailed history.  Insomnia usually constitutes impaired daytime function due to difficulty initiating sleep, difficulty maintaining sleep, chronically nonrestorative sleep, or poor quality sleep.

In your case there is presence of difficulty in maintaining sleep (due to panic reactions), impaired day time function (sleepy whole day) etc. Insomnia is also commonly associated with fatigue or malaise, poor attention or concentration, Social or vocational dysfunction, Mood disturbance and reduced motivation or energy.


The initial steps you need to take is sleep hygiene education, stimulus control, relaxation, sleep restriction, cognitive therapy, cognitive behavioral therapy, phototherapy, and chronotherapy. These therapies can be prescribed by clinicians at any level but it can be better implemented by sleep specialist.

Medical therapy apart from benzodiazepines, Nonbenzodiazepines, Melatonin agonist or Diphenhydramine against prescription for short duration.
I suggest you to consult physician/sleep specialist for further management. Take care and regards.

[Batteryshop01]

Go see a endocronologist. Right down all your issues so you don't forget important information when asked.

[KatEyes]

You are right, a sleep study would be valuable to prevent you from trying solutions that may be good in their own right, but not appropriate for your situation. I think the first thing you need to know is if your episodes during the night are really anxiety or if they could be sleep apnea. Both can cause awakenings with rapid heartbeat and shortness of breath. Sleep apnea, when it results in low oxygen to the brain, can cause dizziness and disorentation upon awakening. It also can shoot stress hormones into the body, which can result in a sense of anxiety. When my sleep disorders were undiagnosed, I was desperately sleepy but avoided sleep untill I collapsed. I think instinctually I knew sleep was not only miserable, but unsafe.

Inadequate or ineffective sleep can adversely affect so many areas of life, as you are seeing. You'd be doing yourself a big favor to move forward on getting answers. What to tell your doctor? That you are concerned that many of your presumed anxiety symptoms are also seen in sleep apnea, and you want to be evaluated. If the study does not show a cause other than insomnia, then you'll know to see what CBT can do for you. There is actually a specialty field of sleep treatment these days called Behavioral Sleep Therapy. You can go to the AASM site for a list of doctors (by location) with this specialty.

But Step 1 is the sleep study. Hope you find answers soon. Sleep is so important to life.