Hitting rock bottom

Sorry to see this Mounty, I can't imagine how hard ongoing lack of sleep like that must be. You will get past this though and it'll feel so good when you do. 

You mention CBT online, have you talked to a professional face-to-face about whether the accident trauma is causing the lack of sleep? 

Firstly you get big man points for opening up and asking for help from a bunch of strangers. 

We are a weird eclectic bunch but hopefully you will get some great advice and help with the sleep deprivation.

It's used as torture and any parents will tell you about the lack of decent sleep being one of the hardest things with a newborn child 

If you're able and willing to could you put down what meds you have tried, that's helpful to the pros and fellow sufferers to know.

Sounds to me like you need a different doctor and possibly some different coping strategies like meditation , CBT or yoga and mindfulness or a combination of everything in the short term. 

Do you catastrophise about things? And get stuck in a tornado of circular thinking that makes your head spin despite being so tired and desperate to get to sleep your brain won't shut down ?

Good morning Mounty and so sorry you're having such an awful time with sleep. The good news is, is that it WILL NOT always be like this.

I agree in that GPs know little to/nothing about sleep issues, but they can help with other aspects, like anxiety. (n.b - not saying this is the case for you, but anxiety is I understand it a big driver, which in turn drives a cycle of anxiousness about sleep itself)

Having suffered with insomnia previously for a prolonged period, I can absolutely appreciate how a dreadful night can make a person feel, both physically and mentally - but as earlier, it WILL NOT always be like this. it WILL improve. 

My tips, taken from CBT-i (that I found helpful when I went through SleepStation) and others:

 - tiredness and sleepiness are different things, I would regularly nod off reading downstairs before heading up to bed as this proved I was sleepy, not just tired.

- fixing the wake up time helped. i.e. 6.45am every day. Regardless of if you got to sleep at 4:00am - getting up forces the habit. Science has proven the brain likes habits, and this includes the time we wake up.

- if you are not asleep after 30-45 mins, get up, go to a different room. This is very important. Read or do a very light activity/listen to a podcast or chilled some music. But try avoid being on a phone/screen.

- Try to make sure where you sleep is just for that, a relaxing place. Good thick curtains and quiet! 

At the moment you are in a cycle, and what do we know about cycles? The are breakable. 

other tips:

- ignore supplements (unless medically told to of course)

- don't be concerned about ear plugs & eye masks

- don't try any gadget or tool promising riveting results

- Try not be hard on yourself

The above feed this cycle, sometimes creating a reliance on 'things that are meant to help'

I want to give you reassurance that it WILL change for the good, and this change will come incrementally, I am promising you that.

If you are getting 2,3,4 hours, etc, whatever that's OK - the extra will come back.

Sleep is a natural process, try to relax and follow your breath (Headspace do some really good sleep wind-downs if you're interested)

This will pass. All the best. 

As above I was going to ask about your lifestyle and how it may affect your sleep.

Do you get any afternoon activity after work I.e walking home from the station or to the shops, or a quick jog etc?

Caffeine/Alcohol intake in the afternoons/evening

Limiting screen time in the hour or so before bed

Removing all distractions from the bedroom I.e set up sleep profiles on phone and leave it in the kitchen

Black out blinds in the bedroom.

Shower before bed I find can be a helpful sleep routine.

A bedtime of say 10pm? In find if I go much later than this and get stuck doom scrolling I can easily lose the next two hours.

I tend to read my Kindle until I drop it on my face and then go to sleep, however I have read that really the bedroom is for sleeping and if you want to read, this should be in the lounge in your PJs etc.

If I wake early I try to be strict about not even checking the time as I find it’s quite easy to get into a routine of waking at 4.30 or 5am, and it takes very little to get my mind going and then I get bored of being in bed and want to get to up, and then suddenly I’m waking early every day.

Finally, have you tried changing GP? I did and found it was incredibly easy. My old practice struggled to retain just one GP and always seemed rely on a stand in paramedic half the week, the new one seems to have 3 or 4 permanent GPs.

No caffeine after lunch time if you love your tea and coffee. Then low sugar or decaf in the afternoon and evening.

I try to limit my simple sugars intake in the afternoon and evening so it's kinda like the Atkins diet with low carb dinner as you don't need quick sugar boost for the 7pm Tele marathon.

Make sure the bedroom is a tech free space. No silicone chips . Leave the phone off or on charge downstairs.

I didn't have it for sleep, but after I also had bike accident related trauma I found online CBT a total waste of time, but having meetings (online) with an actual therapist was brilliant and made a big difference. 

A colleague suffered from this and went to a sleep specialist. It was a long time ago, but he definitely mention one of the comments from paddy001;

“fixing the wake up time helped. i.e. 6.45am every day. Regardless of if you got to sleep at 4:00am - getting up forces the habit. Science has proven the brain likes habits, and this includes the time we wake up.”

against his wishes he also finally agreed to take sleeping tablets, but only for a short time to try and ‘program in’ a go to sleep time.

it was not a quick fix and he had a couple of false starts, but eventually he started getting ‘regular’ sleep. He wasn’t happy with the duration, but felt better as he was sleeping at regular times every day.

There's a TV programme on Friday 27/02 C4 8pm, called 'How to sleep better', there might be something of use in it.

Have you considered medical cannabis for sleep?

I had a similar experience in my early 20s, although not as serious sounding as yours. Probably a year and a half of what felt like zero sleep after I stopped taking pain meds for a leg injury and other complications. I could fall asleep ok at around 10-11pm, then I would wake at 1am and not get back to sleep until 4.30-5am, would feel absolutely destroyed all day and the cycle would repeat.

As others have said, it will get better even if right now it feels like it won't! Lots of good advice above about routines, exercise, diet, etc. The mental side is as important as the physical stuff, so find something you can do to occupy your brain if you're unable sleep, don't just lie there despairing.

20+ years later I'm still a really light sleeper and probably sleep through night once or twice a year, but if I do have periods of insomnia now I'm much better at identifying why and taking steps to prevent it.

Thanks for all the replies, I will try and get through them.

I have in the past tried zopiclone I think?  It didn't work at all. Exercise and getting outdoors has never been a problem until recently. Always either cycled or walked, but its become extremely hard due to feeling exhausted, but I do walk a 5 mile loop from the house on most days, then once a week I go walking in Snowdonia with a couple of guys, but that's causing issues.

Late last year I walked 22 miles in a day to see if it would make me sleep, nothing changed but I have read that increasing exercise will not help.

I have the occasional coffee but only before 12pm. I drink green tea.  I have tried the whole drinking no caffeine, again it makes no difference.

If I had to guess, I would say its sleep anxiety as its been going on for so long now.  I always feel very sleepy around 10pm to 10.30pm. Generally up out of bed at the same time all week.  No issues going to sleep, its the waking up between 2am and 4am, then its very little sleep afterwards, then the alarm goes off, I'm absolutely exhausted.

I am in a low mood at the moment down to being burntout, but I am not depressed, the last doctor told me I was depressed and it couldn't be anything else, I walked out, I am NOT depressed.  I get up everyday and go to work, its a physical job so I am always on the move.

I don't have anxiety about other things in life like work, money, lifestyle, relationships etc, probably just sleep anxiety.

I just cant cope with it at the moment....

Have you tried magnesium. Makes a big difference to me. I can understand the sleep anxiety as I had it a long time after breaking my spine - spent over 6 months sleeping on the settee as I was afraid I'd wake my wife. Having a bad run again currently as I've had tow colds back to back, and my exercise is down, so I've been uncomfortable in my back as I've not been doing enough, so I've been on the settee at least twice a week. Magnesium supplement definitely helps.

I've also found taking OTC co-codamol about an hour before bed helps me sleep - relieves some of the pain and makes me sleepy.

I do understand how a major injury sets you back. I'm 10 years post spinal fracture, and it took a long time to get some sort of decent sleep again, although that's been messed up again as I fractured my hip socket and pelvis, this time last year, so back to the cycle of poor sleep (add in a torn rotator cuff from May onwards that's a pig to sleep with).

@Mounty_73 check this site out:

https://hubofhope.co.uk/services

Stick your location in and maybe try some key words, anxiety, sleep etc. 

See what services come up near to you - online help is great but there are some fantastic people all over the country who can help. 

A physical job + walking 5 miles most days + walking most weeks in Snowdonia... That's a lot of demands on a tired body. You may have been able to handle that and more in the past but we are all getting older and graft takes its toll. It seems that the walking every day is no longer supporting your mental health, so maybe try swapping it for something else? Try sitting quietly and do nothing for 15 minutes? You have to get that mind of yours to quieten down.

"Overtired"? When I am "overtired" I can't sleep. Or, I fall asleep then wake up an hour later and spend the rest of the night awake.

Try doing a bit less. Go to bed with an "I don't care if I do or don't sleep" attitude. 

Namaste

I've posted this before but one thing that helped me was realising that "a full night's sleep" isn't the only way, and once I got comfortable with being awake in the middle of the night I stopped worrying about being awake in the middle of the night which meant that I didn't find it so hard to get back to sleep and I wasn't waking up in the morning feeling bothered that I'd been awake in the night.

https://www.bbc.co.uk/future/article/20220107-the-lost-medieval-habit-of-biphasic-sleep

I don't know a great deal about this, but understand that waking between 2-4am is surprisingly common as it is the phase of sleep where we are most likely to be disturbed by thoughts or external factors & once awake it can be very hard to get back to sleep.

My experience of this goes back just over a year or so when we were having an extension built. It was way more stressful than I ever imagined & I did not feel like the builder was really putting enough focus on certain aspects of the work. I used to go to bed with a list of worries/questions/things that I had to resolve swimming around in my head. It would take me ages to get to sleep and then sure enough around 4am I would go from sleeping well to being wide awake; like a light-bulb had been flicked in my brain.
I would then start stewing over things, sleep would be impossible & by the time I had to get out of bed I was exhausted with my stomach in knots.

I looked at various self-help things like writing lists of everything on my mind, splitting things into things I can control & things I can't control etc. I would get up & have a hot drink (non-caffeinated) while reading a book, then start the sleep routine again. Nothing really worked. 
Eventually I found a podcast on Spotify called Get Sleepy. It is a series of stories read to you in a very dull, soft voice that I think gets gradually slower as the story progresses. Most of the stories have no real purpose so they don't really hook you in; it was just a soft toned voice mumbling away in the background.
This was a great help to me. I can't really explain why but they really helped me to fall asleep at night. If I woke in the night, I didn't try any of the other techniques; just stuck a Get Sleepy story on & although at the start I would be convinced it wouldn't help me get back to sleep, the next thing I knew it would be 2 hours later & my alarm would be going off. Maybe give that a try.

For me though, I definitely had a source of anxiety causing me to wake up. I expect the same thing to be true in your case; maybe you can't put your finger on it, but there will be something there - perhaps it is just the anxiety of knowing you'll wake up that causes you to do so.
Once we had got the majority of the building work out of the way & the house returned to normal my sleep returned to normal & now the only thing that wakes me up is the bloody cat for his breakfast.

Try the sleepy podcast thing. You might find if you find a mechanism that helps you get back to sleep then over time the anxiety of waking during your sleep will lessen & you might get a full nights sleep.
I would also try to find some kind of sleep expert to discuss this with - whether through your GP or some other means. Good Luck.

Not a great deal to add that might be helpful, but I'm sorry that you are going through this. 

I went through a several-months long period of insomnia a few years ago. This was caused by anxiety, which was caused by insomnia, which was caused by...etc. I'm not entirely sure what started it all. 

For me, it did go away by itself eventually. Again, I can't remember why. 

I went to Doctors, who told me I am depressed and put me on a waiting list for counselling. To be fair, I probably was depressed even though I've never had any kind of self-harming ideation or extreme sadness. I too got up every day, went to work, did everything; but there was a darkness around every corner and a lot of fear too lurking around. The also prescribed me Amitriptyline in a very small dose and all it did was make me feel very sick and drowsy all the time but still didn't sleep, so I stopped taking it. 

Anyway, the waiting list was insanely long, and I went private for counselling. It was fine...kinda chatted around the outside of a lot of issues but overall I'm not sure I saw a huge benefit to my mental state from that alone. But it did feel good to not burden my wife or friends with it and burden a professional instead. I dunno maybe it did help!

Over time it just kind of went away. I really wish I knew why.

I still have nights where it takes 3 or 4 hours or more to fall asleep, but maybe once every 2 weeks-ish.

It sounds very patronising to suggest: but I kinda stopped getting annoyed or frustrated at it. My mantra was "Ok, so I can't sleep. But right now, I have nothing to do; all I need to do is lie here. I don't get many chances to do that at all, so I'm just gonna lie here and relax." If I repeat that thought enough it does semi-convincingly sink in. I focus on the "weight" of my body on the bed and make a game of trying to relax every muscle in my body.

(Sometimes I also pretend I am on an expedition in an ice cave in the middle of nowhere)

Insomnia is an absolute sod isn’t it?

For me the sleep hygiene suggestions worked well and created a structure time-wise. 

Being healthily tired after an active day is different to being utterly knackered, I am much better at listening to “today’s news” from my body rather than aspiring to set levels of activity. Took a long time to achieve mind you, but the mental health is generally better for it, despite my dislike of being so unfit. 

One small thing that I found helped was reframing night-time as a time for resting rather than sleeping. This meant that when I woke up during the night and looked at the clock I would (genuinely!) think “yay, 4 more hours in bed doing f*** all” rather than “Oh God, 4 hours of no sleep, that’s tomorrow ruined etc etc”. 9/10 the lack of despair meant i nodded straight off again. Sounds like utter rubbish but it really did make a difference for me. 

Good luck with it  

I often wake up in that 2-4am period, and can end up lying there frustrated until 5am. Echoing a couple of people above, I have found that having something to listen to works well for me, and I can relax and drift back off. 

For a long time I just stuck an ear bud in but it can be annoying so I picked up a fabric Bluetooth headband thingy which is much more comfortable. Audio books, podcasts etc. are great, I just have to strike the balance between interesting enough to occupy my brain and so gripping it keeps me awake. BBC radio 4 In Our Time is a particular fave.

Good luck with it, I hope you find something to break the cycle. 

Same here, wake up every night about 3am and I’m wide awake. I definitely find that if I stick a podcast on I’m back to sleep in no time.

I finally managed to get a doctors appointment via telephone.  I have been given some Promethazine Hydrochloride for 28 days which may help with sleep.

Also I have an appointment with the local Talking Therapy service, not sure if it will help but I have been desperate and I will anything, then another dr appointment in a month for a review.

I am forcing myself to slow down and rest as much as I can, which is really hard for me to do. I am still really struggling with the whole depravation of sleep. Now I understand why its used as method of torture because it is absolutely torture!

Good stuff, it's good to talk. There's so much written / said about how talking though a problem even just to yourself out loud, or to a mascot on a desk etc, can help. If you're into podcasts there's a really interesting one with Chris Voss, an ex FBI hostage negotiator (it's not about sleep!) and he talks about how talking to yourself and your own tone of voice influences you and others, fascinating conversation (The Knowledge Project, Chriss Voss, The art of letting other people have your way). 

From your previous post, I don't think this will make the difference immediately but,
From someone who loves coffee but has (or maintains? not sure) a low tolerance - I can't have a decent coffee at 12 mid day and sleep properly that night, it won't keep me awake but my sleep is not as good, lighter. I have 1 or 2 coffees before ~9am and that's it. I like green tea but that has caffeine in it too? You mention no coffee making no difference though, it might be a case of time w/o but we all seem to cope with coffee differently, like those who have it after dinner. 

Others mention magnesium supplements - you probably tried them, if not they're worth a go. After a few months spell of being wide awake at 3am over-thinking stuff I found they seemed to help, after a few weeks. 

Along those lines the other thing that's suprisingly good is sleep tea with passion flower and valerium (I think) in it. Aldi have it. I took some on a bikepacking trip once as an alternative to an evening beer, I always felt a bit revved up after a long day's ride. Works a treat and it has no side effect the next day unlike some antihistamine or herbal Nytol tablets. I take it on work trips now to help get past jet lag. 

On their own maybe each thing's not going to change much, perhaps a it's a case of marginal gains in a few areas to tip the balance?

https://fs.blog/knowledge-project-podcast/matthew-walker/

Talking of podcasts, found this episode with a 'sleep scientist'. Not listened to it but the series often has good episodes, interesting guests. 

From experience, temporary (6 months) anti depressants that also made me sleep were the solution for me - once I could get good sleep I could gradually start functioning and make the necessary changes. Doc prescribed Mirtazapine https://www.nhs.uk/medicines/mirtazapine/about-mirtazapine/

CBT was total bollocks, the first thing the therapist said was they'd never seen a case like mine (work stress/burnout - pretty common as I understand). Made me feel even more alone so I didn't go back for more CBT.

Good luck, you will get it sorted 👍