Having trouble falling asleep even when I'm relaxed ...

Dear all,

I had to ask you, as in my vicinity there are no experts in this topic or people with a similar problem. I feel super anxious and worried sometimes, and generally think about this more than half the day, especially in the evening scary thoughts sink in that there is something seriously wrong with me hence I want some professional insight. Let me describe the situation in detail, I apologize in advance for all this information but I really want to make sure that your diagnosis would explain everything. I try to give an objective unbiased description of the situation and leave you to determine what the actual culprit could be.

I have been having troubles with sleeping for more than five weeks now. Let me outline some basics about myself before explaining my recent problems.

I am a 21 years old young man, a university student of good physical health. I have always been very energetic and never really liked to go to bed early. It would always take me longer than average time (up to an hour) to fall asleep than most kids. I did notice this but never really annoyed me as I would always sleep eventually. Especially at uni my average bedtime was around 2-3am. Few times, but more often than average, I would have trouble falling asleep. Like this summer I had three sleepless nights (not consecutively).

My whole family was concerned about my sleep habits but I never really cared because I knew once I’d have a job, a pattern would follow. And so, I was right, I started my internship mid-July and after a week of not feeling ‘the most refreshed’ a pattern would indeed follow having me wake up just a few minutes before 8.15am when my alarm clock was set and everything was okay. I would typically fall asleep before 1am. I’d wake up twice 3am and 6am to go to the toilet but never had any trouble getting back to sleep. I’d also go jogging three times a week. This was on for 8 weeks then I’d go home and problems started soon when I travelled back home (same time zone) – I don’t know if that matters but I wasn’t jogging at home, later I would get back to the habit in two weeks.

So, I had two consecutive ‘party nights’ when the next morning I’d sleep in and wake up in the noon. I tried to go to bed relatively early at 1am (at home as I mentioned my average would be 3am) and had racing thoughts until 4am and then slept again till noon. I was a bit upset about that but next night came, again I felt tired at 1am so I tried to sleep and I also had to wake up at 8am to deal with something. I was relaxed and not worried about the sleep too much. Soon I noticed though, that although I didn’t feel awake (I had no racing thoughts – just some random thoughts I couldn’t recall) I was not asleep either (I was constantly checking the clock every 30-50 minutes – which I know is a bad habit – but I wanted to check whether I’ve slept). I must admit in my perception it didn’t feel that long, felt more like a 10-20 minutes period and I very often hear myself starting to snore. That night I remember I was in this half-awake state till 5am then my alarm woke me up at 8am from deep sleep super sleepy and sad knowing that I only slept 3 hrs of sleep, but to my big surprise I was feeling good the whole day. I didn’t feel as good as I would when I do my usual 4am – 12am sleep. But I could function and focus. And this would carry on night after night being in this half-asleep half-awake state for hours and then get like ‘proper’ 4.5 – 6 hrs sleep and feel okay, with my cognitive abilities being good, but never really fully refreshed with a clear head. I was being constantly worried about this and started reading an abundant amount of stuff about sleep. Everyone would tell me there is nothing wrong with me and I was happy to be reassured but still every night until 4, 5, or even 6am I was in this half-asleep state (would wake up between 10am - 12pm) and it would develop into a sleep anxiety me ending up not able to get any deep sleep properly once for two nights. After the first sleepless night I went to the doctors before who would prescribe 5mg Zolpidem which did not work at all for me and so I never took it again. Then on the third night later I took 0.25mg Xanax (I had it from my mom) because I started panicking because I could barely stand on my feet. Thankfully, it helped and I was asleep in an hour and slept for 9 hours with only waking up once that night. It started to get better I would start to be less worried and anxious, I would start taking Xanax every night when I could not sleep. It would ‘only’ take me two hours to doze off. After a few days, I cut off Xanax and soon I noticed just after 6 hrs of sleep without Xanax was more refreshing than 8 hrs with Xanax. One day I was feeling so good that I decided to finally go and get a drink with my friends. I started to feel like I’m making a mistake, and when I returned at 2.30am drunk, the anxiety kicked in when I noticed that an hour later, although intoxicated, I was still awake. I did not sleep that night and the vicious cycle began again.

Being obsessed with this for three weeks of constant symptom checking and not paying enough attention to my studies I filed an extenuating circumstances form and went back home from uni to take a vacation in a less stressful environment. Two days ago, my psychiatrist calmed me down that I don’t suffer from anything bad, she said I have ADHD which somewhat does fit the description but I don’t think this could be the culprit as I would never have this type of sleeping problem for longer than two nights before. I went jogging that day and felt great in the evening very optimistic and calm. I went to bed 12.30am thinking everything is going to be alright with a positive and relaxed mind … but again I could not fall asleep deep until 3am! (woke up at 10.30am) I would also lately get dreams before falling asleep deep which really freak me out as I know they are not supposed to happen only until the end of the sleep cycle.

And I started worrying again. I feel like the problem is more than just mental. Or is it in my subsconsious? Please help! I keep a good sleep hygiene except for my sleep schedule. Could that be the problem?

I was prescribed 0.25mg Xanax and 75mg Trazodam. Xanax is effective for me so far but I know soon I probably get used to it and I’d have to increase the dose.

I really look forward to your opinion.

Thank you,

Tamas

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