Hypnic/Hypnagogic/Sleep Starts Insomnia - Anybody Have This?

Hi - I would like to ask if anybody on here has exhibited the following issues and, if so, what was their experience/how did they treat it/how did they manage it. I am asking because I feel (completely subjective) that my form of insomnia is very specific and a little niche, so I am in search for answers about what it is/what it means/what causes it, etc.

I am 30. For the just a little over a year now, I have had a form of sleep-start insomnia that has increasingly become more frequent over time. Basically, I will start drifting off to sleep and shortly as I drift, I will wake up. Sometimes it is an actual "hypnic jerk" ie. I actually feel my entire body jolt, or just one arm. Other times it isn't really an involuntary movement, but I will feel my pulse down my neck/upper back and wake up. Yet other times there is no physical sensation, only a mental sensation of very subtly becoming awake. This will happen repeatedly for about 2 hours. I haven't found out if it lasts all night because at around t+2 hrs I usually take a 5mg ambien and fall asleep for good.

It started last August and happened one night. It happened once in September of 2017. Then it came back in December of 2017 and occurred about twice a week for 3 weeks. In January of 2018 it happened about 3 times a week for 3 weeks. In March I was prescribed ambien by my former sleep neurologist, but luckily no bouts in March. In April I took a polysomnographic sleep study because I was being tested for sleep apnea (it runs in the family so I wanted to check it out - at the time not related to my insomnia). When I took the sleep study, I took a 10mg ambien and slept fine, was diagnosed with mild apnea (AHI of 12 with mostly hypopneas and very few apneas; below average amount of REM sleep (7% vs 20%) but, on the ambien, almost instantaneous sleep latency). June was when the insomnia really came back. It would occur basically about 3-4 times a week for a period of 3 weeks per month; this happened again in July, August, September, and this month. Oh, and I basically now cannot nap, even when I am tired. When I try to nap in the afternoons on a weekend, for example, the sleep-starts occur so frequently - basically immediately as I start falling asleep - that they are even worse than when I sleep at night.

Look, this might all just be anxiety, as I am an anxious person, though I basically never had sleep problems until last year. It might also be psychosomatic and increasing psychological anxiety about sleep snowballing. I am also aware that the increasing symptoms do positively correlate with my ambien prescription, which I know has rebound anxiety, insomnia, nervousness, disorientation as symptoms, as well as addiction. Needless to say I don't love the feeling I have the next day after I take ambien.

Additionally, for the past two weeks, I have noticed some small subtle muscle spasms and twitches. They aren't frequent and are very mild/subtle, though they tend to occur if I daydream or concentrate intently on reading a computer screen. Could just be stress caused by the insomnia + insomnia induced anxiety + ambien side effects, though I did have one episode for 2 days where every other hour my right chest muscle would just involuntarily twitch.

I am going to see a sleep neurologist (different from my last one, who is now out of my insurance) next week. What scares me is 1) how increasingly frequent these episodes are becoming over time and 2) the form of insomnia it takes, which is persistent sleep-starts, as opposed to just lying awake not having the urge to sleep (though I suppose that would be just as bad, if not worse knock on wood).

Anybody have any insights, advice, or similar experience? How did you manage if you did? Sometimes it the hardest part of this insomnia is not being able to have others understand what you are going through and telling you it's ok.

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