Sleep problem: Vivid dreams & waking up exhausted

hey, how are you getting on, im new to this forum thread and just saying hi to everyone to see how everyone is doing and if anyone is making progress etc.   im going to look into ways to improve sleep as i have the too much dreaming/waking up tired thing going on also, so am looking into solutions as it has been going on a long time now and doesnt seem to want to go away on its own.

im currently taking sertraline (ssri antidepressant)...  will be speaking to my doc in a couple of days

Honestly, I'm still really struggling. I'm sleeping, but I just don't feel like myself I barely have it in me to work a low demand part time job. I get so mentally exhausted quickly. I just don't feel like myself.

I'm really wondering if the antidepressants are causing this problem. I'm on Viibryd and Cymbalta. They work really well for managing my depression, but I didn't struggle with fatigue and exhaustion to this extent when I wasn't on them. I definitely don't want to go back to being so depressed, but this isn't much better. I don't have the energy to take care of myself and exercise and eat well and get everything done that I need to.

The only thing I can think of is to keep going to specialists to make sure I don't miss anything that could physically cause this and start tapering down my antidepressants some. I don't know that it will be a solution, but I need to see if they are exacerbating this. Keep me posted on anything that helps you!

hi KellySusanna, thanks very much for checking in with an update.

god it's amazing how much your story sounds like mine.  i also work part-time, and i purposely stick only to part-time because it is simply all i can do, because my mental health isn't exactly perfect (depression/anxiety...although luckily sertraline is really helping), and also because of being quite tired very often, not just 'a bit tired' but sometimes it's a case of 'ok i need to lay down and sleep right now!' .. (i imagine u can relate to that!)

i often have to nap in the daytime also, as sometimes i just cant get through the day/evening without sleeping again some more.  sometimes i have to sleep again literally 3-4 hours after i have gotten up, which is annoying, but luckily that's not every day).

i can totally relate to the other thing you said also, in that sometimes, if it's very early morning and i wake up but still feel a bit tired and not feeling like perhaps i have had enough hours sleep.. then, if i sleep some more, i will then often go into that intense dreaming stage, so then when u wake up again u are now even more tired (i read that the brain is firing away so much, because of that constant dreaming state, that u become very mentally exhausted).

you also mentioned about 'not feeling yourself',  that sucks doesnt it, i know that feeling;   you are kind of doing not too bad or 'getting through' as best you can, but u just dont feel as good as you know u can feel, or have felt in the past, etc.  u just don't feel like yourself anymore.

like you, i also didn't have this fatigue/sleep/tiredness problem until i started using antidepressants.  but .... i suppose someone might argue that the fatigue/tiredness/poor sleep is part of depression anyway, so eg. when i got to the point in my life where the depression (and anxiety) got so intense that it was difficult do do normal things like mix with people and work etc, and so started taking antidepressants, maybe around then i was on the road to tiredness and sleep issues anyway.  to be honest i just dont know.  i have to say though, as much as i dont like the tiredness and sleep problems etc,  i'm not going to stop taking sertraline as there's no way i want to go back to intense depression and anxiety again.

i guess an option for both of us is, we could try different antidepressants (not just ssri's, but different types such as the older meds, or the newer stuff which work a little differently than the ssri's .. meds like mirtazapine, bupropion, venlafaxine, and so on.. which might turn out to be energizing, instead of 'sedating' so to speak)

speaking for myself though (don't know if u are the same?) ... the problem is i dont want to start switching meds (because as we all know, the problem with antidepressants is they can take months to work.. but also it might turn out to be the wrong med for you, so u might spend months having a really bad time, only to find the side effects dont ease and the med doesnt start working for you, so then you are back to square one again of having to try something else new, which works). and anyway, in my case the sertraline i am taking is actually working for pushing back the depression and anxiety so i can at least live 'reasonably', even if it's not perfect.  i just really wish i could find something to add to taking the sertraline, to just get a little less tiredness or just some better quality sleep, and definitely less 'dreaming phase' sleep if possible.

i am talking to my doc in a few days, i really dont know if he will have any answers (i did ask him if i could see a sleep specialist or maybe should i try some kind of sleep study to try to determine what's going on with my sleep cycles, but my doc kind of just dismissed all that, im not sure why..  (maybe he just though tthe tiredness/sleep problems is simply part of having depression, or that some people have increased tiredness taking certain meds).

anyway, erm sorry  im guessing my post has ended up without any great solutions or anything, and maybe more questions than answers about it all, but i do plan to persue this matter and try to figure something out if i can.   i will certainly report back with anything useful i can determine

ps. by the way i had never heard of Viibryd, so had a read around about it.  i have not tried cymbalta myself.  i hope if u do taper down it goes well, do go slow ok, there's no rush is there.  do you think you might be able to eventually just get on one depression med instead of two?  maybe that would be helpful.  that said of course, im certainly no doctor or expert, and everyone is different anyway, so something which works for one person might not work at all (or be a disaster) for someone else.  for the record though, if you look at reviews for depression meds, the med i am taking (sertraline) scores around the top with regards to efficacy (how well the med works) and acceptability (how likely the patient will take to the med regarding side effects)..

 - if you want to have a look yourself, do a web search for 'Popular Antidepressants How They Stack Up' and have a look at the ABC News article which compares 12 antidepressants  (but of course obviously everyone is different and if you are doing ok on your current med/meds, then of course it might not be beneficial to change them).. but perhaps if you change antidepressants in the future, to try something like sertraline or mirtazapine (i tried mirtazapine myself in the past, and it was very good, and i didnt get tiredness or increased REM dreaming etc), but unfortunately, i suffer from RLS (restless legs syndrome) and sadly for many people, mirtazapine can make your RLS even worse, which it did for me, so i stopped taking mirtazapine and switched to something else, which was a shame as apart from the that, mirtazapine seemed very good and unlike many other meds i tried, it actually got rid of my depression/anxiety really well by about a week's time, as opposed to a lot of the other meds which can take months to work.. such as sertraline.

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hmm ..oh my god this post turned out really long, i hope i didn't 'send u to sleep' (no pun intended)  

..just to add on, in case anyone looks at the article i mentioned above about 12 antidepressants compared, i noticed the ssri called escitalopram is very high on the list, but just for the record (at least for me personally), that med actually increased the amount of dreaming, but oddly enough, i wasnt tired at all when i took escitalopram, so i dont know what was going on there.  i ended up stopping escitalopram anyway, because it just felt 'odd' having the 'dreaming all night' thing going on (even though i wasnt tired the next day), plus i experienced anxiety in the morning when taking escitalopram. as always though, everyone is different and maybe others have more success with it.  it's certainly a very hit and miss world with taking meds that's for sure....which is a real pain because it can make the process of finding the right med for you tricky, and perhaps a slow road (which is the last thing unwell people need).

Hi there . Your post is of great interest to me as i have had similar problems with anti deps as you.  Three years ago i was a nervous wreck having had a major surgery (i am frightened of hospitals).  Dr gave me diazepam, not much use, i asked for mirtazapine ro help me eat and sleep and then i just got worse. The psych changed it to lofepramine as i am on warfarin.  Not much better, dropped it and back to mirtazapine.  Still feeling all wrong in myself so tried to increase above 15mg, major spikes in anxiety so down to 7.5.  Since then tried duloxetine, zombiefied me, later seroquel, suicidal dreams, sertraline, nausea and massive uncontrollable anxiety.   Throughout all this i have had diazepam to take 5mg at night and about 4mg in day.  Throughout these three years every day i have a waking period of horrific dreaming in and out of consciousness until i wake fully feeling bad about another day of this.  I just think they are throwing anti deps as me but nothing is addressing the major anxiety dreaming.  I feel slowed down and ten years older, i dont know what to do.  More anti deps give more anxiety, i have cut down my sociless and i am a bit depressed with anxiety.   I see psych soon and feel like saying i just cannot go on like this, what has he fot for me - more medications probably.

Do you think trying to just come off low mirtaz slowly and eventually just diaz could be the answer to getting rid of lucid waking dreams? 

i only ask as you seem to know quite  lot about all these problems.

hi ann, i wish i had answers but there doesn't seem to be a single 'can't go wrong' solution to this problem.

one thing which seems consistent    is, for many of us, it doesn't matter which med we take from the long list of ssri family type meds:-  it seems all of them cause sleep related issues for many of us, such as vivid dreams, not enough deep (restorative) sleep, and daytime sleepiness/fatigue/tiredness or whatever anyone wants to call it.

maybe ann you could ask your doc or psych about trying a different med.  have you tried modafinil?  that one treats daytime tiredness and fatigue/low energy, and it also treats depression (works right away, dont have to wait months like with ssri meds)...  helps concentration, mood.. might sleep better as it's not an ssri med.

Thank you for your very helpful information.  I dont know how ro ask about modanifil as it looks like another month or more before next appointment. My gp wont change any meds without psychiatrist letter. He is fully booked for weeks.  Dont know what to do.  Hes new.  I dont think he read my notes about bad responses to ssris in past. He didnt even know i was on warfarin, maybe that means modafinil is out.

hi danielle, sorry to hear about your tough time you are having,  im also having the same problem like many others here,  many of us like you having these problems for years.

i dont agree with your mum;   yes it's true we all dream but then there are some of use whose sleep is not quite right (such as too much dreaming or bad dreams etc), so of course we are bound to suffer in the day due to the lack of proper/quality/refreshing sleep..

if i find any solutions to this problem i will post back here.. meanwhile would be interested to know how you are getting on, and hope u are well

best wishes from sparrow

 

hello ben, please if possible let us know how u are getting on and if you had much luck or progress?

there is a blood test you can take which tells you if you have inflammation, so if you didnt know already, go to your doc for the test, to check

if you do have inflammation, dotn worry as diet changes and/or meds will help you (the meds are safe, nothing to worry about)

Hi Sparrow. The issue is still the same, in fact having a bad virus made it much worse, along with the associated anxiety and depression.

I've read a few of your comments here and I'd guess that the antidepressants are likely causing the issue for you. That's just my opinion of course, but many antidepressants are known to affect sleep and make you dream more. I'd talk to your doctor about it!

For me my issue is very complex, seemingly more complex than many of the comments I've read here. It seems to be part of the damage the drug reaction did to me. It's left me with chronic fatigue too. I've had blood tests but they don't show anything, I don't think there are blood tests for chronic fatigue. I've read that chronic fatigue syndrome/ME is actually a type of inflammation in the brain, but again I don't think this shows up on blood tests.

I assume it's possible that n-acetylglucosamine could potentially therefore help CFS, but I'm unsure.

But yeah, I wouldn't worry yourself about this sort of stuff too much, I think it's worth addressing your meds first. I'm assuming you probably know never to just stop taking antidepressants though? Just checking, wouldn't want you to do yourself any harm!

hi ben thanks for replying

i have been taking sertraline for several months now (and have taken ssri antidepressants on and off for many years now).  this time however i don't think i can risk stopping taking antidepressants. the reason is, whenever i stop taking them, my depression and anxiety eventually finds it's way back (sometimes it takes several months, but it always seems to come back eventually).  it's quite often said with the ssri antidepressants, that they ease the symptoms of depression and anxiety (so you can live at least live a 'reasonable' quality of life), but they may not actually cure the depression/anxiety completely (especially for lifelong sufferers of depression/anxiety...  this is the category i am in).

so for a lot of people who take antidepressants or related meds; if they get side effects (such as in my case, poorer quality sleep), they have to weigh up if they would rather stop using the meds and risk going back to their depression/anxiety, or if they are experiencing side effects, to rather have those side effects instead.  for my case, i would certainly rather take the side effects (which i would say for me only really is the poorer sleep, which seems to be down to too much dreaming/REM), because when i am not on meds and when the depression/anxiety get's very intense, it really is the worst thing in the world for me (and i'm sure others can relate).. i literally get so bad that my thoughts are totally messed up, very negative, and i'm stuck with suicidal ideation which of course can be a very dangerous situation to be in.

i was taking co-codamol for my RLS but i have just stopped taking that, as it causes constipation, which i have now decided is worse than the RLS!    annoyingly though, i have felt like crap the last couple of days, and i think it is likely linked to currently experiencing withdrawal from the co-codamol (as it contains codeine).  i will just have to hope i feel better in a day or two.  i'm seeing my doc in a few days so if i dont feel better i will let him know, and also i will chat about my RLS.  i'm kind of worried the sertraline isn't working so well anymore, but anyway, will have to see how things pan out.  i think the real problem for a lot of people, certainly with ssri meds, is they can take so long for you to feel better (in my case it took 3 months!)   that was so difficult to get through, i really do feel for people going through the same thing. and for many people, starting a course of ssri antidepressants can make you feel worse before you feel better!  i mean really, that is the last thing somebody with depression/anxiety is going to want to go through!   (i stuck it out though, and i do feel better now overall thankfully).

so hey ben, with regards to you, have you tried EPA at all to see if that helps your health? (EPA is natural, found in food such as fish)   it really is worth getting your EPA/DHA balance in check, because the health benefits are amazing (if you are very low on EPA though, it can take a few months to get going, so you might not feel much difference at first).

it has been proved that people who have diets which are high in fish tend to be healthier and are less likely to have depression and anxiety, and in your case EHA reduces inflammation.

so if you havn't tried it, give it a go.  i did some research around and didn't like the look of buying fish oil supplements, because i found that for one thing, for the good quality stuff, it was not cheap to buy, and also, many of the supplements were not particularly high in EPA, so i would end up having to take eg. 4 capsules a day...

so i settled on the following which i now do every day (sometimes i might miss a day, which is fine of course, but for the first few months, you should keep it to a daily schedule):   i eat one small can of sardines in spring water each day.  the amounts of DHA/EPA in canned sardines varies between the brands, so if it's something you look into, check the details on the can first as it will tell you the amount of DHA/EPA contained inside.  the brand i settled on which is in one of my local supermarkets, are sardines in spring water, which were caught in the central-eastern atlantic ocean.  the amount of DHA/EPA does vary depending on which part of the world the fish are from.  i have several supermarkets near me, and i was surprised to see how much the DHA/EPA varies between brands, so check the details on the can first to make sure it is very high in EPA.

by the way, the reason i buy the sardines in spring water and not oil such as sunflower oil, olive oil etc, is because, some of the EPA is lost in the oil, whereas with the spring water sardines, this effect is reduced.  also, the spring water sardines have less fat than the ones packed in oil.  there is no risk to health eating a can of these sardines each day, they dont contain mercury because sardines are too low down in the food chain. and finally, like other fish, the sardines are high in omega 3 which is good for many things such as good for the heart, and high in protein etc, as well as giving you energy of course etc

if using DHA/EPA to help depression and anxiety (it has been proved to help in clinical studies), what you want to look for is, whatever fish you eat, that the EPA amount is above 1000mg, when you subtract the DHA amount from it.  so in my case with the sardines i eat, written on the can: (when the spring water is drained): the typical DHA amount is 620mg, and the EPA amount is 2100mg. so if i subtract 620mg from 2100mg, it means i am getting about 1500mg of EPA each time i eat a can of the sardines.  for depression and anxiety, you need to be taking 1000mg to 2000mg of EPA per day, so i am satisfied with the brand of sardines i chose from the supermarket and continue to eat them daily (well, sometimes i forget a day, but since i have been feeling not so good lately, i am going to get back on track and eat them daily for a few weeks).

ok i hope my message was not too long or boring, and maybe you already heard of EPA and the health benefits it brings, but if not, do check it out!

ps. of course i probably should have mentioned for anyone who read my post above, if you don't actually like sardines, there is other fish available which is high in EPA, such as mackerel for example. also, you dont have to go with canned fish, you could always go with fresh fish.  personally though, i chose canned sardines because it is the cheapest, and also don't contain any mercury. i enjoy the taste also; the taste of the sardines can vary between brands etc, so perhaps if you are on a budget like me, search around becasue you should be able to find sardines which are not overpriced, high in EPA, and also taste good.

Hi Sparrow,

I think you misunderstood what I meant about your meds. I don't mean I think you should stop them, I think you should tell your doctor about your sleep issues and ask if they think your meds are causing the issues (I personally think there's a big chance they are). When I said about stopping them, I wasn't advising you to stop them, I was just saying don't stop them abruptly in case you didn't know about the harm that can do. If you tell your doc maybe they can advise you on another med to take that won't affect your sleep as much. Just a thought.

Thanks a lot for letting me know about EPA I'll definitely look into that.