Unusual exercise-induced insomnia
Posted , 126 users are following.
TL;DR: I have exercise-induced insomnia for which no one has been able to explain or provide a solution.
I used to exercise regularly. I would wake up every weekday at 6am, bike to the gym, and exercise for about an hour before work. I would usually jog or do some other cardio for 20-30 minutes, then do weight training for the rest of the hour. I had help from a personal trainer, so I knew what I was doing.
I felt great, and I was in the best shape of my life. I kept this up for about 3 years, before something strange happened: I would wake up around 2 or 3am, unable to fall back asleep. I was 33 at the time, and I know sleep patterns can begin to change around this age.
At first, I noticed that I slept much deeper on days I didn't exercise (e.g. weekends). Then I began waking up in the middle of the night, but would usually go right back to sleep. It got worse. Eventually, I would wake about 4 hours after falling asleep with a feeling like an intense adrenaline rush or panic. It would last about an hour, and I would have poor, restless sleep the rest of the night.
I did not have trouble falling asleep. I was in bed at 9:30pm every night, then would read a bit with lights out by 10pm. I would fall asleep within 10 minutes.
When this started happening, I adjusted my routine. I worked out during lunch, or in the evening. No change.
I tried doing more or less cardio vs weight training. No change.
Today, if I exercise at any point during the day, I will only get four hours of good quality sleep.
I've been to several doctors, sleep specialists, and neurologists. I've had multiple take home sleep studies, as well as one on-site at a medical institution. The only thing they've been able to confirm is that I do indeed wake after 4 hours if I have exercised, but no one can tell me why. Many doctors don't even believe my story -- they think it must be psychological stress that I insist on tying to a physical cause.
I have found that walking, low-intensity biking, and hiking are all acceptable forms of exercise that do not trigger my insomnia. I can hike 10 miles and be fine. But if the hike is over very steep terrain, or if I were to jog for 10 minutes, then I have insomnia. So the intensity is definitely a factor.
The sleep studies did reveal that I have very mild sleep apnea. My doctors have told me that normally it would not warrant treatment, but it could be related. However, the usual recommendation for such a mild form is simlply "get more exercise".
My current pet theory is this: following a day of excerise, one's muscles will repair themselves during sleep, usually around 3 or 4 hours into the night. This process requires oxygen from the blood, so if my sleep apnea lowers my blood oxygen levels, then the repair process might cause it to dip below some threshold; my body panics, sending adrenaline through my body to wake me up to address whatever is happening. However, my sleep studies showed my blood oxygenation stayed over 90% the entire night.
I'm currently trying out a CPAP treatment. I'm still adjusting to it, but so far it hasn't made any difference. There's no real reason to think that it will, but I'm willing to try anything at this point.
When I tell this story, most doctors look at me like I have three heads, so I thought I would seek the collective wisdom of the Internet.
Cheers!
13 likes, 351 replies
curly52088 mekin
Edited
hello mekin , l hope you are well , i have been suffering from insomnia for the past 9 mths , horrific , my insomnia started when i started exercising alot more because we had a new dog and i would be walking maybe 10 miles a day and i was not compensating for this extra activity by eating more so i lost about 18pounds of weight . I started not sleeping one night after playing football and this has continued nine months later.
Throughout this period i would have intermittent periods of sleep but i could never understand why i had slept . Since then i have tried everything from herbal teas , acupuncture ( which seemed to help ) reflexology to various diets none of which offered any consistency of sleep ,,, one thing that has made a difference is stopping my A/D , citalopram which is an SSRI.
I was initiated on this because i could not sleep and the assumption was that i was depressed or stressed which i was not , depression and insomnia are two different entities and do not have to be linked . However since i stopped my SSRI my sleep has improved along with especially if i ensure i have enough calories during the day ,, this is my experience mekin , hope it helps .
james36561 curly52088
Edited
Agree that insomnia and depression are often interconnected (in that the former is a product of the latter) but in many cases they are also distinct and separate. I know that I do not suffer from depression yet I have terrible insomnia.
One of the treatments for depression is regular exercise which as we in this thread know is the antithesis of what we should be doing - giving the body ample rest and minimising overexertion is our primary treatment (pending further developments once the underlying mechanism is identified).
road01001 curly52088
Edited
Are you a male or female? Were you overweight before you lost the weight? How are you doing now?
bradley99834 curly52088
Posted
I have experienced this as well. If I exercise then eat a ton of calories after to offset the calorie deficit, it seems to help me sleep and block all the usual symptoms from happening. Could be that exercise causes too large of a deficit which the body reacts to as a stressor and causes insomnia, anxiet, etc. So bizarre.
How do you lose weight/ remain healthy then if you have to eat so much after each exercise? Seems like a conundrum.
james03392 mekin
Posted
Searching google because I have dealt with the same issue for the last few years. Can confirm every detail you mention. I am a 41 yr old white male. In the military, fitness is important to us. On days when I do not work out I sleep well. Other nights it is 4 hours of sleep, I wake up for two hours before I fall back to sleep.
viktor17916 james03392
Posted
Hi! Have you tried vagus nerve exercises, such as diaphragmatic breathing and massaging certain parts of your ear and behind it? You can google that.
road01001 mekin
Posted
Has this gotten better for anyone? It's been a year for me and it's very slowly getting better, but nothing drastic.
james36561 mekin
Edited
This complaint could have been written by me.
I have been suffering from severe insomnia which is exacerbated by exercise for the past 5 years. I noticed the clear correlation between exercise and worsening insomnia during lockdowns: I abandoned my routine of gym 5 x a week and found myself sitting on the couch doing nothing most days. Strangely, the absence of physical activity vastly improved my ability to sleep (although by no means is my sleep great even when exercise is omitted). By way of history, my sleeping problems started when I contracted a virus whilst travelling - this developed into something akin to post-viral syndrome (something that is receiving significant exposure due to long covid). The insomnia has been debilitating and has had a major deleterious effect on my life for the past 5 years.
I have tried a myriad of different sleeping cocktails - Z-drugs, valium style drugs, sedating anti-histamines, gabapentin, and others - but haven't found the 'solution' to this problem. I seem to build a rapid tolerance to antihistamines (i.e. effective for 2 or 3 days at most) and I try to use gabapentin sparingly as I believe there is a tolerance/addiction issue with GABA-centric drugs. The Z-drugs aren't effective.
The only 'drug' I regularly have is Melatonin and Vit D which I do believe takes the edge off the insomnia but this alone is not enough to address the core of the problem.
I also have a prescription for Mirtazapine - wow does it knock me out. I've never taken it more than 2 days in a row because, despite being immensely effective at making me sleep, it also makes me frighteningly angry/moody/grumpy/unmotivated. I am also fearful of staying on this medication and dealing with weight gain and - eventually - withdrawals if I later choose to stop. The mood changes are so profound that I do not feel the benefits of insomnia relief are worthwhile. I read on this (terrific) thread that there is some science to suggest that Mirtz might be the best solution to this problem as it could address dysfunction in the HPA axis, and thus may be more than a mere 'sleeping pill' for us who suffer from this esoteric condition. Thus, I'm reconsidering this drug with the thought of pushing through the first few days of moodiness in the hope that this resolves and I'm left only with sweet sweet sleep. What do others think? Are there any more benign solutions to this than Mirtz? I truly think that the research into long-covid will also benefit us as the similarities between the two conditions are too profound to ignore.
gary59219 mekin
Edited
i have the same problem and mirtazapine ultimateky mare it worse. been off for over a month now and still feel anxiety.
james36561 gary59219
Edited
First night I tried Mirtz I slept very well - I thought I had finally found the solution to my woes! This optimism was unfortunately shattered the next night where I had the same dose as the night before (approx 7mg) but hardly slept at all. I might give it another go in coming days but the tolerance by which my body builds to this drug is incredible.
road01001 james36561
Posted
That is not good to hear because Mirtazapine was next on my list of sleep aids to try. So far I have tried Doxylamine, Doxepin, Trazodone and pretty much all OTC supplements.
james36561 road01001
Edited
Mirtaz is arguably the best sleep option for our condition so if that doesn't work then there aren't really any options left in the histamine-based class of drugs.
I'm taking pregabalin occasionally which definitely helps but I only take it for 1 or 2 days a week (to coincide with days I need to be rested).
I would love to identify the root cause of the issue and address that - but so far I'm at a loss as to how to property treat this condition.
I'm currently week 4 of the Keto diet but that has unfortunately made sleep even worse (if that was even possible lol) - I'm supplementing with magnesium and electrolytes but that is not providing any relief. Worth a shot I suppose...
road01001 james36561
Edited
Some guy earlier said that you need to take mirtazapine long term for the full effect. Are you going to try that? As for myself I'm currently taking 2k IU of vitamin d in the morning and 2.5-5mg of melatonin before bed. I'm not sure if it does anything. I still have problems with falling asleep and will wake up after 3-4 hours even If I'm sedentary, then it takes me 1-2h to fall asleep again. If I exercise I don't sleep at all.
Yeah I don't think low carb is going to help. If anything there's a guy in this thread who started having this problem after doing keto. I have noticed that for vast majority of people with this problem some kind of a stressful period in their life was a trigger. Low carb, over-exercising, caloric deficit, psychological stress etc.
I have some ideas as to what's happening and I think it's important to do some blood tests. Morning cortisol, TSH, Testosterone, SHBG, free testosterone, DHEA-S. These test are a good start IMO in trying to figure out what's happening. I think it might be some kind of sympathetic nervous system hypersensitivity or maybe adrenal hyperactivity problem that causes them to release too much cortisol and adrenaline with physical activity.
It's a shame that most people seem to have gone away from this thread without any updates as to what's happening. It's a rare and serious issue, we should stick together in trying to figure it out.
road01001
Posted
Another thing people might want to test for is serum Vitamin A.
james36561 road01001
Edited
I'm not prepared to take Mirtz long term - I trialled it for 4 nights and the drug produced some side effects like stiffness in my joints/discomfort in my body whilst sleeping (or attempting to sleep). It didn't improve my sleep either (except for the first night). The overriding impression I got is that Mirtz is not the solution for me.
You've siad that you "don't think low carb is going to help" and you are 100% correct. The 4 weeks while I was on it were brutal and I do feel like it set me back (in a transient sense). I'm back to eating a diet with a normal amount of carbs and almost instantaneously my sleep has improved - as has my general wellbeing. I'd urge all of those doing keto or low carb to re-examine whether this is the right choice for them if they're also experiencing insomnia which is not responding to electrolytes/magnesium. Keto is supposed to be anti-inflammatory so the theory that our condition is an inflammatory disorder may be threatened by my and many other experiences with keto. Does anyone have any theories as to what could be going on? I do know that Keto seems to induce greater cortisol and adrenalin release which further stimulates the mind and body.
As part of my investigations into this condition some 5 years ago I extensively checked my thyroid and sex hormones as I was initially convinced that my problems were hormonal. Tracked my free testosterone, SBGH, Estrogen, etc over a period of a year but didn't ultimately identify a correlation. Given the extensive scrutiny I feel it is safe for me to discount these hormones as being at the root of my problem.
Let's keep the conversation going as sharing our experiences and building a collective body of knowledge may actually enable us to solve this mystery and improve our lives!
james36561 road01001
Posted
I should also add that I'm now doing 10k Vit D - I didn't observe any effect from the 1 or 2k I was previously on. I really do think that 10k Vit D helps to a noticeable degree. My research showed that 10k is a safe level of Vit D to take (although please do your own research). Melatonin also helps me - I think I take a fairly large dosage (10mg). I believe both supplements/hormones are anti-inflammatory and mast cell stabilisers.