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
lee89031 mekin
Posted
Hi Mekin;
I have pretty much the exact same problem that you and some others have described. I have had chronic, worsening sleep issues for several decades (I'm 52 years old) and not exactly sure when the exercise component started. I have had at least 10 sleep studies and have talked with numerous sleep doctors, but when I mention how strenuous exercise destroys my sleep they just scratched their heads or looked at my like I am making it up. My insomnia is entirely sleep maintenance insomnia; I sleep 3 or 4 hours, then have broken sleep or no sleep for the next 2-3 hours. I get very little (1%) stage 3-4 sleep, and doctors scratch their heads about that fact also. The other weird thing is that I can't sleep during the day--I fall asleep and wake up immediately...no matter how tired I am. As far as exercise is concerned, there is a threshold of intensity that sets thing off. Earlier this week I went to the gym and did 15 minutes each on the an elliptical machine and a bike and made sure my heart rate never went above 110. I slept ok. Then yesterday I went to the gym and got carried away and at times my heart rate went up to about 120. I woke up this morning at 3:00 AM totally wired and never fell back asleep. My hunch is that I am extra sensitive to noradrenalin (norepinephrine), which is elevated for up to 48 hours after exercise, more so if the exercise is high intensity and long duration. It's just a theory. I haven't exercised much in the last few years except for hiking, which I tolerate very well, but I am going to monitor my heart rate carefully and see if I can work up gradually to more intensive exercise. I would be curious if you have measured anything such as heart rate and also found there is a threshold that set things off. Good luck and thank you for posting...I thought I was alone in this.
laura98152 lee89031
Posted
Hi Lee,
I'm wondering if you have ever found relief from your exercise-induced insomnia. I suffer from the same problem and am at a total loss. Like you, I have suffered from insomnia for decades but have only recently developed the worsened insmonia in response to exercise. For me, any amount of exercise, even walking, triggers terrible insmonia. I have seen many doctors, sleep, endocrinologist, etc. Were you ever able to find about more about your theory about norepinephrine? Have you gotten any clues at all? It has gotten progressively worse for me and is taking a huge toll on my life. Any updates you can give me are appreciated.
lee89031 laura98152
Posted
Hi Laura,
I'm sorry to say that I haven't really figured anything out. I've pretty much given up trying any intense exercise, but I seem to do ok with occasional moderate exercise lately. But since I never sleep well, I don't recover well from even moderate exercise, so I'm usually super fatigued for a few days afterwards.
It sounds like your exercise intolerance is much worse than mine. Mine has been worse than it is now, so maybe that's reason to be optimistic.
I just went on a vacation and actually had a few days of very decent sleep. I'm not sure what was different except I was outside most of every day and spent little time looking at screens...that must have had a positive effect on my circadian rhythm. Now I'm back at my windowless office, sleeping terribly, and too tired to do anything at night but sit on the sofa and stare at screens. It's a vicious cycle. I'm not sure if sunshine would be a magic bullet, or low glycemic index eating, but those seem like good things to consider. Good luck.
fred73923 mekin
Posted
That's funny because I brought a cardio watch to check my HR in the gym.
I also noticed that if my HR goes above 110 BPM, my sleep is less good.
I set the alarm of my watch to 110 BPM, so when I exercise, I stop my set as soon as I hear the alarm.
I'm surprised how quick the HR goes up and never noticed that before.
Even a set of 12 Reps of a one arm curl with 10 Kg can rise my HR above 110 BPM !
I can't imagine a squat with 2X body weight.
I also went to hospital in order to study my sleep. I slept only for 4 hours and took sleep pills but doctor said all is OK !
He said not to train after 18 pm but even if I train early in the morning, a too high training intensity triggers a bad night.
That's really boring and I feel so weak. last year,I was able to squat 2X my bodyweight !
I made a low intensity training and see if sleep improves for the next weeks.
bruno56842 mekin
Posted
Hello guys,
I'm so glad to finally find people suffering the same issues as mine. I also have been to some doctors and none came up to a solution. The overall symptoms are very much the same as everyone is reporting, with maybe a feel differences. Some interesting stuff that I found about my case and maybe helpful to discover whats going on:
Anyway, thanks guys for your comments, and very happy to see that I'm not alone on this and maybe together we can find a solution for this problem.
Cheers!
fred73923 bruno56842
Posted
I think some researches can also be done on the CNS. Doctor told me it could be an issue with the parasympathic system which is more active than the sympathic system. The body is in an "alarm" state and that keep you awake. Weight lifting can induce overtraining and emphasize the parasympathic system, On the contrary, overtraining on running or biking will result on dominant sympathic system.
parasympathic system wake you up
sympathic make you sleep
RohanS fred73923
Posted
Hi Fred,
Other way around! Sympathetic gets you going and the parasympathetic slows you down.
Bruno, Fred is right. It seems that some of us, for whatever reason have central nervous sytems (CNS) that can get out of balance. I kind of think of it like hiccoughs, when your phrenic nerve is overstimulated. When we excerise, your sympathetic nervous system is involved in increasing your heart rate breathing and stimulating the release of cortisol and other adrenal products (such as norepinephrine) and it seems that after exercise it isn't counter-acted by our para-sympathetic NS. This is bad for our exercise too, because your paraS-NS is to do with everything you need to recover and rebuild, so in effect our exercise by be harming us as much as it is doing us good.
What's worse we can end up getting anxious about not getting sleep, which makes it worse, and not get enough sleep, which also makes it worse. Sucks.
The people who have helped me most is the Chronic Fatigue service at the Royal Free Hospital on the NHS. I ended up with chronic fatigue via over-training, but it's the same processes involved. It's very frustrating, because it means in order to prevent the symptoms requires being extremely measured in your approach to life, which I find antithetical to my entire being. No one knows exactly why some people get it and others don't but there is usually a triggering event and some kind of early childhood trauma or stress is implicated.
In my case, I can probably point to a number of things that kicked it off or contributed to it. Maybe one, some, or all of those factors was required.
What I can suggest that does help, is;
I'm afraid, following all of this is no guarantee. I've relapsed recently and I am back to trying to be really moderate. I'm finding more and more there are people like us though. It is strangely comforting.
fred73923 RohanS
Posted
Hi RohanS.
Thanks for correction.
I started to get insomnia because of a psycho logic stress in my job.
Everybody has a different amount of stress and stress due to training, even if this is good add to the amount the CNS can absorb.
All kinds of stress, family, job, money, training hurt the CNS.
I can get a relative good sleep if I train with a HR below 110.
It is frustrating because my body quickly reaches 110 Bpm, compounds movement, squat, DL and BP are no more possible.
I can easily go over 110 Bpm even with light flies !
When I was at hospital, doctor told me more and more people are subject to insomnia mainly due to a stressful society.
Perhaps all the waves wifi, cell phones, TV, pollution can also affect our brain.
I tried to train in the morning but it does not help. As soon as the insomnia has been triggered, I know I will have a bad night.
Symptoms are : my head is hot, stuffy nose , cough, elevated rest HR which increase when I lay down, as if I had caught the flue.
lucas14544 bruno56842
Posted
Hello everyone,
I may have good news; I've been mostly cured from this strange phenomenon!
I figured, as stated before in this thread, it has something to do with a overactive HPA (Hypothalamic–pituitary–adrenal) axis.
Same as you this concurred mostly when doing psychical exercise. Strenuous exercise exacerbates insomnia related symptoms.
I used to feel kinda off after exercise; i felt tired, stuffy nose and a light headache. In the early evening i felt tired but wired and couldn't shut up my mind. I was not thinking excessively, but i felt like my body was is a fight-or-flight response the whole evening. Which made my sleep, as you may think, a total disaster. I didn't even get sleepy past 4 a.m.
This made me think... Is my HPA-axis maybe too sensitive? Or maybe it's just a factor it's been overloaded for a long time? I think allot of factors contribute too the state we are in. Too much stress, not enough sleep, pushing yourself too hard, etc. And maybe a little bit of genetics and personality.
I've tried almost anything and like you I've visited endocrinologists and neurologists.And visited countless of sleeping clinics here in Holland. None of them did avail some of my problems, but worsened my symptoms!
As I'm a naturally bad sleeper i've always been prone to be overloaded. I guess this screwed up my HPA-axis and made me really sensitive to stress. My sleep was always really light and not refreshing. I think it has something to do with too much cortisol during the night which suppresses endogenous melatonin production. This also contributes in not enough deep sleep. Which is - as you may know- most important for recovery and stress.
So a few weeks back, after doing some solid research, i contacted my doctor. I wanted to get a subscription for amitrityline 10mg (Elavil). It's an off-label drugs used to treat sleep disturbances. It's been known to normalize exaggerated cortisol release, according to research.
Within a few days i already noticed i was extremely tired! Like i could sleep all day! You can say this is normal when using low dose anti depressants, but i felt like i was functioning purely on cortisol and adrenaline before and when starting this it was finally normalized. I finally get sleepy in the evening, just like it suppose to be.
So after two weeks in i felt horribly tired. Almost so tired i could sleep all day. So i started sleeping allot more. From 5.5-6 hours of light sleep to 9-10 hours of deep sleep a night! Marvelous! And even though i felt like crap because i was tired the whole day, my body felt recuperating for the first time in years.
At the moment I'm 4 weeks in. And I'm just typing this during a strenuous workout, just to share this with you 😄 I've been training everyday again since a week or two. I started with 150 pushups and 50 pullups. Normally 1/5 of this would give me horrible insomnia, but not anymore!
I also take taurine (3gr) and trimethylglycine (3gr) in the morning with my shake, which may be relevant. And ZMA (zinc with magnesium at night). All these supplements have a calming effect on the nervous system.
slalomdude lucas14544
Posted
Excellent news lucas. How would you compare the Elavil to the Silenor ? I am trying 6mg of Silenor based on your previous recommendation. Unfortunately i still wake up several times from 2am onwards.
lucas14544 slalomdude
Posted
Hi slalomdude,
I think the most important difference between the two, is that Silenor is mainly for sleep maintenance insomnia. It does not help you fall asleep. And you can take it with food 😉
Silenor worked OK for me. But sometimes i still would be awake the whole night, if i didn't take it early enough. Another thing is that i'm fully awake in the morning. With Silenor i sometimes felt like i got run over by a truck, lol.
With Elevil it's different. It somehow synchronizes my sleep rhythm, because i get sleepy by myself in the evening. Which didn't happen with Silenor. So i don't feel wired anymore. I feel quite relaxed before sleep. Then when i take a Elevil, i look forward to going to bed, lol. It doesn't make me pass out (it did the first weeks), but it feels like it should have been. Just sleepy enough and a little bit tired. When i go to bed i sleep almost instantly, which took me normally like 1-2 hours. Same as with Silenor.
Somehow it really calms down me down. It do think it has to do with an overactive HPA axis.
Here's some research:
https://www.ncbi.nlm.nih.gov/pubmed/8391426
https://www.ncbi.nlm.nih.gov/pubmed/23402534
https://link.springer.com/article/10.1007%2FBF00429087
https://www.ncbi.nlm.nih.gov/pubmed/9543313
Concerning the neuroendocrine implications of chronic antidepressant treatment, amitriptyline (5 weeks, 4.5 mg/kg.day) produced significant decreases in basal (ACTH, -47%; corticosterone, -31%) as well as stress (30 min novel environment)-induced plasma ACTH (-38%) and corticosterone (-57%) levels. Previous experiments have forwarded a role of limbic MR in the tonic control of basal HPA activity. Based on the present data, we hypothesize that during amitriptyline treatment a rise in limbic MR may be the initial phenomenon in a successively adjusting HPA system, as evidenced by the decreasing plasma hormone concentrations, declining adrenal size, and up-regulation of GR in particular brain regions.
bruno56842 lucas14544
Posted
This looks very good news! I'm very happy for you Lucas.
I'll definitely comment this to my endocrinologist (I guess you need a prescription to buy that).
This will for sure come in handy as I feel that my condition is worsening. Yesterday I had sex with my girlfriend twice during the early afternoon and I slept like 2 hours during the night, it seems like the amount of exercise I can do before getting insomnia is decreasing really fast.
Also the vision thing I commented before (I think its called Phosphenes) are getting much stronger and are even noticeable with the eyes open. They are getting super annoying.
Cheers,
fred73923 lucas14544
Posted
Hello Lukas,
I'm not sure antidepressant pills is the way to go.
Be aware of the side effects.
I used to take high dosage of Alprazolan to help me sleep, up to 2,5 mg which is near the toxic dosage for my liver according to my doctor.
Once you are addict to this pills, and it can go very fast, weaning is very difficult, it is a drug for the brain.
Taking this pills hide the insomnia but does not solve it.
They can't be taken over a long period, a few months only.
I'm afraid the insomnia will come back once you stop the pills and you will have to fight again weaning.
It is better to find a natural cure, which I'm still searching for !
lucas14544 fred73923
Posted
Sorry to hear that, but you're wrong. Xanax is a benzodiazepin, which is highly addictive and contributes to a really nasty withdrawal. It's a gaba agonist.
Low dose amitriptyline on the other hand mostly targets histamine receptors in the brain, which make you sleepy. It can be take for long periods if needed.
I understand that your seeking something natural, me too. But I've tried almost anything. I've tried almost every natural remedy out there. None of them really worked or just minor. Or they also have side effects. I'm just sharing what works for me.
fred73923 lucas14544
Posted
OK, Thanks for sharing this information.
This could be a solution, I'll ask my doctor his opinion about Elavil.
RohanS lucas14544
Posted
Thanks to you and Fred for this discussion. Interesting.
I've had a bit of a setback lately. I'm going through the whole business again and sleep is one of the things that's most adversely affected. MAN -it's frustrating. I went for light little run on Sunday afternoon....boom no sleep til 4 in the morning. Wired as hell.
I know it's manageable naturally but it's really really hard. I have to treat myself like I'm stepping on egg shells. It's not cool.
If things don't improve soon I'm going to take a look at Lucas's solutions and take them to my GP.
nfrared lucas14544
Posted
Dear lucas14544,
been reading all these posts and found yours on HPA. It is however 3 years old now. This means you have been collecting quite some experience with amitrityline, depending on how much of it you did. I was wondering how long were you on it, did it wear off in the end/ did you have to increase your dose? And of course - how has the whole exercising been going for you? Please share with all of us! If anyone tried it and has something to report we would all apreciate it a lot! Thank you!