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
BuckeyeChick mekin
Posted
Hi Everyone,
I tried posting a reply yesterday but a moderator deleted it for some reason. I'm not sure why. In my post of yesterday I had some links to some articles I found so perhaps that is why my post got deleted???
Anyway I believe our insomnia issues are related to over reaching or overtraining .I workout 7 days a week usually doing 20- 35 mile weeks -- perhaps I need to scale back to working out only 5 days a week and have 2 rest days where I do just stretches.
Also according to an article I read on intense exercise:
“Strenuous exercise beyond the usual for a given individual does activate stress responsive systems, including the release of cortisol in the evening and adrenaline and it is well known that difficulties falling asleep and staying asleep may occur,” wrote Dr. Eve Van Cauter, director of the University of Chicago’s Sleep, Metabolism and Health Center, in an email.
Let’s look at adrenaline first. The body secretes the hormone and a similar one called norepinephrine in response to exercise. These hormones increase heart rate, blood flow to muscles, muscle strength, sugar metabolism, and alertness. In other words, they help you perform physical activity, but can also make it hard to chill out and doze off.
The amount of these hormones present in your bloodstream increases with the duration and intensity of whatever you’re doing. It also tends to increase the less trained you are, so it’s likely your longer-than-normal bike ride pumped you full of adrenaline and norepinephrine. While adrenaline often falls back to normal levels shortly after exercise, researchers believe that norepinephrine can remain elevated for up to 48 hours, possibly contributing to your sleepless night.
And then there’s cortisol. Endurance exercise also triggers cortisol’s release because the hormone helps increase glucose concentration in your blood so your muscles will have the fuel they need to keep going.
Cortisol also plays an important role in the body’s natural sleep-wake cycles. Normally, the levels of the hormone circulating in your blood peaks around 30 minutes after you wake up, then declines throughout the day until it hits a low that correlates with your going to sleep. But your massive bike ride elevated those cortisol levels and likely threw the whole system off. Instead of rising and falling, your cortisol levels were constantly elevated on the day of your ride. Scientists have found that “flat” cortisol slopes can make it difficult to fall and stay asleep.
As legendary endurance sports coach Joe Friel points out, there may be other factors screwing up your zzz’s as well. Did you ingest a lot of caffeine during your workout to keep you going? Did you stress out when you got home to face a spouse who was ticked off you rode your bike so long on a Sunday?
Bottom line: The hormones that help keep your body going during a tough workout (adrenaline, norepinephrine, cortisol) are likely keeping you up. Staying well hydrated and fueled during your workout can help blunt that cortisol response, which may make it easier to sleep even after an unusually epic training day."
ganv BuckeyeChick
Posted
BuckeyeChick:
Adreneline and cortisol seem to be primary factors in my exercise induced insomnia. I definitely do better if I don't change exercise intensity quickly and if I stay hydrated and eat well. And of course, stress, makes it worse. One odd thing is that often a bad case of exercise induced insomnia will also include a digestive system upset with very loose bowel movements. That may also be an adreneline/cortisol/stress response.
I have been adjusting excercise timing. It seems morning and evening work better than mid-afternoon. A hard mid-afternoon workout leaves me exhausted at 9pm, and if I go to sleep at 10pm, I wake up at 2am with an adreneline rush. An easy mid-afternoon workout will also likely have me up by 4:30 or 5am.Easy morning workouts seem fine, but hard workouts will still have me up at night. Evenings I haven't tried hard workouts, but easy workouts seem to be fine and I sleep until 6:30am when I need to get up. Since I fall asleep easily, I think the usual advise to avoid exercise in the evening to avoid insomnia isn't quite right for me.
fred73923 ganv
Posted
even a light training in the morning, I get insomnia.
laura98152 BuckeyeChick
Posted
Hi Buckeye Chick.
Just wondering if you have found anything that has helped you based on these theories? I suffer from the same problem and am at a total loss. 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. It has gotten progressively worse for me and is taking a huge toll on my life. Any updates you can give me are appreciated.
steveevs mekin
Posted
look at your microbiome, many bacteria produce all the neurotransmitters your nervous system needs. also look at your heart rate variability to train when your nervous system is at peak. loads of apps out there for measuring it.
SleeplessNights mekin
Posted
I recently noticed the same thing. I also have mild sleep apnea. I sleep better when I don't exercise yet I feel so much better physically and mentally after exercising.
Other things about me: I am 55, have polycythemia vera, am overweight, and stopped menstruating about six months ago. I had lost about 30 pounds and put most of it back on in the last year. I slept better at the lower weight. I have been struggling to lose it again and hope that my sleep will then improve.
SleeplessNights mekin
Posted
BTW, I'm writing this at 3 AM after a leisurely 14 mile bike ride today lol
genpyv04 mekin
Posted
Hello everyone, long time lurker of this thread here. I've been struggling with exercise induced insomnia for a few years now and I have tried a lot of things mentioned here. I just created an account to let everyone know what worked for me.
After seeing a sleep specialist I was told that I likely have Periodic Limb Movement Disorder. My understanding is that it is somewhat related to Restless Legs Syndrome. I was prescribed 600mg of Gabapentin and the problem has now resolved itself.
Prior to this I couldn't do as much as walk to my local pharmacy without insomnia the following night. Strength training and running was out of the question.
fred73923 genpyv04
Posted
thanks for the feedback, specialists struggle to explain why exercise induce insomnia. They conclude it is due to extreme anxiety and they advice I exercise early in the morning and sport should help cure the insomnia ! This has not solved the insomnia issue, whatever time I train, even very light, or even walk for to long, I get insomnia.
How long is your gabapentine prescription ?
Did you have restless leg syndrome ?
lucas14544 genpyv04
Posted
Thanks for your contribution. I do think I have some sort of rls as laying down seem to exerbate some my symptoms. Moving makes it better... Will talk to my doctor anytime soon. Anti histamine seem to worsen the tensioning and/or itchy feeling?!
How did gabapentin solve your problems?
When iI have leg day the symptoms are the worst.
laura98152 genpyv04
Posted
Hi genpyv,
I'm wondering if you are still taking gabapentin and finsing it helpful or if you have found anything else that helps? I suffer from the same problem and am at a total loss. 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. It has gotten progressively worse for me and is taking a huge toll on my life. Any updates you can give me are appreciated.
Richyb mekin
Posted
So good to have found this group. Exercised induced insomnia and restless leg been plaguing me since I was about 50yrs old (now 56). Multi pronged approach to this is the only way. No silver bullet unfortunatley.
RLS sorted with drug so sleep much improved + regular Yoga + daily Meditation + proper supplements and good diet.
fred73923 mekin
Posted
No rest leg issue for me but still exercise induce insomnia
lucas14544 mekin
Edited
Did someone encountered progression towards our common 'problem'?
I still think it has something with a dysregulation of the HPA-axis...
I've had two weeks off due to holiday and had enough time for testing. I've done rigorously training at 80% of my 1RM for 1-1.5 hours.
1 workout in the morning with pre-workout --> induced full blown insomnia (hardly slept all night), night sweats, etc. Didn't use any medication.
1 workout in the morning without pre-workout --> induced full blown insomnia (hardly slept all night), night sweats, etc. Didn't use any medication.
1 workout in the morning with pre-workout & tea+honey with magnesium glycinate + mirtazapine (3.75mg) at 20:30 --> induced wakeups, but still enough sleep. No night sweats.
1 workout in the evening (18:00) with pre-workout & tea+honey with magnesium glycinate + mirtazapine (3.75mg) at 20:30 (almost directly after training) --> induced minor wakeups, but still enough sleep +- 7-8 hours. No night sweats whatsoever. Feeling quite rested during the day.
So i'm 90% sure it has something to do with excessive cortisol release. Cortisol and magnesium suppress cortisol serums acutely and lower body heat. A significant decrease in cortisol serums has been observed when using mirtazapine. Using it directly after training seems to bring my cortisol serums back to baseline.
Can anyone confirm? It's works quite OK for me 😄
fred73923 lucas14544
Edited
Still been struggling with exercise induce insomnia.
Light workout, HR below 80 BPM, isolation exercises, induce mid night /early morning insomnia.
After workout I also have thyroid pain all the day as if I was over stressed.
Intense workouts induce severe insomnia with night sweats.
A 5 mg pill of valium help falling asleep.
Magnesium, tea, honey are useless.
I saw a neurologist and spoke about exercise insomnia. He said it is related with over exited nervous system and there are no pills to avoid this, only stop anaerobic/strength workout and do lighter sport, walking, swimming.
Indeed, the only way to cure insomnia is to stop training. I tried to stay away from the gym for several weeks but as soon as I comes back to the gym and do a light workout, issue comes back.
issue as been here for 5 years now.
I red article which says overtraining can take years to cure !!!
mekin fred73923
Posted
Could you share a link to that article?
slalomdude fred73923
Posted
yep, i would agree. its been 6 1/2 yrs for me.
fred73923 mekin
Posted
sorry, I red so many articles on this subject, I could not find it again.
fred73923 slalomdude
Posted
I think at some stage, overtraining becomes chronic and that's why it is very difficult to cope with this issue. Even professional trainers struggle to give advices on this subject. I went to see a sport doctor and he had no clues about overtraining. I think there are no serious researches on this subject and doctors learned no information during there studies for this.
RohanS fred73923
Posted
That's not true - there is a lot of research on over training - well it's fairly well known and there are a number of scientific papers that I have read. I'll dig them up and post them here tomorrow.
I went to a sports doctor and they diagnosed me straight away. I had the third stage of over training and that takes a minimum of 2 years.
However, it is the Chronic fatigue doctors that know most about this. It is exactly the same process as those who develop break downs from stress, or trauma, or from chronic inflammation. The complicating thing is that it can be caused by other factors...or it can pre-dispose you to it.
In my case (and in many cases) it was a form of glandular fever which acts as a primer where people develop chronic fatigue (over training is physiologically no different to chronic fatigue). The syndrome is then triggered by a trauma of some kind. In our case it is often trying to reach new fitness levels, or perhaps a major event such as a marathon or in my case a karate grading and camp.
So in my case, I was warned that I would never be free of it. You can carefully train around it, and pretty much do most things, but if you don't respect it, it will bite you on the bottom eventually. The doctors words almost verbatim.
If you want to know more, the people you need to seek out are the chronic fatigue doctors. I am surprised that a sports doctor was not able to diagnose over training - it's super common.
RohanS fred73923
Posted
Hello - I responded to this post with a good one of my own but it was 'dissappeared' by an over-excited moderator. I have absolutely no idea why. I've written to the site admin and hopefully get the post restored. Otherwise, I will try to get some info to you guys by Monday.
lucas14544 fred73923
Posted
I've had sleeping problems for 16 years now. Especially after working out, i would lay awake in bed all night, sweating and generating allot of heat. I always felt really lethargic and tired but too wired for sleep.
Even though i thought i had to maintain sports on a daily occasion, somehow, something changed recently. I cannot pinpoint exactly what it was... I do still think it has something to do with an overactive nervous system, which reacted to extreme when working out.
I've taking supplements and medicine which lowered my cortisol dramatically over the past few years, which was the first step. And allowed some sleep... but still allot of sweating and shallow sleep occurred.
Currently it looks like I'm in total remission now. Fatigue still occurs sometimes, but i haven't had even 1 night of insomnia like i used too. Even when tired i can workout now, this was unthinkable earlier! It even makes sleep better/deeper.
At the moment i stopped mirtazapine again, which resulted in really bad withdrawal symptoms (insomnia, lethargic, nauseous, brain fog, puking etc) . I used skullcap and gaba to ease this and I've been a few weeks off now. I sleep around 7-9 hours without medication now, for the first in 16 years after working out!!!!
I hope you guys (and gals) all the best! I know how ****** up this is. Especially because there doesn't seem to be a cure or understanding for people or doctors.
majel59110 lucas14544
Posted
hi @Lucas and all the other ones, still reading your messages. Still having problems with insomnia, spasms leggs and hands (just befor sleeping) and dozens other issues and been to a neurologist, somnologist,rheumatologist and will visit an orthomolecular doctor soon. My blood has been checked many times now, my ferritine level was a bit high and there were little high autoimmuun levels. But no one has found anything in my blood or on scans. I read that with the illnes hemachromatosis (iron that builds up), it can cause symptoms that influence your nervous system. I also have the impression that it is my nervous system that causes stress and that it has something to do with "hormones". So i will have that checked out further...The problem of insomnia and spasms revealed to me when I suddenly did intensive boot camps twice a week. Your stories make me conclude that this may well have been the trigger. Lucas, could you tell me the doctor in the Netherlands that you have visited? The doctors i've been to don't understand a my problems at all ...;).
RohanS majel59110
Posted
Hi Majel59110,
I also have elevated ferritin!! I wonder if that makes us more susceptible. I was tested for haemochromatosis and I don't have it, but I am heterozygous, which means that I have one of the genes activated that could cause it to occur given certain environmental factors. If you are homozygous then you have it no matter what. My ferritin levels are over double what they should be.
The people you need to go and see are the chronic fatigue doctors. They DO know about this. In fact, they have been visiting clinicians in our local hospital trust and making them more aware. They think that chronic fatigue costs an estimated £1 billion in lost productivity to the UK economy every year.
The key symptoms are inability to recover from workouts or activity, unrefreshing sleep or insomnia, often people have restless leg syndrome, and I also had these weird momentary "faint" spells, like when you are really sleepy and trying to watch a movie and "nod off". Not great when you're driving. Also, low level tension headaches, and myalgia - my legs felt like the muscles were sunburnt all the time.
Another for me is heart pounding and/or a feeling of being wired.
slalomdude lucas14544
Posted
Lucas, did you stop taking the amitriptyline and start taking mirtazapine. Any reason for the change ?
lucas14544 slalomdude
Posted
I stopped because i always get horrendous side effects from medication...
But the worst was cognitive problems, like a constant brain fog.
I'm a few months of all meds now. I only use mirtazepine (1/8 to 1/4 dose!) if i feel tired but wired to overcome my sleep problems.
I noticed a few things after stopping medication:
So i guess I'm already predestined and prone to have problems with training, because lack of sleep. Although it has gotten 80% better now. I workout mostly 3-6 times a week now, but i really have to listen to my body. When I'm tired it's better to take a day of or do some 50-60% of 1RM. Another tip i find worthwhile is stronglifts (5x5 sets). When i do too much repetitions on my main lifts i 'fry my nervous system'.
I tested this with deadlifting a while back, which is notorious for it. When doing 15x reps of 3 sets, i get the same symptoms as before.
When i do 5x5 (80-90%) i have no problems.
Atm i've set some personal records again (like 125kg benchpress) and increased significant in strength, which is to be honest, finally a little motivation after all those damn years!
I'm still looking for supplements to help recover better from workout or improve sleep. Magnesium glycinate at a reasonably high dose (600mg-800mg) works quite good for me. But only if i didn't got my nervous system fried, lol.
TWK lucas14544
Posted
I too found that Mirtazapine was the cure for me.
I'm now 50. In my mid-40's, I started getting night sweats and early morning waking after hard workout sessions (running or cycling), no matter what time of the day I did the workout. It got progressively worse over the next several years, then I started getting waking and sweats from having a couple of glasses of wine as well, something that never used to happen to me. I slowed down my workout schedule to 3-4 times per week with 1 hard session max (after which I always got night sweats and poor sleep). At 48, I had a bad viral inner ear infection that triggered the onset of severe tinnitus. At the same time, I was also on a sartan for mildly elevated blood pressure, and the drug gave me a wired/anxious feeling all the time. This combined with the severe tinnitus triggered a massive reaction, almost like PTSD in retrospect - constant floods of adrenaline, sleeping only a few hours per night, no matter how tired I was, etc.I quickly got off the BP drug which helped, but the tinnitus remained (and does to this day). My sleeping then seemed permanently messed up as I would never get more than 4-6 hours per night, and I was now even more sensitive to exercise, so that I would sleep even less if I exercised even mildly that day, even if the workout was at 6am.
The tinnitus remained, although moderated in volume a little bit over the next year, and my general state (except my sleep and exercise impact) marginally over the next 2 years. Frankly, I was pretty miserable. Sleep deprivation and severe tinnitus combined with being unable to exercise as I my whole life left me feeling like I was at the end of my rope. About 5 months ago, I'd had enough and decided to try meds (again). I'd previously taken mirtazapine for about 1 month at a low dose (~4mg), but couldn't stay on it because it turned me into a zombie the next day. This time, I took even a smaller dose, cutting a 15mg pill into 1/6ths. After 3-4 weeks, I was mostly over the next-day tiredness and started having fewer instances of trouble falling asleep, and more consistently getting 5-6 hours of sleep per night. At the same time, I started riding indoors almost every day of the week, just laying endurance foundations with lowish watts and progressively longer rides. Jump forward to today, 5 months later - I'm currently sleeping reliably 7-8 hours every night, without the dreaded 2-4am wakeups (after which I almost never got back to sleep) that I had literally for almost two years. My normal sleep patterns really do seem be to returning - something that I felt would never happen. I'm training every single day, with ~2 really hard sessions weekly and getting into fantastic shape. I only have light sleep or waking issues if the workout is reallly hard. Having a glass or two of wine 3-5 evenings with no effects as well, which is most welcome. Finally - absolutely no more night sweats whatsoever. I hated mirtazapine in the beginning, but I really feel that sticking with the low dose of 2.5-3mg nightly over the period of several months (total of 5 months now) is what has enabled my sleep to get back to normal, block the exercise hypersensitivity, and stop the night sweats. I plan to keep with the mirtazapine for 2-3 more months at the same very low dose, then taper off of it.
slalomdude TWK
Posted
Great to hear your improvement. can i ask you about your training routine and how you built it up and where you are at now. I have been taking occasional amitriptyline after exercise but hasn't really helped cure anything. i am thinking i should just commit to a longer term program of taking it while trying to gradually increase exercise
slalomdude TWK
Posted
Strange as i also developed tinnitus about 2 years after all my overtraining issues started. I still constantly have it, 5 years later.
TWK slalomdude
Posted
I did try amitriptyline at low dose (10mg) for just a night or two. It made my insomnia and tinnitus much worse. Mirtazapine is known to reduce HPA-axis hyperactivity, although at the very low doses I've been taking, it doesn't have antidepressive effects, and much of it's effect is through H1 histamine receptor binding (this is why people use it as a sleep aid). I tried taking it only as needed, but it was only after I stuck with it for several months straight at 2.5-3mg/night did my system fully calm down, and the exercise-induced insomnia subside. The mirtazapine did also slightly elevate my resting heart rate and appetite in the beginning, but that went away after a month or two.
For resuming exercise, I think the key is slow and gradual. Rebuilding the endurance base first, even before thinking of introducing any HIIT. Monitoring resting and waking pulse to gauge fatigue, not feeling guilty about taking days off, etc. I used to race (running and triathlon), and in my younger years used to push my (over) training right to the bleeding edge because my system could absorb the punishment and quickly rebound with a bit of rest. Now - there's no need as it is just about fitness, and I don't plan to ever race again. I mainly ride indoors on Zwift, using an HRM. This allows me to totally plan and control all aspects of my exercise and make sure that I don't overdo it. After about 2 months of laying in some easy base miles, I started incorporating once weekly sessions with some intervals or higher intensity climbs. over time, those sessions got harder, and a more frequent, but still with the bulk of rides at ~55-60% of FTP.
Tinnitus is a B1TCH, no two ways about it. For most people it affects sleep for at least a while, until one habituates to it. For me it definitely aggravated by more stress - which is an awful cycle, because poor sleep, stress, and elevated blood pressure make tinnitus temporarily worse, which begets more stress, poor sleep, etc. Hyperactive HPA axis can also play a role in triggering tinnitus - some people develop it during or after particularly stressful times, or when coming off of certain medications like benzodiazapines (speaking of which - never use benzos to deal with insomnia or exercise-induced insomnia - temporary relief with long term issues).
TWK
Posted
BTW, I cut out all stimulants like caffeine and alcohol, both of which I had become very sensitive to. I think EI-insomnia is a symptom of a larger dysregulation of one's systemic stress responses, and besides exercise, one can also develop sensitivities to things that used to be fine, like coffee and alcohol, and consuming them can exacerbate the problem. That said, as my sleep had returned and my EI-insomnia has subsided, I recently have started having the odd glass or two of wine. Still no coffee though!
slalomdude TWK
Edited
Thank you for the detailed reply. i talked to the Dr today and he game me 7.5 mg of mirtazapine. I will cut them in 2 and see how it goes. Thanks again
TWK slalomdude
Posted
Good luck - I hope that it works for you.
A lot of people, me included, get slammed by mirtazapine when they first start taking it (it has very strong H1 histamine receptor effects at low dose), so next day tiredness is an issue when starting. I've been taking 1/3 of 7.5mg (1/6th of 15mg pill) for 5 months now, and the next day fatigue took about a month to subside. It is a bear though, so try to stick with it. It may have a temporary effect of raising your tinnitus too, but that goes away over a few days (at least it did for me).
lucas14544 TWK
Posted
I take around 7.5mg daily. But a while back i tapered down and quit entirely (since I was doing great). At the moment my sleep is really messed up again, to the point where I've problems functioning at work. . . making me nuts.
Somehow it also depends on the time when dosing. When iI take it to late it doesn't really work. I have to take it quite early to see results. Like 7.30 pm (19.30). Else it won't work for me. I do hate the next day feeling though. . .
I think I'll stick to it long term and see how it goes. Why is this so freaking hard?
TWK lucas14544
Posted
I notice the same - best if I take it around 8:00pm in order to get to sleep at 9:30-10:00. If I take it later, I sometimes don't fall asleep until much later and feel a bit wired.
fred73923 TWK
Edited
I think pills are not the solution. I used to take huge amount of benzos (5 X 0.5 mg Alprazolan per night) for years and it did not cure the exercise induced insomnia. Benzodiazepine withdrawal lasted several weeks and was a pain, I was a benzo junky.
Pills will only hide the symptoms but will not cure the root cause, your body can't no more bear sport.
In order to stop insomnia, I had to fully stop training as even very, very light weight training induced insomnia, sometimes even a walk triggered insomnia.
I suppose insomnia was a warning from my body that it was time to stop training, taking pills just hide this warning.
slalomdude lucas14544
Posted
Lucas, what do you think screwed up your sleep again after doing so well off the meds?
lucas14544 fred73923
Edited
I don't agree with your opinion. Medicine are there to help or support your condition.
Medicine helped me to like to function again like a normal being. Not a zombie who can't do any physically challenging tasks and worry about after effects.
Also I think it has something to do with a overactive hpa axis. So if medicine can relieve that. . . Why not?
lucas14544 slalomdude
Posted
Well a number of reason I guess. I'm already prone a predisposed for insomnia.
I just moved (bought a house) , girlfriend is pregnant, busy at work, busy with home and garden improvement, etc.
So it has been rough. I already noticed this in my workouts, so I adjusted this accordingly. But the insomnia remained . . . As I have chronic insomnia . Insomnia + being busy + workout is not a good combination. This has been my pitfall since I've had really bad mono 18 years ago.
As of today Ive been doing workouts on a way lower intensity and mirtazapine + magnesium glycinate and gaba. This really calms my nervous system and helps me get back to baseline. I hope I can continue my training shortly .
slalomdude TWK
Posted
TWK, when you started the endurance training, did you aim to keep your HR below a certain level, like 180 minus age or some other protocol. i ask as most of us seem to have the issues once HR gets elevated over a certain. Both sports dr's i have seen hinted at possible mitochondria dysfunction causing the body to start to produce stress hormones at a relatively low level. One of them mentioned it was repairable/trainable by lots of low level L2 riding. He tested me and told me to keep HR below 115 but to be honest after about 2 months of this, it didnt seem to help much.
TWK slalomdude
Posted
You just started Mirtazapine, correct? If so, I'd stick with the low level riding (<115BPM) for a while, maybe 6-7 weeks while you get used to the Mirtazapine. Early on, it raised my resting heart rate 4-5bpm, but that settled after ~2 months.
The turning point for me was when I started getting 7+ hours of solid sleep per night. After a few weeks of that, I could really feel my brain and body start to calm down and get better. Literally like a healing process.
Be patient, and try to reduce other stress as well. I still find that a couple of long, stressful days at work easily mess up my sleep. The other thing I've learned to do is to not push it when I'm not feeling well. Feeling tired, skip the ride. It's hard for many former athletes to get that into their heads, me included! No longer competing, it's all for health.
Try to add other aspects into the riding as well - stretching, and gentle core conditioning to break the monotony. Stuff that is good for you, but won't get the adrenaline going. Look at diet, and other lifestyle changes too. I found daily 30 min meditation helped calm down my mind a bit, and switching my diet to mostly vegetable-focussed with quality fish as the main protein source. When you're really feeling like the corner has turned, don't just start pounding in hard workouts. Ease up to it with something like one tempo ride a week for a while, and see how it goes.
It is a long, slow process, and there's no magic solution, but the mirtazapine in low dose helped me get there. As mentioned by others, avoid benzodiazapines.
slalomdude TWK
Posted
Thanks for the great information. I will ease into riding while the mirtazapine takes effect. It really puts me down at night, much more than amitrypline even at a low dose of 3.5-4 mg. currently sleeping about 9 hrs a night albeit with a few wake ups.
TWK slalomdude
Posted
It was ~2 months on the mirtazapine before I was sleeping with no wakeups. It took that long for my system to ease out of the over-stimulated mode. I found it helps if I practiced good sleep hygiene as well - no screen time before bed, going to bed at same time every night, and getting out of bed at set time every morning (no dozing or sleeping in, even though Mirtazapine makes it a bear to get out of bed in the morning). Look up sleep maintenance insomnia and follow the tips. We're trying to lower the chronic stress response and reset the sleeping cycle to a normal rhythm.
You may be able to get by with even less mirtazapine too - whatever dose works for you.
fred73923 TWK
Posted
After the long benzio cycle, I have taken 2.5 mg of seroplex for 2 months, I then feel in a better mood but it did not solved the overtraining syndrom. I went to see a neurologist and sleeping specilalist. They explained there is no medication for this issue other than rest. Only try to avoid stress and stop intense weight training and replace by light intensity exercise, he joked and told me its time you go fishing instead !
Even light weight training with HR below 90 trigger the insomnia and bradycardia and thyroid pain the day after.
I have taken lots of pills for 5 years and syndrome is still there.
This insomnia issue was triggered by a bad day in my job.
TWK slalomdude
Posted
Just curious as to how things were going?
I've been on a brief mirtazapine holiday - I ran out and had a night without it prior to getting a refill. Even though I picked up a fresh supply, I decided to see what would happen without taking it. First few sleeps I fell asleep fine, but had a lot of night sweats and wakes, but was always able to drift back off. Last night I slept solid, but then had the dreaded 4:15am wide-awakening, and never fell back asleep , getting ~5.5 hours, which is not enough for me. I'll give it a few more nights, but then might decide to resume it if things don't improve a bit (I know there can be temporary rebound sleep issues after discontinuation).
slalomdude TWK
Posted
So far so good, been cutting a 7.5mg in two and taking about 1.5 hrs before bed. Falling asleep within 10-15 mins. sleeping for about 8-9 hours but definately feeling pretty tired through the day. Not groggy but can easily fall asleep in the chair.
i haven't introduced riding yet, just some hiking and general gardening. Will start some light (hr<115) riding next week. i may also try cutting the tablet in three to help alleviate some of the daytime tiredness. The tinnitis has not changed but the heart palpatations seem to have settled down some.
Have you still been training since stopping the meds?
TWK slalomdude
Posted
I took the week off of training when I wasn't taking Mirtazapine. After 5 nights, I decided to resume because wasn't sleeping well and needed the rest.
The new prescription I had filled consisted of pills from a different manufacturer - they are oval bars instead of previous round tablets. They are a lot easier to cut accurately, so I managed to easily make 1/8ths of a 15mg tablet, for ~1.9mg/dose. First night I took it, I was knocked flat the next day - I guess that one quickly loses tolerance to the drowsiness, but a couple of days after that I'm fine during the daytime at this dose. Actually slept a whole, uninterrupted 8 hours last night and feel great today - at least good enough to pound in a personal best time and power output on a climb in Zwift this morning.
BTW I also get a lot of ectopic beats when under slept, and they resolve after getting quality rest.
lucas14544 TWK
Posted
Good to hear the mirtazapine is working so good for everyone!
I had to take up sick leave due to chronic stress, which was caused by being to busy all the time. Work has been way too stressful and i had no time to recuperate anymore. At the moment I'm taking 15mg mirtazapine , which works quite well. Note that 15mg is not as sedating as lower doses (which caused a lot of daytime fatigue and brain fog) .
The health and safety officer told me to rest for two weeks while trying to train again. It will properly take a few months to recover from all the stress lately.
I wish you guys (and galls) all the best, and of course allot of good workouts. Stay safe and strong!
slalomdude TWK
Posted
so i dropped down to 1/3 of a 7.5 mg and feel much better in the day. i have been riding easy for an hour on the trainer each day. One big thing i notice is that my HR is probably about 10 beats higher than normal when exercising. Even just spinning the pedals my HR will go to about 110. I have had to settle with keeping it at 120 to even get any kind of workout in. I guess its to be expected as Mirtazapine depresses the parasympathetic NS. Ironic as we all seem to be affected by overactive sympathetic NS
Sleep is ok, still disturbed but bearable.
TWK slalomdude
Posted
Yeah, I had same issue with increased HR. For me, it settled over time (a couple of months), and my resting HR and exercise HR response went back to my normals.
daniel95649 slalomdude
Edited
Hi slalomdude and everyone else,
please, I am curious how things have worked out for you in the meantime. I have pretty similar issues regarding exercise induced insomnia and I plan to try mirtazapine as well.
Would really like to hear from you. Thanks.