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Any advice for getting a really messed up sleep schedule fixed?

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I have always been a night owl, always will be, and firmly stand by the idea that there isn't any essential virtue to going to bed at 9:00 and getting up at 5:00.  We all have different rhythms.


That being said, I have gotten myself into a too late to bed and to rise schedule to be productive.  I usually go to bed about 4:30-5:00 a.m. and get up between 1:00-2:00 p.m.  It isn't that I feel particularly bad; it's just that I am unproductive because I have already "missed" the optimal time to work out, get my college school work done, etc...  


I sleep with a C-PAP and Seroquel and Klonopin are necessary for me to sleep, at all (some of you know what I am talking about--no meds = no sleep.


So the main question is how have some of you gotten yourselves round to a more normal routine?  I have tried every piece of advice that I could think of like trying going to bed and being asleep before midnight and getting up early even if you didn't sleep much.  That didn't work at all--just made me go so long with not getting enough hours that I went into a mixed state.  I feel like if I could just myself around to where I could be asleep by 1:00 and get up at 9:30, things would be good enough for me.  It seems like my mind is working to trick itself into the current pattern, making it self-defeating to change because I get so nervous if I think I have to set the alarm for this that I really can't sleep and end up in the same pattern.


I really would appreciate anything that any of you have done to "retrain yourselves"; I figured this might be a good place to get the best advice.  This is really getting depressing.  Thanks!

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establish a going to bed routine, just like the teeth! pjamas! bed! you had when you were a kid. there's no mention in your sig of your diagnosis, but i'm wondering if a chat with your pdoc about taking enough seroquel to have a knock out sleeping pill effect would help, and establishing a routine could be helpful. (mine is usually take sero. at 8pm for 9pm bedtime, rise at 5am - but it's gone out the window due to various social events i've been to of late...).

i think one of the important things also is to ease yourself into it, and realise that there will be slips ups and so forth - but aiming for 80/20 of getting where you want to be after a month may be a doable goal for you. something like that.


good luck with it - and yeah, it's something that most of us with MI struggle with. i've certainly been all over the shop, and now with daylight savings starting - which means 1 hour earlier starts in the morning for 6am yoga - brutal....

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I go through phases of up to three weeks where I don't sleep properly without meds - like you I use a blissful combo of klonazapam and quetiapine to send me off to dreamland. I don't think it's unreasonable to have a few days to weeks to recover normal sleep cycle which have been disrupted. Best thing is to nip it in the bud before it causes a chain reaction of one night after another. Preventative meds I mean. Bad sleep is like bad sex. Who needs it?

Try these rules:

1. Exercise daily but not prior to actually sleeping.

2. Avoid stimulating activities before bed. Sex is probably ok ;).

3. Snack on carbs not proteins, warm milk is effective or camomile tea

4. Keep a dark room, off to all appliances

5. Have a hot shower but go back to a cool room - the process of cooling makes one sleepy

6. Meditate/practise breathing exercises - also good for stress reduction

6. If all else fails accept you can't sleep and enjoy relaxing not worrying that you can't sleep - read, meditate, be at peace with not sleeping (you're less likely to achieve it if you force it)

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A friend of mine was sleeping odd hours (3am - 2pm).  He tried every way to change it and failed.  His tdoc told him that staying up all night and the next day could reset his sleep cycle.  That worked for him beautifully and he was so happy.  If nothing else works, maybe talk to your tdoc or pdoc about resetting like this.  I wouldn't do it without them knowing tho.  I'm pretty sure if I tried, I'd be crawling the walls.

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Thanks to everyone for the good advice.  I will talk with my PDOC about the staying up all night thing.  I am like you, however, and might be climbing the walls!  I didn't think about it, but I think that I get on the computer and maybe that is too stimulating an activity.  I have tried just sitting on the couch in dark light with the television on low.  I go to sleep there, but just the act of walking the few feet to my bedroom wakes me up too much to sleep.


I am going to try and implement these suggestions.  Something has to give!  I went to bed at 5:30 and just now got up at 3:00.  


I forgot to put my diagnoses.  I wish I knew how to have it at the bottom automatically like some of you do.  How do I find out how to do this?  Thanks again!


Dx: Bipolar I Rapid Cycling Mixed States (don't know what they're calling it in DSM V--need to look)



Meds: Lamictal, Pristiq, Seroquel, Klonopin, Lyrica, Xanax (prn)

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Going without sleep makes my bipolar energy kick in and makes it more difficult to sleep the next night. Lack of sleep is a good way for me to start an episode. You may not want to stay up all night if you are like this.


If you have time during the day, maybe just stay up later and sleep later until you are on a desirable sleep schedule and then use sleep hygiene and meds to maintain it.


The walk from the living room couch to my bedroom used to wake me, too. I finally put a TV in my bedroom because it almost always puts me to sleep. I use a timer, too, so that it's not on all night.

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For myself, I have found the brute force method to be rather effective (though it might take a week that will be very unpleasant)


-Set an alarm for whatever your goal get-up time is. Get up no matter what.

-Go to bed at whatever your goal bedtime is, no matter if you are tired or not

-Stay in bed, try to calm your thoughts (similar to mindfulness, imaging beaches, or other environments that make you calm) and just wait it out.

-Do not get annoyed at not being able to sleep! (that's very important)

-Try not to watch TV, be on a computer or do anything else that makes you jumpy at least an hour before bed. Read a book, or poems, look at nice pictures, whatever you like. Listen to calm music. Dim the lights.

-if you can, exercise in the morning


When do you take your meds? Having a regular med schedule can help with sleep, Seroquel and Klonopin are both sedatives and you could try to tweak the med schedule to help with the sleep. Seroquel knocked me out when I still took it (I was on a rather high dose), but the knock-out effect wasn't that long. For me, something like 1-2h before bed worked best.

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Phronni: Go to your username on the upper right hand corner, and click the arrow for the drop down menu; the first choice on the left will be "My Profile." Click on it, and your profile will come up. On the upper right will be "Edit My Profile." Click on that. On the left, there will be a list of profile settings, most of them in grey. Signature is near the top.


It helps to have your dx, what meds you are on, and what meds you have tried in the past, that didn't work. This isn't necessary, it is just helpful for when you need to discuss side effects, or ask about what med to try next.


I hope that was it, I clicked around my profile to be sure.

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I used to go to bed by 11-ish on weekdays (sleeping through 3 alarms to roll out of bed late for work at 8am) and couldn't wait for the weekend so I could "stay up late."  Getting on the Seroquel (5pm dosage) made me sleepy earlier and I finally just focused on setting/maintaining a schedule.  Weekday/weekend same schedule.  I found (and ymmv), that going to bed earlier - 9pm to 9:30pm and just sleeping until I woke up helped me identify how many hours my body actually needed.


I've been on this "early" sleep schedule for more than a month and I've never felt better or more rested.  Additional bonus - for the first time in my life, I wake up in the morning (around 5am) without any alarms to assist.


Even if you're resistant to sleeping earlier - figuring out how many hours of sleep you need (it varies person to person) and carving out the time to go to bed every night at the same time, whether 1am or 10pm, may go a long way to helping you get the rest you need.


And if you keep waking up...  Ambien?


I've never really been able to take sleep aids because I felt hungover until early afternoon the following day.  In acute care they gave me Ambien and I thought it would be the same - I was happily surprised to sleep pretty well (considering I was in the locked ward with a roommate for the first time in 18 years) and didn't feel like shit the next day.


Good luck!

Edited by ScullyClone
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I have delayed sleep phase syndrome which is basically similar to what you describe. The only way I've found I can get back into a normal sleep pattern from a delayed one is the staying up all night and the next day and then going to bed at say 9PM. It is hard to push yourself to stay awake until then and often I'll fall asleep too early and have to do it again, but it's the only thing (besides meds) that works for me to correct the pattern. 


There are more gradual ways to do it. You can just go to bed an hour later each day until you're in a good routine. Another way is setting an alarm an hour earlier everyday, although I find that too difficult. Sunlight (or a lightbox) first thing when you wake up is supposed to be good, too. As is avoiding light in the evening. Same with exercise, do it sooner in the day rather than later. Start avoiding caffeine six hours before you plan to go to sleep, too. An hour before you go to bed, dim the lights and turn off TV, computer, cellphone and anything else that has a light-emitting screen. 

Edited by mcjimjam
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Two things I don't think I've seen mentioned:


1) Don't eat 12-16 hours before you want to wake up. It helped me wake up. And it may have helped me go to sleep, too. Hard to sleep on a stomach full of ice cream, or fudgesicles, or skittles. I think it might do something to reset your biological clock, too. 


2) Oops. See Titania got to it: setting your clock back an hour a week.


I totally get what you mean about "productive hours." I can sleep til two, but then I'm done with the day after 7. Sure, I go to sleep at 3am, but I'm not sweeping the floor at 11pm. It's 11pm for crissakes!

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I am also nocturnal, but I've managed to convince my body to sleep from 1:00 A.M. until 10:00 A.M. This pretty much precludes holding down an office job, which is fine with me because I don't want one anyway. I am also a lifelong insomniac.


I would add just a few suggestions:

  • As you are working to reset yourself do not drink any caffeinated beverages. I hear this all the time on the boards: "Oh, I'm so tired during the day that I just have to drink coffee to stay awake! It's so awful that I can't sleep!" Well. if you're having trouble sleeping at night, YOU HAVE TO GIVE UP CAFFEINE DURING THE DAY SO YOU CAN GET TIRED AT BEDTIME! You'll have a crappy couple of days, but it will help your body adjust. And then you have to give up coffee or whatever during the day-from then on you can only drink coffee within two hours of waking up.
  • Shower in the evening, not in the morning.
  • No electronics in the bedroom. Period.
  • Think about when you take your meds. You may need to experiment with this. For example, I can't sleep if I take my Lamictal in the evening. It's activating.
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1. Turn off all electronic devices

2. keep a chair next to your bed

3. keep a timer and if you haven't fallen asleep for 20 minutes, get out of the bed and read a book for an hour or more until you get sleepy

4. Try as many times as you have to. Initially it took me 5 times

5. Build a schedule and be consistent

6. Put time restrictions on your computer, to lock you out after a certain time, also block websites you find too distracting with firefox addons.

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I also used my router to shutdown my internet connection after midnight. Then I took the router password and put it in a very inconvenient spot in the attic.


I still stay up later than I should, but there's something insanely addicting about the internet -- it's never "done." But it's made a difference of about 2 hours to bedtime.

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  • 4 weeks later...

Thanks, to all, who have replied.  Queen of Ergots...your advice about setting up profile below worked.  Well, I was doing some slight (which I was okay with--can be patient) progress, and then in storms this #$% time-change.  It is this fall-back an hour time change that really messes with me (I can look back before Dx and now understand what was going on with me all these years).  I do fine--love--the spring forward time change, although I know we are all different.


Now, to top it off with being right back on a less than desirable sleep schedule (that, I can work back from-you gave much advice), I am in a mixed state with hellish anxiety which has brought back some PTSD flashbacks that I haven't had in over a year.  I have Xanax prn.  Took one earlier.  Was about as effective as a sugar pill.  I guess the only thing to do now is clobber myself with a bit of extra Seroquel (have PDOC's permission to "play" within a certain range). 


Oh, what fun!  Seriously, though, thanks again to all.

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