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Sleep and depression - Any help to wake up in time?

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Polyfractal

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I have set my alarm to wake up at 1pm, but most times I couldn't wake up and often sleep until 3-4pm. I am wondering whether it's my depression that is causing myself to wake up so late. I want to wake up at 7am, but I couldn't most times. I am on medication escitalopram and olanzapine. Any help I can wake up in time?
 
If I’m sleeping 20+ hours a day? There’s nothing that’s going to work to wake me up, until I’m back to sleeping my normal 4-7 hours a day.

The only ways I’ve ever found to get back to my normal 4?

- EXPLOSIVE and ongoing and pre-emotive stress-venting. Even then, I may simply not be physically capable of burning off enough stress fast enough, or long enough, and find my bones melting to fall asleep mid-activity like a puppy. But even if I can only do 6 hours of exercise? I’m likely to wake up in 10 hours, instead of 20.

- Drugs that are actually meant to knock people out cold. Less because of the ADHD paradoxical/opposite reactions I have to a lot of meds, if I’m not under extreme and un-vent-able stress, they do knock me out cold.

***

Q’s

- Are the meds new / within apx 3mo of this happening?
- Have you had a sleep study done?
 
If I’m sleeping 20+ hours a day? There’s nothing that’s going to work to wake me up, until I’m back to sleeping my normal 4-7 hours a day.

The only ways I’ve ever found to get back to my normal 4?

- EXPLOSIVE and ongoing and pre-emotive stress-venting. Even then, I may simply not be physically capable of burning off enough stress fast enough, or long enough, and find my bones melting to fall asleep mid-activity like a puppy. But even if I can only do 6 hours of exercise? I’m likely to wake up in 10 hours, instead of 20.

- Drugs that are actually meant to knock people out cold. Less because of the ADHD paradoxical/opposite reactions I have to a lot of meds, if I’m not under extreme and un-vent-able stress, they do knock me out cold.

***

Q’s

- Are the meds new / within apx 3mo of this happening?
- Have you had a sleep study done?
I started my meds in July 2021, so it has been for quite a while.
What is a sleep study? I don't think I had one.
 
What is a sleep study? I don't think I had one.
You spend the night in the hospital, or sleep clinic, wearing a “robot suit” 😉 (not an actual suit, just a whole lotta sticky wires, like they use for heart monitoring, “conveniently” pulled back so that you can actually sleep without getting all tangled up) that record all of your different sleep cycles, movements, patterns, etc. over the course of the night.

The vast majority of people are easily diagnoseable in 1 night. Occasionally they’ll refer people back for longer sleep studies (multiple days is the next most common, especially for people who suffer from insomnia, who may not actually sleep at all for 2-3 nights but the data is still incredibly useful from their waking hours), but most of the longer sleep studies the person will be sent home with a simplified version of the monitors… essentially a smart watch, but a bit fancier… rather than be asked to stay in-clinic.

I was once part of a sleep study STUDY, where the clinic asked me to stay first for a week, and then for a month, but neither of those is in any way typical. I just so happened to have super wacky sleep, the clinic just so happened to be researching what’s known as “outliers”, and the type of work I did at the time easily allowed for it. Shrug. It was super cool, and I’m glad I got to be a part of it, but it’s very atypical.


- Disordered sleep & sleep disturbances are VERY common with many different psych disorders, medical conditions, and life events. Knowing what kind or kinds of disturbances are happening? Is an “easy button” for getting waaaaaay better sleep, super fast.

- Sleep Disorders, meanwhile, are often comorbid with many different psych disorders & medical conditions, and occasionally develop/manifest in the wake of certain life events. Ditto the above, knowing which sleep disorder(s) someone may have is an “easy button” for getting waaaaay better sleep, ASAP.

- Certain medical conditions manifest at night, or mimic sleep disorders/disordered sleep, and sleep studies also discover these events that a person wouldn’t notice they have… because they’re asleep when it happens! Sleep apnea is by far the most common, but there are certain types of asthma, heart arrhythmias, endocrine system, digestive system, & other things that sleep studies often catch, thus allowing a person to… yep! Get waaaaay better sleep, ASAP. In addition to getting out in front of potentially serious/life threatening medical conditions. Win/Win.

So it’s something I hands down recommend to absolutely anyone who is having difficulties with their sleep, in any way, full stop.
 
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at the height of my insomnia, i used multiple alarm clocks set about 5 minutes apart. when i set them before i went to bed, i would place each of them in a different places, far enough from my bed that i couldn't turn them off in my sleep
 
I’m not quite following the timing. What time are you routinely going to bed and falling asleep? Did this start when you began the medication?

Regardless, it’s critical to communicate about this with your doctor(s), clearly, and advocate for yourself. It’s worth discussing when this started (around start of the meds? before? recent?) your bedtime, the timing of your meds, food/alcohol/activity habits (these can affect med efficacy and also sleep), inability to awaken, quality of sleep, sleep disrupters (like kids or pets in the house), etc. And as Friday said, do ask about the appropriateness of a sleep study, *especially* if everything else is in solid alignment. By “solid alignment” I mean things like relatively stable mental health on the meds, routinely getting quality nutrition, exercising regularly, going to bed reasonably, good sleep hygiene, etc.
 
I’m not quite following the timing. What time are you routinely going to bed and falling asleep? Did this start when you began the medication?

Regardless, it’s critical to communicate about this with your doctor(s), clearly, and advocate for yourself. It’s worth discussing when this started (around start of the meds? before? recent?) your bedtime, the timing of your meds, food/alcohol/activity habits (these can affect med efficacy and also sleep), inability to awaken, quality of sleep, sleep disrupters (like kids or pets in the house), etc. And as Friday said, do ask about the appropriateness of a sleep study, *especially* if everything else is in solid alignment. By “solid alignment” I mean things like relatively stable mental health on the meds, routinely getting quality nutrition, exercising regularly, going to bed reasonably, good sleep hygiene, etc.
I sleep irregularly, sometimes at 10pm, 11pm, 12am and even only sleep in the midnight morning. I was already waking up late before the meds began.
 
When I'm depressed, I can sleep up to 16 hours a day. At the moment, I'm still needing 10-12 hours a day.

It's hard fitting in life around that. But it is what it is. Some mornings I have to be up at 4am for work, which means I need to go to bed by about 5pm.

Needing that amount of sleep means I need to be pretty obsessive about my sleep hygiene. But it seems to be working for me at the moment, albeit that I don't have much of a nightlife. But hey, when I'm depressed I don't have any kind of social life anyway. Being able to hold down a job, it's worth the trade.

I've worked with my prescribing psychiatrist to tweak my meds regime so that the meds I need are leaving me hungover, which also helps.
 
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