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Waking up from depression vs waking up by sleep apea?

I've been waking up in the middle of night for a long time and can't find the cause. My insurance company refused to cover sleep study for me.

In the past there were times that I kept waking up because of depression. In those times I woke up from a dream and usually had a feeling of anxiety or even anger upon waking up.

Nowadays I sometimes wake up from a dream but most of the time not. I wake up anytime between 2 am and 5 am and can't get back to sleep. I think it must be either depression or sleep apnea however my breath is not short when I wake up.  
4 Responses
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I had a sleep disorder for a decade and didn't realize the problem was not relaxing my mind when I woke up. I read a book about it and have self cured. Perhaps you can find something useful in a sleep disorder book too.
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Sleep apnea is just one of 3 major types of sleep disorders, but it's one that doctors and dentists make a lot of money off of so they like to diagnose people with it.  If you had it, you'd most likely be waking up, falling asleep, waking up, falling asleep, or, you'd be not noticing at all and waking up tired.  If you're waking up and can't get back to sleep, that's probably not apnea.  Obviously, I can't diagnose you, but what you're describing is either medication induced insomnia or that caused by a mental problem.  As for your insurance company, most do cover sleep studies, but only if you do them in a certain way and get pre-approval.  For example, they might require as a first step that you do a home study for apnea.  You might want to look into it further.  But from your description, it sounds like something else.  If you were sleeping next to someone they could tell you if you were waking up repeatedly.  I think my wife has it sometimes, but it doesn't bother her at all -- it often doesn't.  What you might tell us is how much you exercise, what your habits are, how close to bedtime you eat, whether you meditate or do other relaxation techniques, whether you've learned something you can do in bed called progressive muscle relaxation to try to get back to sleep, whether you tried something like melatonin or Calms Forte or chamomile tea or some other gentle relaxant, whether you go to bed too late or too early.  All the usual suspects.  A lot of people just go to bed earlier than suits them because of school or work requirements.  So much can affect a particular person.  But again, an apnea sufferer generally would just go to sleep again and keep waking up for brief periods of time and wake up feeling not rested.  You're waking up and not being able to relax back to sleep at all.  
Thanks for your answer. I do cardio on stationary bike for 30 minutes, 5 days a week, lift 3 days a week and take a long walk almost everyday. I take 50% RDV of zinc every night plus either  tryptophan or L-theanine (not every single night). I used to take magnesium at night but it seems to give me heart palpitations.

I don't meditate as much as I should and no muscle relaxation. My body feels stiff and it's like it's telling me I need to move it more (in the form of calisthenics for example). I eat dinner usually around 7-8 and go to bed around 10.

I've read that hypothyroidism can wake you up in the middle of the nigh too.
P.S. for various reasons I don't have enough interaction with others and I think this contributes to the sleep problem.
Don't know about the latter, some people are fine by themselves but anxiety sufferers will often fixate more on their anxiety when not distracted by being with other people.  I'd stop taking the zinc unless a doctor told you you were deficient in it and even then I'd try to take in foods high in it -- too much zinc is toxic.  It can also interfere with your other electrolytes, and potassium and magnesium are much more important for relaxing your muscles and are in balance with the other electrolytes.  You might be a classic case of something I mentioned -- 10 PM is really early to be going to bed for some people and you might be one of them.  I'm one of them.  Everyone has a time that suits their body clock but our life these days often forces us to go to bed much earlier than suits us.  Don't know if that's you, but it could be.  Two hours after eating might also be just too soon for you -- again, people are different.  It's too soon for me.  Maybe you eat a lot lighter than I do.  If your body is stiff, it could be you're not doing a warm-up before you ride the bike or lift weights.  People differ on the usefulness of stretching, but it might help you -- even if it's only a placebo.  But do warm up before you go all out.  Walking is easier, usually it has a built-in warm up to it.  You might find, though, some benefit for your health and your fitness and your sleep if you don't just do hard-edged training -- maybe put a little yoga or tai chi or chi gong in there and see if doesn't help some with those muscles.  Tryptophan is not well absorbed by most people, as it doesn't cross the blood/brain barrier very well in most people.  It does help some.  Most have switched to a form called 5-HTP, a metabolite of tryptophan, which crosses the blood/brain barrier more easily, but taking it before bedtime isn't necessarily the time to take it.  People react very differently to pushing their serotonin manufacture up higher, assuming that's actually happening -- if the body does't find it necessary it might just wash it out and not use it.  I'd probably try something like valerian or chamomile tea or hops or passionflower or any of a number of herbs that help with sleep and relaxation, but if you're using tryptophan to treat depression, you need the proper dose and sometimes it can actually stimulate you rather than relax you -- this is more common with HTP than tryptophan, but again, that's probably because tryptophan isn't utilized very well for most people when taken as a supplement.  You can get it and use it better by eating foods high in it, such as turkey or dairy, though I'm not a big fan of humans eating a lot of dairy products.  But it is high in tryptophan and in food the body knows what to do with it.  And every single thing I've just said, and every thing you're doing, you should not do if you're taking any medication to treat your depression or your insomnia -- depending on the drug, they target the same neurotransmitters and you don't want an overload.  I'd try melatonin if I were you, about 1mg (most people take too high a dose) to start and see if it isn't your body clock that's off.  If you think you have hypothyroidism, you need to see a doctor who is willing and able to properly test you for it -- they usually don't actually test for the right hormones which are mainly T3 and T4 and to make sure they are properly doing what they're supposed to do.  This is something you can find out, but only if you are a very insistent person with your doctor, because by hook or crook they are going to only test your TsH.  Anyway, I hope this mishmash of stuff has something of use in it, and be careful with that zinc -- for most people the only reason to ever supplement with it is when you're sick in a sublingual form.  Some guys do use it for prostate health and for male health, but again, don't take too much as a supplement -- do your homework on this one.  Good luck.
I did have my thyroid hormones tested a few months ago. They were as follows:

T3 free 3.4  in  2-4.4
T4 free 0.89 in  0.76-1.46
TSH 1.657 in 0.358-3.74

My doctor said I may be hypothyroid based on these and some symptoms such as gaining weight easily or getting stuck in the middle of sentences. He prescribed me 30 mg of dessicated thyroid. I took it for a month and the stopped. My thinking was sharper in that time and I seemed to have more energy however my sleep quality got worse and I was also not comfortable with becoming dependent exogenous hormones.

No meds for depression or sleep.
If you are hypothyroid, and my understanding is your results do show that, the question would be why you are that way.  For some it's a lack of iodine in the diet.  It can be a sign of Hashimoto's Disease, an autoimmune disorder.  If you have it, you do need to do something about it, but what depends on the reason for it.  When it's not caused by a disease state, Eastern medicine has treated it for centuries by using seaweed because it's naturally high in iodine, but if it's a disease state this can make it worse.  I'd get tested again and see if it turns out the same -- sometimes one test is just an aberration, not your norm.  
Great handle, by the way -- into his music?
Exactly. That was why I stopped taking the medicine, I wanted to know the underlying cause. I have both Luggol's solution and kelp available. The problem with kelp is that I don't now how much iodine is in it. I've been solving Luggol's in water and taking what amounts to 100% RDV recently. Have not seen any difference yet.

I don't rule out an autoimmune disease. I sometimes take ibuprofen for headaches and after taking it I feel MUCH better overall. I'm having another consultation next month and am lining up some blood tests.

Thanks. Yeah I do and it sounds a little funny too.  
Careful about iodine treatment until you know if you have a disease state -- iodine works if it's not a disease state but is caused by a nutritional deficiency or other benign causes -- if it's, say, Hashimoto's or some other disease you can push yourself into hyperthyroidism by doing too much iodine.  Everything in it's place.
I did more bloodworks and am actually deficient in both iodine and Vitamin D. I sarted to supplement again. I think the cause of my waking up is indeed  depression. As I said I go to bed around 10 and wake up around 3. A few nights ago I went to bed at 9 and woke up at 2. This is a sign of depression in my experience that I get the same amount of sleep no matter when I go to bed. I wish there was a way to remedy this. Waking up and not being able to go back to sleep is more depressing than anything else.
But it could also be a thyroid problem, which is what you get when you're deficient in iodine.  It can be a sign you're not doing enough exertion during the day to make you all that tired.  It sounds very much like you go to bed too early, which is a common problem in today's society.  It might indeed be a sign of depression, and it might just as well be a sign of those subtle kinds of disease states doctors are not good at looking for.  Lack of those two nutrients can cause all kinds of problems.  If you lack D it's a sign you don't get outside much during peak hours of the sun -- this has also become common in today's society as more people have indoor sedentary jobs, school starts earlier and earlier, and we've all be over-warned about the danger of the sun without considering all the other factors that contribute to cancer in our society.  If I might suggest something that might or might not help a bit, there are a couple of homeopathic remedies that help me some, and I've got the worse kind of insomnia, drug induced insomnia.  One is called Sleep and one is called Calm's Forte, both by Hyland's, and one is called Quietude I think by Boiron.  If they work they have no active ingredients so they won't hurt you any, and if they don't, no big loss, they're very inexpensive.  But they might help you to go back to sleep when you wake up and start that thinking.
If you wake up around 3 am then is going to bed at 10 still too early? Yes I don't think I exert myself enough during the day. I have an intellectually intensive 9-5 sedentary job which is done mostly insolitude. I walk a few miles almost everyday and do the cardio and lifting that I mentioned before. However my body "tells me" it need needs more activity and more time outside. Other than doing calisthenics I don't know what more to do. My fatigue itself makes working out more difficult.

I'll check the homeopathic remedies you mentioned.
P.S. Iodine is giving me acne, eh.
External User
I had this same issue, however I had to start with a home sleep study (the insurance paid) and then I was able to do an in-lab sleep study. Turns out I do have sleep apnea and with the c-pap machine I wake up felling much better AND my depression isn't nearly as bad. Good luck!
20840604 tn?1531064971
There are no proofs that anxiety causes sleep apnea , but it’s possible vice versa. Anyway, healthy and uninterrupted sleep are essential for our well being – physical as well as mental. So, the only thing that comes on my mind, if you don’t have a quality sleep, you become more irritable, less motivated and certainly more anxious. But, that’s only my opinion.
Here are some natural methods to beat sleep disorder:
- Keep it cool. Your body temperature heavily influences the quality of your sleep (i.e. the amount of REM sleep, which is where the magic happens).
- Go to bed at regular hours. Your brain loves habits, so having a nighttime routine can work wonders for your sleep.
- Use your bed only for sleep. Your brain responds to cues, so use that to your advantage. (it should be very comfortable. Better buy some new mattress or  a pillow)
- Use background noise. Humans haven’t evolved sleeping behind tightly shut windows. For thousands of years, we’ve slept outdoors, with the wind blowing in our ears, a river flowing nearby and wild dogs howling in the distance.
Hope this help!
Thanks. Keeping the bedroom cool is a little problematic. Unless the weather is hot, I often wake up feeling cold. I do use background noise and try to use my bed for sleep only. But when I wake up at 3:30 am my mind starts to wander.
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