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Tired of Your Every Night 2 AM Wake-Up Call?

Dear Readers,

Does it seem like every night at 2- 4 AM your internal alarm clock goes off? This is one of the most common problems people with fibromyalgia have, and is increasingly common in the general population as well.

But what if it was optional?

Here are some of the major causes:

1) Drops in blood sugar. This is a major problem in people with adrenal fatigue. It can be especially common in people who are exhausted and “hangry” (hungry when angry) all day and whose minds suddenly go wide awake at bedtime. The drop in blood sugar triggers an adrenaline rush and you’re suddenly wide-awake.

The solution? Have a 1-2 oz high protein snack at bedtime such as a hard-boiled egg or some cheese, meat or fish. A sugary or high carbohydrate snack will actually make the problem worse. You will know if this is helping after one or two nights.

2) Frequent urination. In addition to the other hormonal problems seen in fibromyalgia, people often have a drop in antidiuretic hormone (ADH or vasopressin). This makes it hard to hold onto water so you “drink like a fish and pee like a racehorse.” This can keep you up at night as well.

The solutions?
 

3) Night sweats. This can come from a number of problems. In fibromyalgia, I find that the most common ones are hormonal deficiencies (estrogen and testosterone), and infections (especially Candida). We have discussed how to treat these in earlier articles.

Another common cause is night time acid reflux. Although you may sometimes notice the heartburn when you wake up, other times you won’t and you’ll just wake up in a sweat after inhaling the stomach acid. This is especially likely to be a problem if you have daytime indigestion as well. After three weeks doing the below, you may find your daytime heartburn starts to settle down as well.

Though it’s a bad idea to keep your stomach acid “turned off” during the day (you need it to digest food), you don’t need stomach acid at bedtime while sleeping. So here are a few tips:

4) Pain. If pain is keeping you awake at night, it absolutely should be eliminated. Getting sleep will then actually help the pain to decrease over time. Some especially helpful treatments, which also can help support healthy sleep, include (these can all be used in combination in the low doses recommended):

A) Medications:

  1. Flexeril (cyclobenzaprine) 5 mg. One half – one tablet at bedtime
  2. Ultram (tramadol) 50-100 mg. Although this is treated like an addictive medication, I’ve never seen anybody with a tramadol addiction, nor have the addiction specialists I’ve asked. Still, use the other medications instead if you are taking low dose naltrexone.
  3. Zanaflex (tizanidine) 4 mg. One half – one at bedtime. Stop it in the rare event that it causes severe nightmares and it should not be combined with Cipro
  4. Neurontin (gabapentin) 100-600 mg
  5. Elavil ( amitriptyline) 10-25 mg. this medication combined with Neurontin can be especially helpful for people with pelvic pain, such as interstitial cystitis or vulvodynia.

B) Herbals:

  1. Curamin. This mix has been a pain relief miracle for many people, and can be taken one or two capsules three times a day as well. It continues to increase in effectiveness over six weeks and can be taken with any pain medications.
  2. 5 HTP 300 mg. After six weeks, it helps sleep, decreases pain, and even improves mood.
  3. Terrific ZZZZ. It will also have a calming effect.

For more sleep information, see my recent articles in which we discussed medications and natural remedies as well as treating sleep apnea and restless leg syndrome.

You can get a solid eight to nine hours of sleep a night – even with fibromyalgia!

Love and blessings,
Dr. T