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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by linkadge on June 16, 2008, at 8:57:46
Does anyone go to bed with normal energy but wake up feeling more tired then when you went to bed?
About 3-4 out of 7 mornings a week I wake up feeling profoundly exhausted. I feel like I could go back to sleep for a week. I feel much more tired then when I went to bed.
A few people say "you're oversleeping". Does this sound familliar to anyone? Is there any literature on the "oversleeping" effect?
Thanks
Linkadge
Posted by SLS on June 16, 2008, at 9:33:34
In reply to extreme morning fatugue (energy fine night before), posted by linkadge on June 16, 2008, at 8:57:46
It is important to get 8 hours of sleep. No more, no less. It is also critical to bring yourself to full wakefullness at the same time every morning, even if only for a few minutes. The exposure to light is a zeitgerber to reset the circadian rhythm every day. When you oversleep beyond your regular wake up time, you get what is a sort of jetlag. It can affect you all day long. Just return to bed after resetting your ciradian rhythm, and you can sleep all day if you wish to, without experiencing the fatigue and mental blunting.
- Scott
Posted by SLS on June 16, 2008, at 9:38:11
In reply to Re: extreme morning fatugue (energy fine night before), posted by SLS on June 16, 2008, at 9:33:34
One additional comment. If your depression is worse in the morning, this might indicate that your condition is endogenous/melancholic. This depression subtype seems to be more treatable with tricyclics.
> It is important to get 8 hours of sleep. No more, no less. It is also critical to bring yourself to full wakefullness at the same time every morning, even if only for a few minutes. The exposure to light is a zeitgerber to reset the circadian rhythm every day. When you oversleep beyond your regular wake up time, you get what is a sort of jetlag. It can affect you all day long. Just return to bed after resetting your ciradian rhythm, and you can sleep all day if you wish to, without experiencing the fatigue and mental blunting.
>
>
> - Scott
Posted by Horned One on June 16, 2008, at 10:05:05
In reply to extreme morning fatugue (energy fine night before), posted by linkadge on June 16, 2008, at 8:57:46
>Does anyone go to bed with normal energy but wake up feeling more tired then when you went to bed?
Yes, this is the norm for me. It's so bad i've wondered if I have sleep apnea or something, but I think it's really because I'm a night owl and naturally have more energy at night. Since I moved my sleeping schedule to 12-8 (with the help of zopiclone) to be more 'normal' I've felt rotten. I don't see much point in being awake during the day if I can't function. I have much more energy with my natural sleeping rhythm.
-Horny
Posted by Phillipa on June 16, 2008, at 10:51:42
In reply to Re: extreme morning fatugue (energy fine night bef, posted by Horned One on June 16, 2008, at 10:05:05
Always feel worse in the morning since being a kid. And then worked and did the 3-ll shift so bed at one for many years. So as the day goes by get more energy. I stay up till 2am and sleep till llam. Nothing to do during the day and I like being up late. So guess my clock says bed at l or 2 and it doesn't want to change. Phillipa ps if a nightworker they are up all night and sleep during the day but they arent depressed. So I guess just do sleeping the same each day . Phillipa
Posted by Bob on June 16, 2008, at 13:02:50
In reply to extreme morning fatugue (energy fine night before), posted by linkadge on June 16, 2008, at 8:57:46
I have been plagued by this problem since adolescence also. It has always been difficult for me to rise in the morning. This became a more serious problem when I got into college. Finally with the onset of more serious MDD after college and the exposure to meds it became unbelievable. Often, the very medecines that helped me most in the beginning, such as Effexor, ended up causing outrageous morning fatigue, such that I could no longer get out of bed until the afternoon.
Presently, I have more energy at night and see little reason to fight to get up in the morning when I feel so terrible anyway. Now I get out of bed somewhere around noon and try not to go to bed again until 2-3am. This doesn't mesh too well with the rest of the world, but it is the best I seem to be able to do. I don't work any longer and the sleeping problem is one of the reasons. Two treatments worked towards mitigating the sleep problem and both ended up being disasterous in the end: topirimate, and ECT. They were eventually so bad that I don't think I could ever endure either one again.
As another poster in this thread stated, the morning fatigue could be a sign of a more endogenous condition, and for me I have little doubt of this. Now, if I could just fix it. Ironically, a little while back I tried to get into a study for major treatment resistant depression and they told me they are only taking patients that have trouble with not sleeping enough, rather than someone who sleeps too much.
Posted by linkadge on June 16, 2008, at 14:58:44
In reply to Re: extreme morning fatugue (energy fine night before), posted by Bob on June 16, 2008, at 13:02:50
Something strange happens in the night. I wake up about 3-4 times each in a progressively worse mood.
I first wake up about 1 a.m. and my mood is generally fine. The next time I wake up about 3-4 am in a panic state, my brain is trying to fight off a nightmare of some sort. The next time I wake up about 6-7 I just feel dead (like all the life has drained out of me). It is this very distinct feeling, sometimes paired with a specific type of dream. The feeling is basically like "your life is over, you can die now". At this poiont I am utterly exhausted - zero motivation, zero interest in getting up to do anything at all - I could sleep till 1 or 2.
My energy starts to come back around 5-7pm when I just feel normal. Somtimes I don't want to sleep for fear of the cycle happening again.
Anyhow, thats how it is for me.
Linkadge
Posted by Bob on June 16, 2008, at 15:42:43
In reply to Re: extreme morning fatugue (energy fine night before), posted by linkadge on June 16, 2008, at 14:58:44
Linkadge, my heart goes out to you and I want you to know that I have at least some insight into some of what you're going through. My illness has always largely been defined by a worsening during the night into the morning and when I started taking drugs it got exponentially worse. I have had times when I would build up through the day to a point where would sometimes feel kinda good by the evening, only to be back at the bottom and severely depressed (both physically and emotionally) after a nights sleep. Sleep does something terrible to me and it has gotten worse through the years and with exposure to meds. I too have sometimes actually been scared to go to bed at night for fear of the terrible time I invariably have the following morning. It is extremely, extremely demoralizing and I've never found a medical professional that has done more than merely nod is some sort of vague acknowledgement. It sucks.
Posted by Phillipa on June 16, 2008, at 19:51:09
In reply to Re: extreme morning fatugue (energy fine night before) » linkadge, posted by Bob on June 16, 2008, at 15:42:43
Exactly the same way for me horrible in morning but love to stay up late in the early hours of morning. Feel good then. Phillipa
Posted by Zeba on June 16, 2008, at 21:39:03
In reply to extreme morning fatugue (energy fine night before), posted by linkadge on June 16, 2008, at 8:57:46
I used to feel this way and attributed it to depression. Then I had a sleep study, and I found out I have sleep apnea. Since I have been using a CPAP machine, I have more energy when I wake up. I still take an antidepressant (Parnate), but at least I can now get up in the morning and not feel like I want to pull the covers over my head.
Posted by Yoda on June 18, 2008, at 12:21:57
In reply to Re: extreme morning fatugue (energy fine night before) » linkadge, posted by Zeba on June 16, 2008, at 21:39:03
I thought I was the only person who got this! Its so frustrating, because it totaly removes the point of sleeping. Whats worse is that caffeine just makes the body jittery without removing that wooly brain feeling. Sometimes i even wake up with a headache, these i call "sleep hangovers".
Im guesing it has something to do with the brain staying stuck in a kind of hibernate mode. Maybe eating and drinking as soon as getting up could help. Listen to loud music, bright light, exersise and a cool shower might help as well.
One sure way to stop this is to pop some ephedrine or yohimbine an hour before you want to get out of bed- if you can get it of course.
Posted by Bob on June 18, 2008, at 15:20:46
In reply to Re: extreme morning fatugue (energy fine night before), posted by Yoda on June 18, 2008, at 12:21:57
> I thought I was the only person who got this! Its so frustrating, because it totaly removes the point of sleeping. Whats worse is that caffeine just makes the body jittery without removing that wooly brain feeling. Sometimes i even wake up with a headache, these i call "sleep hangovers".
>
> Im guesing it has something to do with the brain staying stuck in a kind of hibernate mode. Maybe eating and drinking as soon as getting up could help. Listen to loud music, bright light, exersise and a cool shower might help as well.
>
> One sure way to stop this is to pop some ephedrine or yohimbine an hour before you want to get out of bed- if you can get it of course.__________________________________________________
You're not the only person that gets this, but it is not really discussed in the medical community that I can see. This "phenomenon" has been one of the key fatal flaws of meds, as many that have actually helped depression have caused me to not be able to wake up any longer. Seemingly anything with an SSR component are offenders but some much more than others.
Your statement about the brain getting "stuck in a hibernate mode" is quite aptly descriptive. This is how it feels to me.
I have tried many, many things over the years to try and combat the morning coma effect and although some things have worked briefly, nothing ameliorated it entirely. I've tried coffee, melatonin pills, SAD lights right next to my face on a timer, jumping in the shower (dried off and got back in bed), wake up phone calls, alarms, etc. Nothing works in the end except coming off of the med.
Posted by Tomatheus on June 19, 2008, at 0:15:53
In reply to extreme morning fatugue (energy fine night before), posted by linkadge on June 16, 2008, at 8:57:46
> Does anyone go to bed with normal energy but wake up feeling more tired then when you went to bed?
Yes. When my depressive symptoms were in remission some two years ago, I didn't get this; I actually woke up feeling refreshed. The medication that I was taking at the time was Nardil (with doxylamine succinate at night).
To a certain extent, I have always found it difficult to wake up in the morning. However, my symptoms intensified with the onset of my depressive symptoms some eight years ago and remain now that I have schizoaffective disorder. It's something that I feel pretty helpless about. The last doctor I spoke with about my hypersomnia and morning fatigue just basically told me that I need to set my alarm clock, like I don't do that already. I guess that I should be grateful that I experienced relief from these symptoms at some point, even though it didn't last.
Tomatheus
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