Sleep & Insomnia

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It is 4am and I have not been to sleep yet. I have to get up in less than three hours to go to work. I roll over in my bed in the hope that at some point soon, I will fall asleep.

This is a daily situation for me at the moment. I am really struggling with getting to sleep. Every night it is the same, and every day I dread going to bed because I know what is going to happen. I get my stressed and anxious and it then becomes a self-fulfilling prophecy. I am constantly worrying about not sleeping so of course, I can’t sleep. It is a vicious cycle.

It has been like this for me for over a month now. I have always had the odd day a week when I haven’t slept well but it has never been this bad before. I consider myself lucky if I get 4 hours sleep a night. And I know exactly what has caused it. The problem is however, I don’t think there is anything I can do about it.

I have been on the antidepressant Mirtazapine for 10 years. One of the very good side effects of Mirtazapine is that it makes you fall asleep. 85% of the time, I was guaranteed to be asleep with 10 minutes of getting into bed. Wonderful. But it was agreed at the end of last year (2020) that I would taper off mirtazapine and start a new antidepressant; sertraline. So, over a two week period, I reduced my mirtazapine dose while starting sertraline. I took my very last dose of mirtazapine on new years eve. Welcome 2021. Welcome insomnia.

So here I am now, just over a month without mirtazapine and I have probably had as much sleep this month as I would have had in a week with mirtazapine. To say I am exhausted would be a understatement. It is not just the lack of sleep, but the eternal worry of not being able to sleep. Along with trying to function normally as I would have been with 8 hours sleep as opposed to four…or two.

But what can I do? I feel like my only option is to stick it out and wait for my body to adapt to not having mirtazapine make it sleep. But my sticking power is really starting to wear thin. Well, if I am honest, I gave in a few days ago. After a very, very bad night followed by a full day at work, I just needed to sleep. I was desperate. Totally desperate. So I took a small dose of mirtazapine. My god it hit me harder than it ever has before. It completely knocked me out. I was asleep within a minute of my head hitting the pillow and didn’t wake up until my alarm went off for work the following morning. The sleep was incredible. The hangover effect not so much.

I had really wanted to not succumb to going back to mirtazapine. But I was at a loss. I haven’t taken it again yet, but I don’t know how much more insomnia and lack of sleep I can tolerate. I do hate the fact that I feel dependent on this pill to sleep and I worry if I will ever be able to sleep again normally. Hopefully over time, the withdrawal symptoms from mirtazapine will subside and my sleep will resume.

Part of the problem I think I’m having is that I came off mirtazapine too quickly. As someone who was on it for 10 years, it would seem I should have tapered off it over a period of months as opposed to two weeks. However, I was only following advice and I guess it is something I won’t know for sure. Although I am also having several other withdrawal symptoms along with the insomnia.

I have always loved sleep, particularly since having anorexia. Often, I think for people with mental health problems, sleep is a good way to escape. It is often the only time there is peace in your mind and you aren’t having to fight a constant battle. There was a time when all I wanted to do was sleep. Desperate to escape my mind. I haven’t felt like that quite so much over recent years. I had been wanting to start living and experiencing life. And my desperation to sleep now is not to escape and avoid life, but to get the sleep I need in order to live life.

There is no real conclusion to this blog. I don’t know what is going to happen with my sleep over the coming weeks and months. I just hope that my sleep returns sooner rather than later. And I would welcome any comments from people who are experiencing or have experienced similar things. Hopefully I will be able to do an update to this blog in a month or so and let you all know that I am back to a better sleeping pattern. Until then, I hope you all have a good night sleep.

Sleep and insomnia
Sleep and insomnia – Bex Quinlan




3 thoughts on “Sleep & Insomnia”

  1. Hi Bex, Mirtazapine antagonises the Histamine H1receptor with high potency which causes hypnotic/sleep inducing effects whilst Sertraline has no effect at this receptor. Your sleep deprived suffering is expected given this change. This is not ok. Ask your dr to provide a low dose of either mirtazapine or quetiapine ( also an H1 receptor antagonist) and great for sleep when added to Sertraline. At very low doses other receptors are not activated for either add- on drug and there is no risk of serotonin syndrome or other interactions.

    Your wellbeing depends on a good nights sleep and I’ve been there and I also suffered at work having to take sick leave due to drug induced insomnia when I withdrew from add on Aripiprazole ( moderate H1antagonism) to an SSRI.

    Avoid z drugs ie zopiclone as they will mess you up long term. You can gradually taper the quetiapine or mirtazapine over a lengthy period as your body adjusts in need. Right now you desperately need sleep. Be firm with Dr. it’s your life and they serve your needs.

  2. I live with insomnia and it’s such a horrible drain and I really struggle to cope with it too. Totally understandable that you would struggle and I’m so sorry to read that you’re going through this too. It affects almost every other aspect of life and it’s so exhausting. Sending you lots of love

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