How I Defeated Years of Chronic Sleep-Onset Insomnia in the Span of 48 hours

Sleep-onset insomnia, defined as difficulty initiating sleep, is a common disorder with associated impairment or significant distress, associated with daytime consequences.

For eight years, I dreaded the moment to go to sleep. I would lie in bed for hours, unable to fall asleep. I have no recollection of how the problem started in the first place, perhaps an emotionally distressing event. Insomnia became a daily harrowing struggle nothing seemed to fix.

The American Psychiatric Association (APA) cites insomnia as one of the most common sleep disorders. Insomnia is characterized as an inability to fall and stay asleep at night. It also may involve constant tossing-and-turning and/or frequent wake-ups at night. Some studies show that approximately 25% (1-in-4) of Americans struggle with some form of insomnia.

While sleep-onset insomnia primarily causes symptoms at the beginning of the night, other types of insomnia strike at other times. Sleep maintenance insomnia occurs if you wake up frequently or for long periods during the night, after having first fallen asleep, and early morning awakening insomnia is a condition in which you wake up too early in the morning and can’t get back to sleep again. You may experience one or several insomnia types.

Chronic insomnia is often reinforced by another medical condition or by lifestyle factors. In my case, there was no obvious medical or psychological condition that could explain the problem. Because people with sleep-onset insomnia have a reduced sleep time, they often feel groggy, irritable, moody, foggy, confused, and extremely tired the next day. That was me.

I tried every trick in the book to fix the problem. Natural sleep aids like herbal teas, sleep programs, yoga before bedtime, meditation, melatonin, going to bed late until I felt exhausted, counting sheep, making lists. Nothing worked. Next, I switched to Diphenhydramine (Benadryl), an OTC sleep medication which is an antihistamine mainly used to treat allergies. It slightly alleviated the sleep-onset insomnia — I still took up to one hour to fall asleep — but I felt drowsy and lousy when I woke up in the morning.

After two years of that regimen and an average of four to five hours of sleep per night, I resorted to consult a doctor. This led to my first encounter with Zolpidem (Ambien), a non-benzodiazepines class of drugs called sedative-hypnotics that is effective for sleep-onset insomnia.

Zolpidem worked like a charm. I fell asleep within twenty minutes of taking the drug and enjoyed seven hours of blissful sleep with no feeling of drowsiness in the morning (the drug’s half-life is only four hours).

Soon, I figured out several serious side effects. Despite being on a low dose of Zolpidem, I experienced amnesia. The brain becomes unable to store short-term memories in its long-term storage, so you cannot remember what happened to you even a few minutes before taking the drug. I learned that drinking alcohol before taking Zolpidem led to confusion and severe cognitive impairment. I used to call friends before going to bed, and the next morning I had no recollection of making these calls or how confused and incoherent I had behaved. And that was only after drinking two or three glasses of wine.

Zolpidem is supposed to be prescribed for treating short term sleep-onset insomnia problems. After a few weeks, you should reset to normal sleeping patterns without the drug. The problem was that I was living in Italy at the time, and the local pharmacist generously sold me the drug without requiring a prescription. Easy leads to lazy. I became psychologically dependent on Zolpidem despite taking a lower daily dose of 5mg. I simply convinced myself that I could not fall asleep without it, and a few half-assed attempts at discontinuing it just confirmed I was right. Classic confirmation bias.

I should have known better. The dependence continued for several years. I simply took the easy route. Ironically, once I moved to Mexico, I had no other choice than to get a medical prescription, as no pharmacy would sell the drug without it. Once things got more complicated, I realized the cognitive and financial burden (in Mexico prescription drugs are very expensive) of my self-induced addiction, and the mediocrity of the situation I created for myself.

Finally, after several years of self-induced psychological dependence, I let my reserve of pills run out and decided to deal with the consequences. I fully expected to return to my chronic sleep-onset insomnia days. I reframed the problem in my mind by deciding what sort of person I wanted to be, and that definitely wasn’t a drug addict. Stoically, I simply redirected my thought process to dealing with the problem without reverting to anything artificial.

Once I stopped cold turkey after addressing the mindset issue, I regained a normal sleep pattern within forty-eight hours. No withdrawal symptoms, no side-effects. Eighteen months later, I have never reverted to any sleep aid or felt any need for one. Simple as that, mind over matter.

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