Hello and welcome to the forum.

I'll have to say here that I'm not much in support of the condition known as fibromylagia and having been in practice for more than 40 years, there's another side to that whole story that has more to do with a wrestling match to get insurers to pay physicians for treating a host of symptoms all lumped into one category and not associated with anxiety or depression as the primary diagnosis. It's a long story, but suffice it to say that it gets a sideways glance from me.

Many people with anxiety disorder also complain of various characterizations of insomnia. It's important for you to realize that when anxiety is disturbing your sleep patterns, you will only experience frustration and further insomina by trying to employ your routine approach. In other words, if a person experiencing insomnia previously went to bed at say 10pm and tries to employ this same practice, they likely will find themselves staring at the ceiling or tossing and turning throughout the night.

When the circadian rhythm is disturbed, it takes alternative measures to restore one's usual patterns. Here are the basics; do not read, eat or watch television in bed under any circumstances. The body becomes conditioned to certain stimuli and the bed should be reserved for when you are tired and ready for sleep.

The second factor is to remove as much light as possible from the room. This means covering any window openings if necessary and the room should be as absolutely dark as possible. The reason for this is that the reticular activating system in the brain, responsible for initiation of sleep and wake cycles, along with the pineal gland that produces melatonin, are extremely sensitive to feedback from the optic circuits that detect light. If a certain level of light is present, it affects the ability for these brain centers to put you to sleep, sort of leaving you in a light sleep with frequent awakenings. This stage often promotes cognitive activity that can often bring you to the full waking state. So again, as little light as possible in the room.

Do not drink caffeinated beverages or eat foods that contain caffeine after dinner time and limit their use during the day. Caffeine is a central nervous system stimulant and its effects are quite powerful.

Develop a structured approach to sleep that permits you to shut down thinking about the day's residues or tomorrow's plans. This requires practice to accomplish but readily becomes habit once successful. Do not work on projects or try and work out issues just prior to bed. It's necessary to purge these issues from your immediate attention through diversion of watching a television show or reading a book and when you feel tired, go to bed following the other procedures above.

The last part of my suggestion is actually one of the most important; do not lay down and try to sleep simply because it's bedtime. If you're not tired, do not get into bed. Stay awake and engage in an activity until you feel tired or drowsy. Once this sensation overcomes you, then and only then go to bed. Don't let the clock hour concern you or make you anxious, which is a factor that only causes more loss of sleep by persons worried they must have sleep before work. It is true that everyone functions better with a full night's sleep, but what will happen is that you will be more tired the following night and can anticipate more restful sleep.

Lastly, do not go to bed early thinking you can catch up on sleep. This is an old wives tale and does not have scientific merit. You must target a 2 or 3 hour window for first lying down to sleep under the proper conditions and not deviate from them, along with the other things I've mentioned.

It may take several weeks for this to all take effect but once it does, you will find it providing you with more restful sleep. Some intermittent patterns may arise from day to day, but you will begin to obtain more restful sleep overall. While sleep hypnotics are available, they do not generally establish good sleep habits but rather induce sleep purely from a technical standpoint. They are for short-term use only, but represent one of the most misused drugs on the market by patients taking them in a compensatory fashion for failing to change poor sleep habits.

To the issue of your palpitations, you'll be just fine. They are not the consequence of anything pathological and do not represent any type of imminent cardiac event about to take place. In fact, the type of palpitations we're discussing here are incapable of causing any type of interruption or damage to the heart. They are the result of stimulation by the parasympathetic nervous system as a consequence of anxiety disorder.

As I've stated in many postings, in over 40 years of practice I've never once even heard of a person experiencing palpitations of this type ever subcumbing to any type of cardiac event whatsoever. Not even once. They can indeed be frightening, but do not represent anything that can actually harm you, regardless of variability in their presenation.

You're going to be just fine. We'll talk more.

Best regards and Good Health

Okay, if these herbal products make you "feel" better then I'm not going to suggest otherwise, but realize that there is absolutely no scientific evidence to support that herbal preparations such as lemon balm have any effect whatsoever on the vagus nerve. Realize that the vagus nerve, or 10th cranial nerve, does no exist in isolation somewhere in the body and that the properties of the lemon balm can somehow target this nerve complex. It's not medically possible.

You'll find that for every symptom, there is an herbal remedy which pupports to be the cure. If it were all that simple, the world would have no disease. The only folks really benefiting from the use of lemon balm are the manufacturers. You might know by my response that I hold a great deal of contempt for manufacturers of vitamins, supplements and herbal remedies. They are a predatory group and the bottom line has little to do with health benefits.

But again, if you find it bringing you a sense of relief, then sometimes that's all that matters.

Best regards and Good Health

Hi Sue,

I remember when I was going through that dreaded state of sleepiness, only to wake right up in a panic.  It was as though I'm just about to fall asleep and then suddenly, this shot of adrenalline wakes me up (like a sudden jolt as you had described).  It started happening every night, and like you, I dreaded bedtime.  This went on for months, and then I decided to take some Benadryl before it was time to go to sleep.  It did the trick for me, I fell asleep and stayed asleep.  The next night I took Benadryl again, and I slept so peacefully.  I didn't need it after that, it was as though I learned how to fall asleep again, and stay asleep!  I just had to get back into the pattern of sleep, I broke the cycle and it stayed broken.

Whatever it takes (ie, medication, herbs, reading, etc), you WILL break the cycle, it will not go on like this.  One night you will fall asleep peacefully, stay asleep until morning, and it will happen again and again until you are out of that dreaded sleep pattern.  I know it doesn't seem possible but trust me, you will be sleeping like a baby before you know it.  

The panic and anxiety affect so many aspects of our lives, it's learning how to grab ahold of it and NOT let it dictate our lives.  I'm trying my best to do just that, however; it's easier said than done

Take care,
Karen