I managed to get 6.5hrs of sleep last night. My daily cpap score indicated I had a good night. Sure as hell didn’t feel like it upon awakening  Awoke the first time about 330 with my cpap mask still on but I was all stopped up and couldn’t breathe properly. Plus I felt terrible: stiff, achy, anxious, nauseous, generally unwell. Tossed and turned a while and fell back to sleep without my cpap.  Awoke again about . 630 feeling awful again. Something is going on in my sleep but I can’t pinpoint what. But I  think my breathing is being suppressed by the mirtazapine/doxepin combination. Once I get up, have some breakfast I start feeling better.  It’s some combination of breathing & WD from the doxepin OR I’m being to sedated from the 2 drugs. Whatever it is it’s not a healthy situation. And I don’t know what I can do about it?????

I feel you very well, @Pokey449. It is the same for me, I am on the couch all day long, tired and depressed. But what we can do, our brain is deficient now, we have to hope relief and better days. As you, I play piano and loved have a time to do this. Before the injury. Now I have all my time, but I cannot return to the piano, all my soul is in terror. What a Living Hell...

Svetla

Hey Pokey. Glad you got some sleep. I’m sorry it didn’t feel like it. 
 

I don’t understand your breathing issues at all. Everything else sounds like wd to me. I also don’t understand sleep. It’s the most complex of tasks, I’m sure of it. I’ve experienced behind the scenes of its workings myself on a daily basis for 2 years now. There is so much more to it than being unconscious for a set number of hours. This complex process is very much interfered with by these meds.

 

Im hoping as time passes this slowly improves for you. Sleep injury in my experience (and others) can be slow to heal. 
 

I wish I understood more about your breathing etc. Not being a doctor I don’t. 
 

Hope you have a long but more restorative sleep tonight my friend. 
 

Chippy

Morning @Chippy  Well same misery upon awakening at 3:00 and 6:30. Felt the worst at 6:30. Symptoms very hard to describe: felt weak, sick or toxic, stiff, significant whole body discomfort, mild SOB, foggy brain, slow heart rate <60 but normal rhythm. Both times awoke feeling like I could not breathe normally through cpap mask. BUT I awake feeling much the same when I awaken w/o my Cpap mask being on.My breathing is definitely being affected. 

Whatever is going on it seems to be getting worse.  My senses/medical knowledge tell me what’s going on is an idiosyncratic reaction between two drugs that modern psychiatry has absolutely no understanding of their possible interactions & that may be causing either a metabolic malfunction or over sedation in sleep causing a negative cardiopulmonary affect…..that my life may be in danger, that I may not wake up one morning.  Of course  I may be incorrect but no doctor that I know has a more plausible explanation thus far. Logic would say I need to stop either the mirtazapine or doxepin. BUT as we know just stopping one or the other  isn’t an option. I’m in a drug no man’s land 🤔😩🤞🤞

https://www.drugs.com/

 

@Pokey449, you can use this site to see the combination/interaction between the drugs.

What a Living Hell, endless agony... The recurrent cortisol and the inner akatisia kill me...

Svetla

Edited March 15Mar 15 by skamen

20 minutes ago, Pokey449 said:

Morning @Chippy  Well same misery upon awakening at 3:00 and 6:30. Felt the worst at 6:30. Symptoms very hard to describe: felt weak, sick or toxic, stiff, significant whole body discomfort, mild SOB, foggy brain, slow heart rate <60 but normal rhythm. Both times awoke feeling like I could not breathe normally through cpap mask. BUT I awake feeling much the same when I awaken w/o my Cpap mask being on.My breathing is definitely being affected. 

Whatever is going on it seems to be getting worse.  My senses/medical knowledge tell me what’s going on is an idiosyncratic reaction between two drugs that modern psychiatry has absolutely no understanding of their possible interactions & that may be causing either a metabolic malfunction or over sedation in sleep causing a negative cardiopulmonary affect…..that my life may be in danger, that I may not wake up one morning.  Of course  I may be incorrect but no doctor that I know has a more plausible explanation thus far. Logic would say I need to stop either the mirtazapine or doxepin. BUT as we know just stopping one or the other  isn’t an option. I’m in a drug no man’s land 🤔😩🤞🤞

Argh I’m sorry Pokey. Hell of a life this sometimes isn’t it. 
 

We just don’t know is the short answer. We know mirt and Doxepin don’t play well together and as you said you shouldn’t be on both really in your opinion which I agree with. 
 

What to do is hard. My hope is and has been that keeping things steady would see you stabilise. It’s hard to prove that as it takes time to see the results without any interference. And that time scale can be long. Currently you haven’t been holding still long. And on top of that you are still shifting your dose, which isn’t really hold firm. 
 

As you said abruptly stopping either medication isn’t a good idea in pretty much all circumstances. 

18 minutes ago, Chippy said:

Currently you haven’t been holding still long. And on top of that you are still shifting your dose, which isn’t really hold firm. 

Im at day 24 of being at the same dose of doxepin 29.6mg. That dose is divided into 2 doses. 14mg & 15.6mg. I take the 14mg at 8am and was taking the 15.6mg at noon. Both myself & Horowitz thinking I might be having interdose WD sxs in the middle of the night due to doxepins average 1/2 life of 15-17hrs it was recommended by Dr.H that I shift my 2nd 1/2 dose to later in the day. He had suggested shifting it by 1-2 hrs each day until i reached 8pm. I’m going MUCH slower by only shifting it by 1/2 hr every 1-2days. I’m taking that 2nd 1/2 dose now at 2pm. 2pm is a very inconvenient/awkward time to be taking any medication. I’m hoping to get to 4 or 5pm, when I’m normally home and not out & about, and holding there for some time. 
But none of this will address the possibility that mirtazapine & Doxepin, even in low doses like I’m on are a poisonous combination that neither my local psych doc or Dr. H addressed as an issue of concern. Maybe it really is only WD that I’m experiencing l, but I have my doubts it’s that simple. 

3 minutes ago, Pokey449 said:

But none of this will address the possibility that mirtazapine & Doxepin, even in low doses like I’m on are a poisonous combination that neither my local psych doc or Dr. H addressed as an issue of concern. Maybe it really is only WD that I’m experiencing l, but I have my doubts it’s that simple. 

No we just don’t know mate. I suppose with a long hold which starts as far as I’m concerned once you get to 4-5pm, you at least have something to hope will resolve the issue. Some time and stability. 
Your alternative cause I’m not sure what the solution would be. Maybe focus on the main plan and hope that eventually leads you to feeling better. It’s all speculation really as we have no concrete evidence as to what is happening here. 

Well another night awakening to misery. The middle of the night is when my worst hell (symptoms) come out of their dark caves and feed on me like vampire bats sucking the life’s blood out of me. 

 

I do my nightly stretches & go to bed about 10:00. Read a bit, do my meditation/breathing exercise. Put on my cpap mask, turn out the light and I’m asleep within a few minutes. Only then to awaken 2-3-4 hrs later all restless and agitated. A god awful creepy crawly restless anxiousness has overtaken my body. I can hardly lay still. I ache all over. I’m often nauseous. I get up, am stiff, can hardly walk, groggy headed and stumble to the recliner in the living room. I lay there in the quiet lonely suffocating darkness and try to rid the symptoms with self massage and deep breathing. Eventually I go back to bed & eventually go back to sleep only to awaken later with the same awful symptoms. I finally get up in the dark early morning and stumble to the kitchen for a cup of tea or decaf coffee & light breakfast. I usually start feeling better and am able to drag through the day. Some days better than others. 
But today I still feel bad. Rotten!! 
Today is looking like it’s going to be a real drag. I’ll try to go to the health club for some exercise but don’t hold me to that. It may be a couch day. 
Im holding my dose now at day 25 since up dosing 0.5mg as recommended by Dr H. Up dosing hasn’t helped at all. I have also split my dose into 2 halves at his recommendation in an attempt to address possible interdose withdrawal due to doxepins 1/2 life of 15-17hrs. So far that has not helped either. But that maybe because I’ve not reached where I need to be yet with the 2nd 1/2 of my dose and thus may not be stable yet. Currently I take a 1/2 dose at 8am and the 2nd 1/2,now at 2pm.  I’m trying to get to 5 or 6 pm for the 2nd 1/2. Middle of the afternoon is not a convenient time to be taking one’s medication, any medication.  But I think I need to slow down on getting to 5 or 6pm

But I’m getting to the point I don’t know how much longer I can survive this hell. I feel like I’m going to die some days, some days I wish would. I’m not living anymore. 

 

47 minutes ago, Pokey449 said:

Well another night awakening to misery. The middle of the night is when my worst hell (symptoms) come out of their dark caves and feed on me like vampire bats sucking the life’s blood out of me. 

 

I do my nightly stretches & go to bed about 10:00. Read a bit, do my meditation/breathing exercise. Put on my cpap mask, turn out the light and I’m asleep within a few minutes. Only then to awaken 2-3-4 hrs later all restless and agitated. A god awful creepy crawly restless anxiousness has overtaken my body. I can hardly lay still. I ache all over. I’m often nauseous. I get up, am stiff, can hardly walk, groggy headed and stumble to the recliner in the living room. I lay there in the quiet lonely suffocating darkness and try to rid the symptoms with self massage and deep breathing. Eventually I go back to bed & eventually go back to sleep only to awaken later with the same awful symptoms. I finally get up in the dark early morning and stumble to the kitchen for a cup of tea or decaf coffee & light breakfast. I usually start feeling better and am able to drag through the day. Some days better than others. 
But today I still feel bad. Rotten!! 
Today is looking like it’s going to be a real drag. I’ll try to go to the health club for some exercise but don’t hold me to that. It may be a couch day. 
Im holding my dose now at day 25 since up dosing 0.5mg as recommended by Dr H. Up dosing hasn’t helped at all. I have also split my dose into 2 halves at his recommendation in an attempt to address possible interdose withdrawal due to doxepins 1/2 life of 15-17hrs. So far that has not helped either. But that maybe because I’ve not reached where I need to be yet with the 2nd 1/2 of my dose and thus may not be stable yet. Currently I take a 1/2 dose at 8am and the 2nd 1/2,now at 2pm.  I’m trying to get to 5 or 6 pm for the 2nd 1/2. Middle of the afternoon is not a convenient time to be taking one’s medication, any medication.  But I think I need to slow down on getting to 5 or 6pm

But I’m getting to the point I don’t know how much longer I can survive this hell. I feel like I’m going to die some days, some days I wish would. I’m not living anymore. 

 

@Pokey449, I'm sorry about your struggles with these medications.   

 

Keep holding and don't make changes.   When I started this journey, I decided to not make any changes to my medication nor to take supplements or anything.  I am holding as much as I can and as long as I can to allow body stability....

 

I'm at 15 months now, and it's being better than last year hell.   Recently, I started to feel slightly better, but I'm still on this up and down rollercoaster.

 

Hang in there... You will make it....

 

2 hours ago, Pokey449 said:

Well another night awakening to misery. The middle of the night is when my worst hell (symptoms) come out of their dark caves and feed on me like vampire bats sucking the life’s blood out of me. 

 

I do my nightly stretches & go to bed about 10:00. Read a bit, do my meditation/breathing exercise. Put on my cpap mask, turn out the light and I’m asleep within a few minutes. Only then to awaken 2-3-4 hrs later all restless and agitated. A god awful creepy crawly restless anxiousness has overtaken my body. I can hardly lay still. I ache all over. I’m often nauseous. I get up, am stiff, can hardly walk, groggy headed and stumble to the recliner in the living room. I lay there in the quiet lonely suffocating darkness and try to rid the symptoms with self massage and deep breathing. Eventually I go back to bed & eventually go back to sleep only to awaken later with the same awful symptoms. I finally get up in the dark early morning and stumble to the kitchen for a cup of tea or decaf coffee & light breakfast. I usually start feeling better and am able to drag through the day. Some days better than others. 
But today I still feel bad. Rotten!! 
Today is looking like it’s going to be a real drag. I’ll try to go to the health club for some exercise but don’t hold me to that. It may be a couch day. 
Im holding my dose now at day 25 since up dosing 0.5mg as recommended by Dr H. Up dosing hasn’t helped at all. I have also split my dose into 2 halves at his recommendation in an attempt to address possible interdose withdrawal due to doxepins 1/2 life of 15-17hrs. So far that has not helped either. But that maybe because I’ve not reached where I need to be yet with the 2nd 1/2 of my dose and thus may not be stable yet. Currently I take a 1/2 dose at 8am and the 2nd 1/2,now at 2pm.  I’m trying to get to 5 or 6 pm for the 2nd 1/2. Middle of the afternoon is not a convenient time to be taking one’s medication, any medication.  But I think I need to slow down on getting to 5 or 6pm

But I’m getting to the point I don’t know how much longer I can survive this hell. I feel like I’m going to die some days, some days I wish would. I’m not living anymore. 

 

Hey Pokey sorry you’re on a sofa day today mate. Hope you do make it to the health club. But I get it if you can’t. Won’t be holding you to it!

 

If it’s any consolation I’m not having the best day either. 
 

What you describe sounds like a cortisol reaction and is very common as I think you’ve seen. It’s not nice and I’m really sorry you have to go through it mate. 
 

I hope you sleep better tonight. I often think about you and hope one day very soon things start to settle for you. 
 

Chippy

Hi @Chippy As you know I’m in the process of splitting my doxepin dose into 2 halves. I take the first 1/2 at 8am. I’m currently at 2pm for the 2nd 1/2. My goal is to get to 5 or 6pm for the 2nd 1/2 

I got to wondering if it’s important or necessary to get the 2 doses exactly 12hrs apart? Which means I’d have to get the 2nd 1/2 to 8pm. Dr H didn’t say one way or another about this.  
 

Next question. What is a cortisol reaction that is often discussed here? I know cortisol levels tend to rise as morning approaches which helps waking us humans up each day. It’s a diurnal thing. Is one’s cortisol levels abnormally elevated as a WD affect when tapering  off these kinds of meds. 

39 minutes ago, Pokey449 said:

Hi @Chippy As you know I’m in the process of splitting my doxepin dose into 2 halves. I take the first 1/2 at 8am. I’m currently at 2pm for the 2nd 1/2. My goal is to get to 5 or 6pm for the 2nd 1/2 

I got to wondering if it’s important or necessary to get the 2 doses exactly 12hrs apart? Which means I’d have to get the 2nd 1/2 to 8pm. Dr H didn’t say one way or another about this.  
 

No it’s not a problem mate. Just about spreading the dose throughout the 24hr period. 
 

39 minutes ago, Pokey449 said:

Next question. What is a cortisol reaction that is often discussed here? I know cortisol levels tend to rise as morning approaches which helps waking us humans up each day. It’s a diurnal thing. Is one’s cortisol levels abnormally elevated as a WD affect when tapering  off these kinds of meds. 

In wd our hormone production get messed with. When the wd makes the cortisol spike it wakes us early and the high levels cause these awful symptoms like morning anxiety wakings and terror and other types of feelings. B talks about them too. It’s really common. 

@Chippy Humm. Makes me wonder if the reason I’m splitting my dose into 2 halves will solve what I thought was interdose WD symptoms in the wee hours when maybe it’s possibly this cortisol business.  Does stability eventually happen whether a single dose or split into 2 doses?  I’m desperate for stability so I can get a decent nights rest. I’m feeling really fried!! 

5 hours ago, Chippy said:

6 hours ago, Pokey449 said:

Next question. What is a cortisol reaction that is often discussed here? I know cortisol levels tend to rise as morning approaches which helps waking us humans up each day. It’s a diurnal thing. Is one’s cortisol levels abnormally elevated as a WD affect when tapering  off these kinds of meds. 

In wd our hormone production get messed with. When the wd makes the cortisol spike it wakes us early and the high levels cause these awful symptoms like morning anxiety wakings and terror and other types of feelings. B talks about them too. It’s really common. 

Hello @Pokey449 the cortisol reaction is really a common problem during withdrawal. I have asked the ai to make you an explanation. This ai  makes mistakes, but what I have copied matches with what I have researched so far. Maybe the explanation is helpful for you.

 

 

 

The reason many withdrawal symptoms peak between roughly 4 AM and 8 AM is related to a coordinated set of circadian neurobiological processes that prepare the body to wake up. During antidepressant withdrawal these normal processes can feel exaggerated.

---

1. The early-morning cortisol surge

Several hours before waking, the brain begins activating the stress-hormone system. The hormone Cortisol starts rising around 3–4 AM and continues increasing until about 30–45 minutes after waking, a phenomenon called the Cortisol Awakening Response.

Cortisol’s job is to:

• increase alertness

• mobilize glucose for energy

• activate the cardiovascular system

• prepare the brain for waking

When the nervous system is sensitized during withdrawal, this normal activation can feel like anxiety, tremor, agitation, or nausea.

---

2. Activation of the brain’s arousal center

At the same time, a small nucleus in the brainstem—the Locus coeruleus—becomes more active.

This structure releases Noradrenaline, which drives wakefulness and vigilance.

Effects of increased noradrenergic activity include:

• trembling or internal shaking

• rapid thoughts or alertness

• increased heart rate

• heightened startle response

Normally this system is balanced by serotonin input from the Raphe nuclei, but during tapering that balance can temporarily fluctuate.

---

3. The brain shifts from sleep mode to threat monitoring

As morning approaches, the brain transitions from sleep networks to waking networks. During this transition:

• the Amygdala (threat detection system) becomes more reactive

• stress-regulation circuits recalibrate

• autonomic nervous system activity increases

If the system is temporarily hypersensitive, this shift can trigger morning anxiety or agitation without any external trigger.

---

4. Low blood sugar after the night fast

After 7–10 hours without food, blood glucose is relatively low. Cortisol tries to raise it, but if the body senses an energy deficit, the stress response can intensify.

This can contribute to:

• weakness

• shakiness

• nausea

• feeling “wired but exhausted”

Eating in the morning often reduces these symptoms.

---

5. Why symptoms often improve later in the day

After the early-morning peak:

• cortisol gradually declines

• autonomic activity stabilizes

• metabolic systems normalize

As a result, many people notice that withdrawal symptoms ease as the day progresses.

---

✅ In summary

The early morning symptom peak often results from the combined effect of:

• rising cortisol

• activation of the locus coeruleus–noradrenaline system

• increased reactivity of the amygdala

• overnight metabolic changes

During antidepressant tapering, these systems can temporarily become more sensitive, making the normal wake-up activation feel much stronger

 

 

Edited March 16Mar 16 by Nemina

Thank you @Nemina for all the info above.  I really appreciate it 👍 While knowing what’s going on is helpful and knowing that I’m likely not dying ☹️when I get these awful symptoms it doesn’t make it easier to handle feeling like I’m crawling out of my skin & sick to my stomach at 3 or 4 am 😩

This also  likely explains what I may have erroneously thought what was interdose WD symptoms. Thinking that was the case now has me splitting my dose into two half doses taken 1/2,in am and the other 1/2 eventually in the evening. I’ve been working on moving 1/2 my dose towards evening for 1.5months now  & the process of doing so  is having a destabilizing affect on me. I just want to sleep.  

 

@Chippy im in somewhat of a panic tonight.  I know you are likely sleeping at this hour where you should be. But I had to write this post now.
I’ve been working on splitting my dose into 2 halves since February 1st. I’ve been at 29 or 29.5mg since 1/18 after Dr H told me to updose a 1/2 mg.  I started splitting my dose into two 1/2 doses the beginning of February. I’ve moved my second 1/2 dose from starting at 9am to now taking it at 2pm in that time frame. Much slower than even Horowitz suggested.  I’m very unstable feeling tonight.  Should I just hold the 2pm 1/2 dose until I feel better. Go backwards in when I take that 2nd 1/2 dose?  Advice appreciated. I’m fearing tonight’s darkness & pain & that I’ll never be normal again. Sorry for the panic. 

5 hours ago, Pokey449 said:

@Chippy im in somewhat of a panic tonight.  I know you are likely sleeping at this hour where you should be. But I had to write this post now.
I’ve been working on splitting my dose into 2 halves since February 1st. I’ve been at 29 or 29.5mg since 1/18 after Dr H told me to updose a 1/2 mg.  I started splitting my dose into two 1/2 doses the beginning of February. I’ve moved my second 1/2 dose from starting at 9am to now taking it at 2pm in that time frame. Much slower than even Horowitz suggested.  I’m very unstable feeling tonight.  Should I just hold the 2pm 1/2 dose until I feel better. Go backwards in when I take that 2nd 1/2 dose?  Advice appreciated. I’m fearing tonight’s darkness & pain & that I’ll never be normal again. Sorry for the panic. 

I’m sorry Pokey. Think you’re getting the idea now. It’s not just dose level shifts that are destabilising but moving times etc can be too. Brain likes consistency. 
 

It’s best to be deliberate and not chop around in panic. You are moving your dose to address your concerns about Doxepins short half life. This is a valid position to take. If you want to do anything I’d hold here and let it settle. I’d consider not moving the dose at all so you can start your hold/period of no changes. It’s this which brings stability.
 

Even splitting it as you have (8am &2pm) is spreading the dose and helping the interdose wd if it’s a thing for you even. There isn’t a magic 12 hours apart number where it all starts to work. 

Hey Pokey, been reading through your thread. Im sorry to hear you are having such a bad time. I struggle with the early morning panic too. I think withdrawal can really amplify our fear and worries which certainly doesn't help things. I just try to remember its the withdrawal talking not me. I hope you are able to get some better rest tonight. 

Thanks!! @Chippy & @kangamangus 

Yes I was definitely in a state of panic yesterday evening. My apologies for bugging you so much Chippy. I’m going to heed your advice and hold my current dosing schedule at 8am &. 2pm to let my brain settle down. Miraculously I got 7 hrs of uninterrupted sleep last night. I cannot explain why either given what has been going on. I’m a whole different beast this morning. Amazing what a decent nights sleep will do for a person. I have a best friend who is 74 and he sleeps like a baby every night. I tell him he doesn’t know how blessed he is. If I continue to feel stable for a while I’ll resume slowly moving the 2nd 1/2 of my dose towards 5 or 6pm and likely stop the shift there. 
Otherwise I need to get to the health club today for some exercise. This laying around in misery is not good a person.

Thanks again friends. 

11 minutes ago, Pokey449 said:

Thanks!! @Chippy & @kangamangus 

Yes I was definitely in a state of panic yesterday evening. My apologies for bugging you so much Chippy. I’m going to heed your advice and hold my current dosing schedule at 8am &. 2pm to let my brain settle down. Miraculously I got 7 hrs of uninterrupted sleep last night. I cannot explain why either given what has been going on. I’m a whole different beast this morning. Amazing what a decent nights sleep will do for a person. I have a best friend who is 74 and he sleeps like a baby every night. I tell him he doesn’t know how blessed he is. If I continue to feel stable for a while I’ll resume slowly moving the 2nd 1/2 of my dose towards 5 or 6pm and likely stop the shift there. 
Otherwise I need to get to the health club today for some exercise. This laying around in misery is not good a person.

Thanks again friends. 

It’s a pleasure mate. Wish we could do more tbh. 
Glad you slept well. I used to sleep like a log before Mirt. Now it’s better than it was but a million miles off my normal. Blessed your friend is indeed. 
 

Hope you enjoy the health club. 

7 hours ago, Pokey449 said:

Thanks!! @Chippy & @kangamangus 

Yes I was definitely in a state of panic yesterday evening. My apologies for bugging you so much Chippy. I’m going to heed your advice and hold my current dosing schedule at 8am &. 2pm to let my brain settle down. Miraculously I got 7 hrs of uninterrupted sleep last night. I cannot explain why either given what has been going on. I’m a whole different beast this morning. Amazing what a decent nights sleep will do for a person. I have a best friend who is 74 and he sleeps like a baby every night. I tell him he doesn’t know how blessed he is. If I continue to feel stable for a while I’ll resume slowly moving the 2nd 1/2 of my dose towards 5 or 6pm and likely stop the shift there. 
Otherwise I need to get to the health club today for some exercise. This laying around in misery is not good a person.

Thanks again friends. 

Really glad to hear you got some better rest last night, its amazing what a difference it can make. Hope tonight is the same for you!

7 hours ago, Pokey449 said:

Miraculously I got 7 hrs of uninterrupted sleep last night. I cannot explain why either given what has been going on. I’m a whole different beast this morning. Amazing what a decent nights sleep will do for a person.

Great, I am happy for you @Pokey449. 😊

Oh, @Pokey449, It's so nice!

Svetla

 

Morning Everyone. I’m not sure how much  total sleep I got last night. My smart watch stops recording sleep if I get up in the middle of the night which I did again last night. My watch stopped recording sleep at 2:15. I awoke in great physical discomfort again. Stiff & achy all over, headache, groggy headed, nauseous, unsteady on my feet, a creepy crawly restlessness all over my body.  When I checked my HR and O2 they were normal. Got up and stumbled out to my recliner to try and

 “work it off” with self massage, stretching and deep breathing. Went back to bed & sleep to awaken again at 6am with the same symptoms. This occurs when both being on & off CPAP. 

It’s like I’m having 2 cortisol spikes in one night. Is that even possible?? 
I’m hoping  🤞🤞🤞 I may be finally beginning to stabilize since I’m sleeping more. But I can’t account for what’s causing these uncomfortable & troubling symptoms multiple times in the wee hours 🤔🤔