I’ve been waking up between 2 and 4 am pretty much every night for the past 3 months. After that in the best case scenario I’d get some intermittent naps before I need to get up in the morning. This is despite following most of the rules for good sleep (ear plugs, room temperature, early dinner, no alcohol, no screens, daily exercising for 40-90 minutes, sunlight during the day). My oura deep sleep duration is extremely short. It coincided with my ACL surgery, but it’s been 4 months already!

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Not sure if surgery is to blame. Always had sleep issues but never to this extent. Even when I was travelling across time zones weekly for work in my previous job. Also I did sleep study and it said I have mild sleep apnea. Might be another factor but I doubt it’s alone causing it.

My another guess is it might be related to SSRIs withdrawal - I stopped taking Zoloft in March. But I don’t feel any intense anxiety or stress and it’s been 6 months already. So I’m baffled.

You need a sleep study with actionable items. It's the number 1 cause of issues with sleep

Even a mild case can have serious sleep impacts

Early waking can be correlated with stress (surgery is a big stressor) and is an early indicator of a depressive episode. Not saying you’re automatically doomed to slide, but it’s a useful point to raise with your health practitioners

In the meantime - what do you do when you’re up and how long does it take you to fall asleep again if you do? Do you agonize over being awake? Have a little putter? Read? I have heard that accepting the awakeness and doing a low stimulating activity is best (read a book in dim light, make a cup of tea in dim light), whereas fretting about it correlates to worse quality sleep when you do fall asleep again

Other levers to look at, which affect sleep rhythms — when in the day do you exercise, do you get evening light, when do you wind down and how?

Not stressed out in the night when I wake up. Just hanging out with cats and waiting till I’m ready to try and go back to sleep.

Yes to all other questions - I exercise daily usually in the morning, often get evening light, wind down around 1 hour before going to bed.

I’d do a depression screen.

I was diagnosed with depression but my symptoms have been better than average overall. I stopped taking Zoloft 6 months ago.

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