Cant sleep before tests

[intubesteak]

I almost always struggle to sleep before exams--and when I do fall asleep, its that fitful, tossy-turny crap that makes you feel horrible the next day. I can feel myself getting anxious\worked up the weekend before big tests but I can never seem to fully control the feeling. I have been doing fine on tests, but feel like my brain is in a fog and I struggle on the critical thinking problems. Our class tests are easy enough that it hasn't been a problem, but I'm worried about shooting myself in the foot with step1 if I don't get a handle on things. I seriously underperformed on the mcat because of this (4 pts below average nbme scores), and honestly could be scoring better on class exams too.

Heres what I've been trying:

exercise, up to 45 min of cardio now almost daily and even lost some weight. Problem is now I'm in good shape and its getting harder to get that wiped out feeling that helps you sleep.

Benadryl\melatonin. Trying to avoid this as much as possible, but works a little bit. Often still fitful and not restful sleep depending on how worked up I am (which correlates with how prepared I feel for the test)

Mindfulness/meditation/etc. Doesn't help at all.

Limit caffeine-had this down since undergrad..no caffeine after 12 noon


Any thoughts? I'm sure a lot of students struggle with this. Ive considered going to school counselor or whatever but pretty hesitant to do so. Also might not get taken seriously when they see my grades and think I'm just looking for performance enhancers or something, especially when I tell them I've tried all the things they are going to recommend.

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[intubesteak]

Also interesting..

Resting HR without test: low 50s
Resting HR with impending test: low 70s

BP no test: 120/70s
BP with test 135/90s (yikes!)

Stressed much?

 

[FindMeOnTheLinks]

I usually have the same problem and I still haven't figured out how to fix it. Maybe I should change my waking hours to wake up at 6am and go to bed at 10pm instead of wake up at 10am and go to bed at 2am haha

 

[intubesteak]

I usually have the same problem and I still haven't figured out how to fix it. Maybe I should change my waking hours to wake up at 6am and go to bed at 10pm instead of wake up at 10am and go to bed at 2am haha

Haha yeah the 7am wakeup on test day would suck. In all seriousness it hasn't helped me too much. Ive been up early for the past two morning but still can't fall asleep or sleep well even though I'm exhausted. Usually I just crash the day after the test hah

 

[CaliforniaDreamer]

Wondering what people's opinions are on low dose benzos for sleep aids in these situations.

 

[intubesteak]

Wondering what people's opinions are on low dose benzos for sleep aids in these situations.

Yeah me too. I wonder if they would make me too groggy-I hate that about Benadryl and I only take Children's dose 12.5, sometimes halved

 

[CaliforniaDreamer]

Yeah me too. I wonder if they would make me too groggy-I hate that about Benadryl and I only take Children's dose 12.5, sometimes halved

I had a Rx for alprazolam and I would take a tiny amount when I had a long plane ride and would sleep 6-7 hours. It was short acting so it always put me down quick and without a hangover as long as I actually took it at least 7 hours before the time I had planned to wake up. Because I used it so infrequently and such small doses, about 10 pills lasted over 2 years.

 

[intubesteak]

I had a Rx for alprazolam and I would take a tiny amount when I had a long plane ride and would sleep 6-7 hours. It was short acting so it always put me down quick and without a hangover as long as I actually took it at least 7 hours before the time I had planned to wake up. Because I used it so infrequently and such small doses, about 10 pills lasted over 2 years.

That sounds quite nice

 

[caffeinemia]

I had similar fitful rest on pre-test nights as a medstudent too! I sleep minimally at baseline so it didn't bother me too much, but I remember this one time, my classmate and I stopped studying at a set time and said enough is enough; we spent the rest of our night ordering in and going at it; passed the eff out before I even knew it and straight till 6am the next day. Glad I set an alarm before the festivities. If the situation avails itself to you, I suggest you try it to get out of your head.

 

[intubesteak]

I had similar fitful rest on pre-test nights as a medstudent too! I sleep minimally at baseline so it didn't bother me too much, but I remember this one time, my classmate and I stopped studying at a set time and said enough is enough; we spent the rest of our night ordering in and going at it; passed the eff out before I even knew it and straight till 6am the next day. Glad I set an alarm before the festivities. If the situation avails itself to you, I suggest you try it to get out of your head.

Alright I'll try that one tonight and report back 😉 any chance you wanna be my doctor? I like the way you think

 

[caffeinemia]

Alright I'll try that one tonight and report back 😉 any chance you wanna be my doctor? I like the way you think

Only if you think you're gonna need your breasts reduced/augmented/reconstructed in a few years. But advice is free; just trying to approach life in a way that keeps us enjoying it.

 

[intubesteak]

Only if you think you're gonna need your breasts reduced/augmented/reconstructed in a few years. But advice is free; just trying to approach life in a way that keeps us enjoying it.

At this point my breasts are mostly muscle which is probably a good thing as a dude. But ill keep it in mind

 

[coldcase331]

Used to have the same problem. Melatonin+OTC sleeping meds helped a lot. I still only get 5-6 hours of sleep, but it's still better than the 3-4 I was getting before.

 

[Mr Roboto]

Benadryl and melatonin ftw. Titrate your dose for minimal side effects. The "foggy" feeling diminishes in time. An EM doc turned me onto this.

 

[intubesteak]

Benadryl and melatonin ftw. Titrate your dose for minimal side effects. The "foggy" feeling diminishes in time. An EM doc turned me onto this.

I also don't wanna get Alzheimer's. Has there been a consensus on that in the literature or was it one of those fringe studies that got picked up my MSN? I would love to research it myself but I'm currently cramming some anatomy :/

 

[TaroBubbleTea]

Melatonin works for me 99% of the time. You just need to find the right dosage.

 

[caffeinemia]

I also don't wanna get Alzheimer's. Has there been a consensus on that in the literature or was it one of those fringe studies that got picked up my MSN? I would love to research it myself but I'm currently cramming some anatomy :/

The jokes I could make about cramming some anatomy, given the context of our previous posts....

 

[Foot Fetish]

Clonazepam 1 mg po bid prn

 

[Mr Roboto]

I also don't wanna get Alzheimer's. Has there been a consensus on that in the literature or was it one of those fringe studies that got picked up my MSN? I would love to research it myself but I'm currently cramming some anatomy :/

I remember reading that... think it was misleading clickbait. Like it made AD symptoms worse in patients with AD, but wasn't causing AD. Could be wrong; am not a doctor; SDN isn't for medical advice; etc.

 

[Eppur Si Muove]

+1 man, never sleep well. tried the benadryl but makes me feel like crap the next day

 

[Promethean]

L-theanine is an amino acid that I find can be helpful, with or without melatonin.

With caffeine, it yields a smooth, non-jittery boost to my ability to focus. (I have bad ADD, and no prescription to manage it.) Without the caffeine, I find it does wonders for anxiety and helps me get to sleep.

This isn't medical advice. This is just what has worked for me.

 

[chm9332]

I will be an MS1 this coming fall and I also have the same issue. In undergrad, it was ok-- maybe 3-5 restless nights per year that came before finals. But strangely before small exams or exams that I felt confident at, I was fine but then there came the MCAT. I did not get a single ounce of sleep before my MCAT and it really affected my verbal section. Forunately, I think science sections are mostly recall based, so I got my practice exam scores on the real thang except for Bio, but that's probably due to crazy sleepiness that followed lunch. But I am very worried that this same problem will follow me to STEP 1.

 

[OrthoTraumaMD]

Disclaimer: not medical advice, just sharing what works for me as others have done on this thread.
Several rounds of sex followed by a dose of valerian root. The latter is an herbal anxiolytic used since the time of Hippocrates; but, as with all herbals, its effectiveness depends on the person. 🙂

 

[Manual Disimpaction]

6 pack of beer and a fistful of nyquil like the good lord intended

 

[intubesteak]

Disclaimer: not medical advice, just sharing what works for me as others have done on this thread.
Several rounds of sex followed by a dose of valerian root. The latter is an herbal anxiolytic used since the time of Hippocrates; but, as with all herbals, its effectiveness depends on the person. 🙂

I think I would also need to take something before the -several- rounds of sex. My meds list keeps getting longer and longer..cough

In all seriousness Benadryl 12.5 plus melatonin plus wine did the trick. Pretty sure the box says not to do that but what can you do.

*none of this is medical or any other kind of advice at this point

 

[chm9332]

Question!
does Benzo have any adverse effect on your cognitive ability the day after you take it?

 

[CherryRedDracul]

I used to be the same way. Then I stopped giving a **** and just went to bed.

I felt my test-taking performance improved when I stopped over-stressing about exams.

 

[chromuffin]

Here's my story about the impact of sleep. First pharm exam.. 25 lectures for the exam. Spent Friday from 4pm to Monday 8am studying the lectures. I'm slow and average 2h/exam. Granted, I procrastinated and never studied at this point. Only got 4 hours of sleep the night before the exam. Got a 68%. Last exam block of pharm: 55 lectures for the exam. Studied 2 days with 6-7 hours of sleep each night. Got a 93%.
Moral of the story: Sleeping drastically changes performance. It is way better to forget about reviewing a couple lectures to make time for sleep.

 

[whatisthisstuff]

I have this problem too and I don't even feel stressed. Just hard to turn my mind off. I think non-pharmalogical keys are really similar to any good nights sleep. Put the books away a few hours before bed, eat a good dinner, relax and read a leisure book or something. Also no coffee after noon.

That said I don't ever see this as an issue that will be totally solved. I'm sure surgery residents have a hard time sleeping before big cases, etc.

 

[Anicetus]

I almost always struggle to sleep before exams--and when I do fall asleep, its that fitful, tossy-turny crap that makes you feel horrible the next day. I can feel myself getting anxious\worked up the weekend before big tests but I can never seem to fully control the feeling. I have been doing fine on tests, but feel like my brain is in a fog and I struggle on the critical thinking problems. Our class tests are easy enough that it hasn't been a problem, but I'm worried about shooting myself in the foot with step1 if I don't get a handle on things. I seriously underperformed on the mcat because of this (4 pts below average nbme scores), and honestly could be scoring better on class exams too.

Heres what I've been trying:

exercise, up to 45 min of cardio now almost daily and even lost some weight. Problem is now I'm in good shape and its getting harder to get that wiped out feeling that helps you sleep.

Benadryl\melatonin. Trying to avoid this as much as possible, but works a little bit. Often still fitful and not restful sleep depending on how worked up I am (which correlates with how prepared I feel for the test)

Mindfulness/meditation/etc. Doesn't help at all.

Limit caffeine-had this down since undergrad..no caffeine after 12 noon


Any thoughts? I'm sure a lot of students struggle with this. Ive considered going to school counselor or whatever but pretty hesitant to do so. Also might not get taken seriously when they see my grades and think I'm just looking for performance enhancers or something, especially when I tell them I've tried all the things they are going to recommend.

Saw a doc, they gave me ambien. I take one the night before every exam, scores went up and my stress level on test day was way lower. It's awesome.

 

[DrDarce]

A little bit of wine always helps. not too much though of course

 

[mistafab]

Talk with your doctor.

 

[BeddingfieldMD]

Yeah, that's a difficult one. I definitely experienced that from time to time--and I on a few occasions ended up just saying "screw it" and pulling all-nights studying. Not saying that's the best solution, but that's what I did when I literally couldn't sleep at all. I never tried benadryl, melatonin, ambien, booze, or anything like that. Figured it was too risky that I'd be in a fog the next morning.

Definitely noticed the not-sleeping issue the most before Step 1 and my written and oral specialty boards. Not so much for other board exams that were less critical. So it clearly is stress-related, as you noted with your vital sign analyses.

Probably some sort of meditation mindfulness stuff is the best bet. But I never had much luck with that either. My routine was stay up late studying, take the exam, go to the bar and decompress, then fall asleep sometime in the late afternoon or early evening. Thankfully, most of our exams were on Fridays. Not saying that's at all a healthy way of approaching it. Just speaking the truth! 🙂

 

[ab84fan]

Same issue here. My mind just starts racing for some reason because of the non-stop studying in the days leading up to the exam. My thoughts are usually unrelated to Medicine but keep me up regardless.

 

[NotYou20]

I've had this happen a few times.

Step one: intense pushups, squats, ab workout in your bedroom.

Step two: warm shower

Step three: read something until tired

Step four: sleep