Managing Insomnia, Memory Loss, and Attention Issues: A Guide

Insomnia, forgetfulness, and poor attention issues?

Hello, I have been experiencing insomnia for a while, and I've noticed a decline in my attention and memory.
I'm unsure how to address this.
Recently, I've often struggled to recall certain people, events, or terms, and it takes me a long time to remember related vocabulary, names, or the events themselves.
My memories from the past also feel hazy.
I frequently forget what I was previously working on.
While I can read text, I find it challenging to understand the emotions behind others' words.
During conversations, I have difficulty focusing on what others are saying, often zoning out (similar to forgetting the content of the conversation afterward and easily forgetting what I have said).

Regarding my sleep, I started experiencing short sleep durations (about 2-3 hours) since September of last year.
After beginning to take sleeping pills in October, I attempted to stop the medication and felt significant anxiety about my life and sleep situation, leading to about 10 days without sleep.
Later, after switching medications at the end of October, my sleep became more stable, but I still experienced issues with light sleep and occasionally couldn't sleep at all for several days after taking the medication.
Since January of this year, my circadian rhythm has been disrupted.
Although I have been taking one tablet of Lemborexant (7.5 mg) and 0.5 mg of Quetiapine (between half to one tablet), I still find it difficult to fall asleep until around 3 AM to 7 AM, with wake-up times ranging from noon to 2 PM (sometimes waking up in between).
My sleep quality remains poor, and at times I feel like I might not have slept at all, leading to a lack of energy.
In the past two weeks, I have switched to traditional Chinese medicine (three meals a day) along with half a tablet of Lemborexant, but I still find myself falling asleep around 3 AM to 5 AM, with wake-up times also between noon and 2 PM (sometimes waking up in between).
My mental state has improved somewhat compared to before, but I still struggle with focus during conversations and recalling memories.
I would like to ask how to handle my current situation: 1) Should I increase my sleeping medication? 2) Is there a possibility for recovery regarding my memory and attention deficits?

Lili, 20~29 year old female. Ask Date: 2023/02/25

Dr. Wu Enliang reply Psychiatry

1) Should sleep medications be increased? Please consult your physician regarding medication adjustments.
However, if there are no issues with anxiety, depression, or sleep hygiene, a sleep study is recommended.
2) Is there a way to recover from memory and concentration impairments? Generally, improvements in sleep or alleviation of anxiety and depression can lead to recovery.
Dr.
Wu Enliang.

Reply Date: 2023/02/25

More Info

Managing insomnia, memory loss, and attention issues can be quite challenging, especially when these symptoms are interconnected. Your experience of insomnia, coupled with difficulties in memory and attention, is not uncommon and can often be a result of prolonged sleep deprivation and anxiety. Here’s a comprehensive guide on how to approach these issues.

Understanding the Connection
1. Insomnia and Cognitive Function: Sleep is crucial for cognitive processes, including memory consolidation and attention. When you experience insomnia, your brain does not have the opportunity to rest and recover, which can lead to difficulties in focusing and recalling information. Studies have shown that even short-term sleep deprivation can impair attention, working memory, and long-term memory.

2. Anxiety and Stress: The anxiety surrounding your sleep issues can exacerbate cognitive difficulties. When the mind is preoccupied with worries, it becomes harder to concentrate and remember details. This cycle can create a feedback loop where anxiety leads to poor sleep, which in turn leads to more anxiety and cognitive impairment.

Addressing Your Concerns
1. Medication Management:
- Consult Your Doctor: It’s essential to discuss your medication regimen with your healthcare provider. Increasing the dosage of sleep medication may not always be the best solution, as it can lead to dependency or other side effects. Your doctor might suggest alternative medications or therapies that could be more effective for your situation.

- Sleep Hygiene: Alongside medication, practicing good sleep hygiene can significantly improve your sleep quality. This includes maintaining a consistent sleep schedule, creating a restful environment, limiting screen time before bed, and avoiding stimulants like caffeine in the afternoon.

2. Cognitive Behavioral Therapy for Insomnia (CBT-I): This is a highly effective treatment for insomnia that focuses on changing the thoughts and behaviors that contribute to sleep problems. CBT-I can help you develop better sleep habits and address the anxiety that may be affecting your sleep.

3. Memory and Attention Recovery:
- Mindfulness and Relaxation Techniques: Practices such as mindfulness meditation, yoga, or deep-breathing exercises can help reduce anxiety and improve focus. These techniques can also enhance your ability to concentrate and recall information.

- Cognitive Training: Engaging in cognitive exercises, such as puzzles, memory games, or learning new skills, can help stimulate your brain and improve memory and attention over time.
4. Nutrition and Lifestyle:
- Balanced Diet: Ensure you are consuming a balanced diet rich in nutrients that support brain health, such as omega-3 fatty acids, antioxidants, and vitamins. Foods like fatty fish, nuts, berries, and leafy greens can be beneficial.

- Regular Exercise: Physical activity has been shown to improve sleep quality and cognitive function. Aim for at least 30 minutes of moderate exercise most days of the week.

5. Monitoring Progress: Keep a sleep diary to track your sleep patterns, medication use, and cognitive performance. This can provide valuable insights for you and your healthcare provider to adjust your treatment plan effectively.

Conclusion
In summary, while it’s understandable to consider increasing your sleep medication, it’s crucial to approach this decision with your healthcare provider. There are various strategies, including behavioral therapies, lifestyle changes, and cognitive exercises, that can help improve your sleep and cognitive function. Recovery is possible, and with the right support and strategies, you can regain your focus and memory. Remember, it’s essential to be patient with yourself as you navigate this process.

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