I have tried everything listed over seven years. I have been on an "autoimmune protocol Paleo" for two years. Oddly, I never get sick although I frequently live off of a forced 3 hours of sleep every day from taking sleep supplements (otherwise I would get 0 hours; I have tried going without sleep supplements. Imagine no sleep for weeks and weeks and weeks... It is seriously that bad, I literally tried to commit suicide after that.)
No changes in diet make a difference. I have tried a million different combinations of foods. Absolutely no effect or the food simply exacerbates coexisting symptoms. I am convinced at this point diet is not a factor here. Here is the DEFINING FEATURE of my insomnia!!!!: I hear a loud heart beat POUND in my ear at night (I hear it during the day to, I can feel and hear my pulse often when I am sitting down) and I go insane every night, absolutely restless and I certainly do not fall asleep either at all or once then I wake up two or three hours later no matter what time I go to bed and independent of anything! Sleep supplements are useless as well as I have to take a massive amount to sleep 4 hours total.PLEASE HELP I AM MISERABLE AND DEPRESSED! I have seen 20+ doctors for this and not a single one has been able to help me!Thank you.
Sounds like you might not be making enough melatonin, or you're consuming something that keeps you awake. Some people, myself included, are slow metabolizers of caffeine. If you've had your genes sequenced by 23andMe or Ancestry, unzip the file and look for the line that says "rs7625517" - if you see two C's next to it, you're a slow metabolizer too.
Some supplements such as L-theanine are calming, however, you do not want to take them at night, or near night. While calming, it acts the way that caffeine does, it won't allow you to sleep. If you consume any sort of oil near bed time, especially coconut oil or fish oil, it will prevent sleep due to the extra energy you'll get from digesting it.
If you fail to consume enough carbs before sleep, you might wake in the middle of the night because of it. The same happens if you have parasites or the wrong gut flora (i.e. too many candida vs gut flora). They will raise your cortisol, because this causes gluconeogenesis, and it will raise your sugar so they can eat.
If you consume magnesium too close to sleep time, instead of helping you sleep, it can interfere with sleep. Weirdly enough some melatonin supplements can help, but then you'd wake up in the middle of the night anyway. I'm not sure what causes this, I've experienced it myself.
The pounding heart beat sounds like you might have cortisol issues, your pattern could be inverted, that is high at night, low during the day. This is difficult to fix. When cortisol is high, melatonin is shifted low.
What you might want to try is sleeping in an absolutely pitch black room. Get black out curtains and be sure to seal any gaps between them and the window so absolutely no light gets through. Remove any electronics that have LEDs, especially blue or white LEDs, or at minimum get black electrician's tape and tape over the LEDs. If you have an alarm clock in the room, make a cover for it so any light from it won't be visible. Basically the tiniest bit of light can interfere with sleep.
Next on to noise, get a source of white noise, either an air filter or this device, or something like it:
Set it to the white noise setting and set the volume very low, low enough that you don't hear any outside noises; and again, it has an LED, but at least it's a red LED, so tape over the light.
Next, before you go to sleep, try a time release melatonin along with some 5HTP and (this is the important part) a lot of phosphatidyl serine. You'd need to take 800mg a night, which is a lot, you'll likely finish a whole bottle of the stuff within a week, and it isn't cheap, but it will help. You could also try a DHEA tab, but, if your stress levels and cortisol levels are high, this may backfire. (DHEA is the substrate for tons of hormones including melatonin, but your adrenals can steal it and convert it to cortisol.)
You should also consume a few teaspoons of gelatin in the evening, you could use bone broth instead. Gelatin tends to calm down the cortisol, so it will be helpful.
Next, when you wake up, try and get some sunlight in the morning. Actively go outside and look at the sky and keep your face towards the sun (obviously don't stare into it). Get as much sunlight as you can in the morning. This will help reset your circadian rhythm. Get some sun in the afternoon as well, and try to see the sunset too. Try to go for a walk in a park during your lunch hour. Be sure that when you're at work, you don't work in a dark environment, you want to increase sleep pressure and if you work in the dark that won't happen.
Since your cortisol is all over the place, you'll likely need some adrenal support as well, so in the morning, get lots of vitamin C, maybe 1000-2000mg along with maybe 1/4 teaspoon of seasalt and either DGL or licorice (not the candy, the root). DGL is better because it won't raise your blood pressure, but if you don't have blood pressure issues, licorice root powder is fine. DGL/licorice will prevent the cortisol from being broken down, thus letting your adrenals produce less - you're going to train them to produce much less so while it sounds counter-intuitive, this will help calm them down.
If you took 5HTP at night, you should take some L-tyrosine in the morning.
Two hours or so before you go to sleep, be sure you don't expose yourself to bight lights, either LED or fluorescent, and at minimum invest in some orange sunglasses, or the UVEX safey glasses. Don't watch TV, or use an ipad/pod or any other LED light. Maybe replace your bedroom lamp's lightbulb with an orange or red party bulb and try to read - you likely won't be able to read more than 15 minutes by this light before you fall asleep.
Be sure your diet is dialed in, you'll want enough carbs at dinner, maybe two hours before sleep, something like a large sweet potato, or two cups of white rice should do the trick. Lots of good fats and meats for breakfast and lunch, no fasting. If you can try to do a good tiring workout before dinner as well.
The key to this thing sounds like it's either fast heart rate or high blood pressure, for some reason for you it's high at night and that usually means cortisol. It could also mean that due to all the stress of going to sleep and failing that you've trained your brain and adrenals that nights are stressful so they pre-emptively raise cortisol at night, it will take some time to undo that.
See if the adrenal section of this article applies to you, but read the whole thing. There may be an issue you could detect by taking your blood pressure while standing vs lying down. Salt intake (too low can be a huge problem as well as too high) can affect it:
"no effect or the food simply exacerbates coexisting symptoms. I am convinced at this point diet is not a factor here" -- sounds like food is a factor if it exacerbates symptoms.
"I have seen 20+ doctors for this and not a single one has been able to help me" -- highly unlikely you will get the answer here.
But here's a try:
1. Wear a set of sleep headphones (see below) and get white noise(http://www.tmsoft.com/iphone-whitenoise.html)
2. You didn't mention exercise. You should be exercising, regularly:
4. Check for other Issues:
Have you tried exercise?:
Couple of things I haven't seen mentioned yet.
1. DHEA which I mention because only people with Crohn's or something similar get fecal transplants. DHEA lowers TNF which is the same target as Humira and other endgame drugs for such diseases... but it does it by balancing your hormones. Caveats are if you are on some kind of birth control or other hormone prescribed by a doctor. DHEA also lowers cortisol in most people, which can lead to sleep. For me, it leads to a balancing of my circadian rhythm in about three days if I take 25 mg a day, but it must be taken during the day (for me), not at night. YMMV
2. What if you have developed ADHD from all this neuronal excitement? It could be just temporary, but it sounds like you're hyper to me. If that's the case, then test some stimulants to see if they relax you. Sounds illogical, I'm sure, but if you've developed hyperactivity, then it's the stimulants like caffeine that will relax you. Since you have gut issues, I'd say, use a caffeine pill instead of coffee. It also makes it easy to find the right dose. Try 50mg to start one day, then the next day, if it didn't work, try 100. 200 should awaken just about anyone, but it's worth a try. I say this from experience as I have ADHD and use coffee or tea to go to sleep, wierd as that is. At least I no longer use cigs.
You don't mention eating a normal amount of carbohydrates. Low/zero carb is not a panacea.
Agree with others: exercise.
And as for your 20+ doctors, you've obviously not seen the right doctors. Keep seeking doctors that have expertise in sleep disorders. I know it's off label, but have you tried beta blockers?
You may have narcolepsy.
Despite what you may think, narcolepsy is not a disease which causes people to fall asleep at random. Rather, it is a genetic disorder that prevents the brain from properly regulating sleep. Some narcoleptics fall asleep during the day, but nearly all narcoleptics have trouble falling and staying asleep at night.
If you've seen 20+ doctors, I imagine you've had a sleep study. If you haven't, you should. IT is literally the only test that can be performed to directly examine sleep problems. Find a sleep specialist in your area and get the test.
I wonder if doing more stuff during the day would help? (as you said you relax all day) - otherwise maybe another reason it could be something to do with you worrying about it? - Hard not to worry when you're worried I guess - but could try doing lots of stuff in day and then at night don't go to sleep till you're tired - don't worry about it for a week - stay up watch movies (lying down on couch), read books in bed (lying down) - whatever - then see if at some stage each night you don't just fall asleep - you never know - could be worth a try and won't hurt to try it for a week