Dear Jafo,
Do you catch up with a 1 - 2 hr nap mid afternoon ? I've had the same kind of thing for a long time but it's more associated with manic depression (bipolar). I guess if you have had this a long time it might now be your sleep pattern. Entrenched. Negative thoughts can bubble away during sleep and make you anxious.
I only have a couple of things that help - sex, just getting out of the house to walk my dog (at 1am, 4am, etc) and break the "I need to sleep mantra" or hitting the shower at scalding temps. When you dry off and slip back between the sheets your body temp will drop enough to entice you into a deep sleep. It's a bit more natural than meds or benzos. Too bad Medicare can't allocate you a personal massage therapist. Deep tissue relaxation seems to put most to sleep.
If you haven't had a bit of mania creeping in after 5 years of this sleep depravation then maybe your body has totally adjusted to this lack of sleep. Maybe there's an analogy with music practise (I'm a musician). You can do 2 hrs worth and totally waste the time and be inefficient or you can do an excellent 10 mins that will help you forever. This is the thinking by Branford Marsalis, top jazz muso and winner of multiple grammys plus a Pulziter for his project "Blood on the Fields". So you could take that thinking and make the observation that your 4 or 5 hours sleep is more beneficial than someone have a light 8 or 9 hrs sleep.
As your post is fully focused and clear I am thinking that you might have reached a point where your body has adapted, if not your mind. Margaret Thatcher had a similar sleep pattern but used to cat nap during Parliament. The only time I ever sleep 7 or 8 hrs is when I'm in the psych ward and my options are very limited. But when I get up at 5:30am there are a dozen patients milling around waiting for the 6am tea/coffee ! All saying "I couldn't sleep" but all able to function during the day and win a pair of socks during bingo But maybe that's a game you can play in your sleep. Other advice to me has been "no tea/coffee" after 4pm.
Adios, David.
PS Reading instead of watching tv an hour or so before bed might work too.
