I had a PE in March of 10. I had major issues with fatigue about a year out from the PE both on and off the warfarin,

Starting about a month after my PE I had terrible anxiety that both prevented me from falling asleep and woke me in the middle of the night

My sleeping did not change after my PEs. I only wake to use the potty but go right back to sleep. In fact, now that I think about it----- I'm sleeping longer than I was several months ago.

I don't envy anyone with insomnia. I went through the worst possible insomnia a decade or more ago and it took about 6 months following the Stanford Sleep Clinic's protocol to even get to sleeping about 5-6 hours straight.

I am fatigued and really tired most of the time. I am sure insomnia could happen though-warfarin has some weird side effects sometimes!

Here's one list of reported side effects.
http://www.drugs.com/sfx/warfarin-side-effects.html

Doesn't mean if you have something unreported that it's not related to warfarin. This is just a general list. Further down the page it breaks it out by body system.

Personally, and I know some people will disagree, but I think most of what people relate back to warfarin as a side effect, especially the things that aren't documented, are really issues related to recovery, the fact that your body has been through a trauma and is healing, other stuff that may be going on with a person etc. My 2 cents.

I've wrestled with insomnia on and off (mostly on) since about 1998. I was in good shape for about nine months before the PEs ... falling asleep quickly, staying asleep, no drugs ... but the anxiety and fear from the PEs wiped that out completely for about a year. I've spent a lot of time trying to get back to where I was.

You've got a million and one things going on right now in your life and some of the stress might just be surfacing in the middle of the night when you wake up and can't get back to sleep.

My advice would be to get up when you can't get back to sleep and do some quiet activities until you are actually sleepy again. Staying in bed tossing and turning will just increase the anxiety and frustration and will (eventually) make your bed a stressful place instead of a relaxing place.

Few things worse than being exhausted from PE and then being unable to get all the sleep you know you need ... I've totally been there.

No matter the cause of insomnia it isn't recommended by sleep clinics that a person get up and read/watch TV or other do anything that involves turning the lights on.

That 'resets' the clock in your brain. We were told to get up after 15 minutes of non-sleep and sit in another room with no lights on then go back to bed when sleepy. (Repeat as needed! Yes, it's harsh!)

The major component of the behavior training was VERY hard at the beginning. I had to sit up, slap my face/walk around to stay awake until I could go to bed!!

"For example, consider a person who goes to bed at 11:00 p.m. and gets out of bed at 8:00 a.m. but sleeps on average only 6 hours per night. During the first step of this procedure this person will be in bed only 6 hours (e.g., 12:00 am to 6:00 am). This sounds harsh but after a week or so there will be a marked decrease in time spent awake in the middle of the night.

Usually people experience marked improvement in the quality of sleep after a week of restricted time in bed, but they also realize that that they are not getting enough sleep.

In this case, the next step is to gradually extend the time spent in bed by 15 to 30 minutes, as long as wakefulness in the middle of the night remains minimal.

Each new extension of the time in bed is followed for at least a week before progressing to the next extension. The decision as to when to extend the time in bed is based on the percent of the time slept relative to the time spent in bed.

This is called sleep efficiency. If the average sleep efficiency is 85% or more, then the time in bed is extended. If it is below 80% then the time is bed is further restricted. Otherwise the time in bed remains unchanged."
http://stanfordhospital.org/clinicsmedServices/clinics/sleep/treatment_options/cbt.html

It worked on me. And it was worth it.

I realize that almost no one reading this will try it. (grin) But the information is there if needed.

Two and a half years post PE have insomnia regularly and its doesn'rt seem to be linked to warfarin in my case. I spent the first year and a half struggling with difficult symptoms trying to get into a routine and mindfullness meditation has eventually started to help - it should get better with time