For about 1 1/3 years after I got severe T, I used an alarm, but I was rarely ever asleep when my alarm went off.
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I still have this. What I struggle with the most is waking up earlier than normal. During the period where my T was worsening daily/weekly, the spikes would wake me up at 3-5 am in a state of panic. Waking up early now instigates that panic, even without the T worsening.