My own insomnia advice

After being thru the wringer for 6 months, and FINALLY starting to sleep on my own (I got 6hr last night on nothing, I didn't even take my usual magnesium), I though I'd do a quick list of what worked for me, and I'm pretty in tune with my body. I suspect a lot of others would benefit similarly.

One of the MAJOR hurdles we have to face, is that months of insomnia create PTSD. We become terrified of not sleeping, and that just adds to the problem.

The are 2 ways that can help you with that, the only 2 non-drug ways I've tried on my own that actually helped:

1. You need to work on meditation, but that's hard to do when you are a newbie to it AND you're desperate to get some sleep. What I would start doing is the breathing technique, for as long as it takes. I've done it as long as 2hr, and sometimes it was good enough to get me 3-4hr sleep spurts. So to begin, I would start doing the 4 second breathe in, 4 second hold, 6 second breathe out, 4 second hold, repeat. If you can handle doing 2hr straight of it, I'd start doing it tonight. Don't get frustrated if  it doesn't help immediately, just keep on doing it anyway. It's free, it's drug free, and you're lying there in bed anyway, you have zero to lose, and you might notice you at least get 2hr sleeps instead of zero.

2. I tried a machine called the Cool Drift. It's a headband that actively cools your forehead. Sadly the machine broke for me after 2 months (It's on it's way to get repaired under warranty). BUT I did notice a difference with it. I'd put it on and it would cut my sleep onset in half. After 30min of wearing it, all of a sudden I'd feel massive stress relief, and 15min later I'd be out (not on it's own, I still have to take Remeron and Cannabis). It's a similar effect to the breathing technique, except you don't have to do anything. I know it helped because if I didn't use it, the same amount of Remeron or Cannabis would take about 1.5hr to 2hr for me to fall asleep. Adding the machine would cut that time in half.

I feel that breathing technique is a 5% improvement in sleep efficiency vs nothing, and the Cool Drift machine is another 5%

3. Next thing is to stop fearing supplements, and stop fearing the idea that "GABAergic supplements are going to hurt my healing because they are stimulating the GABA receptor". Well, guess what also stimulates GABA receptors? Your own natural GABA, which is ALWAYS being produced. You had no choice, the receptors will be stimulated anyway. The problem (part of it at least) is that the receptor is damaged and unable to fully open the pore. BUT the body will heal it. Think of those times where you've bit your tongue, or your cheek. The environment stays moist, because you can't shut your saliva down. BUT a couple of days later, it's healing anyway. I believe the brain is the same way. My personal opinion is "You heal faster if you sleep with a GABAergic supplement than you do NOT sleeping because you're not using anything to help. Things that should be staples are: Magnesium, Vit D, Vit C, and Zinc. Those are not even sleeping supps, they are just "your body needs these things to trigger healing in general" things.

After that, specifically for sleep, I'd start with supps that have been shown to NOT directly affect GABA receptors: Theanine, Glycine, Taurine, Kava, Melissa, Hops, Chamomille, Melatonin, Tryptophan, Lavender, etc.

If that's not enough, move on to the ones that do affect GABA but will help more than hinder: Passionflower, Valerian, Skullcap, Magnolia Bark.

I was using all of these in different combinations, and I was able to usually get 2hr to 4hr with them, and a couple of times I'd get 6hr.  I still healed. They did NOT affect my healing.

4. Don't fear drugs known to help us, like Remeron, Trazadone, and maybe even Seroquel.

Ideally you'd want to get by on the safest OTC stuff, like Unisom and Benadryl, but those are very weak. They sedate a lot without actually being very useful for sleep. Vistaril would be the next logical step up, BUT IMO you're better off with Remeron. I'll find the studies I read, but Remeron is so powerful anti-histamine, and with the weakest anti-cholinergic effect. This is what you want! The other stuff has stronger anti-cholinergic effects. On Trazadone, I was so constipated that I had to go on a rotation of Lactulose, and Miralax. When I switched to Remeron, I was able to use such low dosages that the side effects were almost zero for me.

Always use the least amount of drug to get you at least 4-6hr sleep. I had to buy a microgram scale, and a pill cutter, and a pill crusher. I'd be living my life like a chemist at night, getting ready for bed and measuring how many grams I was going to take.

Unless you have no choice, I'd stay away from Seroquel. That has very strong chance to damage the cardiovascular system. But if it's the only thing that helps you to sleep, I'd prefer the sleep, since lack of sleep can potentially cause the same problems. Again, use the least dosages possible. Weight the cut pills if you have to.

Also everyone is different, so Remeron might not work for you at all, but Vistaril does, or Trazadone. Try them all and you might get lucky.

5. If you can get Cannabis, use it. You need Indica based. I was using a 70% Indica, 30% Sativa. I probably blasted about 2 months worth of Cannabis, and was getting usually between 4hr-6hr sleep. It did NOT hinder my healing.

I am thankful these things worked for me, as I was able to survive the withdrawal, and not lose my job, or my belongings, and most importantly, my sanity.

I know we are supposed to shun supplements, and whatnot, but I am proof that all of that is a bunch of horse manure. I was swallowing Chamomile like candy, and I used quite a bit of Passionflower and Theanine as well. These supps BTW work BETTER if your mind is already primed to be stress free (breathing and the cool machine worked great for that).

I am now off everything. I got 6hr sleep last night and I didn't even take my magnesium, I decided to skip a day. I hope this helps you guys. I know first hand experience how crippling days on end of no sleep completely destroy your life.

Thank you so much for your interesting advices!

I totally agree with you that meditation is so important during taper. And in general, at least for me, with or without benzos. And after getting off, for sure, too. Still not at that point...

Also in my opinion the main consensus in this board towards supplements is veeery conservative. Which in some cases might be experience-wise and everyone needs to know for themselves.

Anyways, could you elaborate on your take on Remeron / Mirtazapine. Why do you think the less anti-cholinergic effects the better? Cognitive function? Because mine is pretty ruined the day after I have been taking Remeron...

Also, do you know by chance the anti-cholinergic effects of Promethazine?

Thank you so much for your interesting advices!

 

I totally agree with you that meditation is so important during taper. And in general, at least for me, with or without benzos. And after getting off, for sure, too. Still not at that point...

 

Also in my opinion the main consensus in this board towards supplements is veeery conservative. Which in some cases might be experience-wise and everyone needs to know for themselves.

 

Anyways, could you elaborate on your take on Remeron / Mirtazapine. Why do you think the less anti-cholinergic effects the better? Cognitive function? Because mine is pretty ruined the day after I have been taking Remeron...

Also, do you know by chance the anti-cholinergic effects of Promethazine?

I hope my writings will help people in the future. Meditation I think, now that I look back on all this, is probably the MOST important thing. We need to control our fear, and the only real way of doing that is to learn how to meditate. I'm not an expert, but I have learned how to breathe. I would again, recommend that first line of defense to all of us that are terrified of suffering more. Learn how to do it, and do it consistently. You can go to more advanced things afterward.

I know the board is conservative, and I frankly feel that the general idea that most supplements are bad if they are "GABAergic" actually is hurting many many people. There are people that could sleep if they took Magnesium and Melissa, for example, but both are "GABAergic" and people are terrified of hurting their healing, so they don't take these things and have sleepless after sleepless night.

I did a lot of research and I decided it was more important to sleep with something, even if it was "GABAergic" than to not sleep without taking anything. In the acute phase, you'll probably find nothing helps, but at some point, something will help, and that's when you grab on for dear life IMO.

As for Remeron, there are several studies that find that it has very low anticholinergic activity. There are many but I'll post one for now:

https://pubmed.ncbi.nlm.nih.gov/8930008/

Mirtazapine has virtually no anticholinergic, adrenergic or typical selective serotonin reuptake inhibitor (SSRI) side effects.

I can vouch for this in my own experience. With Trazadone, the doses that would help me sleep would cause severe constipation, and severe stuffed nasal passages. I had to go on laxatives and I even bought a nasal irrigation system to cope with the sides (I couldn't sleep due to the pressures at both ends). These are classic symptoms of high anticholinergic activity. When I switched to Remeron, my stuffy nose symptoms disappeared completely, and constipation reduced by 80%. It still has anticholinergic activity (so you still have to manage sides), but not like the other drugs.

Promethazine, from what I'm reading, is supposed to be one of the most anticholinergic anti-histamines:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4377853/

I've never used it so I can't vouch personal experience.

How much Remeron are you using? You feel knocked out because Remeron has a long half life: 9hr to 20hr. This is why I measured the least necessary for me to get 4hr-6hr sleep, it was trial and error, and that ended up being 3.75mg for me.

Andros01

Thanks so much for your post.  I’m just starting to have some nights of serious insomnia.  I was so torn as to whether to take something because of some posts that were adamant about not taking anything and muscling through.  I could not understand how the drug or supplement, if chosen thoughtfully ,could be worse for you than not getting sleep.

After all, sleep is so important to our overall well-being, immune system, daily functioning, etc.

That being said, I absolutely respect others experiences and choices.  It’s just nice to hear another point of view.

I have taken l-Theanine, melatonin at bedtime a while now.  Three times I have taken Doxepin.  It does help me sleep but feel a bit groggy the next day.  I am going on ask my NP if I can try a lower dose. 

I will look into Remeron if that would be a better choice.

I’m was starting to get the fear of bedtime but for me just knowing that I can take something if needed takes some of that fear away

You post was just what I needed right now

Thanks

2cats

Hi Andros, thank you for your comments about sleep.  I have been benzo free soon four years with little/no improvement in sleep. 

On April 2, I had a total knee replacement and since then, my sleep has gone back to zero and none.  Well, not quite that bad, but this week I've gotten maybe 1 or 2 hours. I will have a night of a few hours, then back one or two hours. 

I've tried everything from Costco's OTC to deep breathing, sleep hypnosis on youtube, foods that are supposed to help, going to bed at the same time, etc., etc., What works the first night will stop the next night or two.

I'm back to wondering how much longer I can survive.

My quality of life/sleep began to diminish a few years before I began my taper, so this has been going on for some time.

Any thoughts?

Thanks!

NG

Andros01

Thanks so much for your post.  I’m just starting to have some nights of serious insomnia.  I was so torn as to whether to take something because of some posts that were adamant about not taking anything and muscling through.  I could not understand how the drug or supplement, if chosen thoughtfully ,could be worse for you than not getting sleep.

 

After all, sleep is so important to our overall well-being, immune system, daily functioning, etc.

That being said, I absolutely respect others experiences and choices.  It’s just nice to hear another point of view.

 

I have taken l-Theanine, melatonin at bedtime a while now.  Three times I have taken Doxepin.  It does help me sleep but feel a bit groggy the next day.  I am going on ask my NP if I can try a lower dose. 

I will look into Remeron if that would be a better choice.

 

I’m was starting to get the fear of bedtime but for me just knowing that I can take something if needed takes some of that fear away

 

You post was just what I needed right now

 

Thanks

 

2cats

You can cut the pills yourself and see if lower doses help you get sleep, and minimize the hangover. The only advantage I can think of of Remeron is that it's less antocholinergic. And it's very strong. It's worth a shot if you can get it, but start with half a dose, and go down even more if it's still too strong.

Hi Andros, thank you for your comments about sleep.  I have been benzo free soon four years with little/no improvement in sleep. 

On April 2, I had a total knee replacement and since then, my sleep has gone back to zero and none.  Well, not quite that bad, but this week I've gotten maybe 1 or 2 hours. I will have a night of a few hours, then back one or two hours. 

I've tried everything from Costco's OTC to deep breathing, sleep hypnosis on youtube, foods that are supposed to help, going to bed at the same time, etc., etc., What works the first night will stop the next night or two.

 

I'm back to wondering how much longer I can survive.

My quality of life/sleep began to diminish a few years before I began my taper, so this has been going on for some time.

Any thoughts?

Thanks!

NG

I was a short term user, so I can't really offer a lot of advice, except for a few small things:

The body can repair but it needs the raw materials. Are you able to tolerate supplements? I'd use a greens powder every day, like Greens+ or Barlean's Greens, or CytoGreens.

Then add a few things your brain needs to speed up healing, like Magnesium, Lithium Orotate, and Chamomille.

Are you taking any supplements at all? Is the lack of sleep simply because your brain won't shut down? Or is it due to pain from the hip surgery?