Safe medications to take for sleep maintenance insomnia?

Therapeutic Efforts
#1

As 2019 nears its end, I wonder if there is anything we could take for sleep without worry so far.

Earlier in March I took very polyphenol-rich cacao nibs for a few days and ever since then I am consistently unable to sleep for more than 3.5 hours. Two nights ago I crashed further from having an emotional breakdown. My 3.5 hours of sleep has now been reduced to 1.5 hours. I am in an urgent state, screaming out for help here.

What medication or supplement if any is safe or at least is worth the risk for dealing with our insomnia? I’ll list some of the ones that I deem off the table for me based on perceived risk:

Benzodiazepines and z-drugs e.g., zopiclone and Ambien (zolpidem) - Consistently shown to increase risk of cancers across the board akin to or even greater than smoking packs of cigarettes. Despite this fact, its cancer risk is rarely brought up anywhere. Increased depression and suicidal ideation. Increased all-cause mortality is associated with benzodiazepines. The safest of the bunch seems to be diazepam which happens to be a TSPO ligand.

Etifoxine - If it were more effective we’d hear more about it from people who have tried it. Like diazepam, it binds to TSPO = increases conversion of cholesterol to neurosteroids e.g. allo. Some concerns of acute liver damage, and rarely severe skin disorders like SJS. Episodic liver function monitoring is recommended.

Trazodone - PSSD, fatal arrhythmia, priapism. I personally experienced arrhythmia on this.

Mirtazapine - Very potent 3a-HSD inducer =lowered androgens, scattered reports of PSSD from an unlucky few, tetracyclic class of AD associated with high risk of dementia

Gabapentin - Memory loss (halts synaptogenesis), bone resorption/loss

Seroquel - Tardive dyskinesia, diabetes, fatal arrhythmias

Belsomra and orexin antagonists - Merck’s next Pandora’s black box. Long term safety profile unknown due to no large clinical studies thanks to the FDA. Orexin receptors are expressed in the heart, for a potential surprise. Its safety is being investigated for use in heart failure patients for insomnia in Japan. The Orexin system regulates the serotonergic neurons of the raphe nuclei, which means it could agonize 5ht-1a. May cause narcoleptic symptoms like cataplexy, paralysis, and hypnogogic hallucinations.

#2

Hi Mercked

I’ve been using Xyrem for 6 weeks or so and it has had some mild benefits. Certainly has helped staying asleep after the 4-5 hour mark, but it’s still relatively light sleep. It also seems to help with nocturnal and morning erections.

Certainly not a cure by any stretch, but has improved sleep from 3/10 to 5 or 6/10. Downsides are the cost (which frankly I should be donating to research/foundation, but I have a high stress job and any sleep helps) and the fact I currently purchase illegally due to the ridiculous hoops one has to jump through to obtain legally.

If you’re interested in trialling, hit the dark web and I can recommend a good reliable vendor.

Cheers

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#3

Thank you. Sending a DM.

#4

Explain your insomnia symptoms…

Hydrocortisone may be beneficial in certain instances.

#5

I can sleep for only 3.5 hours at a time then I’d be up for a few hours. There’s no anxiety whatsoever. I just wake up exhausted but wouldn’t have the sleep pressure to go back to sleep until a few hours later.

#6

best bet might be to get a 24 hour urinary cortisol test.

#8

You feel that high cortisol is the reason for sleeplessness??

#9

Unlike dogs high cortisol is no friend of the insomniac.

#10

Recently my new sleep doc who is the head of the sleep center at mt sinai nyc prescribed Lunesta. Its the first time in almost a year and a half that i have gotten more than 5 hours of uninterupted sleep in a row. And I’m able to go back to sleep when I wake. Nothing is “good” as far as drugs but I cant live without sleep … I have 2 kids, a job, wife, house, mortgage, etc… So thats what I have chosen for now. My fitbit registered my sleep rating at 92 out of a 100 last night. Went to bed around 9:30… woke up around 315am… went back to bed and basically woke to an alarm around 6:30 am. Not sure how long this will last but I appreciate it while it lasts.

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Does insomnia ever improve?
#11

has anyone tried doxepin?

thinking about stop taking HCL and trying this.

safety profile seems good from the research i did

does anyone else want to research it to see if they find anything bad?

#12

For a more healthy approach to treating insomnia and improving sleep, try chamomile tea with some real honey.
Improve sleep hygiene (cold, dark room, hitting the sheets same time every night, sleep ritual)
Look at nature’s bounty 5mg dual spectrum melatonin.

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#13

already do that my friend. it helps but i still barely get 3-4 hours of sleep if im lucky.

#14

Yeah, as if anyone who suffers from chronic insomnia hasn’t already gotten the whole spiel about sleep hygiene. Sleep restriction therapy as a part of CBT-I though, that’s something I want to try eventually.

I am curious about chamomile tea. Chamomile increases StAR protein expression and steroidogenesis in leydig cells but apigenin also inhibits 5AR type 1 in mouse testes according to one study. So IDK if it’s another thing that can help some while hurting others.

#15

There’s no magic pill. Sleeping pills are only slightly better than placebo with terrible side effects. I would stay away from them.

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#16

Was just offering suggestions based on what helped me. Sleep for me is still very weird, and not truly restful as it was before. However, I am able to stay asleep. I don’t have children or a wife, which I imagine is a completely different ballgame.

#17

For how long have u been sufferung mate dknighteen

#18

This is not the case at all. Those “studies” are done with people who dont have severe insomnia possibly due to having little or no GABA production. Lunesta works great for me. Otherwise I dont sleep at all.

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#19

Did you find your sleep improved over time. How bad was it at its worst?

#20

Lunesta isn’t available in Australia. What other pill or pills would you recommend for my brother. He has severe insomnia. Several sleepless days throughout the work week. He can sleep on the weekends. So it must be work stress anxiety related.

He’s scared of taking pills cuz of side effects
Currently he has been prescribed zopiclone and Belsomra but hasn’t taken it.

#21

October 23rd was when I took 1mg of Finasteride, been playing ball with PFS for about 15 months. Symptoms completely across the board, and then some.