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Diet and sleep aids for insomnia

 
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I have a serious health problem that straddles the boundary of psychiatric and medical and this thread strikes disturbingly close to home for me.  I am a very serious insomniac.  My insomnia clicked on like a light switch on September 11, 2006.  This had nothing to do with the anniversary of 9/11, I was watching a Monday night football game and my team won.  I was worked up from game and stayed awake all night.  Not one second of even stage 1 sleep.  I was exhausted all Tuesday, but could not get to sleep Tuesday night, nor Wednesday, nor Thursday.  After being awake for four straight nights, I got an emergency doctors appointment and an emergency supply of Lunesta which put me to sleep Friday night.  I slept Saturday night, but was awake Sunday night.

Soon a pattern appeared.  If I had school (I am a teacher) the next day I could not sleep without Lunesta.  After about 2 weeks Lunesta stopped working and I was getting desperate.  This was now late September.  There is a sleep specialist in the area and my wife got me an appointment (she is a doctor)—for January!  Fortunately the specialist wrote me a prescription for clonazepam/Klonopin until I could see him.  Fortunately the clonazepam (a benzodiazepine, related to Valium, Xanax and a host of less well known sedatives) worked well.  For the rest of the school year I took clonazepam before bed each night if I had school the next day and abstained on weekends, holidays and all throughout summer.

By the end of summer I had no problems with insomnia, but the night before the first day of school I laid awake all night.  The clonazepam stopped working (even though I had gone months without touching it).  Even worse, I now had problems on weekends as well.  At first I had my clonazepam dose increased, then increased again.  Clonazepam takes about two hours to work, but lasts 10 hours.  I was taking my meds at 7:00pm so I could wake at 5:00am.  But the larger doses lasted longer and longer.  

Eventually I was switched to an older antidepressant rarely used for depression and now mostly used for sedation.  It is called Trazadone.  I initially started on the minimum dose, 50mg.  I did get to sleep, but I awoke feeling horrible. I was tired, groggy, confused, irritated and heavily fatigued. I seriously wondered if I should have just stayed awake that night.  As this was not having the desired effect, my Trazadone dosage was increased to 150mg with frightening results.

Not surprisingly, my performance at school suffered, as did my performance at everything I did.  My medication was shuffled around.  I think I have been prescribed every single sedative, most of which just did not work or had horrific side effects.  I missed a LOT of school and eventually was placed on disability (an act I resisted fiercely but lost).

At my worst I was at one point awake for 14 days.  Part of this was my fault as I was deliberately abstaining from a medication in order to eliminate the inevitable tolerance I develop.  It was summer and I read on Wikipedia that it could take 10 days to 2 weeks to completely lose my tolerance.  Since I had no other real responsibilities, I just decided to stick it out for 2 weeks thinking that surely I would eventually fall asleep on my own in the meantime.  Nope.  I was stubbornly awake for the whole time.

By this point, I have not slept unsedated for just a little over 12 years.  Some people hear about my problem and strangely get jealous, thinking that I am wide awake all night and can cognitively function as normal.  Nothing could be further from the truth.  I am not asleep, but I am still exhausted.  Two nights ago my medications up and failed me at random and I am still groggy, tired in recovery.  Unfortunately time is not on my side as Aging makes sleep issues worse.

I would love to find out that some dietary change would make this all disappear. Similarly I would love to find that some simple over-the-counter remedy would change this.  Just to make things clear, yes, I have tried melatonin and it seemed like a cruel joke to me.  I took anywhere from 2-20mg, but while it would make me slightly more tired (I am absolutely exhausted all the time, so what is a little extra tiredness), it did absolutely nothing for sleep.  The same is true for every other over-the-counter remedy I tried (and I have tried a LOT!).

I am not trying to hijack this thread as a sort of pity party.  I strongly sympathize for all those other people out there who have conditions worse than my own and if a modified/improved diet would help them then so much the better.  If anyone has any suggestions for dietary changes to help any psychiatric or health issues I would love to hear about them, both for my use and others.

Thanks in advance for your suggestions and my thoughts go out to those who suffer.

Eric
Staff note (James Freyr):

This post was split off from this thread here https://permies.com/t/122758/kitchen/Diet-Psychological-Health

 
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I no longer take pysch meds after doing so for most of my adult life. I think that the biggest change that allowed me to get off of them was reducing stress, for me that means limiting my exposure to people, for others it might mean something else. Other than that, I would attribute most of my well-being from spending a lot of time outside and eating lots of whole foods. I don't exclude food groups, but I need all of my meals to be balanced with moderate carbs, high fat, and moderate protein. A very low carb diet made me despondent, obviously others experiences may vary. Honestly, I would never go back to psych meds, the permanent side effects from some of them are completely understated. That being said I don't have an axis 1 diagnosis, and everyone needs to do what they think is right.

Eric Hanson - in my experience, all sleep medications (as well as many other medications) build tolerance. My best experience has been in rotating through them. The Trazodone, Benedryl, Melatonin cycle works well. Some people rotate through them daily. I've had better experience with changing them once a month. My families joke is that the Witschers are not sleepers. My dad, uncle, paternal grandparents and me, we are light sleepers, awaken frequently, and rise early. I haven't slept through the night in 30 years.
 
Eric Hanson
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Stacy,

I am well versed in medication and tolerance issues.  I am actually a psychology teacher and I strongly emphasize the significance of the biological/physical/chemical aspect of the brain and the effects on behavior.  I do periodically change out medications, though Trazadone is the one with the least tolerance issues.  For years I preached against sleeping medications precisely because of tolerance issues.  That was until I was struck with insomnia myself.

Insomnia rules every aspect of my life, no matter what I try, nor how hard I try.  My insomnia is not the light sleeping/frequent and early waking variety.  Without medication, no matter how tired I get, I simply will not enter any type of sleep for even a moment.  I suspect but don’t know that at some level my brain has lost the ability to sleep on its own.  It is about 7:20 right now and I am already strategizing how to get to bed at 9:00 so that my meds will work but be worn off by 5:00 am when I need to get up.  I have had a sleep study but it was worthless.  It succeeded in telling me that I don’t sleep!  I wanted my money back after getting that result.  Worse still, though my meds induce unconsciousness, the state they induce might not really qualify as sleep.  The stages they induce are terribly disrupted and in no way resemble normal healthy sleep. Trying to reduce stress is likewise fruitless as sleep deprivation IS a very significant stressor.

As I stated earlier, I would love to find the simple dietary or herbal solution, but thus far all have fallen flat.

Eric
 
Stacy Witscher
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I'm well versed in the passing out vs. sleep, but we all need to get what we can. For some of us, passing out is as good as it gets. I would get so frustrated with doctors talking to me about sleep hygiene sometimes naps are the best sleep I get. As I said reducing stress, escaping the rat race has been better for me than anything else. But I do acknowledge that not all of us can do that.
 
Eric Hanson
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I too tire of the sleep hygiene issue.  It is downright insulting to suggest to me that even though I have had a powerful sedative in attempt to force sleep and can feel it failing, wearing off, that turning my clock around backwards so it does not shine on me is going to put me to sleep.

Eventually I had to let my sleep specialist go as he was unwilling to sufficiently address the seriousness of my insomnia.  It was tough.  I really liked the guy.  I always scheduled my appointment as the last of the day and we would have great conversations and I even got quite a technical education (some of which eventually made its way to my psychology class).  But he was unwilling to be more aggressive than prescribing clonazepam and this is a problem.

Clonazepam is not a bad medication to start with.  It is relatively mild and has minimal tolerance issues.  But there are built in issues.  As I stated earlier, it takes 2 hours from the moment I swallowed it to its peak sedation.  One component to my insomnia is “racing mind syndrome” where I just cannot turn off my brain.  I need s medication that works faster than my own brain.  Clonazepam was just too slow.  On top of that, clonazepam works for a whopping 10 hours, meaning it is easy to wake up still sedated (the so-called hangover).  In heavier doses, clonazepam produces a serious hangover.  My sleep specialist just would not go beyond clonazepam and I had to leave him.  Sad.

Eric
 
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Eric Hanson wrote:Stacy,

I am well versed in medication and tolerance issues.  I am actually a psychology teacher and I strongly emphasize the significance of the biological/physical/chemical aspect of the brain and the effects on behavior.  I do periodically change out medications, though Trazadone is the one with the least tolerance issues.  For years I preached against sleeping medications precisely because of tolerance issues.  That was until I was struck with insomnia myself.

Insomnia rules every aspect of my life, no matter what I try, nor how hard I try.  My insomnia is not the light sleeping/frequent and early waking variety.  Without medication, no matter how tired I get, I simply will not enter any type of sleep for even a moment.  I suspect but don’t know that at some level my brain has lost the ability to sleep on its own.  It is about 7:20 right now and I am already strategizing how to get to bed at 9:00 so that my meds will work but be worn off by 5:00 am when I need to get up.  I have had a sleep study but it was worthless.  It succeeded in telling me that I don’t sleep!  I wanted my money back after getting that result.  Worse still, though my meds induce unconsciousness, the state they induce might not really qualify as sleep.  The stages they induce are terribly disrupted and in no way resemble normal healthy sleep. Trying to reduce stress is likewise fruitless as sleep deprivation IS a very significant stressor.

As I stated earlier, I would love to find the simple dietary or herbal solution, but thus far all have fallen flat.

Eric



Hey eric
This sounds like a horrible way to live to be quite honest. Good on you for working though it.
I am curious if you have tried Natural Calm Products?
Ive been taking them for half a year now. I no longer feel as stresses out nor as tight in my body. It helps me sleep a lot.  It helped me with a lot of body pain as well.

Maybe read about magnesium deficiency
Or checkout https://www.radiantlifecatalog.com/category/sleep

Best of luck
 
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Magnesium deficiency is real,, and I have experienced some relief from taking tums before bed. Tums...calcium...works with magnesium to stimulates melatonin to help a person sleep. You have to have both to produce melatonin. But calcium does not always work for me.

Incidentally my calcium and D3 deficiency comes from surgery. When they cut out my Thyroid, there are two cords that go up the windpipe, but in scraping out my Thyroid due to cancer, and wanting to get every last cancer cell, those cords were nicked forever regulating my Calcium and D3 levels. You can easily tell if calcium deficiency is a problem by how itchy your skin is; if it is itchy, try taking Tums and see if it goes away. If it does, you have calcium deficiency.

I am up all hours of the night, and like Stacy, I crash...I never fall asleep. Trazadone does NOTHING for me though, but I am not whining because I have not slept in 4 years; hardly much compared to you guys.

I think the worst situation is doctors who know nothing. I had a Doctor that was convinced there is nothing wrong with me, and literally told me, I "needed to get a better bed." There have been two great days in my life: the day I married my wife Katie, and the day I fired that dumb doctor. I am a farmer and would never lose half of what I have just because I sleep on a lumpy bed.

By the way, I am up now, 21 hours of full-on-being-awake because of another medical reason: I mow the sides of the road and got my mower tangled up in grass. In dislodging it I got covered with posion ivy from my figers to my elbow. A week has not straightened it out, so a trip to the hospital got me Steoids to kill the rash. Those medications keep you up...so here I am, on Permies with the rest of my insomniac friends. I am so sorry you guys have to deal with this too. It is hell.
 
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My heart goes out to you. Not as bad, but I often make it from 10pm to 1am-4am.  Lay there for 3-4 hours with my mind racing, but my body too tired to do anything.  Then I fall back asleep around 6, sometimes completely missing the kids off to school, then wake up again around 9-10 with a terrible hangover.  I've tried Benadryl, but it gives me a hangover worse than being tired.  I've thought about trying Ambien, but have heard some good and bad.  I've got insomiacs on both sides of the family.  My wife easy sleeps 10-12 hours and complains if she only gets 6-7.  I only wish I could sleep like that!  Interestingly enough, I took Tums last night before bed and slept better than I have in a while.  I think I will try again tonight!
 
Eric Hanson
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Gray,  

I have used both Ambien and especially Benadryl.  I have used Benadryl countless times, mostly not for insomnia but for allergies.  Growing up I knew that taking Benadryl would indeed put me to sleep quickly, but the quality of sleep was awful, bordering on just staying awake all night almost preferable to the Benadryl hangover.

Ambien on the other hand actually not only induced sleep, but mimicked normal sleep pretty well.  While it worked, I did get good, meaningful rest.  Unfortunately, this won’t last for long.  Even the Ambien guidance says to only use for occasional difficulty sleeping and specifically not to use it for more than 2 weeks.

I can definitely agree with you that even the best meds have their problems and are no substitute for the real thing.

Eric
 
Stacy Witscher
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Interesting, I don't get hangovers, not from anything including alcohol. And typically when I wake up, I'm up. It has always annoyed others who are slow to wake.

I've never tried any of the sleep medications that are marketed as sleep medications, typically they are not recommended for people with mental illness. I've heard that Ambien can cause vivid dreams, which I would hate because I already suffer from these. Vivid dreaming is not restful sleep for me.

Being able to sleep when I'm tired without schedule or being tied to a clock has been helpful. But now that I'm watching my grandson while my daughter works, it's not as easy.
 
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Huge sympathy for your problems.

Have you explored hypnotism?

My parents quit cigarettes by going to a hypnotist.  In later years, my dad would play with his heart rate; a technique he learned from the hypnotist.  He liked to panic the nurses if he was hooked up to a monitor for other reasons.  He entertained us all night once while he was in ER for a kidney stone.  

I know that seems off topic, but there may be similar body learning to be had this way.
 
Eric Hanson
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Stacy,

Dreaming is a surprisingly complex phenomenon.  In generic terms, people start their first moments of REM (dream) sleep about 90 minutes after falling asleep, but this episode only lasts 10-20 seconds or so.  The next episode starts about an hour later and lasts for perhaps 30-45 seconds.  The next one is about 45 minutes and lasts a minute or so.  And on and on throughout the night such that the most vivid, colorful dreams occur in the last hour of sleep just before waking up.

Regarding Ambien (and a lot of other short acting sedatives) the scenario changes a bit.  Most sedatives really do a number on REM sleep.  Frequently, sedatives (and Benadryl is notorious for this) induce stage 4 sleep and keep you there for most of the night, coming at the expense of other stages, most notably REM sleep.  REM sleep is the most restful sleep while stage 4 is the hardest from which to wake.  Generally, without REM sleep, we don’t feel like we have slept.

Back to Ambien.  Ambien indeed suppresses REM sleep, but being short acting wears off during sleep where our brain tries to regain the lost REM sleep.  For some, this is an incomplete process and leaves us feeling tired when we wake up.  For others, our brains go through most/all of the REM sleep time, but this happens furiously in the last two hours or so of sleep.  For these people, the dreams range from being bright, flashy and super real to being bizarre and nightmarish.  This varies tremendously based on the individual person.

Eric
 
Eric Hanson
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I should add this to my last post.

Though rare, some people get too much REM sleep and are tired as a result.  In reality, we need all of our sleep stages and disruption of any can have unpleasant side effects. I have known people who get too much REM sleep and for them, the solution was a REM sleep suppressant (actually clonazepam).

Eric
 
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Eric, I can't imagine how you are functioning. I tried a few sleep meds. Sure, they knocked me out for longer, but I was tireder and stupider than usual the next day.

I too have insomnia and trouble sleeping, and will watch this thread with interest.. It's gotten better while I have been off work, but is still a struggle. I went from 4-6 hrs of sleep a night (with natural wakeups) to not being safe/alert enough to drive and major health issues and a period of unrestful 10 hr sleeps.  I jealously guard whatever sleep I can get.

My doctor decided to send me to a sleep study. Most useless thing in my life. Hadn't had more than 4 hrs sleep in a week before the sleep study, got about 5 hrs or less during the study. Lying there, staring at the ceiling, listening to the other people get up or whatever. Results were "you don't have sleep apnea". My doctor pressed further, and they said I have  "irregular brain waves" during sleep. What does that mean? Still no idea. After my doctor strong armed the sleep study clinic, I got a follow up with the psychiatrist. Useless. Had I tried blackout curtains, keeping my room cool, and not using devices before bed? No, what a great idea! I can't imagine that sometime in the last 5 years I had never thought to look at a WebMD article on tips for better sleep, let alone in the months i waited for a followup appointment in a city 1.5 hrs drive away. (Sarcasm) I google the guy and discovered he had had his medical licence temporarily revoked for malpractice a few years ago.

Have you tried meditation (this may be a, duh, of course)? I have practiced my grandma's "just rest your eyes dear" theory of insomnia /napping for years, and it works better than nothing for me to become less tired. I close my eyes and just breath and relax for a while, not expecting or asking for sleep, just giving my brain a break. I want to try meditation after listening to a program on CBC about the effects of meditation on sleep quality, and the ability of meditation to change your brain, but none of the online resources I have tried have worked for me. Maybe I will find a class.  
 
Eric Hanson
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Catie,

Thanks for the concern and I certainly sympathize with your own plight.  In fact your experience sounds a lot like mine.  In my sleep study I was diagnosed with sleep apnea.  However, this explains poor quality sleep and not the inability to fall asleep in the first place.

I was put on a CPAP machine.  Actually, for a while I hoped this would really be the answer to my problem.  But sleeping with a CPAP is like being suffocated by an octopus.  I can’t move into a comfortable position, I can’t actually breathe on my own as the machine “decides” when I breathe and in between I feel like I am suffocating.  I called it my Darth Vader machine for the sound it made and the discomfort it induced.

Sorry you have to suffer through this too.

Eric
 
Catie George
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Eric Hanson wrote:  In my sleep study I was diagnosed with sleep apnea.  However, this explains poor quality sleep and not the inability to fall asleep in the first place.

I was put on a CPAP machine.  Actually, for a while I hoped this would really be the answer to my problem.  But sleeping with a CPAP is like being suffocated by an octopus.  I can’t move into a comfortable position, I can’t actually breathe on my own as the machine “decides” when I breathe and in between I feel like I am suffocating.  I called it my Darth Vader machine for the sound it made and the discomfort it induced.



There is a joke among the people that I have talked to that sleep clinics should really be called sleep apnea clinics. The one I went to had videos playing in the lobby, posters on the wall, and brochures about CPAP machines, and not a scrap of material about anything else.  I am the only person I know who has gone and not been diagnosed to need a $1500 machine lest they take away your drivers licence. CPAPs are great for those who really need them, but I sure know of a lot of them sitting unused because they don't address the primary complaint - not sleeping in the first place!  
 
Eric Hanson
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Catie,

After using it for the mandatory first 2 months (or else insurance would not pony up the money), I was struggling to get to sleep one night and feeling particularly suffocated, I had enough and tore the machine from my head and never used it again.  Awful experience.  Not once in the 60 days did it help me get to sleep faster, nor did it in any way possible make me sleep better.  I can’t imagine ever using one again.

Incidentally I had a friend who heard about my experience and was curious as to what it felt like.  I went ahead and hooked it up to him and one breath was all it took to be completely put off by the feeling.

Eric
 
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Catie George wrote:
Have you tried meditation (this may be a, duh, of course)? I have practiced my grandma's "just rest your eyes dear" theory of insomnia /napping for years, and it works better than nothing for me to become less tired. I close my eyes and just breath and relax for a while, not expecting or asking for sleep, just giving my brain a break. I want to try meditation after listening to a program on CBC about the effects of meditation on sleep quality, and the ability of meditation to change your brain, but none of the online resources I have tried have worked for me. Maybe I will find a class.  



Funny how I just got done having lunch with an old co-worker and this issue of sleep problems, breathing issues, CPAP-mania and other things came up.  I'm glad Catie G brought up the notion of meditation which, although not a magic bullet, is highly under-rated for myriad health benefits.   It doesn't matter the source of my occasional bouts of insomnia, an important means of inducing relaxation and often re-entry into sleep is steady, full-breathing meditation.  Whereas you described it as "giving my brain a break", in my own case I feel it to be giving my body a physiological break from the ravaging effects of my brain and busy mind.  I don't know how the various classes in differing locations varies across the globe, but I was fortunate enough to enroll in an 8-week 'mindfulness meditation' course facilitated by a very competent instructor.  That was 10 years ago and I've been practicing ever since, even if during some times of the year I'm more dedicated than during others.  Would highly recommend it for many issues dealing with busy mind/anxiety/insomnia.

Adding this edit some hours later:  https://www.sleepfoundation.org/articles/how-meditation-can-treat-insomnia
 
Travis Johnson
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I know a method to get to sleep, it is staying asleep that I have problems with...

A guy learned to teach this method in World War Two. He was asked by the Air Force to find a way to make the bomber pilots more alert during their almost suicidal missions bombing Germany, and atlas, my own Great Uncle was killed during one of those flights. What the doctor found out was, better sleep did the trick. His methods worked so good, as tapes of bombings played, pilots would go to sleep within 2 minutes despite any of the taped distractions playing.

I can describe how I do it, bit maybe it will work for people, but maybe not. The key is MOVEMENT! If you think of any movement, your brain wakes up. Everything has to be still.

I envison myself on a lake in a canoe...no movement of the water, dead calm. The clouds in the sky, they are still too. Just the sound of birds on the shore. Again...no movement.

I then start to relax my muscles, starting athe top of my head. Every muscle...including your eyes and face...and no your face is not relaxed yet. It takes about three tries for me to completely relax my face. Then i go down, relaxing all the muscles as I go.

I have never got past my chest, and I am fast asleep, but keep going if you make it further, all the way to your toes if you have to. If you feel yourself start to wake up, due to movement or whatever, just start again. I can fall asleep this way with a wife, four daughters, a cat, rabbit and the TV on. My problem is I wake up at 1 AM in a shear panic of (insert whatever worry of the day is ) at that time, and I am up for two hours.
 
Travis Johnson
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I am just full of odd advice, but as my heart really does go out to many of you, I hope maybe something I say helps.

But as odd as this sounds, massage can really do wonders for sleep. Katie keeps me going with back rubs because as a mower operator for the town, my head is always cranked to the right watching my boom mower in the ditch. But there is something that works better for sleep.

Foot rubs.

I know that makes me sound like a sissy, but I admit Katie rubs my feet, and I will rub hers. In fact I am pretty sure Katie would let a drunk, homeless man, fresh out of prison; rub her feet. Yes, she really likes them that much. Within minutes Katie is asleep, and for me...I am usually out before she is done.


 
Catie George
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John Weiland wrote:

Funny how I just got done having lunch with an old co-worker and this issue of sleep problems, breathing issues, CPAP-mania and other things came up.  I'm glad Catie G brought up the notion of meditation which, although not a magic bullet, is highly under-rated for myriad health benefits.   It doesn't matter the source of my occasional bouts of insomnia, an important means of inducing relaxation and often re-entry into sleep is steady, full-breathing meditation.  Whereas you described it as "giving my brain a break", in my own case I feel it to be giving my body a physiological break from the ravaging effects of my brain and busy mind.  I don't know how the various classes in differing locations varies across the globe, but I was fortunate enough to enroll in an 8-week 'mindfulness meditation' course facilitated by a very competent instructor.  That was 10 years ago and I've been practicing ever since, even if during some times of the year I'm more dedicated than during others.  Would highly recommend it for many issues dealing with busy mind/anxiety/insomnia.



Thanks John, I will look for a mindfulness course.

For anyone interested in the news program that got me interested, here's a link to Quirks and Quarks, a science based CBC radio show that I listen to. Great driving listening.  They review some of the science and evidence for meditation, give some cautions about where it might not be appropriate, as well as have the host try it for himself and measure the difference in his brain waves after a week: https://www.cbc.ca/radio/quirks/the-science-of-mindfulness-1.3934579

And another CBC article that popped up, talking about various potential  unusual sleep aids, including meditation.  https://www.cbc.ca/life/wellness/how-audio-sleep-aids-can-help-you-get-a-better-rest-1.5137744
 
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(Interesting that my first post here would be in a sleep topic!)

My sleep issues revolve around Restless Leg Syndrome (RLS); when I’m just on the verge of sleep my legs start to jerk. The more serious episodes involve my foot clenching and the curling up. Involuntarily, andit gets really painful. Only by rubbing BenGay (or generic version) on them will it then stop and sometimes I can go to sleep soon after.

My primary care physician addressed it a couple of weeks ago by prescribing Ropinirole (trade name Requip). It’s primarily for people who suffer from Parkinson’s but it is also prescribed for RLS (dosage is <1% of the dosage for Parkinson’s. It sort of works; the foot clenching/toe curling has disappeared, but the legs still twitch. He thought that there might be a dopamine deficiency as I am an alcoholic; although I’ve been sober for over 17 years, there might still be lasting effects from my drinking. (He was going to prescribe Klonopin, but nixed that upon being reminded I’m an alcoholic; Klonopin being addictive.)

I usually need a Melatonin/Benadryl/Aspirin combo to knock me out. I usually then get decent sleep. Not always.

I was diagnosed with sleep apnea and am on an O2 machine for overnight; I’ve been supposed to go for a sleep study but I regard it as pointless as I know I’m not gonna sleep.
 
Eric Hanson
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Paul,

Just about a year ago I developed RLS also.  Mine presented in a different fashion though.  Since I take sedatives every night, including drugs in the same class as klonopin/clonazepam, my RLS does not show up at night (thankfully).  Instead, after I drink my morning coffee, my legs come alive.  They absolutely crawl.  I squirm and my legs drive me crazy.  I desperately wanted something to calm down, almost hold down my legs.  As this was happening in the morning and not at night, I did not immediately recognize it as RLS.  Eventually I found a non-drug solution that is a bit unconventional but actually works very well.

I ordered a pair of compression shorts.  These were not your ordinary compression shorts though.  They were considered medical grade compression shorts and actually had a compression rating measured in mm Hg worth of compression.  They really compress the legs but are not especially tight in the waist.  Upon putting on the first pair (they were shorts and not pants), the part of the legs they covered immediately calmed down, but the “wiggling” spread downward.  I ordered compression pants from the same site and when I put them on, my restlessness immediately dropped and within minutes went away completely.  I now wear them frequently, and sometimes I think it is silly that I am wearing them so I take them off and within 5 minutes the restlessness comes back.

I have been prescribed the same medication as you and it does help, working best after using it for several days.  I realize that you might not be thrilled by the thought of wearing compression shorts/pants, but it has really worked well for me and is a non-drug solution.

Good job on going 17 years sober.  Clonazepam is not likely to really cause addiction if used as directed, but I totally respect your not wanting to risk your sobriety.  So again, congratulations on your sobriety.  

But just to reiterate, if you are looking for a non-drug solution to RLS, I found compression to really work.  If you want more information I can certainly recommend two manufacturers.

Eric
 
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Hi Paul, Welcome to permies!

You may have heard already that magnesium can help with restless legs.

When I was pregnant and taking a lot of calcium for heartburn, my legs become swollen and crampy and uncomfortable. Midwife suggested magnesium and it helped. Ultimately it was easier for me to stop eating things that caused heartburn and stop taking tums than to add taking Magnesium.

Magnesium/calcium balance is tricky.
 
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Wow, this not sleeping thing sounds awful. Ive experienced nothing similar but I have taken herbs to help me sleep deeper. When I feel an illness coming on (cold/flue/etc) I try to sleep real deep one night and it often helps alot. Thus the herbal experimenting over several years.

Valerian supercalm is a concentrated tincture that helps me fall and stay asleep.

Wild lettuce or sow thistle tea (common yard weed in many parts) has some strong sedative effects. College students tend to use it strong to stimulate interesting dreams.

Pedestrian level herbs you can gind in tea section include chamomile, various mint varieties,

Lastly, there are psychedelic mushrooms and parasitic plants that seem to offer brain reset / repair to many suffering from anxiety and or PTSD. Indian pipe is one I found very helpful in few doses of very small quantities. Long lastong effect.

I hope some of that info helps someone.

 
Amy Arnett
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I'm glad people are suggesting mindfulness meditation. It's what works for me also, especially for slowing racing, careening thoughts. The goal is to practice focusing your whole attention on something, the examples of breathing and relaxing muscles were given. When your brain is fully focused, there is no room left for racing thoughts. The occasional thought will pass through, but that's ok! Just let it on through and out the other side and return to your breath. Even if you don't fall asleep, you get a nice break and feel refreshed. I think of it as a massage for your nervous system.

The technique that Travis described is my favorite, sometimes called "the body scan", and has the added benefit of relaxing muscles that you may not have noticed were tense.
There are many guided mindfulness meditations on youtube. This is my favorite:

This is a 30 minute body scan. It takes practice. If it's too long, just do as much as you like. After a few listens you can get the idea and guide yourself. If the voice isn't relaxing for you, click around! There are sooo many and you can find a voice you like.
Note: Ignore the part in the beginning when the narrator says "this is to wake you up..."
 
Eric Hanson
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J Davis,

You have some very interesting herbal sedative information.  I have just one small and mostly irrelevant quibble.  College students are known for taking some interesting drugs (herbal supplements are still drugs).  Every sedative I know about induces stage 4 sleep which is dominated by delta waves, is the hardest stage from which to wake and dreaming does not happen.  Dreaming occurs in REM sleep which is a very light sleep and easy to wake.  I don’t doubt that college students try various herbs in an attempt to make dreams more vivid, but in all likelihood they are inducing stage 4 sleep which isn’t characterized by dreaming.  Worse, said students likely got to sleep earlier and slept DEEPER, but lost REM sleep and bizarre as it might appear, REM sleep is the restful part of sleep.

Moral of the story is that in an attempt to create more vivid dreams, those students likely wrecked their dreams and woke up groggy and tired.

But as I said, this is a minor quibble and not with you J. At all.  Thanks for listening to my little rant and thanks for the herbal information.

Eric
 
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For many many years I've solved my insomnia with alcohol. When I would try to sleep, I would always be "almost there" and then something (anything) would pull me back. After that I would be wide awake, unable to slumber back to sleep again.

I've tried many times if just the tiredness of not sleeping for days would solve it, but it never did. Being totally tired after 3 or 4 days with barely any sleep (tired as in not functioning at all anymore) would lead to a nap of half an hour around midday, but nothing more and the feeling of tiredness would become so overwhelming that I would grab the bottle again to just reset my brain and knock me out for 6 hours. After that I would always feel "normal" again.

Some months ago I read a comment from a "sleep scientist" that struck a cord somewhere. He said that "the main problem of insomnia seems to be to desperately want to sleep". As in: if you try (too) hard, you are unable to.

That struck a cord because failure to fall asleep always lead to increasing irritation in my head. The longer it would take the more restless I would become, all the way to feeling super awake in the middle of the night, despite feeling drowsy just half an hour earlier.

I have experimented a bit with this over the past 2 months. Not every night, but once every 3 or 4. Just go to bed to relax, not expecting sleep. Just relax, let the mind fly into pointless thoughts, smile about it, and relax. And I slept! Not a full night, but like half an hour, then waking up for whatever reason, relaxing again, and then sleeping again, a bit longer, waking up again and sleeping a full 3 hours before daylight came shining through the window. That was amazing! I cannot remember anything like this for the past decades!

I saw similar sounding experiences in some of the last comments above. Could it be that we're so stressed and freaked out about everything in life that we cannot even relax at all at night anymore? That sleeping has become another job or task to complete so for some of us it has become a burden instead of a cure? I'm slowly trying to continue my own experiment to see if I can get off the booze completely. I think it will work, but I need to practice this "just relax, it's OK" approach, which is a bit challenging...
 
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My issues are kinda complex and it's hard to separate the issues out as they are pretty well interwoven.  So I have no idea if any of this will apply to anyone else, but I'll share what I can remember from what I've worked out so far.

I have issues, sometimes, with both falling asleep and staying asleep.

Some of the causes are hormonal, aspergers, long-term exhaustion, insulin and blood sugar problems, stress and 'grief fatigue'.  

Apparently aspies often have issues with sleep, and also often have hormonal problems.  Hormones have shifted constantly through life, I'm finally through menopause, the hot flashes have all but disappeared, but I did experiment with melatonin as it's a hormone and I figured that as it's available off-prescription here and I'm so prone to hormonal problems that it might prove useful.   It did.  Four weeks on and I've been sleeping better than I have for decades.  Last night I slept from 9.30 to 6.30, which is pretty unprecedented!  It's not a complete 'cure' though as I still have nights that I can't fall asleep, or I wake up and can't get back to sleep.

I'm hypoglycemic.  I make more insulin than I need if I eat carbs or sugary stuff.  Which means that eating them tends to mean my blood sugar crashes, which triggers a surge of stress hormones.  These keep me awake and mess my sleep up.  I don't seem as sensitive now as I used to be a few years ago, and I can get away with some fruit daily and the occasional high carb treat, like once a week or so.  Regular 'treats' will totally mess my sleep up though and I'll wake up totally stressed out, often suicidal.  

I've been a carer for two periods of my life in the last few years.  It's exhausting.  I've never really recovered from it, and being on 24 hour caring duty really messes my sleep cycle up.  I never really recovered from the first round of several years of never getting more than about three hours sleep a night and regularly being woken up three times a night.  

Any stress totally messes my sleep up.  I've learned to put myself and my sleep first.  If I lose sleep, my ability to cope with stress becomes almost non existent, so it's a pretty nasty positive-feedback loop. Anyone who pisses me off gets cut out of my life.  They are literally not worth losing sleep over.  I've turned into even more of a hermit and recluse than usual with only very trusted friends being allowed into my personal space.

I lost my husband last year and seem to be experiencing something called grief fatigue.  Which seems to be constant tiredness and difficulty sleeping that pretty well nothing will influence and will presumably fade and disappear in its own time, which from talking with other people tends to be from one to three years or more. I'm just learning to accept this level of fatigue on the grounds that nothing seems to influence it and the stress of worrying about seems counterproductive.

I have a new partner now and we've just bought a new place.  We're in the throes of doing it up ready to move into, and I'm still trying to sort out all my husband's old junk and projects and general stuff that's lurking everywhere I turn at the old place.  It's amazingly stressful emotionally, and will often trigger really, really bad nights where I can't sleep at all.  I'm guessing that when it's all done and I'm ready to actually put this place on the market and eventually sell it and move to the new place, then I'll be able to move on from the painful and raw memories and at least that reason for disturbed nights will be gone.

Things that help.  Valerian will often help me stay asleep longer, but its effects seem to wear off so I try to keep it for if I'm having a long spell of disturbed nights.  Sometimes I'll take a swig of cherry brandy, which I keep by my bed, for similar reasons.  Only once a night though else I'll get a hangover.  Cherry brandy still tastes good if it's been open for months, and it's very cheap here.  If I have any pain that's keeping me awake, it seems to knock the pain out and is gentler on my liver than pain killers.  If I find I've taken it every day for a week, it's time to step back and figure out a better way though.

Walking, at least a couple of miles, seems to stabilise my blood sugars if they're going wonky, and makes me physically tired enough to fall asleep more easily.  Heavier physical work can be counterproductive as it tents to stir up the stress hormones.  It's a dynamic equilibrium.  Forcing myself to walk if I don't feel up to it seems counterproductive too, unless I keep it very short, maybe just half a mile to get my head to relax.

If I'm really tired during the day, allowing myself to take a nap really helps.  If I force myself to keep going through tiredness, it seems to put my body into 'stay awake' mode, which is still switched on when I want to switch off at night.  But the timing has to be right.  If I nap in the evening too close to bedtime, my body seems to get confused and I won't be able to fall asleep at all.

That's all I can think of for now.  I've just previewed this message and am laughing because it sounds so curt and grumpy.  Even after a good night's sleep I still feel exhausted and it shows in my writing!  Oooops. Sorry about that.  I hope some of it might be of use to someone, despite the grumpiness....
 
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One of the main problems for non- sleepers (me included) is worrying about not going to sleep. I found one way is just to stop worrying if I can't sleep. I put on headphones or a blutooth earpiece and listen to audio books or watch stuff on my computer. The trick is to watch something you are very familiar with so you don't need to follow a plot or even look at the screen. Put your chosen method on an hour timer so you dont waste power if it works, and if it doesn't, lying still and having your brain taken over  by something light and enjoyable is almost as refreshing as a sleep.
 
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My physician just increased my Ropinirole (Requip) to 3 pills a day to see if that works better.

I bookmarked this thread because of the many references in it; I notice that magnesium was mentioned a few times. I forget whether it was my physician or wife who said that iron deficiency may contribute to sleeplessness as well as potassium deficiency.  
 
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This is a bit of a random suggestion but have you considered trying a weighted blanket? I just got one (my work offered to pay for it) so I'm still seeing how well it works, but I do find it very soothing to have on and I have chronic anxiety/depression which I think is a big contributor to my insomnia. They are a bit pricey to buy  but I believe they can be made much more cheaply.
 
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Sleep doesn't get it's due. There are several new studies that show people who sleep under 5 hours a night have significantly shortened lifespans (or over nine hours BTW). There are people who sleep, naturally, little (like under three hours) but they are a tiny minority. The big question with poor sleep and health is cause or effect. As many on here have noted, poor sleep is often an acclimation to some other pathology. Trauma, medications (especially used in formative years which is scary to me given the medications we put kids on for the last few decades), early school days for kids, bright LEDs in devices, decreased UV exposure from sunscreen and indoor play- the list is really really long. Worse, most of these are not modifiable, they are in the past.

Sometimes identifying the initial starting events can help, because some have specific therapies as Travis and others have stated, but it reminds me of the diet question- it seems there are many different therapies and none work universally, and it becomes an exhausting method of seeing what sticks over the course of several weeks of bad sleep. Sleep medications are awful as Eric has mentioned. They all change sleep architecture (with the exception of maybe melatonin) which can provide hours of sleep, but tends toward non-REM sleep. Memory is impaired, in fact without REM sleep you probably won't remember what you had for breakfast the day before- it is when you take medium-term memories and "file" them into the longer learning framework. Eric, your statement about college students and "herbals" is going to be a big issue going forward, because these kids still have high neuroplasticity and they will acclimate to these chemicals like you did to benadryl as a kid, forever changing their chemistry. I predict an epidemic of bad sleep, and I am no prude on psychoactives, I have been around them my whole life. As an engineer I had "Burning Man" coworkers microdosing LSD and those that smoked weed or did a little coke at lunchtime (especially in the Netherlands but in NYC as well), and these led to the requirement for alcohol or "pre-workout" caffeine and ephedrine or some compensating chemical later in the day. In some ways people who don't sleep try to get a "sleep architecture" of mental rest followed by intense creative activity during the day to compensate.

There are a lot of good strategies on here. I don't poo-poo sleep hygiene, it is real. For those that are diligent about it and it still isn't working, I think the best method is to find a way to not stress about the bad nights. I have a couple nights a week that I get poor sleep (not like people are discussing here at this point), but if you are awake in bed- don't lie there tossing if you are not relaxed about being awake. If it is after 4AM I just get up and start my routine. Maybe as a bonus I can exercise before work, and make my family a surprise breakfast. I get whatever projects I can do quietly done to decrease the stress of them needing to be done when I get home. Sometimes I rotate the paddocks in the morning rather than after dark. Try to make lemonade when possible, and not obsess about the bad night which is hard because sleep deprivation leads to repetitive thoughts since you haven't processed them into the long-term architecture without REM. Sometimes a near-nap can help if you can pull it off, just dropping into a near-sleep state from awake for 15 minutes during the day to "file" what you can. I work shifts at night almost half the time and that's a mainstay that I supplement with a four hour "nap" during the day (which is my night that week).

The other option is that alot of people with insomnia are just night people forced into a day world. That isn't me, but I have a coworker that thrives at night, and dreads day shifts. He has found a way to make it work. It's rough on his family but nothing in life is perfect. It would be tough to farm at night I expect!

There are some exciting things being discovered with fMRI, and they may help with some therapies going forward. One of my tasks this AM is to catch up with a friend who is working on some of this stuff. I may be a test bunny for him. I know how I got here (markedly premature with months of no darkness as an infant) and that may lead to more specific therapies in the future. If we can match up fMRI patterns with successful therapies it would be highly beneficial.

The hard part is that poor sleep leads to high cortisol which (among other things) leads to weight gain and sleep apnea which leads to RLS which leads to poor sleep which.... Much of it is trying to duct tape over symptoms without really attacking the problem. Thanks for the good strategies on here, there are several solid ideas and each small advance is key. The idea of weighted blankets is really good. No significant downside I know of. Aromatherapy seems really promising. I would suggest if you are going to take melatonin, get a very expensive and high quality supplement, most "melatonin" sold in the US probably is corn starch- it is basically unregulated as a nutraceutical. I get mine from Germany or from one US distributor that make it in a pharmaceutical facility to pharmaceutical standards. It blows my mind people would bargain shop for a supplement and spend $1200 on a new mattress instead. Eric, if you have been on Ambien or  benzodiazepines for >5 years, you probably never truly remodel to the pre-benzo stage. Based on my interactions with people who have come off numerous chemicals, it is one of the hardest- so don't beat yourself up about it. You do a service to tell people your experience, because they are way over-prescribed in my opinion.
 
Eric Hanson
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TJ,

Excellent analysis and write up!  I think I agree with every point you made.  I say think because you had so much information that I would need to read again very closely to find even a minor point of disagreement, and I am writing this immediately after reading your post because I am highly impressed.

I will make one very minor modification to your statement, and the reason for this is really my fault and in no ways yours.  I never really got acclimated to Benadryl as a child.  I did take it for severe allergies, but my allergies were strictly seasonal, mostly being specific to ragweed for 6 weeks every late summer/early fall.  And I never took them regularly as I absolutely hated the side effects—tired, dopey, dull.  It clouded my mind and impaired my thinking.  If I took it at night, I felt awful in the morning due to lots of sleep in stage 4 and little if any in REM sleep.  Yuck!  I took it as rarely as possible, often preferring to suffer through sneezing, itching and the like rather than suffer Benadryl.  

Just to beat up on Benadryl some more, it always blew my mind that as a nation, we take alcohol impaired driving very seriously.  Alcohol is age restricted, driving under the influence carries severe penalties, your insurance skyrockets, and on and on.  But Benadryl (until very recently and only in some states) is completely over the counter and anyone can buy it!  If I had to guess (and this is only a guess), to compare for driving impairment I would suggest that for me, one 25 mg pill of Benadryl (the typical dose) is worth about 3 standard alcoholic drinks.  Now I certainly have never gone and tested this and I cannot cite a specific study, I am only basing this on how tired Benadryl makes me feel.

The one good note about Benadryl is that I no longer need to take it!  My allergies are still here, but today we have non-sedating anti-histamines.  I especially love Zyrtec as I think it works as well as Benadryl.  However, these new anti-histamines won’t cross the blood-brain barrier which means that while they will circulate throughout the bloodstream and counter the horrible itchy feeling, they won’t actually enter the brain and impair thinking (at least this is true for me).  To boot, we now have over-the-counter nasal cortical steroids that simply turn off the allergy response.  I have not had allergies in a little over 20 years thanks to Zyrtec and nasal cortical steroids and I have used barely any Benadryl in that time.

But again, everything you said really hits the mark, any misunderstanding in my fault. I wholeheartedly agree.

Eric
 
Stacy Witscher
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Eric - I would say that Benadryl can have different effects on different people, as all meds can. One of my kids has the same drowsy effect on all of the anti-histamines out there. Whereas I don't have the dopey tired effect from Benadryl at all, it just helps me sleep. It is over the counter both in California and in Oregon.

I would agree though that meds can permanently change one's body, particularly psych meds. I don't expect that my sleep with ever be "normal", but I have learned to live with it.
 
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