Mental Health Debilitating insomnia

kratnoob

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Aug 23, 2015
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Long story short, I've been using benzos and Z-hypnotics to treat insomnia for the past 5 years. Bad idea I know, but I really cannot sleep just laying in bed, and nothing weaker works. Melatonin does nothing and I seem to react badly to it which I understand is rare but nevertheless I do. I've tried meditation etc, works a bit but doesn't work consistently unfortunately. I have an essential tremor that keeps me constantly anxious and I also have palpitations.

My current routine simply goes like this: low dosage xanax for 1-2 days (0.5mg), which then doubles every 1-2 days to achieve the same effect until 3mg which is my personal max, I refuse to go higher. During this period I am completely productive and normal with my life. 7-9 hours sleep, focused during the day. Life is good.

After building tolerance to the 3mg which no longer does anything at all for sleep, I taper slowly (down 0.5mg a day on average until 0mg) and sleep once every 2 days. When I do sleep its for 4 hours usually. Incredibly fatigued, unproductive, tired. This will last a week (sleeping once every couple days or so), laying in bed for hours with nothing happening, until I begin on 0.5mg again once the tolerance is gone (usually takes 1-2 weeks). Back to a normal life again for a week or so.

Is there any alternative? I haven't found anything I can use to cycle with this, as even non-benzo Z-class drugs have cross-tolerance with GABAa. Besides, for me zolpidem is fantastic for visual hallucinations and talking to furniture but crap as a sleep aid for me. It works with sleep onset but duration is short, and heavy fatigue the next day. Not the case with benzos which work much cleaner. Did some reading here with some people recommending anti-psychotics. I'm not really keen on going that route due to potential mood changes. Kratom used to work well as a cycle however now, years later, if I so much as have a single whiff of the stuff I will vomit. I cannot even open a container of it to put it into a capsule.

Kava kava is restricted where I live, so a reliable import of it is out of the question. Any prescription only medication alternatives for cycling purposes? Preferably looking for advise from someone else who has been in my shoes as a chronic insomniac for many years but found a nice, safe, cycle regime to avoid tolerance? I'm guessing such a thing doesn't exist.

I get plenty of exercise and have a good diet. I don't believe that's the issue. I'm naturally anxious, have essential tremor, and worked night shift before for many years. Not sure if that combination somehow gave me permanent insomnia or not. Anyway just curious if anyone that has first hand experience over a period of years with chronic insomnia may have found a safe, reliable cycling regime to avoid tolerance to any one particular medication?
 
I've suffered from insomnia to a greater or lesser degree my entire life, but have finally got to grips with it in the last few years. I also had problems with anxiety and depression, so bad that I got medical help, except that it was worse than no help at all in the long term.
I could write a book on it, but tbh I don't think you're going to like my solution, you're way too trusting of the pharmaceutical industry's abilites and integrity.
Hmm, actually, if you can get hold of DPP-4, that probably would help, but it will take a long time for the effects cascade to get to dealing with the insomnia. I can't get hold of any, so I can't be absolutely positive it even works, but logically it ought to help.
Melatonin was very odd for me too, it actually highlighted another enzyme imbalance, (CYP1A2).
Another thing that helped a lot for the insomnia was inositol, also found in effective quantity in eggs.
For stress, lots of protein is good, but don't go for cheese, or coconut. Probably not soya either, but I have always avoided that anyway, so can't vouch for it either way, it's just something I came across reading related info.
Thankfully I couldn't get hold of benzo's, but I had them on my list of things that should help.
I can't get hold of kavakava, but I did benefit from other natural maoi's. I was given anti-psychotics and took them for some years, but against doctors recommendatiuns I ditched them as, although they did help me get to sleep and stay asleep, I still felt just as crap the next day. What's the point of sleeping all night if you don't function any better in the daytime?
Some months (nearly a year) after ditching them I realised that my brain fog was not due to increasing age, but was actually due to the b***** tablets!
Have you tried the over the counter sleeping tablets? The anti histamine types? They don't deal with the root cause, but they might help while tapering off the psychoactive stuff.
That's about enough for now, but I will add that I'm not on anything any more, and have gone from a bad night being lying awake all night thinking sweet hopefully sleep inducing thoughts, to a bad night being, 'only' 7 hours sleep due to waking up twice, and taking an hour to get back to sleep. Most nights I get closer to 9 hours, oh and very little daytime drowsiness, even after a bad night. HTH
 
Effective cycle for benzos for sleep? Not really, long-term. Some people seem to be able to take them for a while but I never found them particularly effective for my sleep beyond a short period. Same dislike of melatonin at multiple doses- doesn't agree with me. You can try from 300mcg to the higher doses. Long-term insomnia.

Sleep hygiene is always something to consider, especially if you are naturally anxious and already have diet and exercise covered. Screentime, giving room to sleep, thoughts around sleeping, light timing, space for meditation and relaxing activities, decompression.

OTC or relatively - chamomile may be similarly GABAergic. Valerian sometimes does well by people but has similar qualities and I'm wary long-term. Vitamins and supplements include magnesium (e.g. ZMA), glycine, etc...
I usually take magnesium but glycine actually makes my sleep worse, oddly. I've heard good things.

Suvorexant is newer and kind of weird. I don't know how I feel about it yet. Tried it a bit but I can't say I have a handle on what it is quite effective for, but some people like it.

Ramelteon is pretty much expensive melatonin and did not agree with me.

Don't know where you are but agomelatine may be available. Unsure about liver effects.

They do give barbs like primidone for tremor, but I don't know how readily they would do so at whatever age you are. Same with propranolol, though beta blockers can interfere with sleep for some. Decent for presentations though.

Gabapentin may be worth considering, if you haven't already. A2d calcium channels. May be covered and is third or second line for tremor as well. Not a fan personally.

For me, treating my depression and anxiety improved my sleep more than individual agents. I'm just on an antidepressant now and sleeping better. CBT for sleep actually has some decent evidence.

Antihistamines one-off you know what you get. Hydroxyzine is less muscarinic and has some of that 5-ht2a affinity too...but some people find it different.

I was on mirtazapine for a good while, it really did work and helped my anxiety significantly. Definitely an adjustment period though, can weigh into the next day at the beginning.

Similarly was on seroquel, helped for sleep but was not a good functional choice for me.

Not sure how some Maois would be that good for sleep for some, besides improving other areas. Marked REM sleep disturbance. I was on parnate, and while it was an effective antidepressant and my sleep eventually improved on it, it definitely interfered with sleep if I took it at some times.

Cheers- Best of luck!
 
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it may be directly linked to your regular benzodiazapines, they're very habit-forming and eventually you become reliant on a certain mindset to do things the way you typically normally do under the influence
 
You are absolutely right, Zonxx. Sedative/anxiolytic dependence is big even if other addictive characteristics aren't there. Can be too easy to get into bad sleep habits (and other habits) and compensate with a sedative (or other drugs), making a different mindset and even different baseline over time. Learned behaviors / adaptations.
 
The z-drugs aren't supposed to develop tolerance wrt the hypnotic effects. I think that they do, but not entirely. Benzos do, though, of which xanax is.

If you're using xanax for sleep, could it be that it's really anxiety that keeps you from sleeping?

Regardless, sleep is necessary. But you won't try an antipsychotic, even if it means sleeping or not sleeping? Some of the lower-grade ones, like seroquel, can offer a soporific effect without being too strong an antipsychotic otherwise. I think it may be time to see if this is a good option or not.

Trazodone is an SSRI that is highly hypnotic at doses far below that of being an SSRI.
 
If you really wanna sleep try Seroquel 300-600mg

Works better than lunesta belsoma Ambien benzos

It's the best trust me

Yes it's an antiphycotic but it'll put you to sleep within an hour or so

Not only does it drastically improve my sleep it makes me a nicer person as well
 
some people find low dose mirtazipine sedating. i take it for depression and it doesn’t do much more than make me hungry, so i don’t think unwanted antidepressant effects would be too significant a factor.
 
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No i know i wasn't reffering to you I just read an article talking bout ssri's making people sleepy ao I figured I'd add that to the discussion
 
Thanks for the suggestions guys/gals. Well time to go down the rabbit hole and experiment and see what works.
 
Hi everyone, I understand that this thread is more than a year old, but I really don't know who to turn to anymore. Recently, due to frequent stress, I began to have insomnia. At first, I didn't take it seriously, but now I feel that my body is exhausted. The only thing that helps me sleep is weed. I know it's terrible, but I really can't sleep without it. Because I'm bored at night, I started eating a lot and I now either smoke weed every night to get to sleep or stay up all night and eat a lot of food. I feel terrible because I don't get enough sleep. I don't even know which doctor to go to with this problem... I hope you can tell me how to stop boredom eating and how to change this habit...
 
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Promethazine 75 mg (anti-histamine for sedative properties), works great for me, better than Z drugs.
 
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