I’ve been struggling with sleep issues for over a decade now. My Doctor has prescribed me all sorts of medication, all of which has had many adverse side effects. What I do know that works, is Xanax. My wife was prescribed it for some stress issues and occasionally will give me one so I can finally sleep. Obviously asking my Doctor, “can I have Xanax” Will not go well. I’ve eluded to it in ways and the response has always been along the lines of “that’s habit forming, I’d rather you try this”. Of the many medications prescribed, none have worked. Resorting to the dark web is something I’d really rather not do. Fentanyl laced drugs took my sister and it’s a road I hope to not have to explore. Any suggestions?

  • Boozilla@lemmy.world
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    2 months ago

    Apologies for giving you a boring canned answer when you are sleep-deprived and looking for help. But I swear these things really helped me.

    Number one: think about getting a sleep study done by an actual sleep doc (pulmonary doc or neurologist). This was life changing for me. Don’t go to a chiropractor or whoever the fuck and get a CPAP machine.

    Also, and this is important: Have you looked into tips for “sleep hygiene”? None of them are a quick fix like Xanax, but they can be powerful when used together.

    These include things like:

    • going to bed and getting up at the same times every day. this means getting up at your normal time, even if it’s a weekend, even if you didn’t sleep well that night, just make yourself do it
    • when sleeping…making sure the room is dark, cool, and quiet (ear plugs are a big help here). by cool, I mean 68-69F (about 20C).
    • cutting way back on caffeine and/or eliminating it…and absolutely no caffeine after lunch (the older we get, the longer it takes to metabolize caffeine)
    • not looking at any glowing screens (TV, phone, computer, tablet, etc) before bed time… for at least 15-30 minutes
    • avoid eating / drinking a couple of hours before bed time
    • using your bedroom only for sleeping and for sex

    And when you have trouble sleeping, it’s a very good idea to get out of bed, go to a different room (one that is not too bright) and do something boring like read a text book for 15-20 minutes then go back to bed and try again.

    When we stay in bed and aren’t sleeping, we’re training our brain that it’s OK to do that. You want to beat it into your subconscious brain that the bed / bedroom is for sleeping.

    • Boozilla@lemmy.world
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      2 months ago

      And I should have included exercise. The best sleep I ever get is when I get in a really good amount of exercise during the day. I won’t lie to you, I’m pretty lazy about it myself. You don’t want to do this close to bedtime, either. Go for a really long walk / jog / whatever in early afternoon if you can squeeze that in somehow.

      • GBU_28@lemm.ee
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        2 months ago

        Seriously. Nothing puts you to sleep better than 10 hours of hiking.

        Obviously that’s unattainable most days, but I struggle with insomnia all my life, and one of the things I look forward to most from backpacking trips is the restful call of sleep when I “actually” feel like I “need” it.

    • Anissem@lemmy.mlOP
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      2 months ago

      Thanks for the advice. There’s definitely some stuff here I can try. I have a stressful computer job so cutting back on caffeine makes sense along with several other tips you mentioned!

        • Anissem@lemmy.mlOP
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          2 months ago

          100%. It’s all I look forward to these days. I know that fact in itself is a huge problem though.

      • fine_sandy_bottom
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        2 months ago

        A few things to add to this great list:

        Magnesium supplement before bed. They’re not all the same. Don’t just take a pill. Get one of the proper powdered ones magnesium citrate or threonate. I really like this one.

        Also, pod casts and audiobooks. I use headphones and turn the volume down just far enough so I really need to concentrate to hear the words.

      • AA5B@lemmy.world
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        2 months ago

        Also the exercise thing. I find that when stress from the computer job is likely to keep me awake, a fast walk before bedtime is enough to help smooth that out

    • weariedfae@lemmy.world
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      2 months ago

      Caveat: doctors will only let you have a sleep study if they suspect sleep apnea. Other sleep studies that capture off-the-wall sleep disorders don’t seem accessible, at least in my local health system which is a Catholic-run local monopoly. Perhaps HCA, or Kaiser, or others may have a different philosophy.

      • GBU_28@lemm.ee
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        2 months ago

        This is not universal. I have average US insurance in Colorado and my GP sent me for a sleep study after we tried just a few things for my insomnia.

      • Boozilla@lemmy.world
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        2 months ago

        I wasn’t aware of this. That is discouraging. I think there are like 30-something sleep disorders. Though apnea is extremely common. Some insurance plans will also push hard for an “at home” sleep study first, which is fine if you just need a CPAP machine. But it’s no bueno if you need someone to monitor you and hook you up to all those Star Trek devices like they did to me.

    • Melobol@lemmy.ml
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      2 months ago

      To add to the ‘canned answers’ here is one more:
      As non medication, Magnesium has a muscle relaxation effect. With a big cup of water before going to sleep it could help falling asleep. (Tho make sure you are using the right kind of magnesium pill that actually gets absorbed into the body)

      • Onii-Chan@kbin.social
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        2 months ago

        Magnesium threonate cured my insomnia, it’s fucking wild how well it works. I’d tried everything until I discovered it, from melatonin, to antihistamine sleeping pills, all the way to downing 350ml of whiskey every night just to force sleep.

        Magnesium works better than every single thing I’ve tried (but you HAVE to let yourself fall asleep when you feel it starting to work.)

      • Boozilla@lemmy.world
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        2 months ago

        Thank you! Today I learned. (I’m usually kind of skeptical about supplements but what I’ve been able to find supports what you’re saying here).

  • skillissuer
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    2 months ago

    doc doesn’t want to perscribe you xanax because xanax will stop working and this fucks up many other things in the process

    • Anissem@lemmy.mlOP
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      2 months ago

      Ahh ok. That makes sense, while it works great, long term it doesn’t seem to be a solution.

      • TragicNotCute@lemmy.world
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        2 months ago

        It’s a really bad solution honestly. Benzo withdrawal can kill you and it’s extremely habit forming. Especially if you’re using it to treat insomnia, finding a way to stop taking it is gonna be tough.

        No solution provided, just giving some caution and saying that using Xanax to sleep is roughly equivalent to getting drunk to sleep. Both affect your GABA receptors and both are habit forming and dangerous to withdrawal from.

  • Apytele@sh.itjust.works
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    2 months ago

    Yeah Xanax is literally the worst thing possible for this, especially as a frequent thing. It’ll significantly worsen your sleep quality in the long run. (Hi I’m a psych nurse and I meet a lot of people stuck in insomnia hell because they’ve been slapping a Xanax bandaid on it for a few years while it just continued to devolve and now they’re basically psychotic because they never actually fixed the root issue.

    I’m also hearing a lot from you about medications and next to nothing about any lifestyle changes. No medication will ever actually fix this kind of problem. Medications just give you a leg up on fixing yourself.

    First of all what stimulants do you use, especially caffeine and nicotine? (I would also hope you already know to avoid meth and cocaine and not take stimulant ADHD meds at bedtime.) Are you avoiding them in the last 6 hours before bed? A lot of people (especially with ADHD) will say stimulants calm them down but what they’re actually feeling is a change from their baseline restless anxious awake to a focused, productive awake. The second one feels more settled, and can actually help you fall asleep briefly if the specific problem is difficulty holding still long enough to sleep, but it’s going to completely fuck up your circadian rhythm in the long run.

    Speaking of circadian rhythms, are you trying to keep your body in a steady daily routine? This includes a consistent bedtime, but your mealtimes and daily physical activity are part of your circadian rhythms too. There’s a lot of different schools of thought on how to time meals and exercise to best support sleep, but the general consensus is just don’t do either right before bed. I would also recommend adding a structured “wind-down” period to your nightly routine that takes 15-30 minutes where you do one of like three basic things:

    • something mind-numbingly boring

    • something you’ve always found soothing/comforting

    • Journaling about the day to give your brain a head start on the memory processing it’s about to do.

    It’s also very helpful to create full sensory environments that you use to trigger pavlovian responses. You know how pavlov’s dog drools when the bell rings because it’s used to food showing up when the bell rings? The biggest difference between you and a dog is that you get to decide what you want to be trained to do. The downside to this is that it can take a while to train these responses into your body, so be patient and don’t just give up after like a week. So you’ll want to create at least two full and distinct sensory environments. The specifics don’t matter as much as creating a consistent routine for yourself, but here’s some examples of things I’ve tried or seen people try:

    Alert

    • Sight: Curtains open / sunlight / full spectrum white light is the input that aligns most closely with most people’s existing natural rhythm.
    • Sound: Music, white noise of people talking in the background.
    • Smell: Essential oils are actually really good for training pavlovian responses in yourself because of how powerful scent memory is. A lot of people like to incorporate citrus-y smells for alertness, but personally I actually really enjoy just keeping my used coffee grounds from the morning in a cup on my desk. That also brings us to the next one…
    • Taste: Coffee has a pretty distinct taste that most people associate with alertness, and you can get a similar taste from chicory root and/or decaf coffee, but one real cup right after waking up shouldn’t mess you up too bad. Chewing gum is also an option, however.
    • Touch: The big one for me doing classes from home during COVID was still getting up and putting on “outside clothes” even if I was just sitting at the computer at home.

    Rest

    • Sight: usually red-yellow spectrum light, and much lower brightness around bedtime. You can turn on a red-shift filter for most electronic devices these days, and LED bulbs also often come in a yellow-orange incandescent style color (and a lot of hobby/makeup lights have multiple color settings for this reason as well, white for when you’re working, orange/yellow for resting/relaxing.
    • Sound: some people listen to soothing music, I conditioned myself to fall asleep to the sound of a raging thunderstorm because I sleep during the day and work at night, and the thunderstorm sounds easily block out daytime noises.
    • Smell: Lots of options here too for essential oils or other scented products. You could also use a specific lotion or wash your sheets in a specific scented detergent. A lot of people say they find lavender scents to be particularly soothing, but again, the exact sensory trigger isn’t important as much as you picking one to use consistently.
    • Taste: Herbal tea is my biggest recommendation here, but you could also go with a small snack/sweet as part of your nightly routine.
    • Touch: We already covered wearing different clothes, but some additional options include a weighted blanket or one of those compression sleep pods (I just got one to try out recently and like it so far!)

    Anyway like I said, these can take a while to train your body to do, so pick things that will be easy for you to do, set up your space to make it as easy as possible to keep doing them, and keep at it. The most important thing is consistency and routine.

    • Anissem@lemmy.mlOP
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      2 months ago

      Thanks so much for all this. I only intake caffeine, marijuana and alcohol. Going to start weening myself off coffee for sure and I’m always trying to minimize the other two. Going to spend some months this summer relearning how to live.

      • OhmsLawn@lemmy.world
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        2 months ago

        Alcohol used to wreck my sleep. I’d come home, dog-tired at 7 PM, have a few (and a few more) drinks, look up and 6 hours had passed.

        I ended up burning out, and having to quit both booze and weed. It was the best thing that ever happened to me. Along with all the obvious health, psychological and financial benefits, I sleep amazingly well now.

      • Apytele@sh.itjust.works
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        2 months ago

        I’m glad to hear that but how much alcohol? If you’re maintaining a constant blood alcohol level and get the shakes when you try to quit you should go to the hospital/ER and have them help you withdraw because those shakes can eventually turn into full blown seizures.

    • MrZee@lemm.ee
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      2 months ago

      Wow. I just want to say thank you for such a thoughtful, informed, detailed response. You are an amazing person!

      • Apytele@sh.itjust.works
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        2 months ago

        Ty! Sometimes it’s nice to give you guys tips because my patients usually just start swearing at me at the suggestion that they may have caused at least some of their own problems.

  • JimmyBigSausage@lemm.ee
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    2 months ago

    Here is my best suggestion and it is serious. NO CAFFEINE after lunch. Period. No naps. Go to bed early every night at the same time. Wake up early to start your day. Drink lots of water every day.

    • Maestro@fedia.io
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      2 months ago

      Als, your bed is for sleeping (and sexy times). No phones, no tv, no distraction.

  • ____@infosec.pub
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    2 months ago

    Are you seeing a family doctor, or a sleep specialist? You want the latter, and a sleep study.

    The classes of drugs that might help are imperfect at best, I’d be partial to a benzo before e.g., Ambien or related, given the inherent risks of sleepwalking and worse with those drugs.

    • Anissem@lemmy.mlOP
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      2 months ago

      I’m going to do a sleep study this summer. I have some months off so my plan is to focus on health and wellness.

      • fmstrat@lemmy.nowsci.com
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        2 months ago

        Good choice, and as hard as it is, trust the boring “drop caffiene” and bedtime advice. After a few weeks your body will acclimate to the timing, too. Honestly though, the best thing for me is a long weekend backpacking trip. After a day or so of strenuous hiking, and a terrible first night sleep, it’s like your body sees the sun set and is like “I’m done”. Can really reset your clock.

        • Anissem@lemmy.mlOP
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          2 months ago

          Thanks! Definitely going to ween myself off coffee this summer. Finishing up an edit gig now and it’s all that keeps me cranking