For insomnia, the medication that doesn't disrupt sleep architecture is trazodone

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What is your experience with trazodone for insomnia? As you know, trazodone has a half-life of 5-6 hours, so it doesn’t cause drowsiness the next day. It lowers cortisol through 5-HT2 receptor antagonistism and increases non-REM stages 3-4, which are deep sleep stages. It doesn’t suppress REM sleep. It has no anticholinergic effect, which makes it a good option for chronic use. Also, recent studies show that it clears misfolded proteins in the brain. Are there any similar good sleep medications?

https://www.sciencedirect.com/science/article/abs/pii/S1389945703002065

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1/2 life of 5-6 hours doesn’t mean it doesn’t cause drowsiness. That is actually pretty long for a sleep medication.

Roughly 40% is still around when you wake up which is certainly enough to cause drowsiness if that was going to be an issue.

It seem like the neuroprotective data is all animal and fairly high dose relative to what humans do for sleep.

The DORA class has human data regarding tau phosphorylation and reduced amyloid beta levels. Whether this is helpful is unknown.

People have good reports here from both for sleep. They both are better than alternatives for sleep when it comes to sleep quality and neuro concerns.

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This hasn’t been peer reviewed yet but is quite interesting.

Chronic trazodone treatment consolidates sleep, improves memory, and reduces amyloid pathology in a mouse model of Alzheimer’s disease.pdf (4.7 MB)

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I used trazadone for a while (post ambien and thc) and it worked well for me.

Fortunately, rapa somehow cured my lifelong insomnia, so I don’t use it anymore, but if I did, I would not hesitate going back.

I have not tried DORAs, but if one tolerates them, they seem interesting to me.

PS, LDN also helps my sleep. It went from it being great once I started rapa to off the charts with the addition of LDN.

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IMO: Based on my own experience. Trazodone is a “clean” sleep aid with no detectable side effects. For sleep, its main use is to reduce sleep onset time. When I use it, it has zero morning drowsiness effects.

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FWIW, when I have used Trazadone for a few days in a row (on a trip), coming off of it caused mood issues. I suspect some sort of withdrawal effect. I would have a low mood for no reason, and taking Trazadone again would resolve it. Go figure. I don’t use Trazadone for more than 1 day in a row now, and rarely that.

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I used Trazodone for a while. Found it difficult to come off. Now using only melatonin, magnesium glycinate, TMG and Delta8 Hemp gummies for sleep. Sleep is sound, infrequent awakenings, 1 to 1.5 hours REM and SWS.

My husband has started Trazodone. 50MG and he sleeps soundly through the night but foggy the next day. 25 mg and he wakes up a few times but feels fine the next day.

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How is your deep sleep using this protocol? I’m curious if any of these supplements may have any impact on deep sleep.

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RapAdmin: My deep sleep averages about an hour, with little variation. Have been tracking with an Oura ring and a Fitbit for over two years. (They usually are close but not in total agreement. Usually Oura reports higher SWS but sometimes the Fitbit does.)

I cannot cleanly isolate the impact of various interventions, but I think that the greatest impact is having total blackness and a cool room temperature. Also, not eating for several hours before bedtime, and no alcohol. Among the supps, well, I think the hemp gummies have a pretty big impact.

Have made a couple of changes recently: (1) taking 4.5 mg LDN and (2)moved bedtime one hour later. Cannot really tell if the LDN is helping sleep but knees feel better (but: confounder: have also been doing more resistance training for legs). However moving the bedtime an hour later (from 9:45-10:00 to 10:45 - 11:00) does seem to have been good for both my husband and me. We are very consistent about getting to bed the same time every night (research has shown that timing consistency might be the most important factor for good sleep). But the Oura ring had always alerted that the “midpoint of your sleep was one hour ahead of your chronotype”). I think that the new later bedtime just feels better and my husband agrees.