I got off mirtazapine a couple months ago and the good news is only one consequence, which is insomnia. However, it has been tough to shake. I am trying hard to avoid dependence on OTC sleeping pills, which often seem to be anticholinergic (like mirt). For instance, Diphenhydramine works, but I do not want to take that consistently. I have tried Ashwaganda, glycene, taurine, melatonin, and a couple of other things, but so far no success in really getting back to 6-7 hours of mostly continuous sleep.
What do you all take (prescription and non-prescription) to induce a good night’s sleep, both in quantity of time and quality (for instance more deep sleep)?
Good sleep hygiene and more than 10 000 steps a day… Not habit forming per se, but needs to be a habit in order to work.
Not dangerous, given that you’re not overly fragile or sick.
I would be interested too. Apparently slow wave sleep (SWS) is supportive of the glymphatic system (the brain’s sewage system) and the more of the SWS you get the better. I’ve checked my sleep tracker and I’m not getting enough. My research led me to some prescription drugs, but they appeared to have the risk of habit formation (and I want the option to sleep without them, which would be removed.)
I’m also on glycine, taurine and melatonin. I came off ashwaganda, but can’t remember why - it was probably a contraindication for drug availability of something else I’m on. Its hard to keep up
The key to Melatonin is timing. Best not to use it to get to sleep. It will truncate sleep. Time release is another issue.
I exercise vigorously about five to six days a week. The only thing that appears to make a major difference is yoga. But I am sure that exercising is better for sleep than not.
When best to take it do you think?
If you wake in the middle of the night (sucht that you ordinarily would stay awake) assess when the next sleep cycle might start and take it on a few occasions about hafl an hour before that, then 15 mins then when the cycle should start. Cycles take around 90 mins.
Disappointing paper: the main thing I took away was 'if an intervention made you more chilled out, you reported sleeping better"
I am trying to use this approach. Thanks for the tip. Also I have stopped all nighttime supplements before bed as a part of my polypharmacy reduction plan.
But, if I wake up early I will wait for the sleepiness to come back before (maybe) taking melatonin. I have tried to force sleepiness with melatonin; I get sleepy but no sleep comes of it.
Efficacy of dietary supplements on improving sleep quality: a systematic review and meta-analysis - PubMed (nih.gov)
FULL TEXT: Efficacy of dietary supplements on improving sleep quality: a systematic review and meta-analysis | Postgraduate Medical Journal | Oxford Academic (oup.com)
Conclusions: Amino acids, vitamin D and melatonin supplements were significantly beneficial to improve sleep quality. However, high heterogeneity and wide confidence levels were observed in vitamin D and melatonin. Further research on the effect of magnesium, zinc, resveratrol and nitrate supplementation on improving sleep quality is required.
The Amino acids they refer to seems to be tryptophan:
Interaction between melatonin and nutrients on sleep regulation
Melatonin is a hormone that is involved in regulating sleep cycle and has strong antioxidative effect. While poor sleep quality may be attributed by increased oxidative stress,43 melatonin increases the superoxide dismutase (SOD) activity that prevents damages to cell membrane under oxidative stress.44 Given the roles of melatonin in sleep regulation, it is not surprising to see its impact on better sleep quality. Moreover, omega-3 with melatonin can provide antioxidant effect by increasing SOD activity remarkably in human body.45 Amino acid tryptophan can regulate sleep and circadian rhythms as it increases melatonin level by being a precursor for endogenous melatonin synthesis.46 Magnesium can enhance the activity of serotonin N-acetyltransferase, which is an enzyme required for melatonin synthesis.47
On the other hand, epidemiological studies suggest how vitamin D deficiency can lead to poor sleep quality. A meta-analysis including six cross-sectional studies, two case–control studies and one cohort study, which mainly used 20 ng/mL as the vitamin D deficiency cut-off value, reported that vitamin D deficiency had an inverse relationship with increased risk of sleep disorder.48
Vitamin D receptors were found in brain areas of sleep regulation, such as the anterior and posterior hypothalamus, where pacemaker cells essential in maintaining sleep were present. Furthermore, vitamin D can stimulate tryptophan hydroxylase-2 (TPH-2) which expresses a vitamin D response element at the gene level. Vitamin D can thus regulate tryptophan conversion to serotonin to produce melatonin.48 49
Magnesium can influence the concentrations of cytochrome P450 (CYP) enzymes, which is involved in the activation (ie, 25-hydroxylase and 1α-hydroxylase) and deactivation (ie, 24-hydroxylase) of vitamin D. Both 1α-hydroxylase and 24-hydroxylase are magnesium dependent, therefore, magnesium influences vitamin D concentration by affecting biomarkers of vitamin D synthesis and metabolism.50
Not sure I am getting this. I am trying to stick with a sleep schedule of 9:30-10:00pm to 6:00am.
So I should take 30/15/zero minutes before bedtime?
Its best to use a fitness tracker to work out the timing. Different people’s sleep cycles will be at different times and different lenghts, but start with an estimation of around 90 mins. The main thing is not to expect to go to sleep in 20 mins.
I don’t take any melatonin before going to bed. I only take it either to extend sleep or when I have woken to maintain mitochondria in all cells.
I sleep 7-8 hours on melatonin and glycine. It’s important to go to bed at 9:30 pm, and fall asleep by 10. If I go to bed after 10, I have problems falling asleep. Valerian 2 hours before going to bed helps much too.
A friendly warning: melatonin is not good for everyone. I’ve tried every dose and timing, SR & immediate release, high and low doses, and I always sleep worse. At high doses, I’ll also spend the next day feeling like the skin all over my body is too tight.
YMMV, and probably will.
But me? I no longer touch the stuff. Tryptophan and 5HTP, yes. Melatonin, no.
How much tryptophan are you taking? I take approx 60 mg during pm hours.
I have not tried tryptophan yet. Is it effective for you?
My next thing is to try GABA and 5-htp in conjunction. Has anyone tried either of these?
I take tryptophan to increase serotonin after viral infection. It does help with overall wellbeing, including sleep. The amount I take is very small. It comes in 500 mg capsules and I take approx the fifth of it under the tongue with coffee. Valerian root extract also helps.
That could do, but I’ve sometimes felt that resistance training, especially heavy, low rep sets, later in the day, can activate my nervous system so that it gets hard to sleep.
While walking and running in zone 2 always just makes me tired.
I think the low intensity, and repetitive movements helps the nervous system to relax. Outside you also have a chance to get daylight that helps resetting/strengthening the circadian rhythm.