daridorexant looks very interesting to someone who has struggled with insomnia for years. However looks like medicare and my supplemental policy does not cover it. Looks like costs about $600 for one month supply out of pocket. What are people doing to get this cost down?
Sleep supplements are tricky, as a supplement that works for one doesn’t work for another. Just read this thread. Over the years I have tried many different supplements. Some work better than others; some do not work at all. One of the safer and cheaper ones that works quite well for me is doxepin. (Don’t confuse it with doxepine.) Cheap and available from India. It might not work for you, but since it’s cheap, it would be worth a try. The dose for sleep is 6 mg. But I get mine from India, and 10 mg capsules are the smallest that I can find. This is still a very low dose compared to therapeutic doses.
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I can’t take more than 3mg of doxepine, and I don’t clear it for 16 hours. (CYP2D6, why you gotta do me like you do…)
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And some, like magnesium l-threonate, knock out one person and keep another wide awake for the entire night.
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Well, I’ve tried Quiviviq and it doesn’t seem to work at all for me. But, I’ve still got a bottle of it. So, I’ll give it another try.
Paraxathine? It sounds like it’s better than caffeine. Do you have a brand you like?
GPT says doxepin at sleep dose doesn’t have the same risk as other antihistamine like Benadryl for early dementia, but I’d still feel a bit concerned.
Along these lines I’ve tried trazadone, and while it’s better than not sleeping at all, the “hangover” is so bad that it makes me think there’s no way this is good for our brain.
I’m very sensitive to caffeine (and reset my tolerance through breaks periodically), but I can take paraxanthine as late as 3 p.m. and have zero sleep disruption. I’m just using this.
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Get 50mg prescribed, GoodRX for $135, split the pill with a splitter that can handle odd shapes. See if 25mg is enough.
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As Desertshores said, people are different, and what works for one person may not work for another. When it comes to sleep aids, strong H1 antagonists such as Doxepin, Trazodone, Mirtazapine, Diphenhydramine, and Doxylamine all help me sleep. However, all of them except diphenhydramine cause almost intolerable side effects that persist well into the next day after I wake up.
Unfortunately, diphenhydramine (Benadryl is one brand name) is also anticholinergic, and there have been many studies suggesting an association between long-term anticholinergic use and an increased risk of early dementia. I suspect the other drugs I mentioned have not been studied as extensively for dementia risk. More broadly, I also suspect that many sleep medications in general have not been thoroughly studied for long-term cognitive effects, but that is only my opinion. So, I agree that the hangover effect you mentioned probably is not good for the brain.
For me, ways to overcome the next-day hangover effect include caffeine capsules, coffee, exercise, early morning sunlight, and occasionally Modafinil when needed. In addition, AgentSmith mentioned paraxanthine, which I plan to try as a substitute for caffeine.
My personal justification for using 50 mg of diphenhydramine for sleep is that, by morning, most of its effects have worn off. It has a shorter half-life compared with the other medications, and I do not experience nearly the same degree of hangover effects from it as I do from the others. However, I will sometimes use mirtazapine or doxepin when diphenhydramine no longer seems to work as well for me.
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3 things on my radar to try:
- Magnesium acetyl taurate Magnesium-acetyl-taurate superior to magnesium L-threonate? Recent study poinst to this being true
- Progesterone - Leads to allopregnanolone production in the brain via 5AR enzyme activity.
- Allopregnanolone - Direct exogenous free allopregnanolone or esterified allopregnanolone is very appealing to me. I made a post about it here: Parkinson's disease - #1123 by AustraliaLongevity
I’m also trialling high dose IR melatonin again.
I wasn’t sure if I was getting a cold, I went through all of the suggestions in the cold/flu remedy post and ran it through ChatGPT seeking the most up to date evidence backed remedies to kill a cold in it’s infancy, I did zinc lozenges and high dose melatonin among other things.
Honestly unsure if I did have a cold coming but it seems to be completely gone haha
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hallelujah I finally found my source of shitty sleep. It is the damn Cialis. Apparently, I started it a little over two years ago at same time as many other things and I’ve been literally tortured for over 24 months with most nights getting barely 5 hours, and this coming from someone that had slept for all my life straight eight hours every single night and never even having to get up to go to bathroom. Up to couple weeks ago I couldn’t put the two and two together since there were many thing I’d started at same time, plus anecdotally I’d heard as people get older the quality of sleep gets worse.
Anyway, I had some old Viagra 50mg pills and out of blue about two weeks ago I decided to substitute the Cialis 6.6mg (1/3 of 20mg pill) daily with Viagra 25mg daily (1/2 of 50mg pill) just to get rid of them. Literally same night I started it I had a better night of sleep, and gradually every night was getting better and now I’m back to normal. I feel so upset piece of shit, two tortured years.
Anyway, wanted to let you guys know that in case you’re having sleep issues and you are also taking Cialis, you may want to either stop it, or substitute with Viagra.
Apparently reddit is full of same insomnia stories from Cialis. I’m surprised no one ever mentioned it in these forums.
Cialis 5mg/Daily - Muscle Pain & Broken Sleep : r/CialisPills
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How is DMSA good for sleep? Where do you get it?
I don’t understand the how. I just know I got at least one great night of sleep per week. I generally sleep ok, this stuff adds a couple hours to your sleep. Good stuff.
I got it off ebay from a lab in England. I managed to lose their flyer that they would send with it. Can’t find them now. It came in packets of powder and I had to put it into capsules.
I noticed fullscript has it as a supp, but not available in the United States.
New stack is working wonders:
- 10g glycine
- 6g taurine
- 10-50mg melatonin
- 3g vitamin C
- 2mg GHK-Cu AM and PM, unsure if this is contributing but it certainly isn’t hurting.
Last night I took an additional 10-20g of glycine in a hot drink I made and I slept so good it was unreal. It’s making me consider increasing my glycine dose to 30g.
I ran out of magnesium. I’ll add it back in once it is delivered. Interesting that sleep seems better now than with magnesium glycinate in. Probably a coincidence as I’ve been tinkering with this stack for the last few weeks.
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Personally I find low-dose trazodone (25-50mg) one of the cleanest, safest sleep aids available. When I use it I have no morning “hangover” effect at all.
Gemni Pro:
When it comes to cognitive safety, trazodone is significantly safer than Benadryl (diphenhydramine). The critical difference between the two lies in how they interact with acetylcholine—a neurotransmitter essential for learning, memory, and clear thinking.
| Feature | Trazodone | Benadryl (Diphenhydramine) |
|---|---|---|
| Anticholinergic Activity | Negligible | Very High |
| Mechanism | Serotonin modulator; blocks some histamine receptors | Blocks histamine and acetylcholine receptors |
| Acute Cognitive Effects | Morning drowsiness, dizziness | Confusion, memory blunting, severe “hangover” effect |
| Long-Term Dementia Risk | No linked risk; may improve sleep architecture | Strong, dose-dependent link to increased risk |
The Anticholinergic Burden
Benadryl is a strong anticholinergic drug. It easily crosses the blood-brain barrier and blocks acetylcholine. This action is notorious for causing acute cognitive impairment—often described as brain fog, confusion, or a heavy “hangover”—particularly in older adults.
Trazodone, while also a sedative, operates primarily as a serotonin antagonist and reuptake inhibitor (SARI). At the low doses typically used for sleep, it blocks certain histamine and alpha-adrenergic receptors to induce sleepiness, but it has almost zero anticholinergic activity. It does not chemically disrupt the brain’s memory-forming pathways.
Long-Term Dementia Risk
The most significant divergence in their safety profiles involves long-term cognitive decline.
- Benadryl: Cumulative, long-term use of strong anticholinergics like diphenhydramine is heavily linked to an increased risk of dementia and Alzheimer’s disease. A landmark 2015 study in JAMA Internal Medicine demonstrated a dose-response relationship: taking the equivalent of 50 mg of diphenhydramine daily for over three years elevated dementia risk by 54%. The cognitive damage from long-term use may not be reversible even after stopping the drug.
- Trazodone: There is no evidence linking trazodone to an increased risk of dementia. In fact, some clinical studies at institutions like UCSF have investigated trazodone as a way to slow cognitive decline in patients with mild cognitive impairment or early Alzheimer’s, as it appears to enhance slow-wave (deep) sleep without the toxic anticholinergic burden.
While both medications can cause falls and next-day drowsiness due to their sedative properties, Benadryl actively suppresses the neurotransmitters required for sharp cognition, making it a notably higher risk for long-term brain health.
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I’ve been thinking of getting this to have it on hand. What is a good vendor for this?
Wondering what’s the rationale for 3g’s of vitamin C? Especially when it comes to being part of the sleep stack?
In the US, a PCP can prescribe it pretty easily. There is a service also called GoKick (https://www.gokick.com) that can prescribe it. For 30 days script, its was like 47 cents (US).
I happened to take it one night before bed after having an exceptionally hard work shift that finished really late after someone recommended I take it at that moment and it seemed to coincide with a good sleep along with the rest of the stack.
Maybe it does nothing for sleep. Maybe it does. I’m going to continue taking it for the time being as long as this overall stack works.
Working long hours and finishing late past midnight never causes me to have a good sleep by the way, this was not the factor.
Most of the efficacy outside of melatonin is from the glycine and taurine. At those doses they’re very effective at making me feel sleepy.
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