How is your sleep hygiene?
Black-out drapes in your bedroom, no lights in bedroom, etc.
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Yes - read up on CBT-i
Can you try C.B.T.-I. without a provider?
A review of clinical trials found that self-directed online C.B.T.-I. programs were just as effective as face-to-face C.B.T.-I. counseling. If you are self-motivated, there are several low-cost or free resources that can teach you the main principles.
One option is the five-week program Conquering Insomnia, which ranges in price from about $50 for a PDF guide to $70 for a version that includes audio relaxation techniques and feedback about your sleep diary from Dr. Gregg D. Jacobs, the sleep and insomnia expert who developed the program.
You can also check out Insomnia Coach, a free app created by the U.S. Department of Veterans Affairs that can be used by anyone. It offers a guided, weekly training plan to help you track and improve sleep; tips for sleeping; an interactive sleep diary; and personal feedback.
Sleepio is another reputable app, Dr. Harris said. There are also free online resources from the A.A.S.M. and educational handoutsfrom the National Institutes of Health, which include a sample sleep diary and a guide to healthy sleep.
And for those who prefer to avoid technology entirely, more than one expert recommended the workbook āQuiet Your Mind and Get to Sleepā by Colleen E. Carney and Rachel Manber.
Full article: https://archive.ph/Aa8je
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CBT-I does not significantly improve duration of sleep, just less time in bed, what they call sleep efficiency. Because they tell you not to go to bed until 3am!
Then represent that improvement in sleep efficiency as evidence of effectiveness and say āit worksā. Heck, this paper has that in the title and acknowledges this: We know CBT-I works, now what? - PMC
In regard to total sleep time (TST), this measure has been reliably found to be the least affected by CBT-I6,12,20; only about 45% of patients exceed baseline TST at treatment end21. In the context of acute treatment, mean changes in TST are generally less than 30 minutes, pre-post change is less than 10%, and within-subject effect sizes are less than 0.522ā24.
What insomnia patients need is more sleep, not necessarily less time in bed.
Insane how it is touted as effective and shows no one reads the data and āexpertsā are caught in a circle of groupthink.
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45% is worse than I would expect from random chance!
I get upset about it because I had insomnia and it was one of the worst experiences in my life. So the experts say do CBTI, I look into it and theyāre like āso you canāt sleep and now have anxiety about not being able to sleep that makes it even worse, how about we make sure you feel even more terrible by restricting your time you even could get sleep to 4 hours? Donāt worry it works.ā Then I look at the evidence and it doesnāt even work! At best misleading and IMO actually lying on the part of these experts.
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I find that this one helps me if I really am having trouble falling asleep. I only take it when necessary so as to try to avoid any tolerance.
https://www.iherb.com/pr/now-foods-sleep-botanical-sleep-blend-90-veg-capsules/39374
Also take other things in the eve, Melatonin, Taurine, Theanine.
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adssx
#128
n=1 but my sleep was terrible at some point and CBT-I helped a lot. I used https://www.sleepstation.org.uk . I think itās worth trying and I recommend it to all friends and family.
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Davin8r
#129
Really? Because Iād consider quality more important than quantity. I feel much more rested after 7 hours of quality sleep than 8+ hours of tossing/turning with elevated heart rate.
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They could be lying. Ever more papers are being retracted because of plagiarism and manipulation of the data.
This is the latest from Harvard:" A review of alleged data manipulation in studies involving four top scientists at Dana-Farber Cancer Institute has led to plans to retract "
This is probably just the tip of the iceberg.
I donāt think the data is actually fraudulent, but presenting it as effective based on efficiency is very misleading when total sleep time is what anyone not getting enough sleep cares about
@adssx glad it worked for you!
Vulcan
#132
Two things help my sleep. The first is theanine. It is a GABA agonist. GABA is an inhibitory neurotransmitter. There are several Chinese studies showing that it is also a mast cell stabilizer which means that it can reduce cytokine and histamine release from mast cells. I take about a quarter of a teaspoon before bed.
The second is reducing histamine. I tend to have an immune response to a lot of things.
Histamine is an activating neurotransmitter as well as an immune system signaling cytokine. The best thing I found for reducing histamine is rupatadine. āRupatadine is a second generation antihistamine and platelet-activating factor antagonist used to treat allergies.ā
The antihistamine function block shistamine receptors and the platelet-activating factor (PAF) antagonist reduces the release of histamine. Note thereās some suggestion that a PAF antagonist also reduces the kind of overactive immune response that causes the cytokine storm that kills people with covid.
I usually sleep pretty well now without any of these things but when inflammation gets ramped up a bit, I will take theanine and rupatadine before bed. These usually get me through the night. When Iām in overactive immune system mode, they give me five or six hours of good sleep.
I can tell when histamine is high because I get a little wired and mentally clear and it keeps me from sleepingā¦
When histamine is generally high, Iāll take the normal dose of theanine and rupatadine at bedtime. Iāll also put a little cup with a couple theanine capsules, about a gram, and one rupatadine tablet next to the bed. When I wake up in the middle of the night to pee, Iāll take those and sleep until my normal waking time.
You can get theanine any place you get supplements. Itās very often a brand called sun-theanine and itās patented so a lot of supplement companies use this flavor.
Rupatadine is not sold in the United States. I bought it from Canada and Mexico where the price is pretty similar. Recently, I bought a couple hundred tablets from India and it was around a third of the price.
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I have lifelong sleep issues and have tried many, many things. Even with impeccable sleep hygiene, I generally need help a lot of the time.
As far as meds that work and are not detrimental to sleep, I think trazodone has to be one of the best. Although it is a histaminergic and adrenergic antagonist at low/moderate doses, at very low doses it is primarily a 5-HT2A antagonist, which promotes an increase in slow wave sleep; it even has significant 5-HT2A blockade at doses as low as a few milligrams. I donāt like the way antihistamines feel, but I donāt notice these effects below 10 mg or so.
I have also found cannabis to be very helpful, even with long-term use at low doses. Cannabis has also been shown to decrease REM sleep and increase SWS. I canāt find specific literature on CBN, but it has also been very helpful to me in promoting sleep without the level of psychoactivity of THC.
Also, as far as I remember in the literature exogenous GABA does not cross the blood brain barrier in any appreciable amount. Claims of efficacy may be more placebo related.
Valerian has some solid backing behind it in terms of efficacy, although sometimes with mixed results. One issue with Valerian is that there a number of compounds in the plant that havenāt been studied. In fact, one study suggests that valerian can be an agonist at adenosine receptors if extracted with aqueous versus non-aqueous solvents, in addition to itās modulating effect on GABA receptors. Some components may also antagonize itās sleep promoting function. Anecdotally, Iāve found that steeping the valerian root powder in water and then filtering it before drinking works better for me.
Lastly, I have paradoxically had success improving my sleep with moderate caffeine tolerance. My hypothesis being that caffeine tolerance upregulates adenosine receptors so that when tolerant, and a drop in caffeine blood levels by night, there are more adenosine receptors available for binding, thus promoting tiredness. This has worked for me for many years, although it obviously comes with the caveat that youād have to consume caffeine every day at moderate doses. For me this worked well above a tolerance of 100mg/day.
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Tim
#134
@sallyjane
I have found valerian to be useful in combination with a few other substances.
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Tim
#135
@melivelongtime
In addition to valerian, I take take several anticholinergics, which are strongly associated with cognitive impairment. But so is a lack of sleep. I also take 5-10 mg of THC and1 mg of Klonopin. Far more often than not, I sleep through the night.
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scta123
#136
THC is not legal where I live, but on recent vacation I tried it for sleep, on several nights I took a quarter of 25mg edible but my sleep was not refreshing, I slept trough the night but woke up with a strange feeling, similar to alcohol hangover, but no headacheā¦ also my apple watch recorded far less REM sleep on the nights I took it. It took me few hours in the the morning to start functioning properlyā¦ maybe if you take it regularly body adjusts?
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AnUser
#137
Whatās the point? The good part about THC is that it gets you high. I donāt think it helps with sleep, never heard of that. It should decrease REM sleep, but REM is important for most.
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scta123
#138
It certainly knocks you out.
I can confirm it helps you get to sleep and stay asleep, especially low dose, I am just questioning the quality of that sleep.
Well I tried it as I accidentally went to dispensary instead of grocery shop next door and was amazed by the array of choice. Drinks, salty, sweet edibles, inhalers, and assortment of strains. Like a kid in a candy store.
I have notoriously bad sleep if I drink any quantity of alcohol during the day, especially towards the evening. I tried it to see if it can compensate for that. The only thing it did, it kept me asleep for 8-9 hours. The rest of the markers, like HR, HRV, REM and personal feeling in the morning donāt support the use of it in my case. I tried it for comparison on non alcohol days too. Decreased REM significantly, maybe just one or two cycles in 8-9 h. I will rather keep it for occasional high.
AnUser
#139
Yeah I took way too much of edible once canāt recommend and luckily I fell asleep since the the feeling of being high seems to be able to scale to infinity. I had to lay extremely still since slight movement felt overwhelmingly (unexaggarated) intense. I did take it in the evening. The body high of edibles is nice though at an appropriate dosage.
I quit since I got bored of it though. I guess I used it too often.
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Vulcan
#140
I have to sa
The last time I had cannabis, I shared it with a woman friend who just flown in. After we got settled, she said she was having problems getting to sleep she didnāt want to take the cannabis she usually used for sleep on the flight. I got some from our hosts for her. I asked to share because I had not had it for 25 years. Instead of having a romantic evening, I promptly passed out. The next morning she woke up and said in a sultry voice, āWas it good for you too?ā
So I can attest that it helps me sleep.
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SNK
#141
Cabanis is obviously two types sativa and indica. One type helps you sleep, another one helps you stay awake. Tried (about 5 years ago) the sleep one and it did work 100% of time. I would sleep within 15 minutes of taking it. However, i hated the way I felt in the morning. I felt it was very inflammatory (even though I never inhaled more than three times, and that was enough to make me sleep. One joint would literally last me more than couple weeks).
btw, sex is from another planet (as in good) when doing cannabis, but not stoned completely as some do, but rather if you want to have the greatest sex ever just puff it twice (not more) about 10 minutes before the action, and youāll be on cloud nine. LOL
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Whatās the point? The good part about THC is that it gets you high. I donāt think it helps with sleep, never heard of that. It should decrease REM sleep, but REM is important for most.
The point is that it has been show to aid sleep and, unlike some medications (e.g. benzodiazepines), it doesnāt trade deep SWS or REM sleep for light sleep (N1/N2). So, even though it may decrease REM sleep, it is at least because it is providing more deep SWS (N3) sleep and not decreasing both. For me, this has made me feel more refreshed than not sleeping, and I have been able to use it long-term at low doses (i.e. not to get high) and have it remain effective.
Anecdotally, CBN is also sleep promoting for a lot of people, although the research is lacking. There seems to be possibly be at least one RCT in the works to test CBN for sleep. The upside is also that CBN is far less psychoactive than THC, though it is a bit more expensive because it is generally present in far lower concentrations in cannabis.
Also, cannabis/THC has a biphasic profile. Too much can cause severe anxiety and insomnia, whereas more moderate amounts (for your particular biology) can be relaxing and sleep promoting. Iāve definitely forgotten this fact once or twice, particularly with edibles, as have many others 
.
EDIT: Clarification that the initial positive impacts of cannabis on deep sleep (SWS) do not persist in chronic users, with multiple metrics of sleep quality negatively impacted by cannabis in long-term users. See reply/comment below.
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