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