Before going for hardcore pharma and also since you don't have ME/CFS I would recommend working on other aspects of your health and lifestyle first.
Do you exercise regularly? If not you should and try to do fairly vigorous exercise it really helps with sleep.
I used to exercise 5-6 days a week very rigorously but recently discovered that I have low cortisol and hypothyroidism which I'm addressing before resuming my workouts. I've been doing tai chi when I have the energy.
Are you overweight or have a bad diet with a lot of sugar and bad foods? Do you drink/take a lot of stimulants? If so these should all be examined and improved. Do you have bad sleep hygiene? Have you gone to the doctor and examine other causes of poor sleep, such as endocrine abnormalities? There are so many things that can be improved.
I'm on a low lectin, epi-paleo diet, don't drink alcohol, drink lots of water, bone marrow broth in the morning, no stimulants, take supplemets that increase ATP in the morning like PQQ, MitoQ, NAD+, creatine, etc, try to get some sun every day, try to eat lots of DHA (ie live oysters, cold-smoke salmon, lamb chops).
sleep hygiene: dark, cool room, white noise machine, magnetical sleep pads, fasting after 6pm, TD magnesium, pre bed meal consists of magnesium calm, 5g ghee, 5g trehalose. 5g glycine, honey, l-theanine, uridine, one egg
anxiety reducers: low stress job, acupuncture 3 times per week, tai chi several times a week, meditation
I've been a poor sleeper since I was a kid.
Also there are so many other sleep meds that are not GABA agonists that you could try? Especially there are certain classes that increase SWS which we all want and many indirectly increase GABA without all the nasty long term effects of GABA agonists. These classes are:
- 5-HT2A antagonists (e.g. trazodone, remeron)
- GAT-1 reuptake inhibitors (e.g. tiagabine)
- α2δ ligands (e.g. gabapentin, pregabalin)
- MT1 agonists (e.g. rozerem)
- alpha-2 agonists (e.g. clonidine, guanfacine)
trazodone can lead to pripism so I won;t touch that
remeron I was considering once or twice a week but it leads to weight gain
gabapentin and pregabalin decreases spermcount, cause ED, and is antiandrogenic
rozerem is melatonin and it does not keep me asleep
I'll have to research alpha-2 agonists as I don;t know anything about them. However, I have low blood pressure as it is so I don;t think this med would be appropriate. Thanks
So I guess I'm left with rotating Phenibut, xyrem, remeron, and baclofen