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Ways to get sleep. Methods, drugs, everything.

Discussion in 'General Treatment' started by redo, Mar 4, 2012.

  1. redo

    redo Senior Member

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    I'd like to invite you all to share your tips and tricks for getting sleep. It can be drugs, alternative remedies, methods - basically everything. I have severe insomnia at the time myself, so I hope we can make this into a through thread.

    Here's what I've tried, and know of. Please weigh in with your own experiences.

    Drugs
    Benzodiazepines. I've tried nitrazepam, flunitrazepam, diazepam, but they don't work very well for me. And on top of that they can only be used for a short period of time.

    Benzodiazepine like drugs. Ambien, Imovane. I fall asleep with them, but I keep waking up. They've only worked moderately well for me.

    Antihistamines. Alimemazine have worked wonders for me. I sleep well, I don't wake up, and it's really been great. But, I've built up a tolerance for it, so I have to go way beyond the normal max doses for it to work now. Hydroxyzine (brand names Atarax, Vistaril). Worked to begin with, but now I have a tolerance, and need to go way beyond the max doses for it to work. Dexchlorpheniramine (Polaramine), had somewhat of a effect, but less than the two others.

    Valerian (herb). Had somewhat of an effect the first day(s).

    Melatonin. I've tried Circadin, and other brands. Doses of 2-10 mg. Mostly 2 mg, but sometimes 10 mg. I've used it for over a year, but they haven't worked so well for me.

    Nosinan (levomeproazine). People tend to fall asleep of it, but they often get really spaced out the next day. It might work on a low dose. Or perhaps the hangover gets lighter if it's taken regularly.

    Chlorprothixene (Cloxan, Taractan, Truxal). People tend to fall asleep of it, but they often get really spaced out the next day. It might work on a low dose. Or perhaps the hangover gets lighter if it's taken regularly.

    Quetiapine (branded as Seroquel, Ketipinor). I know of a person who falls asleep with it (used off label as a drug for insomnia). He doesn't get a hangover from it.

    Amitriptyline. Has a good effect on some. Snowathlete has had great experiences with it http://forums.phoenixrising.me/show...g-for-the-first-time-in-my-life-Amitriptyline. The hangover gets lighter when taken regularly.

    Here's a pretty thorough list from Wikipedia of drugs which have hypnotic effects.

    Methods and appliances
    Get a slow breathing rhythm. Take long slow breaths, three seconds between them is an alright pace.

    Count. It takes my mind of other things. I normally think of everything I have done that day, and what I should do the next when I get to bed. Counting, 0-1000, helps to stop concentrating.

    Sleep in a new place. This has worked great for me. If I can't sleep for many days in my bed, and I am used to laying awake until early morning, sleeping in a new place, like the cough, can actually set the brain to sleep better than in a bed one hasn't got real good sleep in for a long time. Absolutely recommended.

    Daylight lamp. Many PWME are too sick to be outside and therefore don't get sunlight. Studies have shown that people who never get sunlight, often gets disrupted sleeping patters, and that some twenty minutes in front of a daylight lamp helps some. I've tried it, but it didn't help me.

    Real sunlight. Getting out on the porch, and getting some real sunlight. It has had some effect on me, but not great.

    Meditation. Has an effect on some. I guess it works much in the same way as other methods of getting the mind to not be so busy when lying in bed.

    Getting up when not being able to sleep. This is a recommendation I see time and time again. If one lies in bed for say an hour or so, one should get up, and do something else, and get to bed again when one feels a little sleepy. Problem is for me, I don't feel sleepy, even after a whole night or more of not getting sleep. It works I guess in a way that the mind doesn't become conditioned to see the bed as a place to lie and think, instead of a place for sleep.

    Not using the bedroom for work. For the same reason as for the latter. If the mind thinks of the bedroom as a working or leisure room, even if it's done in daytime, it can actually get a lot harder to sleep there.

    Ventilating. Get oxygen poor air out.

    Getting the temperature right. I normally sleep best if it's a little cold in the room, but warm under the blanket.

    Exercise. It helps me some, but is no magic bullet.

    Massage. Getting a massage late in the evening works well for going to sleep. But I keep waking up after I've fallen asleep (just like I do with ambien).

    Getting the right bed. Some sleep best in a hard bed, others in a soft. Buying a new mattress if the old one is worn out.

    Not concentrate late in the evening. To avoid mentally exhaustive tasks after say 6 pm.

    Getting it completely dark and silent. I've bought curtain which shut out all the light, and I use earplugs to not get any noise.

    I'd appreciate to hear from you what you do for sleep. Or to share it if you know of methods or drugs not covered here (I am sure there are plenty).
    taniaaust1 likes this.
  2. SOC

    SOC Moderator and Senior Member

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    I slept badly all my life; it's not just an ME thing for me. Before ME, I tried all of the things listed under Methods and Appliances with mild success. I would add 3 things to the list:
    Counting backwards from 100 (a modification of the counting strategy. It helped slow down my busy mind in a way counting forward didn't)
    Listening to audiobook. I have player that turns off in 60 minutes. I don't look at a clock if I'm not falling asleep; if I'm still awake when the book shuts off, I know I have to take further measures. I don't listen to new or exciting books. I stick to ones I've already read so they won't keep me awake following the story. :D
    Eating something small with carbs, like a slice of bread, right before bed. I have no idea why this works.

    I have been told that my sleep disorder includes both initiating sleep and maintaining sleep -- so a double whammy. Most sleep treatments only address initiating sleep -- something to consider if falling asleep is not your primary problem.

    The program that has worked best for me is:
    Tylenol PM (a mixture of acetaminophen (paracetamol) and diphenhydramine),
    Zyrtec (Cetirizine), and
    trazodone (but not the Pliva mfg generic -- I had horrible rxns to that). Occasionally, I have to add ibuprofen if I don't fall asleep for a long time.
    I also use listening to audiobooks to keep my mind from being too busy to sleep.

    The analgesics (acetaminophen, ibuprofen) and antihistimines (diphenhydramine, cetirizine) help me fall asleep quickly -- usually within 15 mins. The really winner for me, though, is the trazodone, which keeps me asleep all night.
  3. Jenny

    Jenny Senior Member

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    10 mg of amitriptyline has helped me, 4 hours before bed. Also zopiclone when I occasionally have problems in spite of the amitriptyline.

    Jenny
  4. Kina

    Kina Moderation Team Lead

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    For me it's diphenhydramine hydrochloride (OTC Sleeping aid) 25mg with 5-HTP 100 mg -- knocks me out and keeps me asleep.
    I just started this recently.

    Kina.
  5. justy

    justy Senior Member

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    Hi, this is a good thread. Everyone will have sucess or otherwise depending on what mixture of factors is causing or maintaining sleep problems. For me i wake frequently but have no problem falling asleep. At its worse i would sleep 20 mins then wake up for a few minutes then sleep 20 mins on and on all night. At the same time i would have a never ending cycle of extremely vivid or violent dreams or nightmares. I would wake up sweating, pounding heart, hyper alert etc. What helped the most with this was eating before bed to stabilise blood sugar levels as some of my symptoms were caused by hypoglycaemia (and adrenal exhaustion problems)
    I would eat half a banana and a small handful of almonds every night before bed - this started to help straight away.
    I also worked with a medical herbalist for the past 3 years, using calming herbs (valerian daily for 2 years low dose) as well as adrenal support and immune modulators.
    I cut out alcohol. sugar and caffeine a long time ago, but it goes without saying that they are a big no no (even in the day)
    I learnt to meditate and meditated every day for 20 mins as well as using relaxation visualisation tapes every day for half an hour.
    I learnt about not missing the sleep bus - sleep comes in 90 mins cycles so if i'm not asleep by 9 pm then it has to be by 10.30. If i miss 10.30 ill probably be asleep by 12, but if i miss midnight i get very overtired and will always be unable to get on the 1/30 am sleep bus and not sleep till 2 am. I try to be asleep by 10.30 every night.
    I learnt how to use sleep dreams to get to sleep. Basically choose a nice relaxing thin or memory and then focus on it. For me i would remember our last foreign holiday in the south of france and just imagine laying on a lounger by the pool in the hot sun. My daughter who is 8 likes to imagine me and her friend going surfing in Hawaii with pink surfboards in a pink jeep. (none of us have ever surfed or been to Hawaii) whatever works for you.
    Mindfullness breathing helps me to get back to sleep or go to sleep, especially if i am very overtired - which can make me horribly jittery.
    A friend with M.e gave me a tip for getting back to sleep quickly if constant waking is a problem. I give myself a rule that i must not open my eyes, and i focus back on the dream i have just been having, which always works to pulll me back into sleep.

    I did try Valium at one point but although i can use it occasionally during the day for dampening down overstimulation if i need to go on a long journey or something like that, i find if i take it for sleep it makes me very hungover and drowsy and doesnt keep me asleep all night.

    Sleeping in a different bed always makes it worse for me - i wake constantly, maybe 4 or 5 times an hour. My own bed, which is very large and very warm works best (firm but not hard mattress)
    All the best, Justy.
  6. redo

    redo Senior Member

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    Yes, 5-HTP, I forgot to list that. I tried it for a couple of days, but it didn't help me. I might have taken a too low dose, or done it for a too short period of time. Do you know if 5-HTP should be used for weeks or longer until it gets the best effects?
  7. mon me

    mon me

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    Eating something small with carbs, like a slice of bread, right before bed. I have no idea why this works.

    I read that eating a carb before bedtime stimulates the release of insulin which helps clear other amino acids that compete with tryptophan which allows more tryptophan to reach the brain which in turn increases melatonin and serotonin inducing better sleep.

    This works for me too.
  8. Calathea

    Calathea Darkness therapy

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    Good thread, and I like the way you've formatted it.

    Benzodiazepines - Temazepam works nicely, but I can't use it for more than 3 nights in a row, a few times a year. So it's more for coaxing my sleep pattern back into place than dealing with long-term problems. I occasionally use 2mg diazepam for premenstrual anxiety, or combined with co-codamol for pain, and I do tend to sleep a bit better after that, but again it's not something I would risk using regularly.

    Melatonin - the tablets didn't do squat for me. I'm guessing that this was due to blue light exposure suppressing the melatonin. Inducing my body to create its own melatonin by using darkness therapy works very nicely indeed. I've written an entire website about my methods for sleep at In Search of Mornings, and the main thing is darkness therapy. It's virtual darkness (blocking/filtering out blue light) rather than pitch black, in case you're wondering, so the main thing is wearing specs tinted orange for three hours before bed.

    Light therapy - bright light therapy controls the Non-24 Sleep Wake Cycle, although darkness therapy seems to do the same job too, I just happened to find light therapy earlier. Incidentally, 20 minutes is unlikely to be enough to have any effect, some lightboxes need to be used for anything up to 2 hours, and there are plenty of crap lightboxes on the market too. It can be worth checking that you've actually been doing it right. Dawn simulation makes it easier to get up in the morning.

    Antihistamines - no discernible difference.

    Gabapentin - slept like a log when we were increasing the dose, slept increasingly badly when we were decreasing the dose, appalling sleep once I came off it. Six weeks later, my sleep is gradually improving but still not back to normal ("normal" in this context being the reasonably good sleep I have been getting for the last few years due to darkness therapy, which is probably still short of deep sleep and so forth but does at least occur at the right times and for long enough). I'm wondering if it's interfered with my melatonin production somehow.

    Dark, silent room - essential, I've messed around with blackout blinds and so forth. Remember to avoid light exposure if you get up to use the toilet at night.

    Small snack before bed - don't always need this, but generally keeping an eye on blood sugar levels helps.

    Valerian - takes the edge off, sometimes.

    Z-drugs e.g. Ambien/Zolpidem - not going near those again with a barge pole after some nasty experiences involving hallucinations and being horribly stoned for the following week.

    Amitriptyline - makes my sleep worse, for some odd reason, plus I get GI side-effects.
    redo likes this.
  9. Dreambirdie

    Dreambirdie work in progress

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    What works best for me is:

    1000 mg of L-tryptophan,
    400 mg of magnesium,
    compounded progesterone cream from my naturopath,
    and a Chinese herbal sleep formula prescribed for me by my acupuncturist.

    If I wake up in the middle of the night, I find that it's best for me to stay in the same position I woke up in, not open my eyes, and refocus on the dream I was having just before I woke up. Staying in "right-brained" consciousness (non-verbal, visual, spatially oriented) is more conducive to sleep than being in left-brained thinking mode. If this isn't enough I do another dose of the above (minus the progesterone) and add some holy basil and a small dose of mb12 (250 mcg) to the mix.

    PS I noticed that Justy had the same idea about refocusing on the dream. Good to know it works for someone else too.
    Sing and justy like this.
  10. SickOfSickness

    SickOfSickness Senior Member

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    I have not figured out something that works for me.

    Tiny doses of medications work, but I get too many mood side effects, so I refuse to do that except rarely. Small doses of herbs help but they usually lose effectiveness and they only work sometimes. Other conditions have to be right.

    It helps if I did enough physical activity in the day, but if I did that much, I am probably going to hurt for 2 days. So that's not worth it either, unless I really needed to get something done anyway.

    One thing I usually do is mentally tire myself out and make my eyes tired from reading. Then while in bed, I have to do something to occupy my mind, but yet be tiring. Something like reading but I don't read, I do easy (not too easy) activities on the laptop, until I am seconds away from falling asleep. I still have trouble but it helps some days.

    The other thing I used to do, but don't anymore, is eat foods I am sensitive or allergic to. Lots of them make me sleepy. I also have to avoid some foods that make me more awake.

    Avoid caffeine for 5-6 hours before trying to fall asleep. Also avoid chocolate and tea for a while, and sugar for a short time. Sugar I used to also use, relying on the crash about 40-60 minutes after I had the sugar. (First there would be a burst of extra energy.)
  11. Sushi

    Sushi Moderator and Senior Member Albuquerque

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    • LDN (once I got up to 3.5 mg)
    • catnip tincture--a fairly high dose seems to calm the sympathetic system
    • a "comforting" daydream
    • theanine
    • GABA
    • And many of the other things that have been listed help me too

    Oh, and eating before bed probably draws blood to the stomach and thus away from the brain.

    Best sleep wishes,
    Sushi
  12. taniaaust1

    taniaaust1 Senior Member

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    I dont usually have trouble staying asleep but rather getting to sleep. My sleep issues are
    1/ circardian rythm issue of reversed sleep cycle
    2/ my brain also has trouble going into the right brain wave states (I have abnormality on my EEGs when I shut my eyes..my brain dont go into the normal state)
    3/ I also think I have non-24hr sleep/wake cycle..a cycle which is over 24hrs.

    Diazepam didnt help me at all with sleep either.

    It works well for me too but the thing is it can only be taken a couple of times a week. Ive developed a tollerance to the origional dose I was on.

    Antihistamine (Doxylamine Succinate) works as well for me, almost as well as Tempazam (I take it with melatonin). Issue is after a few weeks Ive developed a tollerance to my original dose.

    Valerian does nothing for me.

    Circadin didnt work well for me..
    Slow release melatonin I took dont work well for me, Ive had more success with normal release melatonin. I found that once one has found a dosage which works, increasing it dont help it to work more eg if I get some result at 2 or 3mg iincreasing to 6mg provides no extra bonus.

    Melatonin is said to only help sleep by 1 and a half to 2 hrs and that is only if one has circardian rthym issues (otherwise taking melatonin wont do a thing). eg if one has a normal sleep time of 9.30am.. using melatonin may be able to bring ones getting to sleep time to 7.30am. Hence for any severe sleep issues it needs to be used in conjuction with other things.

    I was given Seroquel for sleep at one point and it didnt help me to get to sleep, it just gave me terrible mind fog and made me feel horribly dazed... and when one FINALLY does get to sleep (as it didnt work for that).. I then woke up terribly hungover and unable to get out of bed at all (after effect of extreme lethargy). It really felt like it was doing some damage to my brain.

    counting sheep or counting backwards dont help me get to sleep at all. I once counted back from 1000 and was as awake as I was to start with and by that point EXTREMELY frustrated as it was such an effort to keep counting.

    Ive had no luck with that.

    No affect on me.. Ive many a time meditated ALL night until daylight with no success. (Its not racing thoughts which keep me awake as I can still my mind right down but still not be able to sleep).

    That "can" help me "at times".. but only if its frustration with not being able to get to sleep which is helping to stop me from getting to sleep. By getting up to do something else it is also providing some activity.. activity tends to help tire me so can help for that reason too.

    same here.. I need to be warm but coolish room for best sleep.

    me too. Thou if I overdo it, well then my sleep will be worst. There is a very fine line with how much exercise I need to do to help me sleep. (by exercise in my case its just housework).

    That dont seem to help me get to sleep. (probably cause Im very good at relaxation and meditation myself and can get myself in a relaxed state easily thou it still dont help me to sleep).

    Comfort is essential to having the most hope of getting to sleep

    I cant sleep unless it is dark and silent, the exception is like white noise or tv I arent really listening to, I fall asleep easier to background noise I arent listening too. (If anyone is doing anything outside it keeps me awake).

    I tend to do things eg watch TV (something not too exciting and not scary.. no adrenaline rushes) till I fall asleep as if I TRY to go to sleep, it seems to stop me from getting to sleep.

    1/ I found that trying to sleep with the electric blanket on was making my sleep issues worst but I didnt realise that until I stopped using it at night. (Im obviously sensitive a bit to EMF as far as sleep goes).

    2/ I need to avoid the computer at least 3 hrs before I try to go to sleep (maybe that is another area EMF was affecting me?)

    3/ Snack before bed (other wise I can wake up hungry)

    4/ With my reverse sleep cycle I became more active at bedtime. I have to fight that and make sure I dont start doing things like housework at that time or otherwise it prevents me from sleep.

    5/ Try meds in combinations when one has no luck individually. (Ive found that meds tend to work better when doing that, eg taking melatonin which wasnt doing much, helps the anti-histamine work for me quicker and better in combination).
    Doing a certain amount of activity during the day thou can help me to get to sleep that night.
  13. redo

    redo Senior Member

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    Prothipendyl. An anitpsychotic used by some ME doctors with good effects on insomnia. 0,5-1 tablets before bedtime.

    Mianserin (brand names Bolvidon, Depnon, Norval, Tolvon). A tetracyclic antidepressant which may work very well for sleep. People tend to begin low in dose, and work their way up. I've tried it, it worked alright, but I got really high AST and ALT levels, and low levels of neutrophil granulocytes and red blood cells, so I had to stop...
  14. Sallysblooms

    Sallysblooms P.O.T.S. now SO MUCH BETTER!

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    I just needed to balance my hormones. That's it. :D
  15. PhoenixDown

    PhoenixDown Senior Member

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    How do you know it was the EMF and not something else about the electric blanket? Can you recreate the effect by using a stand alone device that puts out the same EMF frequencies?
  16. svetoslav80

    svetoslav80 Senior Member

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    Eating 3 hours before bed is the best "medicine" i've found so far. Other ideas are to exercise (if possible), and not to sleep during the day. St John's wort also helps me a lot.
  17. Phil

    Phil

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    Hi,
    I've gone from lifelong difficulty getting to sleep to very seldom having a problem. I did not use regular or alternative sleep methods. I never ever used drugs for sleep. I practiced a number of approaches that helped me to experience myself more as a whole body rather than experience myself mostly out of my head (or mind or thoughts if you like). These approaches helped me in various ways - getting to sleep was one of them that was sorely needed. Here's what clearly helped me plus a couple of areas with multiple methods in them that I'm pretty sure helped significantly too - they just were not done in such a way as to be so clear cut in their sleep benefits.
    Les Fehmi's Open Focus - Maybe best single approach I ever did for myself.
    http://www.openfocus.com/
    http://www.amazon.com/Open-Focus-Br...6120/ref=sr_1_1?ie=UTF8&qid=1331052788&sr=8-1

    Eeman screens (aka BioCircuits) - This is a rather out there kind of thing and maybe it does not work for the
    reasons it's thought to work but work for me it did. L.E. Eeman was a
    fascinating pioneer.
    http://www.amazon.com/Biocircuits-A...=sr_1_1?s=books&ie=UTF8&qid=1331053448&sr=1-1
    http://altered-states.net/barry/newsletter525/index.htm - I list this source
    as I see that they have all 6 copper pads and all copper connections.
    Both are important and both what Eeman was using in his last years as
    best we can tell. Some other sites have similar ones but are overpriced.
    http://www.quantumbalancing.com/biocircuits.htm Make your own

    Various forms of biofeedback, body work, body sensing techniques and also work with trauma (particularly with emphasis on the body in trauma). I cannot quantify how much these techniques helped with sleep but I'm betting that in general they did.

    Several of the above are cheap. Biofeedback , Body work, trauma work are not. Though David Berceli's trauma releasing exercises can be done on your own and are therefore cheap (and effective). Body sensing is essentially free. Open Focus and also BioCircuits are quite inexpensive.
  18. ahimsa

    ahimsa Senior Member

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    for patients with orthostatic intolerance (specifically NMH)

    I have no idea whether this is true for all patients with Neurally Mediated Hypotension but here's my experience for what it's worth.

    Extra rest
    Resting all day is guaranteed to make my sleep better (still not great, but much better). Repeat for a few days in a row and I'll get a better night's sleep.

    Avoid NMH triggers
    Anything that triggers my NMH (standing, heat, too much exertion, forgetting to take my midodrine) makes my sleep worse.


    Details:

    I had wonderful sleep before I got sick. I was one of those people who could fall asleep in a few minutes and stay asleep all through the night, every night. I could sleep through anything.

    After I got sick, I still had pretty good sleep for a few years. Gradually my sleep quality started to get worse. I still fall asleep within minutes. No problem with worrying or thoughts running through my head. That's just not my personality (I'm know that I'm lucky because my husband has this problem - he's had some luck using RescueSleep).

    My problem is waking up during the night. I have no idea why I wake up. I wake up, wonder why I'm awake, roll over, and go back to sleep within 5 minutes. On a good night, if I've rested 2-3 days in a row, then I will wake up only about 4-5 times during an 8 hour period of sleep. On a bad night, I may wake up 12-14 times a night. So, I'm sleeping for roughly 1.5 to 2 hours at a time on a good night and 20 to 40 minutes at a time on a bad night.

    I do know that it's not apnea because I was tested and didn't have that at all. I had a brief period where I was waking up and my heart was beating fast (posted about this on the forums a while back) and I thought it might be apnea. So, I had a sleep test screening that ruled out apnea. But most of the time when I wake up it's not a nightmare, there's no heart pounding, and there's no pain. I just think - "Huh, I'm awake. I have no idea why. I'm sleepy. ZZZZZZZZZ"

    I added my experience with extra rest helping my sleep because it is so counterintuitive. Most healthy, normal people (including myself before I got sick) generally get better sleep if they've have a day of exercise (unless there's unusual amount of muscle aches and pains). But for me, I know that if I want to get a good night's sleep I need to rest as much as possible. And I need to remember to take my midodrine (vasoconstrictor) during the day.

    I'm pretty sure it has something to do with my messed up autonomic system but I don't understand the mechanism that interferes with sleep.

    Of course, if all I did was rest all day, every day, I would go stark raving mad. So, I try to find the right balance between rest and activity.

    Edit: I forgot to mention that I don't actually take any sleep medications at all. And my afternoon midodrine dose has worn off long before I go to sleep (lasts only for 4 hours). In fact, they warn you to make sure you take the last dose at least 4 hours before going to bed to avoid having your blood pressure rise too much. So the midodrine is not helping my sleep directly. Taking the midodrine during the day helps to minimize the NMH symptoms and that helps to eliminate whatever it is that is interfering with my sleep.
  19. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    I have found a nice quick wallop with a sledge hammer is the most certain way to get a nights sleep, its alot quicker then banging your head against a wall, he he he.

    cheers!!!
    taniaaust1 likes this.
  20. SOC

    SOC Moderator and Senior Member

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    Now why didn't I think of that? [smacking forehead] :D

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