meds for deep sleep

[heapsreal]

I know there are meds that supposedly help with stage 3/4 sleep or dont interfer with our sleep cycles but has anyone seen any studies involving med combinations like a benzo(which is suppose to interfer with deep sleep) and avanza/mirtazipine which can enhance deep sleep, there are lots of other combination but just wanting some actual info on this.
In my case avanza by itself doesnt help me much but when i use a benzo with it like valium i do feel like i sleep better then with valium alone. I will note that i do rotate bewteen a few meds to avoid tolereance and have used combinations as well under my docs advice.

cheers!!!

 

[urbantravels]

I took Ambien for a number of months but it doesn't stick to my ribs at all: its short half-life seems to be especially short in me. I would wake up at 3 am in full wired/tired red alert mode and take another. And my sleep wasn't deep, it felt restless and unsettled.

What finally has worked for me: Alprazolam (Xanax) 1 mg and Trazodone 100 mg. I am pretty consistent getting 7-8 hours on this combo, and it feels as if it's been reasonably deep. I think the alprazolam helps put me to sleep and the trazodone deepens it/normalizes the sleep cycle. I was originally started out on trazodone alone, a lower dose, but that didn't ever seem to *put* me to sleep; the combo of a benzo + alprazolam seems to put me to sleep and keep me there.

 

[August59]

My sleep doctor still swares by Trazadone, but he requires of the patient that they take their dose at least 2 hours prior to going to bed because it doesn't start promoting "deep sleep" until it's 4th through 7th hour after taking it. I'm geussing the half-life is a little long. He has given many lectures to neurologist about why it needs to be taken this way. The down side is that I can't take because of an allergic reaction (nose swells shut) and this is a pretty coomon occurence. Dr. Lapp told that his wife tried and the exact same thing happened to her.
There is always Xyrem if you can get it prescribed.

 

[heapsreal]

in australia i think it will be years before something like xyrem comes here and if its already here it would be priced out of my league.

 

[Alesh]

I think mirtazapine is a very good drug for one's brain: neuroprotective, neurotrophic, nootropic... But it gives me unpleasant cardiac arrhythmias.

I am using 50-100mg of quetiapine (Seroquel). It has shorter half-life than mirtazapine but it's a 'nastier' drug.

It would be interesting to try agomelatine.

 

[SOC]

Dr Lapp recommended Tylenol PM to induce sleep and trazodone to maintain sleep. I've never slept well (including during childhood). Other docs prescribed xanax and other anti-anxiety and antidepressants, but none of them did much for my sleep. Dr Lapp's Tylenol PM and trazodone have been miraculous for me. Falling asleep in less than half an hour, sleeping all night, and dreaming like normal folks is a wonderful thing!

 

[heapsreal]

i use seroquel as well but find i get a very restless sleep , i feel achey all over but have found if i take a low dose of a benzo with it i then sleep really well, i think seroquel is a good drug for hard core insomniacs, i use it probably twice a week. other days i use hypnodorm(the supposed date rape drug rohypnol) which is quite relaxing but doesnt turn the lights off but with avanza i sleep very well , zopiclone is another med i rotate between which seems to give me good sleep as well. so i have a few choices i use for sleep and rotate between, off late ive been getting good sleep most nights(touch wood, fingers crossed).

alesh can u tell us more about agomelatine, any new sleep meds coming out are of interest, insomnia is one of my worst symptoms. cfs/me has definately broken my sleep organ which is located somewhere between my shoulders and the top of my head, lol

cheers!!!

 

[Hope123]

There are certain sleep medicine that promote more stage 3/4 sleep, which is what many of us lack. I remember there are 4 meds that do this but can only remember 2 at the moment: Trazadone and Xyrem.

I use trazadone myself at a low dose (50mg) and am able to get more than 8 hours of sleep on it although I still wake up feeling unrefreshed. It is better than getting no or little sleep at all though. Trazadone also has decades of safety data, less tolerance developing than a benzo, and is dirt cheap in the US. It doesn't put you to sleep though but it will help maintain sleep. Doesn't work for everyone though but worth a try if you haven't tried it.

Mirtazapine -- a common side effect is increased appetite and weight gain.

Quetiapine (seroquel) -- from Wiki:

There is a risk of development of tardive dyskinesia, an incurable neurological disorder, with any prolonged or high dose (over 200 mg) use of quetiapine and some other neuroleptic drugs.[32][33]

The rare, but life-threatening, neuroleptic malignant syndrome may also result from quetiapine use.

Weight gain can be a problem for some patients, as quetiapine causes the patient's appetite to persist even after meals. However, this effect may occur to a lesser degree compared to some other atypical antipsychotics such as olanzapine or clozapine.[citation needed]



[Unless a medicine is super amazing, it's safer to use older meds since they often have a long track record of use and side effects better known. Also tend to be cheaper.]

 

[heapsreal]

hi hope,
Like u have quoted , doses of over 200mg theres an increased risk of side effects when used chronically. Thats why i use it intermittently and i have also read that the sedative effects of seroquel level out at 200mg, so if someone is usuing more then 200mg all the time then i would think they were using it for something else then just insomnia. I was prescibed this for my insomnia when nothing was working at the time, but i found even seroquel doesnt work all the time for me if i use it every night which is what all sleep meds do to me. I find seroquel though has a different effect, its sort of like a reset button for my poor brain, after a night of sleep with this drug, im alot calmer and the next night other more benign meds work alot better.

yes i have found weight gain from using mirtazapine all the time and its sedative effects wore off quickly, so thats why i use it intermittently as well has it helps avoid these side effects. I have tried many meds for sleep and i have found all the supposedly sedating antidepressants of no use including trazadone(i had hi hope for it but?) except doxepin and mirtazapine.

I was scared to death to try seroquel after reading about it and it took a couple of years before i had nothing to lose trying it. My doc prescribed 100mg which i only took a 1/4 of has i have read where people sleep for 18hrs from such a dose, and it had no effect, i increased this dose by 25mg until i got to 100mg then slept like a baby. Now after using it for over 12 months intermittently, i dont know what all the fuss is over this drug, but in saying that everyone reacts differently to meds.

its taken me awhile to develop my sleep strategy with my doc, but i really believe without the sort of sleep i have been getting with medication, i would be house bound. i believe my sleep problems are from cfs although i have been a shift worker working rotating shifts for over 20 years, but others i worked with dont suffer insomnia like i do, the onset of my insomnia was with cfs.

 

[onebush]

hi hope,
Like u have quoted , doses of over 200mg theres an increased risk of side effects when used chronically. Thats why i use it intermittently and i have also read that the sedative effects of seroquel level out at 200mg, so if someone is usuing more then 200mg all the time then i would think they were using it for something else then just insomnia. I was prescibed this for my insomnia when nothing was working at the time, but i found even seroquel doesnt work all the time for me if i use it every night which is what all sleep meds do to me. I find seroquel though has a different effect, its sort of like a reset button for my poor brain, after a night of sleep with this drug, im alot calmer and the next night other more benign meds work alot better.

yes i have found weight gain from using mirtazapine all the time and its sedative effects wore off quickly, so thats why i use it intermittently as well has it helps avoid these side effects. I have tried many meds for sleep and i have found all the supposedly sedating antidepressants of no use including trazadone(i had hi hope for it but?) except doxepin and mirtazapine.

I was scared to death to try seroquel after reading about it and it took a couple of years before i had nothing to lose trying it. My doc prescribed 100mg which i only took a 1/4 of has i have read where people sleep for 18hrs from such a dose, and it had no effect, i increased this dose by 25mg until i got to 100mg then slept like a baby. Now after using it for over 12 months intermittently, i dont know what all the fuss is over this drug, but in saying that everyone reacts differently to meds.

its taken me awhile to develop my sleep strategy with my doc, but i really believe without the sort of sleep i have been getting with medication, i would be house bound. i believe my sleep problems are from cfs although i have been a shift worker working rotating shifts for over 20 years, but others i worked with dont suffer insomnia like i do, the onset of my insomnia was with cfs.

Hi,

Do any of you start feeling better at night? I always think I am getting better. LOL It is hard for me to give up the good feeling and go to sleep but I am going to have to or try. I do seems to have bouts of not sleeping when I am feeling so good at night. I mean still up and wide eyed at 4:00AM. Is it the quiet and dark or quiet that makes me feel so good? I do go to sleep then but it is backwards. A lot of things are backwards with me win this DD.

I am using Trasadone now and i did not know about taking it ahead of time. I will take the Trazadone
ahead of time tonight and see what I get.

Margaret

 

[heapsreal]

if your feeling good at night and dont sleep because of that you probably have a delayed sleep cycle. basically your body cant tell if its day or night. melatonin can help this and possibly something else for sleep, on its own melatonin hasnt done much for me but does help get out of strange sleep cycles we get in.

cheers!!!

 

[glenp]

Cortisol

It might be your cortisol levels. Healthy people have a higher cortisol count in the morning and it lowers as the day goes on. Many of us with CFS have opposite levels.

glen

 

[zoe.a.m.]

Other than Xyrem, Trazodone is the medication "known" to assist with deeper stages of sleep. I think that to some degree it's as individual as what sleep meds will help any given person to sleep. Ambien is touted as being an effective sleep aid and a large percentage of the population takes it, but it doesn't work for me at all--but study-wise and according to physicians, Ambien is highly effective.

Seroquel caused ataxia for me on the very first night of taking it. I'm glad for that actually, as it sounds like it's better to be off it as soon as possible if you get the potentially-permanent side effects.

When I began researching more about the benzodiazepines, I mostly stuck with Heather Ashton's information as she seems to be the world's expert on them. In addition to the multitude of negative things associated with their long-term use, I did come across one surprising thing: Research has shown that benzos keep one from getting deeper sleep, but only in the beginning of usage. After the first few weeks or months, supposedly that effect wears off and deep sleep is again achieved. I don't feel that I can attest to that one way or the other, but it seemed like useful information at the time. I wish I could recall when and where I read that.

Count me in as another 'delayed sleep phase' person. I felt I was always on a later schedule than my peers, but did not move to a truly delayed cycle until after becoming sick with CFIDS. I believe wholeheartedly that infection causes insomnia and can make it quite difficult to fall and stay asleep. That, of course, wears the body down, and then you get too weak to sleep and I think this starts off the vicious cycle that eventually becomes delayed sleep phase. Just my opinion, but I've gone through a lot of these episodes and they play out like clockwork. I do wish melatonin worked as well in reality as it should theoretically, but who knows if the body can even really absorb and use it correctly or if other irregular hormone levels force the melatonin out of whack?

 

[heapsreal]

thanks for that info zoe, i knew benzos interfer with deep sleep but i didnt know this stopped after continual use, thanks. meds are very individual, i used ambien intermittently for 2 years then they stopped working, after a long break from them, as in 2 years or so it still doesnt work for some reason but zopiclone/imovane as been working for longer then 2 years now, touch wood. xyrem seems to be the top shelf stuff but i dont think it will come to australia and if it does will be out of my price range.

 

[Hope123]

My theory is that dysregulated cytokines (chemicals in the blood that are high with inflammation/ infection/ autoimmune disorders and which cause flu-like symptoms) is what is keeping us from sleeping well. There is some pre-lim work that shows at least for FM, cytokine levels at night that should be low are high and vice versa compared to healthy people. Suprise, suprise -- no one has done a similar study in CFS although the pattern of feeling a bit better at night is common among people with CFS.

That's why I think even though getting sleep helps me, I still wake up fatigued. Sleep medicines likely do not affect cytokine levels.

 

[urbantravels]

Well, screwy cytokine levels at night would also be a potential explanation for waking up with that feeling like somebody's been using you as a punching bag all night.

 

[zoe.a.m.]

Yeah, I've heard the cytokine cause before. I think there was a study posted on PR a few month's ago about cytokine dysregulation and sleep/night-time (and I think Nancy Klimas was one of the authors). I do think it sounds like an excellent explanation. What can be done about it though? I may just be having a severe sleep-deprived duh moment right now, but I can't recall if there's a treatment for that yet?!

I'm glad that info is useful for someone heapsreal, and I sure hope that I got it right. When I'm closer to the well side of the scale, I'll look through my bookmarks and print outs and see if I can find the source so that I can be sure it's true!

 

[Frank]

Trazodone

Amytriptilyne

 

[Otis]

My theory is that dysregulated cytokines (chemicals in the blood that are high with inflammation/ infection/ autoimmune disorders and which cause flu-like symptoms) is what is keeping us from sleeping well. There is some pre-lim work that shows at least for FM, cytokine levels at night that should be low are high and vice versa compared to healthy people. Suprise, suprise -- no one has done a similar study in CFS although the pattern of feeling a bit better at night is common among people with CFS.

That's why I think even though getting sleep helps me, I still wake up fatigued. Sleep medicines likely do not affect cytokine levels.

The cytokine theory rings true for me. When I'm PEMed, my sleep is much worse. Pretty sure tired and wired is the cytokines. I worked for many years (out of necessity) in basically a constant state of PEM.

 

[JAXintheCity]

I take the poor man's version to sleep at night... Tylenol PM or Simply Sleep. (Ambien made me hallucinate.) It helps me get to bed at a reasonable time... though it can sometimes leave me groggy. But really, I can't tell a difference anyways!