What is the best sleep medication for CFS patients?

[hmnr asg]

I am having the hardest time sleeping. I sleep 1 hour, then up 4 hours, then sleep 2 hours... its making my CFS much worse.
I was wondering if any of the typical sleep meds could be useful for sleep and maybe as a bonus might help with CFS? (or at least not make it worse?)

 

[BrightCandle]

What I have come to is a combination of the following and its sufficient for me most of the time.

1 teaspoon of Glycine
2x Magnesium Citrate
0.3 -0.6 mg of Melatonin (bulked with glycine). Sometimes it takes up to 1.5mg on a crashed day but usually 0.3 does the job.

When I was suffering a great deal more I also took ~50mg of 5-HTP.

Amitriptyline gave me hallucinations and much of the rest I can't get a GP to prescribe so I haven't had much choice to use the rest but what I am doing is based on the premise the Trypothan pathway isn't resulting in the neurotransmitters properly. I am just supplementing that end product and dealing with specific problems like restless legs and after a couple of months things improved and I have stuck with it.

I also find calcium and protein containing foods help as well before sleeping.

 

[Judee]

@NickMDal talks about some sleep medications in this thread: https://forums.phoenixrising.me/threads/long-sleep-therapy-for-healing.88000/#post-2404470

Maybe he'll have some suggestions on your list.

I'm a little nervous to try anything stronger than otc or natural remedies though.

 

[Rufous McKinney]

If you can find a good chinese herbalist, they have some entirely different approaches to the sleep issue.

 

[L'engle]

I took a small amount of mirtazapine for a few weeks when I was having some really bad sleep problems.
It did help with wakefulness at night and a bit with actual sleep. It had a calming affect so I would take it around 730-8pm in advance of a 9-10pm bedtime. For me it made me more drowsy in the day, and my sleep problems were mostly resolved by other things( they had a specific cause).

It didn't seem to have any other noticeable side effects at the 5mg( iirc ?) amount that I took. It certainly made me feel more pleasant during some of the worst of it. No idea about long term or higher does usage.

 

[heapsreal]

I liked to use a combo. A z drug like zopiclone mostly or zolpidem to help initiate sleep and then an antihistamine such as doxylamine or diphenhydramine etc to maintain sleep and melatonin to keep a healthy sleep cycle plus its a good antioxidant for the brain.

 

[Insomniac]

There should be more than one vote allowed. I find Zolpidem and Ambien very similar. I voted Ambien but would also vote Valium if it was there because it is easier to taper off than other Benzos.

I would also add specific antihistamines to the poll.
The other things in the poll give me side effects.

 

[jaybee00]

Ambien is the same thing as zolpidem

 

[JasonPerth]

I had no sleep issues when i was Mild CFS
But instantly had issues once I suddenly declined to Moderate + housebound
The moment i started H1,H2,H3 antihistamines for MCAS - i suddenly fell asleep around 10pm instead of 2am
It wasnt maintained. But worth noting that as soon as i tried to contain MCAS-Histamine / sleep became more normal.

Although i was suddenly sleeping at 10pm though, i would wake up at 12-3pm and then be wide awake.

So very interesting. Ive never tried a hardcore sleeping drug because i know i dont have a sleeping disorder, its a ANS / Dysautonomia disorder with these crappy symptoms.

Magnesium has done nothing for me since being housebound- Melatonin 5-20mg gets me tired and is the only natural thing that probably assists.

 

[hmnr asg]

Ambien is the same thing as zolpidem

oops sorry!
Seems like I cant edit the option after creating them.

 

[GreenEdge]

I said Amitriptyline but I should not have voted when I haven't the experience of the other options listed. The advantage of Amitriptyline is the drowsiness effect starts from day 1.

I find high THC cannabis oil with a little CBD works best for me.

 

[Dude]

Half a pill of mirtazapine before going to bed works fine for me.

 

[Treeman]

Melatonin 2.5mg to 5mg does the job . Cheap from piping rock. I slept 8.5 hrs uninterrupted last night.

 

[heapsreal]

I liked to use a combo. A z drug like zopiclone mostly or zolpidem to help initiate sleep and then an antihistamine such as doxylamine or diphenhydramine etc to maintain sleep and melatonin to keep a healthy sleep cycle plus its a good antioxidant for the brain.

I will add another Z drug that is handy is zaleplon. It has a half life of 1hr, so its good to help you fall asleep but not as good as other z drugs like zopiclone or zolpidem. But where I find it useful is when I wake up at 2 or 3 am but I don't need to be awake until 6am for work. They can help you get a couple of extra hours sleep and the drug is out of your system quick so no after effects. I'd only do this if I had to be up early for work etc. If I didn't have anything important to do the next day, I'd either stay up a few hrs until I felt sleepy again or take another zopiclone, both not practical ideas if one has to work.
So zaleplon has its place I think for times when you wake in the early hours in the morning and don't want to take a medication and sleep half the day away, although sometimes it can be tempting???

 

[Springbok1988]

I have been on all of those except Seroquel. They all either had too many bad side effects or they stopped working after a while. Dayvigo (or Quviviq if your insurance will cover it) works great for me. They are both orexin antagonists. I take Quviviq now with gabapentin for restless legs and sleep better than I have on any other medication.

 

[Mary]

I tried amitryptiline, which I hated - it just made me feel awful the next day, even at low doses, though I "slept" - it didn't feel like real sleep. I didn't feel like myself on it. I also tried trazodone and again hated the way I felt the next day, plus it wasn't very effective. I did like lorazepam very much but of course had to get off of it. Too bad benzos are so bad for us!

However, a couple of months ago I inadvertently discovered that Now Foods Hawthorn Berry (540 mg.) gave me the most amazing sleep, better than I have had in over 20 years. I started taking it to lower my BP, 2 caps 3 x a day (with meals) and almost immediately started sleeping. And I'm still sleeping pretty well with it, plus it is helping lower my BP, so a very good win-win situation. Also, I'm realizing that it is helping lower my extreme sensitivity to MSG in all its forms (https://www.truthinlabeling.org/names.html) whicih used to give me extreme insomnia, unable to go to sleep until after 3:00 a.m. if I accidentally ingested anything that had one of those ingredients at dinner. I think it is just calming my whole system down. Also, I've started taking naps (not too long) in the afternoon - before I was always too wired. Part of me resents taking naps though - I don't want to go to sleep during the day, but oh well, I love sleeping at night!

 

[Vladimir]

Mirtazapine worked best for me in terms of quality of sleep. Side effects were extreme hunger for sweets/pastry (fine with me, I do not gain weight at all for some reason) and eventually urinary retention which caused me to stop it (as well as any other medication that increase serotonin level)

 

[maple]

Progesterone and melatonin before bed

 

[hmnr asg]

Thank you all for your responses.
I took trazodone last night for the first time and I was able to sleep 8 hours for the first time in a while. When I was mild I used to sleep 10-12 hours, but now that I have entered moderate-severe territory my sleep is completely wrecked. But this helped (at least just last night)

Also, why isn't anyone mentioning Quetiapine (Seroquel)? It might even help with CFS (afterall, abilify which helped a lot of us is an antipsychotic. so maybe this med can help with sleep AND CFS?)

 

[heapsreal]

Thank you all for your responses.
I took trazodone last night for the first time and I was able to sleep 8 hours for the first time in a while. When I was mild I used to sleep 10-12 hours, but now that I have entered moderate-severe territory my sleep is completely wrecked. But this helped (at least just last night)

Also, why isn't anyone mentioning Quetiapine (Seroquel)? It might even help with CFS (afterall, abilify which helped a lot of us is an antipsychotic. so maybe this med can help with sleep AND CFS?)

I use seroquel when my sleep is in a rut but if I use it consistently I get RLS, from it or just tight back muscles especially in-between shoulder blades. But it is good when going through a bad cycle and need sleep badly and want to break the cycle. It sort of resets the brain ??