Falling for sleep | Hacker News Reader

Falling for sleep

aeon.co

44 pointsprostoalex14 comments

Stopped halfway through because the author is apparently one of those people who think "making stuff up" becomes productive if you call it "spiritual".

Yeah, this is basically mythmaking. That's fine as far as it goes, but it's a poor substitute for medicine. The author has several hallmarks of being a quack: he is described as practicing "dream medicine", makes sweeping medical/health claims despite not (as far as I can tell) having a degree in physiology or medicine, and is part of a center for "integrative medicine" headed by alternative medicine guru Andrew Weil.

Unfortunately a common affliction of aeon.co authors.

The article clearly is a cultural piece about the role of sleep in our society and I don't see where the author is making stuff up . He largely seems to be making observations about the role of sleep in our performance driven society and how that might be creating problems for us and that it might be worth taking a more aesthetic perspective on the matter. Don't think there's anything blatantly wrong with that attitude

The headline is currently the more evocative "Falling for sleep". The article doesn't describe a cure for insomnia so much as a repudiation of the concept as it's generally understood.

Interesting article. When I have trouble falling asleep, it often seems as if there is part of me that wants to fall asleep, but it is stuck and the part of me that wants to stay awake is keeping the sleepy part from getting what it wants.

"Not a medication, but a natural neurohormone, melatonin is Nyx in a bottle." So taking a hormone isn't a medication? Not only is it a hormone, but we take it at many times the natural level of that hormone. There are a few new melatonin receptor agonists that are even stronger (but are still super expensive; I haven't tried them).

The main problem with medications may just be that most of the ones we have now are not that good. I suspect in many cases how a person relates with sleep may have an effect, but sometimes it doesn't. And sometimes medications can help a person who has developed bad habits change them. F.Lux or redshift (to reduce the blue light in displays in the evening) are quite helpful also, I find.

Many people do not know that melatonin patches exist. They are harder to find (I only have seen them online). For me they have a different effect: oral melatonin, even extended release, helps me get to sleep but makes it more likely I'll wake up later and not get back to sleep (plus they cause digestive issues) and melatonin patches help me stay asleep but not get to sleep. I haven't tried both oral and patch together. I'm currently using a quarter of a 5mg patch, which is less effective than a half patch (but less bad when I forget to take it off) but I couldn't tell the difference between a half and full patch.

Uridine monophosphate (150mg sublingually) is one that I find helps me feel more rested for the same amount of sleep (I have circadian rhythm issues; this may not happen if you don't). It also seems to help me get to sleep, although it doesn't have such a dramatic effect as some and seems to become more effective over time with regular use. While it seems to have few short term effects, long term effects have not been studied and it might potentially increase cancer growth. So still a high risk medication at this point.

The other one I've been taking lately is baclofen 20mg (phenibut 900mg is similar but I prefer the balofen). While not commonly used, it is the best I've found at keeping me asleep. I need a break of at least two days in a row per week or it looses effectiveness. I've noticed rebound effects for over a week after stopping it so it isn't entirely a positive effect on sleep, however I do get much more sleep with it than without and it doesn't seem like less restful sleep. Baclofen and phenibut can cause withdrawal effects if taken continuously without breaks and phenibut can be addictive. They also seem to conflict with many other drugs (including, it seems, something as mild as L-theanine). So they are higher risk, but not as bad as most sleep drugs.

Going back to non-medical sleep aids, waking up at the same time daily seems to be much more important than going to sleep at a consistant time. Bright light in the morning but avoid it in the evening. Consistent meal times may help. I'm always interested in hearing what other people do to encourage better sleep.

Steve Gibson of GRC.com is a "health hobbyist" and has been experimenting with various Sleep Formulas, with some success, which you might find interesting: https://www.grc.com/health/sleep/healthy_sleep_formula.htm

He may be interested in hearing about your experiences in his forum

Thanks, I'll look into it more. I forgot to mention that it does seem like uridine causes increased B vitamin usage so adding an extended release B vitamin at bedtime is an interesting idea.

I'm only interested if he also sends samples to labs for testing. There's a bunch of "melatonin" in the US that contains no melatonin.

The fact he mentions alcohol as useful for sleep (especially for people who wake early) shows how clueless he is.

More suggestions - vasodilation in your feetsies [0]

[0] http://www.nature.com/nature/journal/v401/n6748/full/401036a... - Physiology: Warm feet promote the rapid onset of sleep

> Even healthy people occasionally have difficulty falling asleep. Psychological relaxation techniques, hot baths, soothing infusions of plant extracts, melatonin and conventional hypnotics are all invoked in the search for a good night's sleep. Here we show that the degree of dilation of blood vessels in the skin of the hands and feet, which increases heat loss at these extremities, is the best physiological predictor for the rapid onset of sleep. Our findings provide further insight into the thermoregulatory cascade of events that precede the initiation of sleep.

If you find that you're regularly not able to sleep.. (for me, 1-2 hours for unconsciousness eventually became falling asleep every ~1.2-1.5 days).. you probably should (if you're aware of risks and don't think they'd be any more ruinous than insomnia) (IANA Doctor/Psychiatrist) be taking z-drugs / benzos. Thank you, sweet temazepam.. Honeymoon stage? Probably, but still worth a try.

I don't think recommending long-term benzo / z-drug usage outright is a good idea. They should be the absolute last resort. I have never met anyone who hasn't used them long term who was aware of their risks. These are some of the most prescribed medicines on earth and even the doctors prescribing them have no idea of their effects, let alone how to get you off them.

This is, most likely but not necessarily, a life-long addiction one enters into where the risk of going without can cost one's life. Also, some people have paradoxical effects: basically, the opposite of sedation / sleep. Getting off them takes at least a couple of months, if you're lucky, up to a year or more during which you can't really do anything like work, etc. They are especially nasty to people suffering from depression, something quite common (if not actually the same underlying condition) in the sleep-deprived.

At the very least, one should exhaust all other possibilities, including much safer sleeping aids like melatonin and cannabis, before making a plunge into what is almost guaranteed to be a life-long dependency.

Melatonin is about as dangerous as it is effective, imo - lightweight. Cannabis is not without risks either, but they're nearly negligible. Outright recommendation is not really what I was talking about, either - I was talking about situations where I would go multiple days without being able to sleep, and not for a lack of trying..

David Nutt et al. are better qualified to talk about it than I am I guess.

Over the last decade there have been further developments in our knowledge of the risks and benefits of benzodiazepines, and of the risks and benefits of alternatives to benzodiazepines. Representatives drawn from the Psychopharmacology Special Interest Group of the Royal College of Psychiatrists and the British Association for Psychopharmacology together examined these developments, and have provided this joint statement with recommendations for clinical practice. The working group was mindful of widespread concerns about benzodiazepines and related anxiolytic and hypnotic drugs. The group believes that whenever benzodiazepines are prescribed, the potential for dependence or other harmful effects must be considered. However, the group also believes that the risks of dependence associated with long-term use should be balanced against the benefits that in many cases follow from the short or intermittent use of benzodiazepines and the risk of the underlying conditions for which treatment is being provided.

https://www.bap.org.uk/pdfs/BAP_Guidelines-Benzodiazepines.p...

There are definitely cases where long term use of benzos is the only viable solution and your sounds like one of them. But this paper just rehashes the same things about benzodiazepines. Are they saying that only some people become dependent on benzos? Do they have an example of anyone who's been on them for four weeks that isn't dependent? I doubt you could find someone who has been on them for two weeks who isn't dependent. They completely gloss over the fact that doctors have no idea how to get people off and rehabs are even more clueless (you can't do anything in 30 days other than damage for a long-term benzo user). Doctors often use a patient's dependance to squeeze money out of him and not provide any actual care outside the prescription, a prescription they know with certainty will bring the patient back regardless of how awful the rest of the services are. Often, they will stop seeing patients without warning, literally leaving them in life-or-death situations that they need to resolve themselves, situations they might not be able to resolve without going to a black market or emergency room. I'm not saying the guidelines are bad, just that they are extremely incomplete, they unacceptably play down the risks involved, and most doctors have never heard of them. The situation will hardly change given how much profit comes from benzos to all parties involved (except the patient)

Reply on news.ycombinator.com