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Comment by Puer | Hacker News Reader

I'm currently in my 20s and I've been a type 1 chronic insomniac my whole life. Physically, I'm healthy and fit and I have been my whole life, but mentally my mind feels slower and foggier than my peers and I struggled through high school and college because of it. I know this might sound morbid, but I am fully expecting to die early despite doing everything in my power to live a healthy, balanced lifestyle. I can't see getting 2-3 hours of sleep a night with all-nighters ~once a week being sustainable as I age and I wouldn't be surprised if my brain has already deteriorated in function significantly.

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Have you checked your testosterone levels? Low testosterone can cause sleep disorder and significantly impact short-term memory.

I'm curious have you ever tried working out in the early hours after waking up? This alone determines if I'm getting good sleep or not. I'll end up staying up way later into the night unless I worked out that morning.

People with chronic insomnia have generally tried everything and it’s unhelpful and annoying to offer your suggestions, I realize you’re trying to help but yeah.

I wasn't actually trying to help per se. I was just wondering if it was something he's/she's tried is all.

Also pretty obnoxious to jump in as a third party and sass someone for trying to be helpful to someone else. Puer can speak for himself if this is bothering him, and since he's posting about it on a public forum, I actually doubt that it does.

Throughout college my routine was to go to the gym every weekday at 6 AM before class. In my case, my insomnia is diagnosed as insomnia in the absence of other external factors. Lifestyle choices like proper light exposure, getting consistent exercise, melatonin, not drinking caffeine, not using electronics before bed, etc. don't affect my quality of sleep.

As a teenager who would play games often into the early morning hours (I remember I'd just be going to bed as my father went off to work) feeling like complete garbage and just mentally slower for a few days because of it. I couldn't imagine this all the time...

Waking up early and doing a workout for an hour or two helps me to sleep very well for next 3-4 hours after the workout -- or keeps me sleepy for half the day. Works totally differently in the evening. Brain just goes at double speed after an evening workout.

Have you tried thc? My wife has sleeping problems and thc really helps her a lot.

No, I've never really used any recreational drug, including alcohol. I don't mean to sound judgmental, but for me personally the long-term effects of THC aren't understood well enough for me to try it yet. If you don't mind me asking, does your wife have to take it on a consistent (ie nightly) basis to sleep well?

Maybe when I'm older with less to lose I'll experiment more and see if things like that work.

This seems like an odd stance to take, especially when what is known about the long-term effects of THC rate them as considerably more benign than the long-term effects of chronic sleep deprivation.

If you're expecting to die early, what have you left to lose?

I think you're overthinking it. It's not really "recreational" when it can help your quality of life significantly.

I'd suggest a tiny pinch (<0.05g) of dry herb in a vaporizer, a couple hours before bedtime. Recurring costs are <$20/month in a legal state.

The immediate effect is quite interesting: routine tasks become less-accessible while imagination becomes more-accessible, so you think more about what you're doing, which often spawns new ideas (e.g. the desire to exercise or play an instrument, understanding both as a cyclical muscle control problem.) Afterward, the transition to sleep feels trivial.

Large doses are generally not beneficial.

Sorry for not replying sooner. She took it nightly yes (we are no longer somewhere with legal cannabis), but on the order of 5mg of THC (via edibles). It's not really enough to get her high, but it does help her stay asleep. The effect is more or less immediate and stopping takes away the effect more or less immediately.

The article mentions meditation as a sleep aid. I have no idea if it could help someone with a sleep disorder, but I’m just curious if you’ve explored that option.

Have a doctor perform a sleep study examination.

I have. I was diagnosed with Delayed Sleep Phase Disorder and Type I Chronic Insomnia.

What recommendations did the doctor have for next steps?

The doctor will almost certainly have recommended "sleep hygiene" (including things like a dark and quiet room at night, not staying in bed when your mind is racing, don't use your bed for non-sleeping activities, try to wake up at the same time every day), light therapy, and melatonin. That helps some pople, but many (maybe most) people it doesn't help and in that case you are considered untreatable. The vast majority of sleep medicine is focused on sleep apnea at this point and it sounds like this is unlikely to change any time soon.

For anyone with circadian issues, the Circadian Sleep Disorders Network is a patient advocacy group that has some helpful info:

https://www.circadiansleepdisorders.org

There is also an independent mailing list mentioned on that site for people with circadian disorders. I'm not sure what similar resouces are available for just insomnia.

Edit: Oh, there is also "Cognitive Behavioral Therapy for Insomnia", which is a structured approach to "sleep hygiene".

Edit2: My overall impression with insomnia is that things like racing thoughts or caffine keeping you awake can be treated but if you deal with all of that stuff and still can't sleep, there is no treatment (and often circadian issues are involved).

CBT for insomnia helped me quite a lot, but it took months to get off a waiting list and in to a class. Mine was (I think, in retrospect) heavily linked to some specific work stresses, though, rather than a generalized life condition.

Yeah we are going to die early. Work is killing me. No choice but fit in with the business schedule.

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