As someone who has chronic maintenance insomnia (so bad that I've been off work for more than 6 months), is there anything I can do?
Exercise daily, starting today.
Ditch or at least dim all screens a few hours before going to bed. Hard ban on screens when unwillingly awake in the middle of the night. Paper books are okay.
Look into techniques to fall asleep, this article helped me: https://www.artofmanliness.com/articles/fall-asleep-fast/. The article and the research it cites are male-oriented, women may try it more speculatively. Intuitively it seems to me that gender differences should not be relevant.
Septum surgery helped my sleep enormously by making breathing easier, see if it's for you.
Hard ban on stimulants, including sugar and coffee, a few hours before going to bed. Hard ban on stimulants when unwillingly awake in the middle of the night. For a severe case such as yours, consider a hard ban after midday, or even a complete permanent ban.
Currently, I try to take a walk at least 30 minute everyday in the morning and then I do the 7-minute-workout in the afternoon, even when I have no energy. My sleep's improved for the past couple of months since I started this workout routine. I can't tell if it's because of that or my sleep just improves on its own but I'll keep doing it since exercising is better than doing nothing. I also started 18:6 intermittent fasting. That might also have helped.
Still, my improved sleep means about 5 to 5.5 hours (sometimes less) a night with at least 2 awakenings in between. My normal sleep was about 8 hours with 1 awakening, and I'd still nap in the afternoon if given the opportunity. Now, I can't nap and there's no rebound sleep (i.e. I don't sleep more the next day because I sleep very little the day before). It's a pretty messed up situation and doctors haven't found anything abnormal from medical tests, including MRI and EEG. Sleep study indicated 50% sleep efficiency, reduced REM and deep sleep, but no sleep apnea or any common cause.
I tried the 2-min fall asleep method when my condition first started but it didn't really help. And yes, I only drink green tea and have some chocolates before lunch time in terms of stimulants.
I've also read Why We Sleep before my sleep got this bad. In fact, knowing too much about how sleep work and the negative impact on health with lack of sleep makes it much worse for me. So now I tend to avoid reading articles like this and learning more details.
I guess what I'm asking is if there's anything more I can do, like something to supplement or eat/do to make up for the stuff lost due to insufficient sleep. It's a long shot asking in a tech forum, but I'm willing to give anything a chance to help improve my sleep. Let's hope there's more research into sleep as insomnia is one of the worst form of suffering.
>insomnia is one of the worst form of suffering
I once had a “day” that lasted four days or so. The last one was pretty hell on earth. Idk how people stay awake for weeks in stories out there. For a reader who never experienced that: it is not “I don’t wanna sleep and it’s probably bad”. No, you are tired as hell, your brain is almost failing, you want to sleep, but you just can not.
> you are tired as hell, your brain is almost failing, you want to sleep, but you just can not.
I know exactly what you mean. I was like that for the whole winter. Fortunately this scenario's not happened for quite some time. I'm at least getting some amount of sleep everyday.
It's possible that something is keeping you awake--a fear, an anxiety, a repressed emotion, loneliness, etc. If your mind perceives that resting would be risky for some reason, it won't--whether or not the risk is physically real, or imminent. There is a lot to be worried about in life, from immediate personal issues to global social and environmental concerns.
A therapist, psychologist, or psychiatrist may be able to help. I don't mean sleep therapy specifically, but general emotional and mental health.
PM: Magnesium (multiple forms), melatonin, l-theanine. AM: Vitamin D (from sun preferably) in the AM, moderate exercise 5 days/week
Diet: keto / low-carb
Also: Get checked for sleep apnea. Use Oura or a similar sleep tracker, preferably find a good one for SpO2 (Oura does not)
Good luck. Finding good sleep in modern society is hard.
I tend to exercise more, sleep more, feel better.
Baclofen and phenibut are similar GABA-B receptor agonists (phenibut also has a weak gabapentin effect), phenibut is more effective at usual doses (600-900 mg phenibut vs. 10mg baclofen), however the side effects are potentially worse in some ways (some people find it quite addictive and heavy use over a long period of time might cause retinal taurine depletion leading to permanant vision loss). However, baclofen has an increased chance of causing seizures, although I think the chance of this is low at 10mg (but phenibut can be started in higher doses while baclofen would need to be stepped up and down). Both have a chance of causing central apnea (as do a number of other medications). Some people don't find one or both helpful (I seem to have a fairly slow drug metabolism that might increase the effectiveness) and even if they do help they become much less effective if taken every day. I've tried various schedules and with baclofen 10mg every other day or possibly two days on and one day off seems to work the best. I've also done 10mg baclofen, 600mg phenibut, and a day off, although due to the issues with phenibut I would recommend just using baclofen. Balofen is prescription only and not commonly used for sleep (even sleep doctors might not know it can help), however there are a few studies using a daily higher dose that found it helped and that was enough for my doctor. I haven't seen any studies using the 10mg every other day. I did try 10mg every day for a month once and it still seemed to do something but it seemed quite a bit less effective. Overall, while not a great option in a lot of ways it has been helpful for me.
I'd recommend against seroquel, valproate, benzos or similar GABA-A receptor agonists, or any of the other more powerful antidepressants or antipsychotics. Some people find them helpful, but others have bad reactions that cause lasting damage. First-generation antihistamines might be better as a "get to sleep soon" drug, either diphenhydramine or, I've heard but haven't tried yet, ultra low dose doxepin (.5 to 4mg liquid form, works just as an antihistamine at that dose but has a longer half-life). Or a few other first-generation antihistamines that are harder to find these days that I haven't tried. However I don't think antihistamines are all that good for sleep maintenance issues.
Some people find delayed release melatonin helpful, however any form of melatonin just causes me to wake up early (this is not all that common so worth trying first if you haven't).
Ok, one other thing: I take 150mg sublingual uridine monophosphate mostly for circadian reasons but it does seem to make it a bit easier to cope with less sleep. The two possible side effects that I've heard of with uridine are digestive issues or there is concern that it might increase the chance or growth of cancer, although I think that seems unlikely to be the case at that dose and hasn't been reported in humans at any dose. I take at least a couple of days off every month or it looses effectiveness.
Actually a few more (that you might be doing already): keep the room as dark as possible when you sleep, ideally block all light. I also found an air purfier to be helpful due to the noise of the fan blocking irregular sounds. To limit circadian issues, try to get out of bed at the same time every day if possible (eventually it isn't if you don't get enough sleep).
I also have the "no rebound sleep" thing most of the time, although it has at least partly come back at times for a little while. I wonder if the loss of rebound sleep correlates with worse outcomes (I am also unable to work).