Sleep habits may have long-term benefits
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Unless you're fat, doctors will rarely even consider the possibility. And once you do get a polysomnogram, the usualy course of action is to throw a CPAP machine at you and send you on your way, without much followup. This, predictably, leads to abysmal compliance and the perception that PAP-therapy is awful or innefective.
And while I'm on my soap box, I really wish the PAP-manufacturers would dislodge their collective head from their collective arse. Trying to lock down machines and preventing patients from accessing their data (and settings) is plain evil. And maybe put some money into R&D for better machines? There's literally hundreds of millions of people with sleep apnea, there's bound to be a market for better devices ...
I am a thin guy with very low body fat. As soon as I told my doctor that I had woken up 2-3 times with my soft pallet dry & semi-collapsed, also that I would wake up regularly with a dry mouth, he immediately sent me for a sleep test. I went and did the test and the results were that I had mild sleep apnea. The sleep doctor told me that they were ordering a CPAP machine for me. I asked why I needed it for mild apnea and also told them I wouldn't use it. They ordered it anyway and told me to take the issue up with my doctor.
While all this was going on I was in the process of reducing the amount of meds I took (bad accident in 2010). I also started reading up on & studying sleep apnea. One of the first things I learned, and that worked, was keeping my mouth shut during sleep (many ways to accomplish that). The other thing I learned is that Big Pharma/FDA does a horrible job of listing medication side effects. I say that because "causes sleep apnea" was not on the list of side effects for carbamazeine (used for my peripheral neuropathy). As soon as I stopped the carbamazepine the apnea symptoms vanished. I have no need for a CPAP, it was ordered and I've received many calls about it, but there it sits at the sleep doctor's office..
Having designed and run clinical trials, I think your assertion based on a single experience is unreasonable.
Companies are very interested in unexpected events, particularly bad ones (called “adverse events” in the jargon). Viagra was “discovered” because of an unanticipated side effect of a drug being tested for a heart disorder.
That long list of side effect warnings? The companies love that list because it reduces legal risk (and marketing risk: doctors will tell patients what to look for and/or will avoid giving it to patients at risk of effect X).
While it seems plausible to me that sleep apnea could be a side effect of a drug like carbamazepine (though it’s not a benzo) it was not reported to any statistically significant extent.
since you have to report all AEs, the FDA will, in some cases, zero in on one that was reported at a minor level for additional study, because someone in the review panel thought worthy of investigation due to some scientific issue in their specialty. Drug companies hate that of course, but that’s one reason why there’s a review panel rather than a single reviewer.
>Companies are very interested in unexpected events, particularly bad ones (called “adverse events” in the jargon). Viagra was “discovered” because of an unanticipated side effect of a drug being tested for a heart disorder.
Tell that to Moderna and Pfizer. They, nor the FDA, have shown any interest in adverse events reported by both patients and doctors to VAERS [1], unless whatever hypothetical minimum number of people report it. I've had, as well as Dr. Greg Poland [2], a pretty severe adverse reaction to the mRNA vaccines but our problems remain unaddressed because not enough people have reported it, science knows little about our reaction, or it doesn't monetarily benefit anyone (liability or profit). As for the Viagra discovery, it was a monetary benefit.
Scientists and researchers in the medical field need to realize everyone is different and we have different reactions to various drugs. I guarantee you that carbamazepine was causing my apnea problems. It also caused two other adverse reactions that are not listed as side effects.
Now that I think about it, your entire comment screams pharmaceutical marketing to me.
[1] https://vaers.hhs.gov/ [2] https://www.mayo.edu/research/faculty/poland-gregory-a-m-d/b...
edit: mRNA
You really think that they do not realize this? The whole reason for phase 3 trials is to have a candidate drug tested on a sufficiently large and diverse population that represents the treatment population in order to look for these very variations.
If there is anyone who doesn’t want to recognize this, it would be the actuaries at the insurance companies.
> I guarantee you that carbamazepine was causing my apnea problems.
I never suggested otherwise. I merely said that a statistically significant number of such cases did not show up in trials so it wasn’t listed as a side effect for doctors to look out for.
Your comment about vaers doesn’t make much sense either. Vaccines have absolute insurance coverage provided by the government so that companies will make them at all. Vaers is a postmarket surveillance system for the government. Both Moderna and Pfizer’s Covid vaccines have been through the full phase 1,2,3->NDA process (i.e. no longer under emergency use authorization) including ae surveillance.
Sleep study was a complete joke - I slept in a creepy hotel like room in a clinic for maybe 3h total. Uncomfortable and totally different sleep then at home.
AHI of 5, given CPAP with no follow up. It really felt like this sleep Doctor got paid to hand out machines.
Hacked the settings, used it for 8months then quit cold turkey as a test. Felt the same.
My sleep improved more from:
Drastically reducing alcohol, smoking, weed. Septum correction and tonsil removal. Sleep alone in bed in complete darkness in a cool room.
In that they diagnose you with apnea, throw a CPAP machine at you, and then do no follow up.
I’m curious what part of this you are saying is not aligning with OP?
I ended up getting a "boil-and-bite" mouthguard thing that kept my lower jaw from slipping backwards when I sleep.
That helped for about 6 months, but eventually I would wake up throwing up in my mouth. What happens is that you fall asleep, your throat collapses, you go to take a breath and since you can't bring in air through your mouth, instead you try to bring the stomach acid from your stomach up into your lungs.
eventually went through the hassle of getting a machine, found the nasal pillows mask was *much* better than the default mask, and have been good.
If you want to criticize the pap manufacturers, there's a lot more than just that too. There's a shortage of machines because of the negligence of the Philips company. Documents have shown that they knew their machines were causing problems for years before finally doing a recall.
I would call it the no booze hangover. Sometimes the symptoms would be like a mild hangover. You wake up with a headache, still tired, and a little bit of a “what happened last night?” vibe.
Except that “what happened last night” was drink plenty of water and go to bed at a reasonable hour.
Which means it's profitable and they will double down on it
I was given the machine, which was titrated to the wrong pressure settings, with the cheapest mask that was too small for my big nostrils. If it hadn't been for the fact that I had a friend whose life was greatly improved by CPAP, I probably would have thrown in the towel on the first night. But I stuck with it, asked for help on Apnea Board, tried to learn as much about apnea and PAP-therapy as I could, and eventually got to a point where I'm pretty happy with it.
[1] https://www.sleepfiles.com/OSCAR/ [2] http://www.apneaboard.com/forums/
The biggest "cause" once you remove factors like alcohol is heredity. You get the shape of your face from your parents, why not the anatomy of your airway as well?
if you’re not fat and have sleep apnea, the other major cause is alcohol consumption/smoking.
seems odd to treat the symptom eg sleep apnea and not try to cut out alcohol and smoking and then reevaluate.
Nice illustration of my point that public awareness on sleep apnea is lacking.
Good luck figuring out the root cause of sleep apnea. Years of research hasn't turned one up. There's a wide variety of contributing factors (including weight, alcohol, asthma/COPD). But there's also plenty of fat asthmatic drunks who don't have sleep apnea. It's obviously not as simple as you're making it out to be.
Inadequate jaw development. We're so used to people having recessed jaws that we're just used to considering several mm of recession as a normal, non-recessed face, and we don't even think about the fact that most kids have jaws so tiny that their teeth don't fit properly and they need braces.
This causes both narrow, collapse-prone airways, and tiny nasal cavities that have high airflow resistance and deviated septums.
Both age and obesity largely just convert people from waking up out of airway collapse to overt apneas.
According to your initial post, you should be glad for the questions so that you can combat misconceptions.
Unless you're a doctor, you should probably stop giving unsolicited medical advice on the internet.
Doctors “have given up” implies there was a time when doctors would dish this stuff out as a treatment plan. At least in the US, I don’t know if that’s ever been true.
Even doctors that do not own their own practice are incentivized by the people who do own the practice. In the same way that a store clerk is incentivized to sell high margin items over low margin items. Or a Facebook engineer is incentivized to get users to engage in unhealthy social media addiction. There's nothing wrong with the individuals, its the incentive system that they are operating within.
When a physician works for someone else's practice or hospital, generally they're pressured to see as many patients as possible
Every single doctor (in the US) profits off of handing out treatments. It's a pivotal part of how the economics of medicine works in this country. The entire thing would, quite literally, fall apart if doctors/practices did not profit from handing out treatments.
Note that I am not claiming that doctors are out there prescribing medicine they shouldn't be prescribing just to line their pockets or whatever...you seem to be convinced that I have some sort of negative view of doctors and I don't. What I am saying is that they operate within a system that literally requires them to prescribe medicine in order to stay in business. So given the option of "prescribe medicine, bill insurance, and see the next patient in line" or "suggest a lifestyle change and work with the patient over the course of months and years to monitor those changes"...they all choose the former. AND THAT IS FINE. But to be blind to it is simple ignorance.
Hell, it's what most patients want. Most people go to a doctor for medicine, not lifestyle advice.
> generally they're pressured to see as many patients as possible
That is because this is what maximizes profit for the parent company. It is a business like any other.
the “official” food pyramid put out by the government still tells people to eat mostly refined grains and carbs.
Most Americans are also sedentary and don't exercise at all so again, even just walking more is an improvement for most people.
All that being said, I also have not had a doctor who didn't first ask me what my diet and exercise are like before making suggestions
you don’t take nutrition in medical school. doctors wouldn’t be able to prescribe a more personalized nutritional plan even if they wanted to
whether or not they say this or don’t won’t change anyone’s life
Advice for a healthier lifestyle, more energy, longevity, etc? Yes of course. Advice for sleep apnea that’s already set in and affecting a patient nightly? Not at all.
One of the major causes of sleep apnea is being overweight, so it can definitely be helped with a change in activity levels a diet modification
Apparently this isn't true anymore. The Food Pyramid was replaced with the current "MyPlate" model in 2011 [1]. That said, grains still feature prominently on the plate and the details say up to half of those can be refined [2], which still seems high.
[1] https://www.health.harvard.edu/blog/crumbling-confusing-food...
Telling me that "having trouble falling asleep," or "having trouble staying asleep," or "not feeling alert upon waking" are working against me is useless to me. These aren't "habits." I'm not choosing to do them until they become routine. They just happen to me.
Tell me how to FIX those things. Tell me what habits would help me fall asleep, stay asleep, and feel rested.
As-is, this isn't actionable. It's just, "Hey, people who don't sleep well don't live as long."
There are many resources available that get into the practical/tactical aspect of improving sleep. But if you don't believe sleep is a problem yet, you won't seek those out.
The Huberman Lab has put out a number of good resources for this [0] including a podcast episode speaking with Matt Walker, PhD, sleep researcher and author of Why we Sleep [1] (also a good read).
I've been a night owl for most of my life, and only more recently did I fully realize how connected this behavior was to traumatic situations growing up. When I started going down the rabbit hole on how to improve sleep, it was encouraging to find the emergence of a ton of practical non-pharmaceutical resources (I did try sleep aids for awhile, but couldn't deal with the side effects).
The hard part is that it does require willingness to implement real changes. They're not pleasant at first, but I went from an average 3AM-10AM sleep cycle to 10PM-6AM, and I've realized that all the things I told myself over the years about needing to be up all night were simply untrue.
I started this journey by setting a goal for myself to see/photograph a sunrise. I now regularly take pre-dawn walks and have seen more sunrises in the past few weeks than I had during the prior 30+ years of my life.
It's worth the effort.
- [0] https://hubermanlab.com/toolkit-for-sleep/
- [1] https://www.goodreads.com/book/show/34466963-why-we-sleep
You also seem to sleep an hour more, so some changes you experienced might be due to that.
Sleeping longer while going to bed later didn’t help much with quality (deep and REM phases were poor/short), and was also difficult to achieve for practical reasons.
I took about 3 months to fully shift the schedule, and I was tracking stats along the way. I started to notice improvements once my average bedtime was closer to midnight.
Once I hit that point, I kept shifting earlier because I wanted the benefit of the morning solitude that comes with getting up earlier. But sleep quality kept improving as well.
In short, we’re becoming increasingly aware of the impact of light throughout the day on the body’s circadian rhythm. Bottom line: natural selection didn’t design to be up throughout the night.
As for the benefits I’ve personally noticed:
- I’m significantly clearer in the head throughout the day and feel more able to make better choices during the day (about food, time spent, etc)
- My mental/emotional state has improved, and I have more capacity to deal with challenging emotions
- Increasingly (this has been shifting steadily) I start each day ready to tackle the hard stuff and I don’t have to use as much willpower
- This is the other side of the “mental/emotional” item but I generally feel happier, or have more capacity to experience happy feelings
- There is also a body of research about getting morning sunlight in your eyes, and I’ve found that on days that I do, I sleep much better. Sleep tracking confirms this. Having a science-backed reason to witness/enjoy the sunrise is nice on mornings when my body just wants to stay in bed.
More generally, such a question is starting to look like similar to questions about a healthy/balanced diet: some of the benefits can be experienced now, but prevention of long term issues is just as important. The links between lack of healthy sleep and degenerative brain issues later in life (dementia, Alzheimer’s, etc) seem to be getting stronger based on recent research.
- [0] https://www.frontiersin.org/articles/10.3389/fnetp.2021.8303...
Point 5: "feeling well rested after waking up at least five days a week"
But of course! I'll fix my sleep by ensuring I wake up well rested.
Some people need this advice, and a clear metric to hit. I’ve known them, and although I failed to make a dent, eventually something did. Maybe it was an article like this.
I added links as a response to the sibling comment with some practical resources, and I think it's important to recognize that work focusing on the impact of sleep or the lack thereof is not necessarily in the same category as work that seeks to provide remedies / improve sleep.
Thankfully, as we continue to learn just how important sleep is, we also continue to learn about ways to improve it.
Do you have a reference for this? 20 C is freaking cold. I wake up because of cold below 23 C.
The author quoted in the press release seems quite confident that we can eliminate these bad mortality outcomes by teaching people to sleep better, but another way to interpret the result is that any factor that increases stress will damage health and also disrupt sleep.
I also wonder where the author gets his confidence that "good sleep hygiene" can have such a great impact. How does he assume that "sleep hygiene" will overcome the factors causing poor sleep? Does he really believe that they've controlled for every other factor and isolated "sleep hygiene" as the root cause? My personal experience says that what he calls "sleep hygiene" helps a little bit, but it doesn't overcome the effects of stress or poor life management due to depression, and those factors have to be managed directly.
1) Potentially expensive/disruptive (control of the sleep environment may imply moving house or installing soundproofing materials, air conditioning, etc.)
2) Contradictory (get out of bed if you don't fall asleep in 15 minutes, but also don't look at the clock)
3) Not individually tested or validated
4) Based more on old-school behaviorism than on anything specific to the processes of sleep.
EDIT: forgot an important one
5) Only addressed at difficulty falling asleep initially, not staying asleep or improving sleep architecture.
It cost a small fortune but Jesus Herbert Christ on a tandem bicycle has it made a difference on how I feel during the day. I fall a sleep faster, wake up more well rested.
First few mornings I was just sort of confused by the feeling of waking up profoundly physically relaxed. Felt very weird and unusual. I don't think I've been that relaxed for years.
Cheap spring mattresses seem to be getting harder to find online. I believe the margins are much higher on memory foam products.
My wife got a foam topper and an 'under mattress inflatable thing' for my bed about 10 years ago - it was like sleeping on a new bed. I think it was around $150 at the time. Possibly getting a new bed this year, but those gave new life for a long time.
A bit of a hassle, but well worth it though.
But it's a bit of a compromise. My girlfriend hates foam mattresses even though I thought they felt great. This set-up lets me get a somewhat similar feel of sinking into the bed while being well supported.
She's also much lighter than I am and wants a soft mattress, so her side of the bed is softer.
But overall it's just much better suited to my body. I'm pretty tall so I need a relatively firm mattress to avoid sinking into it and sleeping all banana-shaped, but with this bed the core is firm but the top layer is soft. Hard to explain, but it's amazing.
If the bed is too soft, it might be comfy for a few nights but then my back and neck start hurting.
Basically a thing you put on top of a mattress for extra comfort and it makes making the bed a bit easier and cleaner.
I'm getting the best possible treatment (standard of care) which is cognitive behavioral therapy, but man, is it a slow process to recovery.
I had a serious episode of ptsd after a natural catastrophe and I couldn't shut both eyes for months. Meds became a life saver.
Sleep. It's underrated.
Nobody takes a video of their kid screaming their lungs out at 3am with snot running from every orifice because their favourite toy fell off the bed or the pillow is the wrong colour.
I want to forget, but can't.
https://www.theguardian.com/science/blog/2010/dec/17/sleep-p... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7170365/
Basically by not getting REM sleep after a traumatic event your brain doesn't get the time to actually form and store the memories of the event.
I've been thinking about this a LOT over the years. I feel like children were meant to be able to roam around and find different adults to glom onto until they're too annoyed and then move on to the next, all the while learning different specialized skills and niches to find one they fit in with.
I can't help but feel that more-than-2-adult households would have a huge advantage in this era.
Looking at today it feels we'd alleviate a ton of parental pressure if we had households like that and not depend on the traditional couple.
People lose their minds when I tell them I have three kids and that my wife and I have rarely ever had less than six hours of sleep.
Teenagers and adults also need a "third place" [1].
It's all about community. Current individualistic trends and cost of living undermine this.
If you gain 1.5 years of extra time awake but lose 0.5 years of life, did you win or lose time?
Now, if you're already not sleeping enough for your body and get woken up groggy and tired by an alarm every morning, that 20 minutes probably won't kill you faster than the lessened sleep you already get.
But you might just work retail, do shiftwork at a factory, or work in any number of places that require weird hours. Healthcare, plowing snow, train conductor, and anywhere that you wind up on-call just to name a few.
1. Dim house lights 1-2 hours before going to bed.
2. Earplugs + blackout curtains.
3. Doing some sort of physical activity during the day.
Depriving your body of food, water, oxygen or sleep is no joke.
Caffeine is an absolute killer that we don't talk about nearly enough when it comes to sleep.
Lack of good sleep hygiene is unlikely to give you a highly genetic mental disorder.
Though fasting is a thing, and when well performed has health benefits (self reporting here).
And I've -- probably for good reasons -- never heard of oxygen of sleep fasting :)
[0] https://www.goodreads.com/book/show/34466963-why-we-sleep
After I encountered the book "Why we Sleep" and heard some podcast interviews with the author, I was convinced that I needed to change my habits and started taking this seriously. Here's what I did:
1. If I slept on the couch, I'd stay there. My first priority was to start getting full nights of sleep. This involved "giving in" to my couch sleeping, and stocking the couch with sheets/blankets so I could set myself up for success. I found that once I was no longer "oh shit, I did it again", I could actually sleep through the night.
2. I started a morning mindfulness habit. Over time, this helped me notice more clearly each morning how I was feeling, and how my choices the night before improved or degraded my day. If I passed out while watching something, I would always wake up less rested.
3. After getting some regularity in my schedule, I started feeling more rested, and my meditation habit seemed to be providing even more clarity. One day, I started internally questioning why I was sleeping on the couch when my bed was far more comfortable.
So I went to bed on time. And then I kept doing it. For the first time in over 30 years, I feel like my relationship with sleep and going to bed has fundamentally changed.
I realized that my poor sleep was more about bad habits I'd been clinging to since I was a kid, and the more I improved my sleep, the more clearly I could see this.
YMMV, but figured I'd share how this went for me.
> if I'm out late with friends and stay up till 3am, I'm still up at 7am.
This was a hard pill to swallow, but as I dug more into the sleep research, it became clear that the body is not well suited for the occasional (or regular) 3AM morning. The body seems to be optimized for regularity/consistency, and adding a 3AM night is never without cost.
This doesn't mean I never stay up late, but I now do so knowing exactly what to expect.
My cofounder in one venture you never know when he is awake or asleep as he refuses to set an alarm.
1: https://en.wikipedia.org/wiki/Cognitive_behavioral_therapy_f...
2: https://onboarding.sleepio.com/sleepio/onboarding-sleep-test...
I never go to bed if I'm not tired and if it takes too long for me to fall asleep I get back up, trying to force sleep will just cause physical pain. I usually have a ~30 minute nonsense trivia podcast playing for me to fall asleep to. If I can hear it ending, I get up and do something else.
#2 was switching to a job that's less stressful. If my day-job requires me to juggle 20 things at the same time, it's impossible for me to wind down enough to sleep - or at least I couldn't figure out a way. For a co-worker journaling worked, basically they offloaded their brain to a physical notebook and that gave enough peace of mind to relax and fall asleep.
Falling asleep is much easier for me now, whereas I used to struggle with it a lot.
My thoughts used to feel unstoppable and the moment I would wake up in the middle of the night, they started going and I was wide awake and no longer sleepy within seconds.
Now it’s like I’m observing them, but no longer get excited. I still have bad days, it’s not a 100% consistent solution, but it’s helped me massively.
Falling asleep or staying asleep is not an issue, with rare exceptions. However, how I wake up is a whole other story. I hardly remember the last time I woke up truly relaxed, that happens maybe 10 times a year. It's a huge spectrum, most of the time it is somewhere between okay-ish (feeling exhausted after waking up, but it gets much better within 1-2 hours) and super exhausted (like the biggest hangover in my younger years. Can't concentrate at all, minimal effort activities like going up a small staircase become demanding, strained cardiovascular system in general, not hungry.. in short, a lost day). How I wake up is not predictable, there is no obvious pattern or causality.
I am closer to being underweight than overweight. Even on a mediocre day, I can be cheerful. Doctors therefore do not necessarily take me seriously and things happen slowly. Personal "experiments" with an oxygen and pulse tracker clearly show ups and downs when sleeping, but not to a degree to alert doctors with. Over the course of the last 10 years, I actually did 5-6 polysomnograms at a diagnostic center, but every time it was difficult for me to get any sleep there, so the results are close to being worthless. For the 45-60 minutes of sleep that I got per night, the graphs actually did show small irregularities. Which was enough to end up with a CPAP device that I rarely use because I don't feel any better with it.
Although I'm quite sure poor sleep is the immediate reason for my exhaustion, I do not rule out that the root cause is not somatic. There is this other problem of mine, a skin disease which makes me very susceptible to sunlight, which has a severe impact on the way I life and do things. I mainly stay indoors. Doing sports, running errands etc. usually happen after sunset. Bad weather is my friend. I really like my job and colleagues and get well along with everyone, but my personal social circle is small and most of the (spare-)time, I'm alone. Although I don't feel depressed and can be cheerful on most of the days, I talked to someone in therapy for a few months, but it didn't help much. As a software engineer, rational und deterministic thinking makes me wanna try antidepressants, just for the sake of trial and error. But it didn't come to that.
By the way, the last time I went to polysomnograpy, they also did two other tests regarding daytime fatigue. I failed miserably on the first test (basically my ability to keep my pupils focused on something), but succeded in the 99.5 percentile on the second test (reaction time), which is unusual. They came to the conclusion that I have become so accustomed to the situation that my body compensates very well for it. Which coincides with my impressions and helps me in my job and daily life. But doesn't help much when it comes to overall quality of life, or... potential conseqential damages to my cardiovascular system. Over the years, I got used to this whole situation, even with all the time I lost feeling miserable. Sometimes, I'm trying to ignore it and get on with my life, there are some good days after all. But lately, there is this emerging fear of said potential damages. Being in my 30s or 40s and tied to a bed for the rest of my life due to a stroke or something similar is a thought that makes me shudder. Much more than not surviving it.
Maybe it's just plain old sleep apnea with a wrongly adjusted or otherwise not helpful CPAP device (I was at the diagnostic center for trying an ajdustment, but guess what... I just can't sleep at that place). Or maybe the root cause purely psychogenic. Or it's something in between. Which is my current guess, but would be even worse, since it requires some interdisciplinary work and thinking from doctors, which, from my experience, they don't do that much.
I have no clue what to do.
I do relate to that state of barely getting any sleep and then having a lost day. 2022 Dec was my worst month so far when it comes to sleep. I had a few weeks when I'd sleep for 1-5 hours for many consecutive days and then I couldn't function on those days at all. My performance at work really dropped. I took a sabbatical with the main goal of improving my sleep.
In January I went for 1 week to Morocco (I'm originally from Northern/Eastern Europe) to visit a friend, and my sleep was dramatically better there. I did take my sleep medication on a few nights, but still the quality of sleep was very different. It might have been a combination of psychological (foreign place, less stress) and physical (sun, movement/walking) factors, but the main lesson for me was that improvement is possible.
After going back to my home country my sleep returned to baseline (terrible), but over the last several weeks it's been improving. It'd take a lot of text to describe all the things I've tried during all those years.
One of my recent discoveries was that I probably wasn't consuming enough protein (I'm fairly physically active) and consuming too much fat. Changing that improved my sleep ~15%. Just being on a sabbatical and having no work related thoughts/stress improved my sleep maybe 20%. I'm also currently experimenting with Magnesium L-Threonate and Apigenin (I only started those, but I do seem to notice that I feel better the next day).
Your situation might be very different, but with this comment I wanted to say that your solution might be somewhere out there. Just don't lose hope.