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Comment by Ironlikebike | Hacker News Reader

I have always had insomnia and have to maintain very good sleep hygiene. Here's a few things I have found that help me get to sleep:

- No exercise after 18:30/6:30pm

- Absolutely avoid Vitamin D and Vitamin B supplements in the evening. These will suppress deep and REM sleep and I'll sleep lightly all night long if I take them.

- Hot sauna, shower, or bath before bed.

- Anti-histamine (cetirizine hydrochloride aka Zyrtec) as needed - I'm allergic to my wife's dog and some nights I feel like I have bugs crawling on my skin. It can even wake me up.

Things that keep me from waking up at night:

- Gas X as needed to avoid acid reflux

- Anti Inflammatory helps keep me from having to use the bathroom when I know I'm inflamed (getting old sucks).

- No alcohol in the evening

- No videogames, interesting books, or French lessons right before bed, or I'll be sleeping lightly and find myself ruminating in light sleep over these mentally engaging topics.

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> - Anti-histamine (cetirizine hydrochloride aka Zyrtec) as needed - I'm allergic to my wife's dog and some nights I feel like I have bugs crawling on my skin. It can even wake me up.

Antihistamines are associated with increased dementia if you take the wrong ones, so it's not a good way to get more sleep. Melatonin, trazodone or a newer sleep drug is safer.

that seems to be associated with benadryl:

https://www.health.harvard.edu/blog/common-anticholinergic-d...

which is sometimes used for it's drowsy effect. cetirizine/loratidine are non-drowsy and I don't see any association known with dementia

Yeah, Benadryl is a weird drug. Look at its interactions with various receptor sites in humans: https://en.wikipedia.org/wiki/Diphenhydramine#Pharmacology

Benadryl does nothing to me except kill my deep and REM sleep and leave me "sleeping" but conscious. I'm exhausted the next day. I only take cetrizine.

agreed, any drowsy things seem to turn off weird parts of my brain but im left feeling like an awake zombie

Just make sure your anti-histamine is not in this list of drugs to avoid.

https://youtu.be/16n80OQCVSM?si=_Ve2HH4U2N-ATTnj

I think that's why they specified zyrtec which is a second generation (not anticholinergic) antihistamine

Most off-the-shelf antihistamines are now non-drowsy.

I asked the pharmacist for a drowsy antihistamine the other day and they gave me something from behind the counter (no script required). No idea if it was anticholinergic: most drugs require compromises so if something works better for sleep for me I'll judge the risks for other side-effects.

Normally I use a loratidine if I wake in the early hours and that usually gets me back to sleep, even though it is non-drowsy.

I wanted to try a different antihistamine to see if it worked better: jury's out on that at the moment.

Personally I think it is very important to experiment on yourself, and test a variety of solutions. I will even test alternative medicine for important problems. I strongly avoid dangerous solutions. I am fairly conservative and I especially dislike taking pills, but I believe in the value of trying a bit of science on your problems.

The antihistamines that make you drowsy are first generation antihistamines like benadryl that research has suggested are very bad to take more than occasionally (linked to dementia risk, etc.)

If you need something for sleep I highly suggest you either try melatonin if you want something OTC or talk to your doctor for something that requires a prescription.

Aside from melatonin, pretty much every OTC sleeping drug you can get is an anticholinergic drug which is better to avoid.

Cheers.

Yes Promethazine (the anti-histamine I'm using) is a moderate anticholinergic.

AFAIK Melatonin needs a doctor's prescription in New Zealand.

I will balance the risks as best I can (lack of sleep is also very unhealthy!!), and keep scientifically trying softer alternatives.

Funny how you say avoid Vit D, yet another poster swears taking Vit D before bed solved their issue.

Suggests there's other variables involved, like time of day taken, other supplements taken simultaneously, metabolic processes, diet, and maybe even the placebo effect.

If you pubmed vitamin d and sleep you find that in general vitamin d makes sleep quality worse. (I'm sure there are exceptions)

I have a wealth of experiential data on this, validated as recently as this previous July over a two week period. Like clockwork, if I take my Vit D supplement in the evening (like before bed), I will have almost zero REM sleep and will wake up from 8 hours of sleep exhausted. I have no idea why this happens but it's very repeatable.

What really kills me is acid reflux. If I get it at night I just have to wake up and sit down or stand up until it passes... fortunately it happens rarely enough and I kind of know what will trigger it, but it still sucks.

Are you eating within 3 hours of sleep?

Alka-Seltzer always knocks reflux down for me pretty quick. Still get woken up by the reflux and have to haul myself out of bed to get the goods, but a few sips and I can get right back in bed.

Oh interesting, I see that it's made with bicabornate sodium. Just bought some! And some tums as well. Let's see if any of these work :D thanks!

Try OTC reflux medicine like Prilosec (Omeprazole). Works way better than Tums for reflux in my experience.

I have some from Costco and IIUC you need to take it in the morning or something for 2 weeks? Never seemed to do much to me though, especially when I really need it.

Don't eat near bedtime, and you might want to consider tilting your bed a few degrees.

FWIW and for others reading this. If you experience reflux regularly, go get checked. I had an undiagnosed H Pilory infection for years (can lead to cancer). 2 weeks of antibiotics fixed it.

Interestingly I had this issue and got better for a while. Maybe I should get checked again.

For me it's really an intestinal gas issue that's forcing my stomach to compress, such that when I lay down, the acid makes way to my esophagus.

> I'll be sleeping lightly and find myself ruminating in light sleep over these mentally engaging topics.

Huh, interesting. I find that I sometimes force myself to think on mentally engaging topics as it helps quiet the other, more negative things I might instead be ruminating on. It's counting sheep for me, really.

Curious how gas x helps with acid reflux. My understanding is that it's for bloating more than reflux. Do you find it works better than antacids?

It helps reduce bloating. If you have bloating + weak esophageal sphincter (or just really bad bloating) you can get reflux as a result.

Actually, more accurately, gas-x has an enzyme that helps break down oligosaccharides. The mechanism may be more complex than above if your acid reflux is somehow related to microbiome stuff (oligos are favorite food for all kinds of gut bacteria).

Thanks, never knew that!

Indeed, when I have intestinal gas, it pushes my stomach 'up' and exposes my esophagus to the acid.

What anti-inflammatory do you recommend? Ibuprofen works great for me but it's not something I want to use regularly. Turmeric/curcumin?

I just use Ibuprofen when I know there's an issue. It's not ideal, but it works.

No alcohol or weed in the evening is critical for me. Either after about 5pm completely ruins my sleep.

I on the other hand can't get to sleep without weed, and that's my sole purpose for consuming it.

Sounds like a stress/relaxation issue.

Have you also tried no calories after 5 PM? That has given me the deepest sleep with vivid dreams.

Something that helps me is to do something physically exhausting during the day. Probably not right before bedtime though. For me it's weightlifting, that's the only exercise I've been able to stick with. If that's not your thing, try to find something else that elevates your heart rate/makes you sweat for 30 minutes or so, that might help you sleep better. Even some deep stretching/yoga can get your muscles firing and get your heart rate up.

You might also try no screens/TV/computers after dark. Keep interior lights at low levels and a warm color temperature after dark. Be intentional about doing calming, quiet things before bedtime.

When do you usually go to bed?

Conventional wisdom says do not eat within 3 hours of sleep. If you go to bed at 10:00, nothing after 7:00.

I thought vivid dreaming was an indicator of sleep interruption, not quality sleep. IIRC dreaming happens during our deepest sleep when you would not normally be easily woken up. Remembering your dreams mean you woke during that time.

I thought that too, but what seems to happen is that I wake up remembering a very long dream rather than just a jumble of dream snippets from the night.

Would you mind sharing what you take for the anti-inflammatory? Do you take it daily?

I take Ibuprofen, and only when I can tell there is a problem (like when I've been up several times on preceding nights). It also seems correlated with junk food and alcohol. I generally have a very clean diet, and if I slip, I generally feel like I have inflammation a few days later which keeps me up at night when I wake up needing to go.

>having to use the bathroom when I know I'm inflamed

What does this sentence mean?

If i had to take a guess i think this person might be referring to an enlarged/inflamed prostate.

Oh! Ok, I get it now.

I thought he was feeling any kind of inflammation in his body.

Parent is correct. It might or might not be prostate, or my intestines putting pressure on my bladder.

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