Sleep Difficulties

[LucasZ]

Hello everybody...

I've been reading allot about sleeping difficulties for a while now and have tried allot.

I've tried several pharmaceutical compounds from amitriptaline to zoldipem (mirtazeojne, seroquel, trazodone, etc). They all work but I'm lethargic and not motivated to do anything. Only seroquel worked wonders! But I also had to quit that because I had terrible anxiety attacks and I was sweating non stop.

Also tried almost every natural compound. Melatonin, glycine, inositol, ornithine, valerian, etc but none seem to help enough. Glycine works OK, but I keep waking up after four hours.

The problem is that I have problems with sleep maintenance. I wake up quite often and have been dealing with this problem like 20 years (I'm 30 now). It has put my professional career on a low level and also working out is really hard because I'm always tired. If I do too much I don't sleep at all.

I've also visited 4 sleeping clinics and tried cbt-i, but that didn't work out anything. This problems even occur when I'm on holiday... Sleep hygiëne is good.

I'm at a loss what to do next because my quality of life is crap like this. Any advice on medication or what I can try because I feel groggy as hell in the morning...

Thanks allot!
I calling my doc to morrow for cypro

 

[Jem Oz]

That sucks.

When I had sleep issues, cypro was a gift from the gods. I was groggy on it for the first few days then I adapted. It enabled me to sleep for 12-14 hours straight, and then have a run of great nights so I could catch up and 'reset'. I don't take it now but I know it's always there. Hope that works for you mate. (thankfully it's an over the counter med where I'm from, so no awkward encounters with the doc).

Other than that I'll ask the standard question: what's your diet like? What are you eating before bed? Are you sure you're getting enough cals and the right kind, so that stress hormones don't rise too high during the night?

 

[raypeatclips]

Things that are important for me regarding sleep are exercise, sunlight, (if I am indoors all day sat in front of a screen, then sleep will be bad) Eating more fat allowed me better sleep and I also noticed more protein. I suspect I might be overcoming a possibly lifelong protein deficiency, and now I am generous with eating meat, alongside what I usually got from milk and cheese, sleep is pretty solid no night time awakenings anymore.

Go ahead and try find a drug that helps you sleep or a supplement, but it is incredibly shortsighted IMO. Like the guys that search for fat loss pills, while eating garbage and not exercising. It will only mask the problem and not solve anything.

Also (hate incoming) the more I orgasm, the more I feel unrested and groggy on a morning when I wake up. After 1-2 weeks of abstinence I get up for the day with my alarm ready for action. This probably isn't everyone's issue though.

 

[bawild]

Were you evaluated for sleep breathing disorders like apnea or UARS?

 

[LucasZ]

That sucks.

When I had sleep issues, cypro was a gift from the gods. I was groggy on it for the first few days then I adapted. It enabled me to sleep for 12-14 hours straight, and then have a run of great nights so I could catch up and 'reset'. I don't take it now but I know it's always there. Hope that works for you mate. (thankfully it's an over the counter med where I'm from, so no awkward encounters with the doc).

Other than that I'll ask the standard question: what's your diet like? What are you eating before bed? Are you sure you're getting enough cals and the right kind, so that stress hormones don't rise too high during the night?

I just talked to the doc. Cypro is a controlled substance here and the pharmacy doesn't know it in Holland. How can I get it?
My diet is a+
I eat about 3000 kcal a day. 3500-4000 kcal on training days. Although I'm not training more atm because I'm way too tired...

Diet is high protein, high fat and low in refined products. Lots of fish, avacado, nuts, Greek yogurt. Mostly eat whole grain and rice products.

I mostly eat fat Greek yoghurt with some honey before sleeping.

 

[LucasZ]

Were you evaluated for sleep breathing disorders like apnea or UARS?

None whatsoever. Only too many awakenings and daytime sleepiness...

 

[Lecarpetron]

what is your body temperature like in the morning, at noon, 5pm, and before bed? In order to feel alert vs. sleepy at the appropriate times, you should wake up to ~98.0, cross 98.6 around 10am, peak at 99.0 at 5pm, then slowly drift back to 98.0 as you get sleepy at bedtime. If your temps are off that could be a piece of the puzzle.

 

[Jem Oz]

Amazing that cypro is a controlled substance. Here in Australia it's called "Periactin" and you can literally buy a year's worth of the stuff over the counter. You will need to try importing it. From memory @haidut now has a cypro-based product in his Idealabs stable.

On the diet front, seems like you're eating a good amount of calories, perhaps do some research around these parts into the perils of nuts, fish and grains. Might be negatively impacting you more than you realise.

Otherwise, without knowing you from a bar of soap of course, have you considered psychological origins? That whole 'angle' can never be discounted

 

[raypeatclips]

I just talked to the doc. Cypro is a controlled substance here and the pharmacy doesn't know it in Holland. How can I get it?
My diet is a+
I eat about 3000 kcal a day. 3500-4000 kcal on training days. Although I'm not training more atm because I'm way too tired...

Diet is high protein, high fat and low in refined products. Lots of fish, avacado, nuts, Greek yogurt. Mostly eat whole grain and rice products.

I mostly eat fat Greek yoghurt with some honey before sleeping.

The foods you eat are pretty much opposite as to what Peat would recommend. Why not try alter your food choices rather than try find a drug to help you sleep? I'll let you into a secret, pharmaceuticals aren't the long term answer.

 

[biggirlkisss]

have you tried bright sunlight before bed and sleeping with light on. as well as eatting right before bed. try all the above.

 

[walker_in_aus]

I just talked to the doc. Cypro is a controlled substance here and the pharmacy doesn't know it in Holland. How can I get it?
My diet is a+
I eat about 3000 kcal a day. 3500-4000 kcal on training days. Although I'm not training more atm because I'm way too tired...

Diet is high protein, high fat and low in refined products. Lots of fish, avacado, nuts, Greek yogurt. Mostly eat whole grain and rice products.

I mostly eat fat Greek yoghurt with some honey before sleeping.

Hi Lucas,

I want to tell you a story - I was eating an "a+ diet" as per fitness fanatic standards of low carb, medium protein and high "healthy" fats and the same thing happened to me. I got insomnia so bad that I had to take two months off work, turned me frequently suicidal and the sleep drugs I was taking made me regularly black out during the day. Don't be disheartened - because it's led you to the wonderland of Ray Peat.

You're operating on Protein and "Healthy" fats = health. Except perhaps now your health is deteriorating. Aside from not sleeping, are you losing hair, having dental decay issues, finding your digestion a little compromised?

It's a big turnaround but fatty fish, nuts and avocados can be pretty detrimental to metabolic health, and give you hue problems sleeping. You're gonna want to spend a bit of time reading, and don't do it all on this forum because we're just average people here mostly and we get a bit fanatic and excited. But in summary:

You need to not eat anymore PUFAS. Stick to saturated fats!
You need to eat more sugar. Yes, sugar. Ripe fruit, quality milk... and sometimes even the white powdered kind.... Honey at night is fine, but like two tablespoons. Sugar isn't as bad as they say, especially with a diet rich in minerals and low in PUFAs.

Liver Glycogen storage is a key factor with "sleep maintenance" and what is likely happening during your night wakings is your blood sugar is dropping and your cortisol is rising. Do you sweat in the night? Do you feel a bit panicked? Your liver is probably not doing so well at storing glycogen... and your body is having tp break down protein in the night to provide your cells with glucose.

This blog was my life saving read - I highly recommend it.
How to Sleep When You Can't

Welcome to the world of carbs my friend - step away from the avocado smoothies....

 

[Lecarpetron]

Don't be disheartened - because it's led you to the wonderland of Ray Peat.

+1

This blog was my life saving read - I highly recommend it.
How to Sleep When You Can't

+1

Good point about the lack of carbs. OP, ice cream is your friend...doesn't have to be forever, but it's a great nighttime crutch to stave off the adrenaline rush that's making you alert when you should be sleepy.

 

[tara]

Hi,
Sleep is important, so it's good that you are trying to find ways to improve it.

I eat about 3000 kcal a day. 3500-4000 kcal on training days. Although I'm not training more atm because I'm way too tired...

Diet is high protein, high fat and low in refined products. Lots of fish, avacado, nuts, Greek yogurt. Mostly eat whole grain and rice products.

I mostly eat fat Greek yoghurt with some honey before sleeping.

I too think it's worth reviewing diet and seeing what possibilities there are for experimenting with change there. What, how much and when you eat can make a big difference. What works well can really vary from person to person. Some people sleep best with nothing in their digestive tract at night, others can't sleep unless they have supper, and some need a small snack in the night to resume sleep.

Liver Glycogen storage is a key factor with "sleep maintenance" and what is likely happening during your night wakings is your blood sugar is dropping and....

Wouldn't surprise me - running low on glycogen, and resulting stress hormones is what I think used to wake me up too.

Consider trying:
- reading articles on Peat's website: raypeat.com
- seeing what you can do to minimise PUFA and replace those calories with more saturate fats (eg coconut oil, milk fat), fruits and veges
- reducing grains, replacing with roots, fruits, etc
- don't overdo the oily fish and avocados (not saying avoid completely, but maybe not massive amounts)
- see if you do better with fresh milk than yogurt - some do - lactic acid can be a burden.
- check nutrition in cronometer or similar to see if you are covering all micros well. Eg check B-vits, minerals ...
- consider trying gradually moving towards at least as much carbs as protein, maybe 2 or more x, and see if it helps.
- small high carb snack if you wake in the night, disturbing yourself as little as possible.

Also in favour of checking breathing during sleep. If you have someone around, you can ask if they've noticed if you always sleep with your mouth shut, or soemetimes/always have it open. If it's open, using a chinstrap or a little tape to keep it closed can make a difference. Maintaining good CO2 levels helps keep you relaxed; overbreathing through open mouth tends to lower CO2 and promote stress mechanisms.

Consider whether you are pushing yourself too hard - overtraining or similar. Maybe reduce training to fewer days/week, less exhaustive.

Getting regular sunlight on skin during day?

Sleep hygiene means different things to different people, so I'm not sure what you mean by it.

If emotional stress is involved, finding ways to play and laugh in relaxing ways with other people can be as useful for adults as for young ones. Sometimes the techniques recommended for calming as part of sleep hygeine can have different effects for different people. The same things don't calm everybody.

 

[NathanK]

I'd look into experimenting with light therapies, which has helped me (along with a good diet).
Search for these topics on the forum as well. We've had similar conversations over the years:
Non-24-hour sleep–wake disorder - Wikipedia
Delayed sleep phase disorder - Wikipedia

 

[LucasZ]

what is your body temperature like in the morning, at noon, 5pm, and before bed? In order to feel alert vs. sleepy at the appropriate times, you should wake up to ~98.0, cross 98.6 around 10am, peak at 99.0 at 5pm, then slowly drift back to 98.0 as you get sleepy at bedtime. If your temps are off that could be a piece of the puzzle.

I can' tell for sure as i got no thermometer. But my body temperature is mostly hotter during the night/morning then day (allot of sweating also).

Amazing that cypro is a controlled substance. Here in Australia it's called "Periactin" and you can literally buy a year's worth of the stuff over the counter. You will need to try importing it. From memory @haidut now has a cypro-based product in his Idealabs stable.

On the diet front, seems like you're eating a good amount of calories, perhaps do some research around these parts into the perils of nuts, fish and grains. Might be negatively impacting you more than you realise.

Otherwise, without knowing you from a bar of soap of course, have you considered psychological origins? That whole 'angle' can never be discounted

Yeah it's really crazy. My own doctor didn't even know it existed. He subscripted a low dose of doxepin to sleep through the nights some times.

Importing is pretty hard. I can only from Europe (no restrictions). Or maybe i can ask a fellow-peater to help

I've been to several psycholigists and did CBT-I. They couldn't find anything as i'm not thinking the whole time or obsessed about it. CBT-I didn't hardly anything.

Hi Lucas,

I want to tell you a story - I was eating an "a+ diet" as per fitness fanatic standards of low carb, medium protein and high "healthy" fats and the same thing happened to me. I got insomnia so bad that I had to take two months off work, turned me frequently suicidal and the sleep drugs I was taking made me regularly black out during the day. Don't be disheartened - because it's led you to the wonderland of Ray Peat.

You're operating on Protein and "Healthy" fats = health. Except perhaps now your health is deteriorating. Aside from not sleeping, are you losing hair, having dental decay issues, finding your digestion a little compromised?

It's a big turnaround but fatty fish, nuts and avocados can be pretty detrimental to metabolic health, and give you hue problems sleeping. You're gonna want to spend a bit of time reading, and don't do it all on this forum because we're just average people here mostly and we get a bit fanatic and excited. But in summary:

You need to not eat anymore PUFAS. Stick to saturated fats!
You need to eat more sugar. Yes, sugar. Ripe fruit, quality milk... and sometimes even the white powdered kind.... Honey at night is fine, but like two tablespoons. Sugar isn't as bad as they say, especially with a diet rich in minerals and low in PUFAs.

Liver Glycogen storage is a key factor with "sleep maintenance" and what is likely happening during your night wakings is your blood sugar is dropping and your cortisol is rising. Do you sweat in the night? Do you feel a bit panicked? Your liver is probably not doing so well at storing glycogen... and your body is having tp break down protein in the night to provide your cells with glucose.

This blog was my life saving read - I highly recommend it.
How to Sleep When You Can't

Welcome to the world of carbs my friend - step away from the avocado smoothies....

Thanks allot for your contribution! :)

I already eat allot of fruit, about 3-5 pieces a day a.t.m. because i get it really cheap. Maybe i do need to up my sugar intake.

I do wake up sweating allot, sometimes accompanied with high pulse. It's really hard to get sleep again from that point.

Can you tell me more about PUFAS? My diet is mostly mexican/asian food (home cooked though). I thought about it earlier it had something to do with liver glycogen, but i was not sure.
I don't have allot of health problems other then my sleeping is bad. No hair loss whatsoever. I'll read up on the link! :)

The foods you eat are pretty much opposite as to what Peat would recommend. Why not try alter your food choices rather than try find a drug to help you sleep? I'll let you into a secret, pharmaceuticals aren't the long term answer.

I know that pharmaceuticals aren't the answer. But it always comes in handy. My docter just prescribed doxepin because i really need to catch up on sleep.

 

[LucasZ]

Hi,
Sleep is important, so it's good that you are trying to find ways to improve it.

I too think it's worth reviewing diet and seeing what possibilities there are for experimenting with change there. What, how much and when you eat can make a big difference. What works well can really vary from person to person. Some people sleep best with nothing in their digestive tract at night, others can't sleep unless they have supper, and some need a small snack in the night to resume sleep.

Wouldn't surprise me - running low on glycogen, and resulting stress hormones is what I think used to wake me up too.

I think this might be the culprit of my nighttime awakings...

Consider trying:
- reading articles on Peat's website: raypeat.com
- seeing what you can do to minimise PUFA and replace those calories with more saturate fats (eg coconut oil, milk fat), fruits and veges
- reducing grains, replacing with roots, fruits, etc
- don't overdo the oily fish and avocados (not saying avoid completely, but maybe not massive amounts)
- see if you do better with fresh milk than yogurt - some do - lactic acid can be a burden.
- check nutrition in cronometer or similar to see if you are covering all micros well. Eg check B-vits, minerals ...
- consider trying gradually moving towards at least as much carbs as protein, maybe 2 or more x, and see if it helps.
- small high carb snack if you wake in the night, disturbing yourself as little as possible.

I will do that. Thanks for the tips.
I already do eat allot of fruit (about 4-6 different pieces a day)

I don't eat allot of grains. I mostly eat warm dinners (2 times a day) and i tolerate yoghurt a whole lot better then milk.

Minerals en vitamins are all ok:)

Also in favour of checking breathing during sleep. If you have someone around, you can ask if they've noticed if you always sleep with your mouth shut, or soemetimes/always have it open. If it's open, using a chinstrap or a little tape to keep it closed can make a difference. Maintaining good CO2 levels helps keep you relaxed; overbreathing through open mouth tends to lower CO2 and promote stress mechanisms.

No problem with that. Already checked with GF.

Consider whether you are pushing yourself too hard - overtraining or similar. Maybe reduce training to fewer days/week, less exhaustive.

I think this is true. I already stopped my training because I'm to exhausted. When I'm sleeping better i will pick it up on lower intensity. It also contributes to worsening my insomnia (for days!)

Getting regular sunlight on skin during day?

I always go outside 12 'o clock for lunch break (30 min)

Sleep hygiene means different things to different people, so I'm not sure what you mean by it.

Sleep hygiene is the recommended behavioral and environmental practice that is intended to promote better quality sleep
Sleep Hygiene Tips - Research & Treatments | American Sleep Assoc

If emotional stress is involved, finding ways to play and laugh in relaxing ways with other people can be as useful for adults as for young ones. Sometimes the techniques recommended for calming as part of sleep hygeine can have different effects for different people. The same things don't calm everybody.

Ok thanks :)

 

[AlphaD]

How is your stomach/gut? Have you had any issues with either recently?

 

[LucasZ]

How is your stomach/gut? Have you had any issues with either recently?

I have no problems with my gut or stomach. Except when i take to much magnesium (disaster pants, lol).

I'm gonna try some magnesium citrate with 1 tablespoon honey + 1teaspoon Himalayan salt for a few days and change my diet :) Hope that works a little bit! Still i wanna try Cypro, but i can't find a EU source.

 

[AlphaD]

I have no problems with my gut or stomach. Except when i take to much magnesium (disaster pants, lol).

I'm gonna try some magnesium citrate with 1 tablespoon honey + 1teaspoon Himalayan salt for a few days and change my diet :) Hope that works a little bit! Still i wanna try Cypro, but i can't find a EU source.

I have the exact same problem as you, I have the same groggy symptoms next day when I take antihistamines (mirtazapine, doxylamine, diphenhydramine and even cypro). Mirtazapine makes me sleep 10 solid hours but next day, you don't want to be around me. It's a mystery to me why I have these symptoms to antihestamines. After extended use (a few days), another symptoms manifests which makes my sleep worse (heart rocking/beating in my head) so I have to come off the antihistamines for a while. I got so desperate I just started a cycle of antibiotics to see if it helps (I tried so many things I'm running out of options). Cypro is great (started using it about 2 weeks ago), works as good as doxylamine. You tried doxy and diphenhydramine right? How did those work out for you?

 

[LucasZ]

I have the exact same problem as you, I have the same groggy symptoms next day when I take antihistamines (mirtazapine, doxylamine, diphenhydramine and even cypro). Mirtazapine makes me sleep 10 solid hours but next day, you don't want to be around me. It's a mystery to me why I have these symptoms to antihestamines. After extended use (a few days), another symptoms manifests which makes my sleep worse (heart rocking/beating in my head) so I have to come off the antihistamines for a while. I got so desperate I just started a cycle of antibiotics to see if it helps (I tried so many things I'm running out of options). Cypro is great (started using it about 2 weeks ago), works as good as doxylamine. You tried doxy and diphenhydramine right? How did those work out for you?

Yeah it's really bad. I've tried most of them, but they all make my feel like an extreme lethargic/depressed zombie with brain fog. When i met my GF... It took me 6 months to remember her sisters names and her birthday... That bad! Because i used a low dose mirtazepine. I was in a sleeping clinic that time. They never saw anyone fall asleep during the day so fast <1 min after a nap test (8 times). They said i had CFS, but all symptoms subsided when i stopped using mirtazepine , lol.

The only thing that worked is Seroquel, but it has serious side effects and a horrible withdrawal (i really felt like a junkie for 3 weeks).

I feel you. It's so frustrating to not be able to sleep properly and see everyday subside because you're tired all day...

About doxylamine and diphenhydramine - they can only be used short-term as effectiveness decreases vastly with regular use. Also, in Holland, i too need a prescription for these... But Cypro is different then most anti-histamines, that's why i would like to try it. Just to catch up on some sleep in the weekends.