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Here is my advice:
Trust your body knows how to sleep – it has not forgotten and you will sleep in the end.
You do not need drugs. It may take a while for the effect of the drugs to leave your system, but they will. You may have a few bad nights in the interim.If you do not sleep much one night (or at all on some nights as I regularly used to), you will get through the next day. You may not get as much done, but you will be OK.
If you do not sleep, you won’t die and your body will sleep the next night or in the end.You have to trust your body.. It has not forgotten how to sleep, the drugs you are taking is just confusing your system a bit.
See the podcast I did with Martin for more.
Oh, and don’t expect to sleep like other people do with 7 or 8 hours, you probably don’t need that much, after all can you wear their shoes if they are two sizes smaller than you?!
I thought I would just comment more on Mirtazapine.
So, here I am and now it has been over a year since I had a nil sleep night. I used to get regular nights of no sleep at all – and how I dealt with that problem and how I overcame it is explained in a video shown under the success stories.
It is called “Success with CBTI and ACT/Mindfulness” – and was put up here on October 16, 2019. Do please look it up!One of the things that I used to help me sleep when I had those nil sleep nights was a drug called Mirtazapine, sometimes also known as Remeron, which I wrote about before here.
Now I must be clear, it was not the drug that got me better, it was the techniques I talked about in the video. However, when I was in in a very dark place, I did use Mirtazapine to help me – and I have sympathy for anyone who does take drug help. It did help me.
I explained in the notes in this discussion that it became clear from my research of User Reviews of this drug and also from my own experience that very small doses worked much, much better than the normal doses that they give to people for its main line use – which is for depression. (Relatively few doctors know it can be used also for insomnia, however). In fact, many people at User Review sites report that normal doses -like 15mg – may not work to help folks sleep or that if they do, they stop working.
As I explained here, I would break down the pill into eighths or sixths (though it is hard to get less than sixths often, as they are so small anyway, you tend to get powdery!)
Naturally, the makers of the drug must know how, counter-intuitively, that it works better in v small doses for insomnia, but I guess being the lovely profit driven, Big Pharma that they are, they are not keen to share this knowledge. (As I said, I only found out from User Reviews and from personal experience).
I also found that by far the best way to take it, (and for far better results), was to stick it on your tongue and let it slowly dissolve. It does not taste of anything, makes your tongue a little bit numb for a bit, but that numbness does not last.
The rest of the notes – and my experience with this drug are in the preceding discussion here – on this thread – so I won’t repeat it here.
The only 2 things I would add are this to my previous comments are about drowsiness next day and effects on libido.
Drowsiness, first, This drug makes you very drowsy most of the next day too. Not only drowsy but also I would describe it as a little bit “dissociated” if that makes sense – and that effect lasts for about 36 hours after taking it, though the most drowsiness is in the first 12 to 18 hours after taking it.
As someone else noted here – it can be damn hard to wake up and get up after it, it can be a real struggle. You may need a few alarm calls and a brisk shower!
I noted before that I had put weight on – but was still fit.Well, many months after having last taken Mirtazapine, I STILL have that excess weight that I put on with it. Still 8% excess weight. In my view, as I still do regular exercise and only consume same type and amount of food and alcohol, the increase must be due to this drug.
What I am saying is that the excess weight has been hard, well impossible so far to shift.
The other effect is on your libido. It seems to reduce one’s libido for about 3 days. I’m a man, not sure if it has the same effect on the libido of a woman.My experience with it has made me rather wary of the side effects of all drugs – and topically –that wariness would apply to vaccines too – but hey, let’s not go there.
Do I regret having taken it?
No, I don’t because it helped me get over a very dark place when I would not sleep at all as many as 9 or ten nights in a period of a month.But as I said, I think the techniques I was leaning here and eventually, combined with my realization that insomnia is an obsession problem, would have got me better in the end. It just would have taken me a bit longer.
I hope the interview I did with Martin under the Success Stories helps you to put insomnia to sleep for ever – as it did me. Martin’s emails were a great help too.
I wish you all the best – and I hope this post and this thread helps you too.
Best wishes DafPlus, Martin I linked in the video on what mindfulness is – the “7 attitudes” by Jon Kabat Zinn in the interview he did with me, in the Success Stories
ACT stands for Acceptance Commitment Therapy. As applied to insomnia, get the book by “Guy Meadows”, a proponent of using ACT to deal with sleep problems.
Mindfulness is a key part of ACT and ACT uses a lot of mindfulness techniques.
There is lots of info on the internet about both.Most folks seem to put 8 percent or so weight on.
For me it is all round tummy. Was 81kg, went to 88kg, now down to 85kg.im 5 ft 11 inch man. Age 57.
But feel as fit as ever.
And would take the weight gain over the past horrors of not sleeping. Not that I think Mirt was essential, but it helped at times.Hi Ele,
Good question. I put about 8% weight on.
Once it was on, it is hard to get the weigh off, even after stopped taking Mirtazapine.Still about 5% overweight now – and the last pill I had (a one off of 1.95mg was about three months ago). But I feel as fit as ever, which is odd.
Luckily I was not overweight to start with.Have you also read the Success with CBTI/ ACT Mindfulness video interview Martin did with me, published in the Success Stories. Worth a listen!
Kind regards
DMy reduction off Mirt is described in posts above.
I can update you now that I had no serious issues coming off using the method described above.
The only thing was that 3 to 5 days after reducing and then later when stopping, my sleep was quite broken up, so I’d wake up a lot. But I’d always get back to sleep OK.
So, yeah no problem.
I had suffered for 2 years with nil sleep nights at least once a week.
Now, have not had nil sleep night for 5 months.
I did it on my own but also went on a course in our N H S, UK health service.
But I did not find their course really helped much, because I just don’t agree with getting up if not slept for 15 mins, nor their focus on having same get up time.
Plus most of the other people in the group were not as bad as me in terms of lack of sleep, which made me feel worse.
I think working with someone one to one can help and I imagine Martin is pretty good, as insomnia is his focus.
I would try to stay in bed and be in acceptance usually, but sometimes I might get up, but that would be at least after an hour.Hi Manfred,
Realising I was obsessive DID help me, maybe not others.
Because I could see a pattern in my life when I realised I could, from time to time, became obsessive about things, that self knowledge just seemed to help me. “Oh hear I go again. I don’t have to be like that. I’ve done that before about this matter or that matter. I don’t need to do this”
Having that attitude helped.
I guess it is like a recovering alcoholic – they see the signs and the drivers coming up that may make them relapse, so they do whatever they need to do to avoid those signs.For me I think the same getting up time is too restrictive. E.g. How would that work if you wanted to stay out late on a Saturday, like a normal person does? So I just targeted 4.5 hours and was flexible about when I got it, as long as it was at night time.
Was getting up after 4.5 hrs depressing?. No, not when you used to get nil sleep nights, not at all.
I was always in a good mood to have got 4.5hrs and at least, some sleep, so no, not depressed at all. And I functioned fine on 4.5hrs, which I think I did for about 3 weeks, then increased gradually.
I now normally get about 5.5 to 6.5 hours net sleep, but it varies. I try to avoid getting any more than 6.5 hours because I know I wont be tired the next night at all – and I wish to avoid that.After any sleep, I would get up, have a cup of tea, watch TV, get on the internet, maybe go for a run outside.
When I was suffering, after nil sleep nights (or les than 2 hours), yes I’d feel awful – tight feeling in chest and stomach, feeling a bit sick, but mindfulness helped deal with that. Also, writing down my feelings in a journal and focusing on being positive (CBTi) also helped.
Also, I’m lucky to have a supportive wife and friends.Today, I v occasionally get anxiety feelings come up, especially around some trying family situations. If that happens, I may do a bit of mindfulness and will always go for a walk in a v quiet park and have a chat to myself as I do. It all helps.
Kind regards
DavidHi Guys,
Quick reply.
Yes, it’s obvious from just reading the posts that the people on here with severe insomnia (and those who have recovered) are deep thinkers, bright, seem above average intelligence and perhaps over caring, sensitive people. (I have said this before). Likely therefore to over think and be obsessive, and that can lead on to anxiety, in this case, anxiety about sleep.
I believe that ACT and CBTi / SRT are in fact complimentary generally. However, it was SRT/ CBTi that really got me better. ACT helped a bit to just chill but mainly to better deal with those nil sleep nights I used to get – whether at night or the next day.
No, I rarely do mindfulness now. Only occasionally when something stresses me out a lot – like having to deal with my elderly Mum and Dad. I might then take 20 mins out. But I’m too driven and active a person to stop my day and do it, but if you can, then great, it will do you no harm.
The 7 attitude of mindfulness in that video of Jon Kabat Zinn are excellent ideals to live by, whether you’re a catholic like me, Jewish, Muslim or atheist. It is just good advice originally from our Buddhist friends!Did I get up if I could not sleep? Sometimes, but not often – and if I did, it might be after about an hour or two of lying there. If I did, I would watch TV – something light like a nature programme. I don’t agree with all SRT strictures and the one about getting up after 15 mins of not sleeping is one I think is not for me.
Plus I don’t think a strict getting out of bed time is key. My start was just getting 4.5hrs a night at first, but that could be 11 to 3.15 or 1 to 515. I built from there. One needs to vary time getting up to still have a flipping life at the weekends and be a normal person!
Yes it is hard getting up after only 4.5hrs, but I did it most of the time. Occasionally I said, “hell, I wanna stay in bed and sleep for 8 hrs” and I did, but then was cool I may not get tired the next night, so would stay up for a long time. Don’t be too hard on yourself but try and stay near to the programme of sleep restriction in the early days.Have a listen to the podcast if you’ve not already. All this is in there.
…and to just add re the obsessiveness in previous post, my slightly obsessive ways created an obsession with sleeping (or not), (the sleep issue first started after a breathing / asthma condition developed).
I believe the obsessiveness is a form of anxiety and hence insomnia is actually tied up with anxiety, for most people.
I also am convinced (partly from all I have read on forums like this) that most people who are obsessive are also successful and driven and thoughtful / maybe over-caring types of people. But that good stuff can morph into over-obsession (in this case, obsession with sleep).
Think about it: Do you think many people who have a genuine “breeze through life” attitude ever worry about sleep. (Of course, you may not really know them, deep down. Even my many of my closest friends would not think I’m obsessive, but I am)
Hope this helps.
In the Success Stories, the podcast is called “Success-with-cbti-and-act-mindfulness”
Daf (David Lawrenson)
Debs, Sounds like you’ve got the right idea. But many struggle with this mindset… And it’s not easy, takes practice.
Acceptance and mindfulness is not about stopping thoughts at all, it is about letting them happen and “being OK” with that. Watching the thoughts, just observing them, not trying to stop them.
You must let thoughts happen. It is a fallacy that the best mindfulness practitioners and Buddhists in monasteries in Tibet are in a Zen like state in which they don’t have lots of thoughts. They have thoughts, they just observe them.
And the point about ACT for sleep is to accept the thoughts and accept “how things are”.
If your attitude is, “Well I’m doing this acceptance sleep for the sole purpose of sleep” I think you’ve rather missed the point.
I’d refer you to the podcast I did in the Success Stories and the link to the Jon Kabat Zinn youtube pieces there, about what mindfulness really is.
Having said all that, whilst ACT and mindfulness did very much help me to cope with those nil sleep nights I used to have (and deal with the anxiety I used to get whenever I had a nil sleep night). it only helped a little with actually beating insomnia.
If you listen to the podcast you’ll find that what really did help me, was my realising I was actually an obsessive type of person (just the realisation of that was huge) and also my restriction of sleep to 4.5hrs a night and then slowly building up from there, plus of course doing all the sleep hygiene things ( though the sleep hygiene ought to be a given and surely hardly needs repeating to folks on here!)
Realising I would sleep in the end also helped, plus the fact that I simply do not need as much sleep as other people also helped me. (Now I generally sleep between 4.5 and 7 hours net of sleep a night). Now over 9 months since a non sleep night. Not sure though as I don’t count it any more nor record it.
Hope that helps
David LawrensonPhil, Interesting points about sexual release. I’m very much of the view that regular sexual release is good for sleep. However, for me I needed to avoid having sexual activity v late at night.
Also goes without saying that if you have had a nil sleep night you won’t feel like sleep at all.One thing I observed when I used to take sleep aids such as Zopiclone and Mirtazapine (Remeron) was that there was usually a knock on effect to later nights.
So, for example, with Mirt, it would assist getting a good night sleep on night one and also, the following night (even if not actually taken then, due to it’s long life), but on nights 3 and 4, I always noticed that sleep was quite “broken up” and “In and out” and light.
I am just saying that I observed this, because I see some of you, who occasionally take a sleep aid/ tablet, often also say that their sleep is a little like this on later nights, when you have taken nothing.
The best thing is to take nothing at all, of course, and maybe best you realise that there is some impact on subsequent nights, when you stop taking them.
Hope that helps. It is based on my observations of what happened to me.
