Treating Unrefreshing Sleep

[energyoverload]

Trying to Remedy Unrefreshing Sleep in ME

Source: http://findanswerstome.blogspot.co.uk/2012/07/trying-to-remedy-unrefreshing-sleep-in.html


This is just a quick post I will follow up with further links to studies when I have the time.

Things that can help some people with the paralyzing feeling left over from unrefreshing sleep. I have found that Pregabalin 300mg can increased Slow Wave Sleep Stages 3&4.

Also 5HT2a antagonists such as Risperidone inhibit only 5HT2a receptors at low doses (i.e. 0.5mg) a higher dose will cause side effects and not as selectively target the 5HT2a receptor and thus inhibit other receptors such as D2 etc.

I have found that Pregabalin 300mg combined with Risperidone 0.5 give the best results for reducing that dreadful feeling where you wake up feeling like you've had a seizure - like your head's been kicked around like a football (aka unrefreshing sleep). Take these an hour before you go to bed - you may need to use them in conjunction with a sedative med like low dose doxepin 6-10mg that does not interfere with deep sleep. I use this to get me to sleep. I would not use any benzodiazepines in conjunction with these deep sleep meds because benzos will reduces Stages 3&4 sleep. Zopiclone, zolpidem etc are okay because they do not reduce SWS.

In the near future more potent deep sleep inducing medications will become available in the form of 5HT2a inverse agonists such as Ketanserin. These could provide a safer alternative to Sodium Oxybate (Xyrem).

I have to say though unfortunately I seem to build tolerance to almost all medications and hence I would recommend to administer these drugs in a cyclical fashion, rotating them frequently or if an alternative is not available, coming off them for several days before going back on. This should reduce receptor downregulation to some extent.

 

[heapsreal]

mirtazapine is also a htp2a antagonist and might be easier to get then resperidone. Baclofen is another med which works on gaba B receptors which is different to traditional benzo's, baclofen is said to increase deep sleep and it has been mentioned its the poor mans xyrem. I have found it good for improving sleep quality but not much good on its own. I also agree with pregabolin, its great for improving sleep quality but i find all these i build a tolerence to their effect within a few days so i alternate them regularly but find i need something else to initiate sleep like zopiclone or zolpidem, occassionally i will use valium to initiate sleep.

Even very long breaks from certain meds is needed as well. In the past i was using trazodone to improve sleep quality and it helped abit but nothing to rave over, then i stopped using it for well over 12 months. Recently i have started using it again and its working better then it did the first time i used it. SO i dont think u can write things off, for some strange reason sometimes over time things change and treatments that werent as effective or stopped working can start helping, know idea why this happens other then our brain chemistry probably changes over time.

cheers!!!

 

[energyoverload]

Heaps,

That's interesting how baclofen helps the quality I read a few studies on its effect on SWS. out of interest what dosage do you take close to bed time?

Trazadone is interesting too it can improve SWS but interestingly has far less affinity for the 5ht2a receptor than risperidone. I don't know if your able to find any information on the receptor affinities (Ki/nM) for Mianserin this is similar to mirtazapine. I also have taken mirtazapine it didnt seem to help deep sleep at all in my case it has much lower affinity for 5ht2a receptor so a much higher dose is needed - at which it does not have significant H1 antagonism at higher doses. thanks!!!

 

[heapsreal]

Heaps,

That's interesting how baclofen helps the quality I read a few studies on its effect on SWS. out of interest what dosage do you take close to bed time?

Trazadone is interesting too it can improve SWS but interestingly has far less affinity for the 5ht2a receptor than risperidone. I don't know if your able to find any information on the receptor affinities (Ki/nM) for Mianserin this is similar to mirtazapine. I also have taken mirtazapine it didnt seem to help deep sleep at all in my case it has much lower affinity for 5ht2a receptor so a much higher dose is needed - at which it does not have significant H1 antagonism at higher doses. thanks!!!

Lately what i have been doing with baclofen is using 50mg, which is quite high but it gives me a really goog deep long sleep, strange thing is if i use it wthout zopiclone it doesnt work nearly as well. Dose i would recommend is starting at 10mg and take it from there, the study i saw used 20mg that increased SWS. Can buy it in 10mg and 25mg tabs. I use it once maybe twice a week and usually when i know i can sleep in.

Mianserin sounds interesting, i know its suppose to be similar to mirtaz but never used mian, have u tried this med??

I looked into the different receptors etc for sleep awhile ago, many of the antidepressants that are sedating mainly work through antihistamine effects as well as 5ht2a, some other meds also block dopamine as well like seroquel, risperodone etc which help cause sedation. I have used seroquel and it works well for sleep but i wake up feeling very stiff and sore, so i use it very rarely.

There is suppose to be a new antidepressant similar to trazodone, spelling ends in 'done' i wonder if it helps sleep too.

cheers!!!

 

[xchocoholic]

Thanks. I've been experimenting with sleep supplements (theanine, 5htp and melatonin) for a few years now. I've
varied the dosages of each and found the right combo for sleep but they leave me too mentally sluggish the next day or two.

I recently reduced these and added 1/4 of a .125 mg of sublingual klonopin to reach a deeper
more refreshing level of sleep. It works great but even this small amount is making me hung over and unable to function for
at least 24 hours.

I have seizures, mainly petite mals and myoclonus, so I have these on hand. Interestingly, I finally realized that klonopin makes my petite mal
feelings worse. Doh ! But they help the myoclonus. Aaaagh !

I'll take a look at these now ..

Tc .. X

 

[physicsstudent13]

Trying to Remedy Unrefreshing Sleep in ME

Source: http://findanswerstome.blogspot.co.uk/2012/07/trying-to-remedy-unrefreshing-sleep-in.html


This is just a quick post I will follow up with further links to studies when I have the time.

Things that can help some people with the paralyzing feeling left over from unrefreshing sleep. I have found that Pregabalin 300mg can increased Slow Wave Sleep Stages 3&4.

Also 5HT2a antagonists such as Risperidone inhibit only 5HT2a receptors at low doses (i.e. 0.5mg) a higher dose will cause side effects and not as selectively target the 5HT2a receptor and thus inhibit other receptors such as D2 etc.

I have found that Pregabalin 300mg combined with Risperidone 0.5 give the best results for reducing that dreadful feeling where you wake up feeling like you've had a seizure - like your head's been kicked around like a football (aka unrefreshing sleep). Take these an hour before you go to bed - you may need to use them in conjunction with a sedative med like low dose doxepin 6-10mg that does not interfere with deep sleep. I use this to get me to sleep. I would not use any benzodiazepines in conjunction with these deep sleep meds because benzos will reduces Stages 3&4 sleep. Zopiclone, zolpidem etc are okay because they do not reduce SWS.

In the near future more potent deep sleep inducing medications will become available in the form of 5HT2a inverse agonists such as Ketanserin. These could provide a safer alternative to Sodium Oxybate (Xyrem).

I have to say though unfortunately I seem to build tolerance to almost all medications and hence I would recommend to administer these drugs in a cyclical fashion, rotating them frequently or if an alternative is not available, coming off them for several days before going back on. This should reduce receptor downregulation to some extent.

I take klonopin+gabapentin, the combo together is effective while only one is not. I have a seizure disorder PLMD which disrupts my sleep. klonopin is supposed to really reduce central apneas while Gabapentin increases stage 3/4. I'd like to try the pregablin+risperidone, I have severe sleep apnea and wake up with low oxygen headaches

 

[physicsstudent13]

mirtizapine and trazodone I don't think worked for me alone. I find that I must take a benza+gabapentin to sleep better and have higher oxygen levels (mine were about 63% on a recent study).
is pregabalin better than gabapentin/neurontin/gabix? It does make a huge difference when combined with klonopin. the major side effect of gabapentin might be no new synapse formation and klonopin may cause memory damage problems short/long term
I need the klonopin I think because I have a seizure like disorder PLMD twitching of the leg or arm which keeps waking me up or interrupting my sleep and oxygen levels.
I've been trying amitryptiline which seems to be ok. anyway I have a sleep apnea machine an asv which is essential