[perl4ever]

>Once you have a consistent schedule, barring medical issues, sleeping is easy

I respect your personal experience, but you are coming on a little strong in terms of assuming everyone is just like yourself.

Something I've seen other people mention, and may have myself (although not formally diagnosed):

https://en.wikipedia.org/wiki/Delayed_sleep_phase_disorder

I have worked 8-5, 2-11, and 11-8, and no matter what my schedule was, I had the urge to stay up a little later, but needed at least 8 hours to feel adequately rested. So typically I would get 7 hours or so and feel exhausted every morning. Without work or appointments, I would rotate my schedule around the clock, day by day. It's as if I was tuned to a planet with a slightly longer day.

After many, many years, I found by accident that bupropion (aka Zyban aka Wellbutrin) fixed it, just like that. It was amazing. But I wasn't able to tolerate a full dosage, so that didn't last. It does point to some dysfunction of nicotinic receptors.

[Twisol]

> I respect your personal experience, but you are coming on a little strong in terms of assuming everyone is just like yourself.

This was actually a significant point of contention between myself and my advisor, who interpreted my working late at the lab as though I was trying to cram extra time to make up for not being there otherwise, or something. Those are just my most productive hours ¯\_(ツ)_/¯ but to him I was lazy and irresponsible.

My natural sleep period seems to be around 9 hours. I can make myself do 7 (I currently keep a ~1:30am-9am schedule, with some effort), but anything less has noticeable effects on my cognitive state, and I still start getting tired again around 5pm. If I do sleep at 5pm, I'll wake somewhere between 11pm and 2am, which is bad but in the other direction. So I have to fight through the late-afternoon slump. It's very easy to knock me off of this schedule, and I've been keeping it for two years since I left grad school.

Sleep disorders are real, and they are not simply symptoms of a poor work ethic.

[bobf]

I'm the same way, naturally preferring something like a 26-27 hour day with 17+ hours awake and 9+ hours of sleep. I'd be very interested to hear more about your experience, especially of bupropion helping - could you email me (in my profile)? I've found melatonin, doxylamine succinate, zolpidem, and alprazolam to each be somewhat helpful at times although they all have diminishing returns over time and seem to affect sleep quality.

[cik2e]

My sleep history has been all over the map and at times I've also gone for the sleep aids. I've tried all of the meds you've listed and none have been particularly effective when I've really needed them.

You may want to look into Suvorexant (https://en.wikipedia.org/wiki/Suvorexant). It's the one drug that I've found to be extremely effective without causing any sort of hangover in the morning. It really felt like a miracle drug as compared to things like zolpidem and antihistamines. YMMV but I'd say it's worth looking into if you're really struggling.

I should also mention that I've found a combination of exercise, time in the sun, and proper sleep hygiene to be the only viable long-term solution. But I do believe that sleep aids can be a useful bridge towards developing a consistent sleep schedule.

[bonestamp2]

> proper sleep hygiene

Can you expand on what you mean by this?

[perl4ever]

Based on my experience and people I know, everyone seems to react to every drug differently, and if you read studies, you will find assertions about what it does that contradict individual experience.

I found that 75 mg twice a day made me feel ready to wake in the morning like I basically never have been, but it also had intolerable side effects. Going back to 75 mg/day, halving it, is bearable, but also reverted my sleep pattern.

I am taking melatonin at the moment, because why not, but I don't notice much effect except an increase in dreaming (or remembering it).

[bonestamp2]

Assuming it's is legal where you are, have you tried cannabis? No hangover like alcohol, small doses won't make you feel intoxicated, sleep is easier to achieve and the quality is great. It doesn't help everyone, but it's worth a shot if you haven't tried it. Depending on where you live, you may be able to order it online and have it delivered like anything else. I like edible gummies. Take 30-60 minutes before you want to sleep, easy to take, easy to divide into smaller doses, no smell.

[shados]

My understanding with weed is that it reduces the amount of REM sleep you get. You may come up ahead over all with this tradeoff, but not ahead of someone who sleeps "normally".

[oarabbus_]

>sleep is easier to achieve and the quality is great

It's easier to fall asleep sometimes, but I find sleep quality markedly worsened with cannabis, personally. I have to sleep an extra hour or two if I've consumed cannabis prior to sleep.

[jdabney]

I was diagnosed with Delayed sleep phase disorder and have the same issue where sleep aids only work a few days at a time before stopping with diminishing returns everyday. Nothing but just letting myself sleep when my body wants to sleep has worked.

[remar]

I suffer from this too (only formally diagnosed with sleep apnea though) and found that 0.5mg of melatonin about 20-40mins before I want to go to sleep has helped me align my sleep cycle to a 24hr schedule. I also get a consistent 8hrs registered on my CPAP so it doesn't seem to interfere with my sleep quality/duration either.

I buy melatonin that comes in 1mg pressed/powder pill form and just bite it to split it in half and toss the other half back in the bottle.

I've been doing this for 2 years now and have never had to change the dose. At one point I even considered seeing if .25mg would be sufficient but depending on the brand sometimes the pill crumbles up too much so I stick with .5mg. I've used Nature's Bounty and Webber Naturals and both brands seem to work the same for me.

I really wish I had figured this trick out a lot earlier in life as it would've saved me from missing out on a lot of opportunities in my career.

(more detail about my experimentation below)

Before I discovered this I tried everything from reducing screen time before bed, cranking up night mode in flux/redshift, abandoning coffee/caffeine entirely, working out earlier in the day instead of evenings, etc. _Nothing_ worked for me - my brain would remain wide awake and I would have to stay up until 5-7am before I even began to feel tired (where I would have to wake up between 10-11am for work).

I had even tried melatonin before too but it was a 3mg pill and it would produce very erratic results in my sleep quality. I'd sometimes wake up drenched in sweat or wake up feeling very groggy for hours so I figured melatonin just wasn't for me. It wasn't until I came across some advice on /r/n24 or /r/dspd to try .5-1mg of melatonin that I decided to try again (IIRC it was a post about how doses >=2mg can actually result in melatonin overdose and result in the types of symptoms I was observing - TBH I didn't really bother verifying that info and just figured I'd try .5mg and see what happened as I was desperate for a solution).

And for the record, with this approach I haven't had to make any other modifications to my daily routine. I continue to lift heavy in the evenings and drink 1-2 cups of drip/espresso every day.

The only situations I've noticed where this trick falls apart for me are:

1) if I ever try to push past that 20-40min period where I start to get drowsy, it results in me being awake again. This rarely ever happens and I usually just end up sleeping about an hour later. I make sure to take the melatonin just before I begin flossing+brushing and get in bed right after

2) for some reason drinking a can of coke/pepsi in the evening will keep me wired awake all night. I've had cups of coffee in the evening rarely which never had the same effect, but coke/pepsi will...

Anyway, just thought I'd share since this made a huge difference in my life - maybe worth trying/experimenting.

[DanBC]

Low doses of melatonin can be really helpful, especially if people have tried all the "sleep hygiene" steps and that's not working and they don't need a z drug yet.

One of the problems of melatonin is that in some countries it's sold as a supplement not a medication, so the regulation is much less strict.

The dosing varies so much, even in product labelled as 1 mg.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5263069/

> In this issue of the Journal of Clinical Sleep Medicine, Erland and Saxena systematically analyzed the actual melatonin content (and presence of contaminants) in 31 melatonin supplements purchased from groceries and pharmacies in one city in Canada (before countrywide OTC use of it in Canada was banned). Their findings herald what may also be true in OTC melatonin supplements marketed in the United States. Melatonin content varied from an egregious −83% to +478% of labeled melatonin and 70% had melatonin concentration ≤ 10% of what was claimed. Worse yet, the content of melatonin between lots of the same product varied by as much as 465%.3

> The most variable sample was a chewable tablet (and most likely to be used by children). It contained almost 9 mg of melatonin when it was supposed to contain 1.5 mg and also exhibited the greatest variability between lots (465% difference). The lowest melatonin content was −83% compared to its labeled value in a capsule that also contained lavender, chamomile, and lemon balm. Capsules showed the greatest variability between lots. Liquid supplements surprisingly showed generally high to median stability with low lot-to-lot stability. The least variable products were those that contained the simplest mix of ingredients, generally oral or sublingual tablets with melatonin added to a filler of silica or cellulose derivatives and were the most reproducible. The last disturbing finding was more than a quarter of melatonin products contained serotonin, some at potentially significant doses. Serotonin is a breakdown product of melatonin metabolism but could have medicinal effects and should be taken without oversight. In short, there was no guarantee of the strength or purity of OTC melatonin.

[remar]

Very interesting, thanks for sharing!