Insomnia solutions?

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hds
Hi all,

I have searched the forum for answers but found my situation might be somewhat unique. I had paroxysmal Afib, onset by a Covid infection and subsequent Long-Covid (still recovering - classic ME/CFS symptoms), and Afib appears to have stopped altogether which my cardiologist (EP) indicated might happen start to recover from Long-Covid.

I have bouts of insomnia and am looking for a safe way to get through the night. I usually wake up around 1-2am and this is very typical for people with Long-Covid due to hormone issues caused by the condition. I currently take 10mg Zaleplon to get back to sleep. I sleep anywhere between 6 and 9 hours, but interrupted, so low-quality sleep, and would still classify as insomnia.

Question: what is the 'safest' option for me to get me (mostly) through the night? - something that won't inadvertently trigger arrythmia:

1- Melatonin - what's a good dosage?
2- CBD, THC, a combination, or one of the other derivatives?
3- Something else?

Since it is hormone-caused, CBD-I is not an option. I can calm myself easily with Yoga Nidra.

Thanks in advance!

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calvin
I can only relate my use of melatonin for severe Insomnia. I purchased 3mg dosage pills and found at 3mg I woke up in the morning and was severely tired and sleepy for 5 to 6 hours after waking!! More tired than the insomnia. So I cut the pills in half for a dose of 1.5 mg and that seemed to be much better. My insomnia was from Sotolol and I finally got used to it and now have 4 to 5 hours of uninterrupted sleep with out the Melatonin. If it matters I weight 145lbs.

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Daisy

Hi all,

I have searched the forum for answers but found my situation might be somewhat unique. I had paroxysmal Afib, onset by a Covid infection and subsequent Long-Covid (still recovering - classic ME/CFS symptoms), and Afib appears to have stopped altogether which my cardiologist (EP) indicated might happen start to recover from Long-Covid.

I have bouts of insomnia and am looking for a safe way to get through the night. I usually wake up around 1-2am and this is very typical for people with Long-Covid due to hormone issues caused by the condition. I currently take 10mg Zaleplon to get back to sleep. I sleep anywhere between 6 and 9 hours, but interrupted, so low-quality sleep, and would still classify as insomnia.

Question: what is the 'safest' option for me to get me (mostly) through the night? - something that won't inadvertently trigger arrythmia:

1- Melatonin - what's a good dosage?
2- CBD, THC, a combination, or one of the other derivatives?
3- Something else?

Since it is hormone-caused, CBD-I is not an option. I can calm myself easily with Yoga Nidra.

Thanks in advance!

Unfortunately I have a lot of experience here! I have ME/CFS (onset post viral) and sleep has been an ongoing problem and I have sometimes resorted to medication so as not to be literally awake the whole night. Recently my Primary Care suggested a low dose of cannabis gummies but told me to check with my Electrophysiologist due to my history with Afib. I did and he suggested a certain dose of oral CBD rather than THC. Since he has treated me for Afib and that is his area of expertise, the risk of arrhythmia would be top in his mind. I have been using it and find it effective.

I have also seen a psychologist specializing in CBT for insomnia and after going through many sessions with me, she and I both agreed that it hadn't worked because my insomnia was coming from an imbalance between the sympathetic and parasympathetic nervous system that was biochemical and not responsive to Cognitive Behavioral Therapy. That is my experience. If you would like more details, send me a private message.

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gloaming
If you haven't been ruled out as a sufferer, sleep apnea, even a mild form, is enough to disrupt sleep. Might be worth a formal assessment.

Most people take far too much melatonin, and too often. I have seen research (didn't think to tag it, sorry) suggesting that taking it ever night is not a good idea. I don't sleep particularly well, and to my knowledge I have never had COVID. However, after both my angiogram and my two ablations, I found that sleep was elusive. I asked my GP and he prescribed a very stingy count of Zopiclone. My pharmacist, who knows about my OSA, cautioned me to take only a half pill the first night, not a whole one as prescribed, to see if that had enough of a soporific effect. Happily, it did, and even when I cut the halve in half I got a decent improvement. Sometimes, just the idea of getting help is enough to take the edge or worry off.

I don't know if it will be relevant for you, but I never take any assistance two consecutive nights, and I try to go at least three without. Yeah, some nights aren't great, but after each assistance I seem to be better either the next night or the one or two following. Then, I'll get another iffy coupla nights and it's back on the melatonin, or 1/4 Zopiclone (7.5 mg/tab). The point is to not rely on the drugs or they'll lose their efficacy over time, just as anti-arrhythmic drugs and rate control drugs seem to do for most of us.

As always, follow your prescriptions. They top my advice or anecdotal information.

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Carey
CBTI

Google it. Apparently, it's very successful and no drugs are involved, nor do you need to continue the therapy beyond about 6-12 sessions. I've heard multiple doctors praise it, including sleep experts.

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mjamesone
You've been given some very good advice, but you're not doing it already, you might first want to up your sleep hygiene habits.

One bad habit a lot of us have is laying in bed in bed too much while we're awake. So keep the bed exclusively for sleeping and not for relaxing.

And along these lines, if you wake up in the middle of the night and can't get back to sleep in say 15-20 minutes -- then best to get up, sit in a chair with with lights on low and read a book or listen to some music until hopefully you will feel the need to sleep.

If you stay in bed too long while awake, your body will begin to associate being awake and being in bed, which is the opposite of what you want.

Jim

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gloaming
Only ever 3mg, which the research seems to have settled on being the maximum needed dose.

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Carey

Only ever 3mg, which the research seems to have settled on being the maximum needed dose.

Yep, read an article about melatonin a while back, and research found that the most effective dose is in that range, while higher doses actually have a paradoxical effect that impacts sleep negatively. But most people don't realize that and assume more is better, so they buy the supplements with the highest dosage. The supplement makers know this so keep boosting the dosages so their product is the highest dosage on the shelf, which is the one you shouldn't buy.

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Pixie
I did a quick search on Medscape and saw there was an interaction with Eliquis. Any thoughts on this would be appreciated,

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Carey
No, I wouldn't hesitate. Are you taking the diltiazem for rate control or hypertension? If it's for rate control then the interaction doesn't matter at all. If it's for hypertension, just watch your BP for a few days and if it goes up, talk to the doc who prescribed it about perhaps changing dosage.