Taking of nervous system while tapering series: INSOMNIA

INSOMNIA: Mirtazapine (my poison) is famous for the WD symptom of rebound insomnia - other drugs also have this WD symptom. While the cause is primarily due to the drug's action of blocking histamine and the reversal of that when tapering, this symptom has a big impact on the nervous system, which easily becomes a negative feedback loop in which your CNS gets more and more sensitive and reactive with continued inadequate sleep. I've learned the hard way that feeding into that with anxiety and trying to control it makes it way worse and perpetuates a vicious cycle. The idea is obviously to manage your taper to avoid this and other bad WD symptoms, but it's not always possible, even with the best tapering, and most of us make a few mistakes along the way and end up with more/worse symptoms than is reasonable at times. STRATEGIES: I take a few supplements 1-2 hours before bed that I think help a bit (what helps people is very individual), but my primary strategies for dealing with this are as follows:

• Acceptance and doing my best to live mindfully in the present moment all throughout the day
• Interrupting and reframing thoughts that want to focus fearfully on the issue of sleep throughout the day
• Keeping my nervous system as calm as possible throughout the day (quite a bit in this; happy to give more detail if anyone wants, but I've mentioned a few of those things in other comments on other threads)
• Eating a light supper with a bit of protein and healthy fat before bed
• I take a 10mg 24-hr Zyrtec before bed - not sure how much it helps sleep, but I think it may help a bit, and I need to take it anyway since I get bad histamine symptoms from early afternoon on
• My particular pattern is that I mostly go to sleep ok and sleep reasonably soundly for about 6.-6.5hrs, but tend to wake too soon and not be able to go back to sleep (btw, this pattern predates Mirt, and is likely due to hormonal and age changes, as I didn't have this problem before peri-menopause - it's hard to know how much current insomnia is due to Mirt WD and how much is a return to the original issue that led to taking Mirt, but either way, these strategies help
• When I wake up too early, I do the recommended things in the resource posted below, but I add this in: I do lots of gentle self-talk and a reverse psychology thing on my brain where I tell it I'm not trying to sleep, just resting, and then I focus on a breathing pattern that calms the vagus nerve: four breaths in, six out - very often, I do fall back into a light sleep; if I wake too early yet again and still feel tired, I repeat the above, and often I go back into a light sleep

RESOURCE: This 20-min vid is very useful - this woman has a YouTube channel focused on CNS sensitisation and how best to manage it; a lot of her focus is on how a sensitised nervous system can cause neuroplastic symptoms, including anxiety (there's a thread in the Symptoms & Self-care forum along those lines), which may or may not be of interest to you (it's very relevant to my case), but this one on sleep would be worth the time of anyone here struggling with sleep; she even talks about insomnia as a drug WD toward the end. https://www.youtube.com/watch?v=_W6DImPelyc&t=3s I could go on, but that's more than enough for now. I'll wait and see how much interest and engagement there is with this forum and give you all a chance to weigh in.

SUPPLEMENTS: Here are some of the supplements I'm using that help with sleep - I'll also note some I've tried that, for whatever reason, I'm not pursuing at this time, but that might work for others. Bear in mind that there isn't a supplement or drug capable of completely countering WD insomnia unless it can knock you out completely - what I'm listing are subtle supports, so best to view them as nervous system aids rather than solid insomnia fixes, but, along with other strategies as mentioned above, they play a part in helping to calm the CNS in a way that helps sleep. Also, remember that what helps re supplements is very individual; they can be expensive, and we can be extra sensitive to them while tapering, so proceed with caution. Less is more in the first instance, and as always, listen to your body.

• Reishi (a medicinal mushroom touted for immune and nervous system benefits; there are some shonky products out there - I buy from a company called Oriveda, which is considered one, if not the, best, and their gear is third-party tested)
• Melatonin (this is a big help for me, and I currently use time-release 3 mg plus 1.5mg of mix instant and timed release - I take the 1.5 first to help me get sleepy and the 3mg about 15-20 later - I buy from iHerb, which has decent prices and range)
• Oral micronised progesterone (not relevant to the menz - this can help sleep for women in peri- and post-menopause; for some, it's a God send - I plan to hold my Mirt taper and try coming off this soon, though, because I have suspicions it is contributing to another health issue, as some can be progesterone intolerant and I want to test whether I am)
• Magnesium: magnesium glycinate and l-threonate are the best forms for sleep - I think the max for women is 320mg and men 400. I take around 320 of these combined about an hour before bed; this should also help those with muscle-related WD symptoms

Products I've tried or plan to try that might work for you:

• Seriphos (this is touted for sleep and adrenal dysfunction - it definitely helped my sleep but did leave me feeling a bit tired the next day; I've heard that it wears off, and some swear by it - still have some at hand and might return to it at some point - bear in mind, it does have a small amount of magnesium in, so that should be factored into your daily max if you're taking magnesium separately)
• Neurocalm Sleep - I'm not using this yet as I'm currently doing okay without it, but have it at hand and plan to use it when tapering off progesterone, as P affects GABA in a positive, sleep-promoting way and apparently, the herbs in this also work on GABA, so I'm hoping it eases the P-taper path; also, I went on Mirt because of bad insomnia, which kicked in during peri-menopause and I'm eyeing this as maybe something to continue on with, if it suits, through the last leg of my taper and beyond

"Maybe a mod/staff can help me move it if they see this?" — @Mcat

Where do you want this moved to? It's already in the following forum sections: Do you want me to mark this as a "Guide" so it will come up in the Guides tab? It's a great thread! 👍

The most important thing in my recovery from dr. Induced cold turkey and withdrawal is my nervous system. I understand that my brain is working hard through my nervous system to find homeostasis. I imagine my poor brain as wondering what the hell I was doing, but then she wouldn’t know that it wasn’t my fault?😀. So, I need to care for her by gently caring for my nervous system. For me, that means lots of quiet, a good diet of veggies and proteins, hydrating well all day, protecting myself from social interactions that might upset me. Insomnia is definitely a problem for me. I have known that good sleep is healing. For the first 3 months I slept no more than 3-5 hours at night. I joined an app called REST which is gently helping me control my life around preparing for a good nights sleep. I am 82, widow, grown 6 kids, living in a senior community in Southern California. My apartment is small, but my life is rich. I take very few meds now and I am learning to listen to my body.

"wish I could pin this, @Mcat . so gooooooooooooooooooood. thank you" — @anne noni moss

You can definitely "follow" this thread @anne noni moss so you'll get updates. I'm not sure if you use your home computer when you're on the forum, but if so you can use the Bookmark bar at the top to create different folders for things and then add specific links to those folders so you can find them quickly. Hope that makes sense!