I tried to post this yesterday but it evidently went astray.
I'mcoming up for 87 and would like to enjoy my remaining time rather than be tired.
I’ve posted here previously on my long term insomnia that started along with many other problems after being prescribed Fluoroquinolones in 2012. In the last two years it has worsened as I have arthritis in my toes and feet and although not actually painful they are stiff and uncomfortable in bed and I’m always aware of them. I also have a problem with my body thermostat in that my temperature is usually under 96F but I feel very hot in bed without it actually going up. I try to keep our bedroom as airy a possible but it gets the evening sun but I usually find it too warm and I find the warmed air makes breathing difficult. I only have a sheet over me until about 6am when the world gets cooler.
I stay up until after 12.30 until I start to feel that I will sleep and alway expect to sleep . Most nights feeling hot and not breathing happily I’m up after twenty minutes and sit in a cooler room. Usually I’m up twice in the next hour before sleeping for less than two hours before getting up again and going to the toilet and probably having some warm milk. Back to bed and take a while to get back to sleep for another maximum of two hours.
Perhaps twice a week sleep does not come and I’m up until about 4am until getting to sleep until about 6.30 when suddenly I’m wide awake. Hopefully I get back to sleep until about 7.45 when it’s not worth trying again.
I’m at the stage now when lack of sleep is affecting all aspects on my life. Most of the day I’m in a brain fog. My whole body is suffering from not being refreshed and my walking already affected by a form of neuropathy from being Floxed and having knee problems is much worse. That and Covid exercising restrictions has greatly affected the strength of upper legs and put more pressure on my knees. I ‘m wondering if others have the same limitations from their lack of sleep.
Sleeping pills herbal or prescription did not work for me and I still woke up in the night and in a more dangerous state for walking. Differing strengths of Melatonin and CBD oil taken long term were of no help.
I often have severe indigestion at night and recently what feels like severe gastritis almost 24/7.
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They are antibiotics part of a group with Cipro and others that can cause great damage. Their use has now in the past three years in the main been restricted and warning labels put on the packaging.
It's a very long story and I and others here have also posted about it. Put Fluoroquinolone into the search bx and many will come up.
I really commiserate with your insomnia problem. It all sounds all-too familiar. My mom is 86 and is developing insomnia, which i suspect in her case, could be due to advancing dementia.
It is affecting her quality of life in that she's sleeping a lot more in the day time, so its a vicious cycle.
I do not regard my self as old far less geriatric. My wife and I I have nothing in common with people like Insomnia is one of myriad of effects of Fluoroquinolones.
A visit to a sleep clinic, referred by your GP, is a must. For that heartburn/gastritis you need to ask about Lanzoprazole. a purpose-made knee pillow should be between your knees. Try a frozen hot water bottle at your feet, suitably covered. I am a very longterm sufferer of insomnia and thsese things help. Also, a cool shower and natural dry before bed would reduce your body temperature. Your breathing sounds like it needs investigating too, but I'd start with a sleep clinic referral.
We don't have a sleep clinic locally. Do you just suffer from insomnia or is there something physical preventing you ? If long term was the sleep clinic much of a help ? I have always had late nights and not enough sleep but it never was a problem to me. I did have a period in the 1970's after having what was then called Yuppie Flu when I could not sleep and took large quantities of a sleeping pill that did not help after years it resolved itself when I gradually cut down on the addictive pills. I've been taking Lansoprazole or other PPI's for far too long ... about 30 years. My digestive system is a chronic condition and I have previously had two duodenal ulcers. I get chest pain from it that mimics cardiac symptoms that I now know to ignore. When this is probably gastritis started I increased my PPI and when I spoke to my GP he agreed it was the right thing to do. I always eat a very bland diet.
Showers hot or cold waken me at night. The thing is although my body feels hot my temperature is still about 96F and hardly ever goes over 97.5.
I’m never comfortable with a pillow under by legs and I only sleep on my left side. This is really a Summer thing. It does not happen in Winter when I seldom turn on the bedroom radiator.
You really need a doctor that is willing to do more. Only taking a fluoroquinolone medication is not a solution to your problems and a possible source of problems. Have they given you prescription NSAIDs or steroids for the arthritis and bronchitis? Aside from basic NSAID pills you can get diclofenac topical cream otc (at least in the US) for arthritis and nasal sprays like flonase, rhinocort, etc.... that are mild steroids for respiratory disorders. Inhalers of those steroids do require a doctor and prescription but even nasal sprays can have some systemic improvements for lung problems. A budesonide inhaler was the first thing my doctor gave me for bronchitis. Steroids can increase the risk of yeast or fungal infections such as oral thrush or fungal sinusitis but if you can't breathe it's worth the usually minor risk that can be reduced by rinsing out your mouth well after using the inhaler.
I had to leave the bathroom door open when I showered or the humid air would make it too hard to breathe until I started taking hydroxyzine(also helps with sleep) instead of newer antihistamines, using a budesonide inhaler and nasal spray, and some non-steroid otc nasal sprays like citridrops.
Arnica creams can sometimes be extremely useful for general muscle and joint discomfort. Penetrex is a common one you can find on amazon. It finally gave me relief from the vague discomfort that wasn't quite pain I couldn't explain well to doctors and did not improve with non-prescription painkillers like ibuprofen.
You should also check the humidity in your house. When you have respiratory issues there is a narrow range of air moisture that is easiest to breathe. Much over 60% and the moisture can make it harder to use the air or encourage mold growth (you often won't see it) that increases respiratory inflammation. Under around 50% humidity (some are fine to 40%) the air can dry out your respiratory tract and increase inflammation as well as making you more sensitive to any dust, pollen, or other irritants because you don't have as much mucus to stop these things and expel them from your sinuses and lungs. Controlling the humidity can make a major difference in respiratory problems.
Keeping the windows open all the time makes it much harder to maintain a specific humidity and let's in a lot more irritants but it does also remove some irritants like mold spores and dust from your house. Whether it's better to close the house up or get as much air flow as possible really depends how polluted, pollen filled, or dusty the air outside is versus what's in your house and how much benefit you get from maintaining a specific humidity and temperature.
Keeping the room cool enough to sleep is extremely important and you shouldn't just try to make do with outdoor temps if you want to improve your sleep and health. We live in a big old farmhouse from the 1800s with very badly done upgrades. It doesn't heat or cool evenly at all. We have a window air conditioner in our bedroom that we can set a schedule so it automatically keeps the bedroom in the middle of the night 66-68F(18.8-20C) and turns off during the day. Then there's one in an upstairs window that is just a basic unit you set a strength and it runs until you manually change the dial. That's along with central a/c that should be blowing through the whole house but it's not sufficient for me to sleep comfortably.
I know some areas of the world a/c units are not as common but that is likely changing as everywhere experiences periods of hot weather and it is far more important for people with sleep disorders or certain health issues to control the temp. Here you can get a window unit for as cheap as $100 US if you just want to cool a single room with manual controls. You can get lighter, movable room units that sit on the floor and vent out a window by only a small tube but they are more expensive and usually harder to find. That might depend on location though since some countries the windows may not be easy to install ac units so the indoor units with alternative vent systems might be more common.
Hormone issues can cause spikes in temp at night despite not being actually hot but that shouldn't be an issue if you aren't taking replacement hormones after menopause. Replacement hormones after menopause might be a good idea though. It could improve the problem and other health issues along with sleep. Bioidentical progesterone is increasingly being found to reduce health decline related to aging. Reproductive hormones contribute to balancing a lot of things including the immune system to prevent things like arthritis or bronchitis, bone density and tissue health to again reduce things like arthritis, may affect thyroid function from day to night, and helps prevent developing general weakness and aches. You can get topical progesterone oils without a doctor in most countries and sometimes estriol but estrogen replacements come with more potential for health risks than progesterone so may require a doctor experienced in treating age related health problems or some of the newer "longevity" experts to prescribe it.
Online groups and medical clinics that concentrate on longevity attempt to use generally mild medications along with supplements, and natural substances the body produces and loses over time such as hormones and antioxidants like glutathione to reduce the effects of aging and maintain better health and an active life for longer. They can be very useful for solving vague health issues or any problems that typical doctors have not provided a solution for.
One problem doctors often ignore is that many things have to change from daytime to night time to create proper sleep. It's not always the levels of hormones like thyroid, cortisol, or estrogen that matter but the change that happens in the morning and evening. So perfectly fine thyroid at 2 in the afternoon or normal 24hr cortisol test may look good during the day but could still be contributing to symptoms at night when levels change or are supposed to change and don't. Practically no doctors look at this because of the testing difficulty and unreliability of at home 24hr testing methods. Integrative or naturopathic type doctors tend to pay attention to these things. They also tend to consider ideal levels for a given individual instead of just whether you fall within average. Most tests rely on if you are average for other people your age but average thyroid levels for you may cause symptoms when it doesn't for someone else.
Overall tests by typical doctors do not completely rule out problems and should not be considered a final answer in all situations.
As for your starting question... you can be VERY tired and keep getting through the day. My sleep disorder hit when I was around 12 and no one realized it. I just spent a steadily increasing amount of time laying in bed awake and sleeping less until I was so foggy I didn't realize how little I was sleeping until I was probably surviving on 3-4hrs every night. All my teenage years I functioned while so sleep deprived I'd look for even the tiniest chance at a break. I'd line myself up with my destination and close my eyes while trying to walk straight for the few seconds of mild relief. I think my brain was going into episodes of microsleep while I was sitting in class. I'd lose time. I'd forget what class I had just been in and which one I was supposed to be in next. I was constantly underweight no matter how much I ate. I'd pile plates with ice cream when I got home from school and constantly go through several gallon tubs of mint chocolate chip. I kept stashes of food in my room to have a constant source of extra energy required by my lack of sleep. I passed out and fell down once when the school wouldn't allow me to have snacks in class and took away the peanuts I'd been relying on through the afternoons. I remember sitting on my bed and feeling my body under so much strain that the strength of my own heart beat felt like it would knock me over.
Somehow while I did fail some classes that required things like creative writing and poetry I passed all math and science classes with high grades. I continued to test in the 95-99 percentile on US standardized tests. That means I knew the entire national curriculum as well at least 95% of students my age across the entire US. On top of that I competed to state level in horseback competitions and took care of a 12 horse stable by myself when my grandma passed away because my mom was never interested in the horses.
How tired can you be and still function? VERY VERY VERY tired. A level of tired and sleep deprived most people don't even realize exists. However, if you aren't a teenager or healthy person in their 20s your body won't handle the strain. No one dies of lack of sleep directly but it puts stress on all your organs and makes all your health problems worse.
NSAIDs can (cf Aspririn) mess up Melatonin production although I find that although they make my sleep worse they make me better able to cope with bad sleep. The effect lasts according to research 36 hours so taking a solid Aspirin dose will mess up the next two night's sleep.
That's really going to depend on your melatonin production and sensitivity to it. Many people find no benefit from extra melatonin, some find it leads to reduced sleep quality, and most don't notice slight drops in levels even when they have insomnia disorders. Too much can actually interfere with sleep. Especially later into the night. Besides melatonin your body also relies on a rise in adenosine-blocked by caffiene, drops in estrogen, rise in progesterone, drop in dopamine, drop in serotonin, reduced cortisol production, reduced orexin-which effects many other things, less histamine production.... So while some people find maximizing melatonin is useful others find concentrating on it pointless when they have other issues going on.
If you do want to improve melatonin levels then natural increases from something like daylight therapy and recently experiments with infrared light usually is much more useful than taking supplements. Probably partially because the things that increase melatonin affect many other substances that are helpful for sleep and overall health. These other substances are just less well known or understood.
Inflammation can contribute a great deal to insomnia and it can also make you feel hot when you aren't. It can mess with the HPA axis, thyroid gland, and trigger a whole lot of vague, unexplained problems that don't show up on test results. Immune problems are theorized to be the cause of many of our most difficult to diagnose and treat chronic disorders. It really could be the source of your entire set of problems.
Covid has actually helped us to understand immune responses and resulting long term damage and symptoms from things that trigger immune system flare ups. Unfortunately none of this is understood well enough to be applied yet. We do know many immune components like histamines and cortisol are alerting and keep you awake. Inflammation can also reduce your response to triggers for sleep or keep your body from producing those triggers in the first place. It has even been shown to reduce neurotransmitter levels so your brain cannot function as well. Not taking an anti-inflammatory can make the extra melatonin it might get you useless because your brain won't react to it as well as it normally would.
Finding a way to reduce inflammation that works for you is extremely important for improving sleep. Joint pain and bronchitis mean there is probably not just some individual localized inflammation but likely a widespread problem that may need multiple approaches to improve. Taking steps to reduce irritants and respiratory inflammation could reduce inflammation throughout the body without needing to risk as many side effects of medications. Some find certain things in the diet that never bothered them before can suddenly contribute after they start having joint pain.
This one gets technical but the study was done because the relationship between inflammation and insomnia had not yet been properly tested. It starts to put some science behind why many simpler articles state that sleep problems and immune system problems create a loop that only gets worse until you improve both problems. You can't just treat the insomnia because the inflammation will interfere with your attempts.
As an alternative to air filtering and blocking outdoor irritants wearing a mask with a pm2.5 filter insert is proving to be a very useful way to reduce respiratory problems indoors and out for those with allergies, asthma, or copd, which includes disorders like chronic bronchitis. Now that we have fancy new masks that are more comfortable and come with various filtration options this is actually a possible solution that many people are starting to rely on. This article mostly concentrates on using filters to reduce the spread of covid but it covers the design and purpose of masks with filters. It also explains the sizes of particles and some of the damage particles of 2.5microns or smaller can do.
Temperature by itself does not usually contribute to respiratory problems but it has a big impact on humidity and that has a big impact on respiratory problems. That's why I mention repeatedly that you may need to control humidity in order to control your respiratory inflammation and allow for sleep. Light exposure is the first thing we attempt to improve sleep disorders and humidity is the first thing attempted to improve respiratory problems. If low humidity is an issue a mask can help but if high humidity is an issue it may make it impossible to breathe due to trapping moisture from your breath. That also means it would not work as a method to protect your airway from irritants. You need a dehumidifier to deal with high humidity or if you run ac and heating units it dries the indoor air some so it's not an issue for all of us who would never consider living without air conditioning. Maybe if I moved to Alaska....
I also mentioned citridrops nasal spray as an alternative or along with steroid sprays. Colloidal silver nasal spray is another that proved the most useful for respiratory inflammation for me and both were recommended by an ENT. There are a lot of other types of nasal sprays out there but no others had a noticeable improvement for me. Microbalance company that makes citridrops also has many other products to support the immune system if you are exposed to mold or other irritants and for possible yeast/fungal infections.
The problems with NSAIDs, as well as with steroids, is why I asked if you had taken them and gave alternatives. The standard treatment from most doctors for joint discomfort and respiratory inflammation is generally NSAIDs and steroids. For many that would work just fine to control their symptoms and improve their sleep. For some it doesn't but it's one of the first things that is attempted. Personally I find oral NSAIDs to be mostly useless and completely useless for pain while often causing excessive bleeding or stomach problems.
Topical diclofenac (NSAID) gel that I mentioned proved slightly better since it mostly remains localized to where you apply it. While it eliminated all the side effects of NSAIDs it was not effective enough for me and I needed to apply it to a larger area than the recommended daily amount would treat. It has more potential if you have a few specific joints that are a problem.
Arnica creams lack the side effects of NSAIDs while having an extremely similar result on inflammation and pain, are often applied over a large area, are better tested for muscle discomfort as well as joints, don't require a prescription, and are used successfully as an alternative painkiller by many for all types of injuries and chronic conditions. You can find it in some sports creams, ointments for muscle cramping (along with magnesium), neuropathy and arthritis topical treatments, etc.... With a variety of secondary ingredients that may help or may be annoying. I mention Penetrex because it's one of the simpler formulas that has proven effective for many.
For a stronger effect I actually take arnica extract orally in very small doses. It's entirely worth finally not getting in and out of bed repeatedly over several hours before finding a comfortable enough position to sleep but it can cause liver damage if ingested instead of topically applied. Aside from very diluted homeopathic preparations orally ingesting arnica is not recommended without a very reliable product and testing for liver and kidney function.
Our situation with covid may be helping us understand some chronic health conditions but it is also contributing greatly to many others due to lack of outdoor light exposure. Including UV that makes vit d. This interferes with sleep cycles and increases inflammation.
While having symptoms of inflammation makes it among the priorities normally temperature and light are some of the first things I suggest anyone with insomnia attempts to improve. These potentially have the greatest impact on sleep triggers. You need sunlight and warmth during the day with darkness and cool starting in the evening. The body raises and lowers many substances to create alertness and drowsiness from day to night. When this system breaks you need to take steps to increase the day/night triggers so your body will get back on a schedule.
If you don't go outside before noon you should use a light therapy device or light fixture with the correct spectrum and wattage.
You need to avoid bright light and blue light from electronics at night. Use dimmer or incandescent lights instead of bright fluorescent bulbs for evening lighting. Blue screen filters or blue light sun glasses can reduce the problem of blue light exposure if you can't avoid the use of electronics during the evening.
You also need a cool room at night. Research has shown the ideal temperature to get sleep at night is 65F(18.3C). I tried to give suggestions for that. Aside from ac there are very few ways to improve that problem and it is potentially a very big problem.
Light and temperature will likely have a much greater effect than trying to take melatonin supplements and it has no side effects. Only good things for your health.
You just can't get around those things. There is no sleep aid whether prescription or otc supplement that will counter improper light exposure, hot temperatures, and poorly treated health conditions. No one can improve your sleep if you can't address some of those factors.
Treating inflammation is very difficult because what is anti-inflammatory for one person may make it worse for another. CBD actually increases my inflammation. As does progesterone if taken in too high of dose at once instead of slowly absorbed topically. Both are normally used as anti-inflammatories but it depends on the type of inflammation. Reducing triggers for inflammation such as respiratory irritants is much simpler and a more effective place to start than trying only medication or supplements.
Unfortunately selfhacked.com now requires an account or at least email address because google is attempting to bury sources of medical info that are from individuals rather than medical associations. Including forums like this one. Selfhacked is a very useful site for many topics and detailed information on supplements including any scientific studies done on them.
selfhacked.com/blog/vitamin... -some nordic countries have recommended nearly the entire population start taking vit d supplements from recent research into the benefits of vit d and problems from even slightly low levels
I highly recommend glutathione or NAC (converts to glutathione) supplements for brain fog, inflammation and insomnia combo. This video mentions why it's useful while explaining some details about inflammatory disorders.
Antibiotics can upset the microbiome in your gut and have all sorts of effects throughout the body including setting off inflammatory disorders. One of the most common problems is that it let's yeast proliferate and even without external signs such as rashes you can still have issues of fatigue, poor sleep, and inflammation from candidiasis.
The bacteria in your gut also creates many substances that are anti-inflammatory or help remove waste products as well as many of the neurotransmitters your body makes are found in high levels in your intestines. A probiotic can sometimes be extremely helpful for what may seem like the most random things such as insomnia problems. Many doctors are coming to believe a probiotic should always be taken with antibiotics and it is often standard practice in veterinary medicine. Especially any long term usage or high dose antibiotics.
Live, liquid probiotics are far more effective than pills. EM-1 is a cheap beneficial bacteria compound discovered in Japan when they were researching how to improve soil for crops. It contains many of the bacteria found in typical probiotics for humans and lots of people found it superior to existing probiotic options despite not originally being developed for that purpose. The company has since produced a version specifically for use as a human probiotic.
It is entirely possible it all started with the Fluoroquinolones. You probably were already borderline for developing certain health problems in order for that to happen though.
Without going through all of that Aspirin limits the production of prostaglandins which are required for endogenous melatonin.
I would be surprised if this does not affect anyone's ability to get to sleep. It is, of course, possible because people can sleep.
In terms of exogenous melatonin if you take it before going to bed it is not going to do much good.
As it stands I generally get to sleep quite well and it is sleep maintenance I am messing around with. Very often I take melatonin to get back to sleep.
The most I have taken in a night so far is 200mg or 200,000 mcg. I would recommend people are careful with it, however. There is also a suppository at 400mg that I want to try some time. In the USA there is a melatonin glutathoine mix called sandman that strikes me as interesting although I am not sure it will do much more than melatonin on its own.
Melatonin does a lot more things (generally good) than its GABAergic effects. It does, however, have some side effects in large quantities such as creating intestinal pain if you eat too much (taking it sublinqually or as a suppository does not cause that problem), it also stimulates more Human Growth Hormone which can cause aches and pains.
When I started with melatonin generally 3mg or 5mg could get me back to sleep, but I am not that tired now and I also don't need melatonin to get to sleep. (In fact I don't think it has ever helped me get to sleep).
Another thing I am experimenting with now is the Muse S eeg headband. That means that I sleep both with the headband on and also the Fitbit on my wrist. I have only just got the headband. Last night in my first sleep session the headband had me sleeping for 5 hours 48 mins and fitbit said I was asleep for 5 hours 46 minutes. I then took 20,000 mcg melatonin and fitbit said I didn't sleep, but muse said I slept for another 45 minutes. Whichever is right and I think Muse is more sensitive I am not at all tired today and will be able to function 100 % all day.
Muse also does meditative coaching which should help with the HPA axis which also is an issue. I think it is the noradrenaline which is created as a byproduct of the Cortisol Awakening Response which causes the situation where I wake up in the earlyish morning and cannot get back to sleep. However, I don't want to measure the cortisol response until I have a day when I think I am not doing anything particularly experimental.
Coming back to Aspirin, however, what it does do is to hit the production of ACTH through the same pathway (prostaglandins). I think this could hold back the Cortisol Awakening Response. I want to do an experiment some night with a smaller dose of aspririn to see the effect during the night. Previously I took 300mg and I intend taking 75mg. However, I know that it may hit melatonin production the next night. Hence I may try a smaller amount. The reinstatement of prostaglandin production appears to be on a straight line basis over 36 hours so that may not be an issue.
Another more interesting experiment on the same vein is to try some ethanol (probably in the formation of a quality port) which also should impact on the HPA axis, but drunk in the middle of the night with a view to extending sleep. (remembering the ethanol rebound that occurs when alcohol disappears from the system). Ethanol has a dual effect both on neurons being of the nature of GABA and also restraining glutamate, but also has an effect on the HPA axis.
Majority of that post was elaborating and providing proof to the OP who seemed to not want to listen to anything I said in my first post.
A few people are sensitive enough to melatonin changes they notice little things like you've found some medications can do but such people would also have higher odds of bad results from taking actual supplements because of that sensitivity. Too much melatonin will have very negative effects on sleep if you aren't desensitized to it. All my initial attempts to even use mcg worth left me stuck in light sleep or sort of half asleep. I'm not sure if you'd call it hallucinating or dreaming but I was imagining things based on what I was hearing in the house around me while experiencing sleep paralysis and aware I couldn't move or open my eyes.
Some years later after various medications including countless benzos when I tried melatonin again I found I was less sensitive to it. I did an experiment adjusting my body to larger dosages and taking some of the very high quantities seen in a few studies. The result was that my body just stopped responding to any dose of melatonin day or night after awhile. I could take 500mg and nothing happened to my mood, alertness, sleep amount, or sleep quality. The body tends to do that when overly flooded with a substance if you don't take steps to prevent it or balance out what you are trying to do.
For sleep purposes the numerous studies only found benefits from mcgs to a couple mgs in most people and studies using eeg started to see negative changes to sleep architecture by 1mg. For other health issues and especially in an atypical brain such as autism they have found useful results in brain function as well as mood, GI problems, nervous system sensitivity, and other effects when giving 100s of mg in a day. There isn't really a health risk with melatonin dosing but a sleep quality issue. Unless you have a physical neurological difference or are trying to treat something other than sleep then at minimum large amounts are generally just not useful and with the small amounts needed it's relatively easy to make up any loss from other things with natural light or a low dose supplement. Given how many studies have been done and how few have found any benefit to sleep at high doses I'd experiment more with dosage timing, different absorption methods, or slow release versions instead of quantity.
Alcohol has a similar effect to sleep architecture. In fact melatonin and alcohol look mostly identical on my oura ring sleep data. With more frequent but extremely short rem period that overall result in less rem, microawkenings, and less deep sleep with hours of light sleep between. Exactly the opposite of what I'm trying to do since my brain has issues getting anything but light sleep in the first place.
Be careful sourcing US melatonin. A recent study found the dosages in even the most common US brands are wildly inaccurate. They found dosages ranging from 2-10x higher than the listed amount in nearly all brands tested. Many products were also found to be very unstable, which they may be adding in extra to avoid listing a very short expiration date, and other brands have potentially harmful stabilizers.
I never take aspirin. It has too many secondary effects beyond reducing inflammation. Plus I end up bleeding like I cut my finger off from a paper cut.
The difficulty is that the human metabolism is really quite complex. Certain chemicals can have multiple effects in different circumstances. Sleep is one of the most complicated activities as it has so many different components.
Many of the prescription drugs for sleep accentuate the GABA effect on Neurons. This has two negative elements, firstly that it can wear off, secondly that if you stop taking them things can suddenly get really bad.
Over time I expect research to develop more subtle, but reliable techniques for improving health. I am working on that for my own purposes to improve my own health with in my view some success.
When it comes to your situation there are solutions that could be suggested, but a lot of information is needed to give really good suggestions. You do need to make sure you are not deficient in things like vitamin D, various Vitamins B. Vitamin K2 is massively more complicated as it has a range of effects.
It may be worth taking 3mg of boron a day to see if that helps with the arthritis and some fish oil may also help with aches and pains.
What you eat is important.
Whether you drink alcohol, when you drink it, the concentration and the quantity is also important.
Unsurprisingly advice on websites will rightly slow be cautious. Personally I think the importance of melatonin and the advantage of taking some additional melatonin will be more recognised in the future, but you should be really careful with it.
What I read in being unable to get to sleep is probably (a) not generating enough melatonin in your pineal gland in order to get you to sleep. Alternatively (b) you could be too stressed. It is possible to be too stressed about not sleeping to be able to sleep.
That (a), for example, could be caused by a shortage of vitamin B (I think B6, but that is without referring to paperwork). It may be that taking some tryptophan or 5htp would make it easier for your pineal gland. I have not seen this in myself, but it might be some good.
Alternatively it may be that your going to sleep routine is messed up and the SCN messaging is wrong. That is resolved by CBT (and why CBT - sleep hygiene etc - is something always to do). CBT is good in that the body tends not to reduce the effects over time whereas taking substances can have a law of diminishing returns.
If (b) applies, however, then meditation and/or breathing exercises can help to calm you down and reduce the HPA axis stress. Breathing exercises can be as simple as breathing in for a count of 4, holding your breath for a count of 4 and then breathing out slowly for a count of 8.
The point about meditation, however, is to get your mind off any other worries in such a way as it does not cause additional stress.
I have seen research evidence that shows that melatonin receptors get maxed out and after that are less responsive to melatonin. I think that is probably a more general thing for receptors. It is definitely also true for alcohol on the neurons.
Hence you have a situation where the same dose of something will initially have an effect then the effect will wear off.
When I take large doses of melatonin it is for the wider effects rather than just sleep, but I aim to take it to extend sleep.
I agree with you that there is some uncertainty as to the accuracy of dosage. Hence I try to keep to the same manufacturer and ideally the same size pill, but taking different numbers of them, but I acknowledge that even then the dosage can vary.
As I have said previously I am not sure that taking melatonin before going to bed is much use (at least not for me). There are MT receptors in the SCN which could act as a negative feedback. My experience leads me to conclude that for me there is a negative feedback loop either there or directly in the Pineal.
What I am looking for is a routine where I vary what I am doing on a day to day basis, but with predictable outcomes. It has its challenges because I also move around the country a bit and I vary as to what I am doing during the day. However, I am isolating out a number of variables.
When I get the chance I intend having a good go at the ketones as I think that has the potential of sustainably extending sleep through the GABAergic effects. However, I need to control as many other variables as possible before doing this as otherwise I may not be able to isolate the results sufficiently. That is harder this week as I am away from my normal home and don't have everything set up yet.
The point about metabolic issues is that as a human being varies the impact of an input will vary. Hence doing tests which simply see the impact of a standard input on a range of people is going to be difficult to get subtle results from.
Obvious things like if someone is D3 and Mg deficient then giving them D3 and/or Mg is more likely to have an effect than when they are not.
The state of receptors, however, is really hard to determine. Hence doing this properly requires following one individual and trying to isolate out variables. That could be done for a number of individuals, but working out the patterns is quite difficult.
I would like to thank you (kaliska0), however, for some useful informative posts in this forum that have suggested to me different avenues to investigate.
I am 73 and suffer gastritis 24 7 makes me so tired and don’t have any energy whatsoever my sleep pattern is all over the place nothing seems to help ☹️
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Insomnia is one of myriad of effects of Fluoroquinolones.
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Sleep Apnea after concussion?
Still not sleeping despite meds 
I don’t know how to sleep anymore
