what works if anything ?

[warbaby42]

4 months ago approx I started suffering with insomnia. up until then I had no trouble sleeping.

I can fall asleep - no problem. I just can't stay asleep. I am 82 years old.

Ive tried everything - Nytol useless. Sleepeaze from Boots, worked at first but not now. Also have tried Melatonin tablets which have had the best improvement, but not 100%.

I don't look at my computer or mobile for an hour before bed. No caffeine either.

Would welcome posts from what others have found to work.

[kaliska0]

Both nytol and sleepeaze are simply the antihistamine commonly sold as benadryl. It is the weakest of the antihistamines that can cause drowsiness. Doxylamine is generally the strongest non-prescription anithistamine that can promote sleep. However, this approach is really only useful for short term sleeping issues or along with other solutions and mainly for trouble falling asleep. The best non-prescription substance I've found for long term use was valerian root but it's still not my first choice after 20+ years of constant sleep difficulties.

The problem is that most sleep aids actually reduce deep sleep and sleep quality. People can fall asleep easier and steep longer but they often need to sleep longer to get all necessary stages of sleep and for some they never get enough deep or rem sleep using sedating sleep aids. When you wake up during the night you are typically not getting deep stages of sleep already and sleep aids have shown to further reduce the time spent in deep sleep. Melatonin even contributes to lighter sleep and being woken up easier. Sedating sleep aids are best for helping some people feel tired enough to fall asleep faster and they often go back into deeper sleep without even realizing they nearly or briefly were technically awake. Spikes of brain wave activity that matches being awake but doesn't last long enough to remember waking up are frequently seen when sleep quality is poor and as a side effect of medication. If you remember lots of dreams you are likely experiencing brief periods of near wakefulness in the middle of rem sleep and are prone to fully waking up each time it happens.

You can also get stuck asleep enough you are not aware of the passage of time but not asleep enough to be completely unaware of every thing. This is not at all restful and makes it feel like you spent forever in bed despite still being very tired the next day. Melatonin gets me stuck like that. I registered sounds but couldn't think about them logically so I heard my cat meowing and imagined I had forgotten to close my bedroom door and he was in the room waking me up. Then I couldn't move at first because I was stuck between awake and asleep. When I finally got up I reached for the door in the dark thinking I actually saw it open and nearly fell in my fish tank when my hand landed on nothing.

Sleep aids may make people feel like they fell asleep easier but they really mess up stages of sleep and sleep quality. You have to be very careful with the dose and not take so much you feel like you can't stay awake or it may contribute to not sleeping as well throughout the night and still being tired the next day. I was getting 12 hours of constant sleep on sedating sleep aids but I felt more rested when I stopped them and concentrated on improving how well I slept rather than how long I stayed asleep for. 6 hours of better quality sleep left me feeling like I'd slept more than 12 hours of being unaware of anything but getting only minutes of rem and deep stage sleep each night while on sedatives.

As you get older melatonin does decline or fail to have the same effect. In those situations it can be helpful to increase it. Ramelteon was approved specifically for older people who have a decline in melatonin. Instead of just providing more melatonin it makes the receptors more sensitive so the body responds stronger to what melatonin you do produce. This is not usually effective in people who don't have a decline in melatonin so it's not used that often and many have never heard of it. Including medical professionals. It is one of the safer prescription sleep aid options and easy to try. Usually it has better effects with less negatives than taking melatonin.

The exception to sleep aids reducing sleep quality is orexin antagonists. The first of those was belsomra and there are at least 2 stronger ones. These feel absolutely nothing like a sedative. Many people give up on them because they usually can't force you into going to bed. You still have to be motivated to follow good sleep habits and lay down in a quiet, comfortable bed long enough to fall asleep. This also tends to make them far better for people who fall asleep fine but don't sleep deeply and wake up easily. They also have minimal side effects, health risks, and no withdrawal or addiction risk in studies. Over time I noticed it was easier to stay in bed even if I didn't immediately fall asleep and after stopping and starting belsomra numerous times I decided I was sleeping much better when I consistently took it every night for several weeks.

Orexin is responsible for keeping you alert and was found to be lacking in people with narcolepsy. Attempts to increase orexin to treat narcolepsy resulted in discovering the opposite medication type. Unlike most sleep aids that try to trigger signals in the body that make you sleepy the orexin antagonists block being alert. This allows you to fall asleep if you are already tired and laying down instead of making you feel so tired you can't function and must go to bed or even falling asleep while sitting up. Some people do find it harder to get up in the morning but this is likely because orexin antagonists encourages deeper sleep and it's harder to make yourself get up from deep sleep than shallow sleep. It's still best to compare the rest of the day and how fast you get tired instead of how you felt in the morning in order to know if you slept better.