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Comment by bluedevil2k | Hacker News Reader

I'm curious if sleep aids, whether it's OTC like melatonin or Rx like trazodone and Ambien, can help this situation. Is it just the sleep that's beneficial or is it "natural" sleep (that term doesn't mean anything, but you get the point of it)? In other words, should people who have difficulty sleeping look to aids as a way of staving off dementia later in life.

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Melatonin is a hormone that can assist you with falling asleep, but it has no capability to keep you asleep or allow you to reach the 4 stages of deep sleep. Ambien is worse, in that it can make you feel like you are going to sleep, but you will not get into the deep states of sleep required for the brain to detoxify itself. The same is true for weed. Some folks use weed to help themselves sleep, but they are actually depriving themselves of the 4 stages of deep sleep. Chronic use of Ambien, weed and other drugs can cause a person to have mild hallucinations, delirium tremens or worse.

This will be an unpopular opinion, but I believe the better method of improving sleep is to improve eating habits, go easy on caffeine, get exercise, get rid of artificial light hours before going to sleep and stay away from people and things that cause you stress. Easier said than done.

I think melatonin and ambien are longer-lasting in their neurological effects than THC. People use fat solubility and detection to counter that, but I don't buy it since that's separate from effect.

I was under the impression that melatonin regulates your sleep wake cycle, and so you take it to do a reset, not to just get to sleep one night

When you consume it as a supplement, you are inducing what your body would normally produce anyway if you are in normal cycles and in the dark. The only difference is dosage. Your body produces very small amounts. Stores sell pills that range from 1mg to 10mg and sometimes even higher. Even 1mg is a lot. That is why they suggest you stop taking it for a couple weeks, every few months. One use of melatonin is to attempt to reset a sleep cycle if your cycles have been thrown off by travel or other circumstances. Other uses are unrelated to sleep and have interactions with the gut. Hormones are almost always multipurpose. Melatonin has no ability to keep you asleep however.

Resetting your sleep cycles can take a day, a few days or weeks depending on your age, health, hormone levels and environment.

In terms of wake cycle, your body will metabolize the melatonin and then later start producing more adrenaline. As people get older and if damage has occurred to their adrenal glands, or a myriad of other problems, then they may start producing adrenaline too soon and wake up early, feeling anxiety. This can also be a result of too much Cortisol (stress response hormone). These hormones are a complex topic all by themselves, even leaving out confounding factors.

If you get the melatonin strips that dissolve on your tongue, you can cut them into 1/8ths and the dose becomes more reasonable (0.3ish instead of 3mg)

What you said about adrenaline in the morning - very interesting!

Thc is found to increase deep sleep and reduce rem, which isn't ideal but significantly better than RX drugs like ambien and benzos.

Trazodone actually increases deep sleep and is associated with reduced risk of dementia.

The first line of treatment is CBT-I.

I wouldn't start CBT-I without first getting a sleep test, particulary for sleep apnea which can be present without obvious symptoms beyond insomnia or a delayed sleep phase. It's also much more common in young fit people than is often thought.

I would by virtue that CBTi isn't just sleep restriction, the most important component is CBT. At any rate restriction need not be very severe.

My point is that CBTi isn't what you need if you have sleep apnea or some other treatable disorder as the root of your sleeping issues.

CBT-I is psychotherapy targeted at treating one specific cause of insomnia. It does not address any of the physical ailments that may also lead to sleep disorders.

If you aren't careful, you'll lose your internet medical license with such bold medically unsound claims.

I think our friendly internet medical doctor was trying to say that there are some useful principles in CBT-I that could be helpful for a lot of people, which is probably true.

As someone who took way too long fussing with sleep hygiene and the like before finally getting a proper sleep test though, I see the potential danger of telling people what to do first. (Though in my defense, I did get a sleep test a while back and it ended up the sleep tech was trash and I should have gotten a second opinion)

CBTi is generally effective, and "physical ailments" are not generally suspect in the case of insomnia. You can get checked for ailments such as sleep apnea anyhow and CBTi doesn't somehow jeopardize that. It's not like it has to be either or.

if you're interested on learning more about it, read Why We Sleep. It talks about sleep aids and the importance of quality sleep

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