I Haven’t Slept in 4 years. What to Do?

[tropicaldaze1950]

I’m also testing out 20mg EOD now, and it’s only been 2 shots so far of it, but I’ve had the best 3 nights sleep already that I’ve had in a while. I’m sure placebo at some level, but I don’t care. I just love sleeping well. For 4 years, I’ve been waking wide awake at 3am and unable to go back to sleep until it’s time to wake up, consequently feeling like trash the following day. So frustrating and resulted in lots of grey hair and had aged me quite a bit. I’m hopeful though this continues or improves even more.

I hope, too, that your improved sleep continues. I'm so lost with that aspect and I know that my declining health has been driven by worsening sleep, along with the use of Klonopin. Do you take your shot in the morning, afternoon or evening? I've tried all those times and perhaps the best one, for me, is around noon, since my circadian rhythm is out of phase. I feel better(relatively speaking) late morning or early afternoon. But, after dinner(between 5 & 6) I become seriously sleepy, with brain fog. Stumble around for a few hours, then begin to 'wake up' around 9. If I went to bed at 7 or 8, I'd likely wake up at midnight and be awake most of the night. I was told by a world renowned psychiatrist/researcher that the aforementioned pattern is common in people with bipolar. Aren't I lucky.

 

[Vman]

Have you tried an ED/EOD protocol for your testosterone injections?

I've been injecting every day for 2 years and I still have sleep issues. I've never tried any other protocol. Maybe my sleep would be worse on less frequent injections.

 

[GreenMachineX]

I hope, too, that your improved sleep continues. I'm so lost with that aspect and I know that my declining health has been driven by worsening sleep, along with the use of Klonopin. Do you take your shot in the morning, afternoon or evening? I've tried all those times and perhaps the best one, for me, is around noon, since my circadian rhythm is out of phase. I feel better(relatively speaking) late morning or early afternoon. But, after dinner(between 5 & 6) I become seriously sleepy, with brain fog. Stumble around for a few hours, then begin to 'wake up' around 9. If I went to bed at 7 or 8, I'd likely wake up at midnight and be awake most of the night. I was told by a world renowned psychiatrist/researcher that the aforementioned pattern is common in people with bipolar. Aren't I lucky.

I typically take my shot in the morning. After years of horrible sleep and daytime dragging, I’m so relieved to be sleeping well (at least so far).

 

[sammmy]

I hope, too, that your improved sleep continues. I'm so lost with that aspect and I know that my declining health has been driven by worsening sleep, along with the use of Klonopin. Do you take your shot in the morning, afternoon or evening? I've tried all those times and perhaps the best one, for me, is around noon, since my circadian rhythm is out of phase. I feel better(relatively speaking) late morning or early afternoon. But, after dinner(between 5 & 6) I become seriously sleepy, with brain fog. Stumble around for a few hours, then begin to 'wake up' around 9. If I went to bed at 7 or 8, I'd likely wake up at midnight and be awake most of the night. I was told by a world renowned psychiatrist/researcher that the aforementioned pattern is common in people with bipolar. Aren't I lucky.

Getting sleepy after dinner and then regaining steam after your body had broken down the food is related to human digestion, hormones, and neurotransmitters. That pattern is common for many people who are not bipolar. I find it rather odd that a 'world renowned psychiatrist' explains it away with being bipolar and simply means the guy understands nothing of physiology.

You can try to eat late dinner then go to bed after that. I use that strategy with one of my HIV drugs - I noticed it causes drop in my energy level 2 hours after I take it. So I take it with dinner at 10pm and go to bed around midnight. The drop in energy helps me fall asleep. It's not a perfect normal sleep but beats trying to fall asleep energized after the energy drop has passed.

 

[tropicaldaze1950]

Getting sleepy after dinner and then regaining steam after your body had broken down the food is related to human digestion, hormones, and neurotransmitters. That pattern is common for many people who are not bipolar. I find it rather odd that a 'world renowned psychiatrist' explains it away with being bipolar and simply means the guy understands nothing of physiology.

You can try to eat late dinner then go to bed after that. I use that strategy with one of my HIV drugs - I noticed it causes drop in my energy level 2 hours after I take it. So I take it with dinner at 10pm and go to bed around midnight. The drop in energy helps me fall asleep. It's not a perfect normal sleep but beats trying to fall asleep energized after the energy drop has passed.

I've thought about eating dinner closer to when I would go to bed, sammmy. When I awaken at 3 or 3:30, I realize I'm hungry. Regarding the psychiatrist, he said that he hears the same issue from patients with bipolar; being tired/sleepy all day, then getting energized around 9 or 10 pm. Some patients, I've read, have a flipped circadian rhythm; day is night, night is day. Maybe eating later in the evening will keep me asleep, soundly, through the night. Going to try a higher dose of doxazosin, a bp med used off label for PTSD. I have C-PTSD from personal trauma issues related to bipolar and many years of marital problems. I also have strange dreams every night, continually wake up, fall back asleep and thrash around. Exhausted whenever I get up. Sleep study was normal.

 

[wondering]

DO NOT take ANY benzodiazepine. They are a horrific poison and withdrawal can start very soon and it is just the most horrible experience imaginable.

TRT did not help me at first. Possible you need a little Hydrocortisone (10mg) first thing in the AM. That helped settle me down. Waking up is very often a sign of elevated norepinephrine at night. HC in the AM can help take the burden off your HPA and calm your nervous system down. I don't think I could have done without it.

 

[Systemlord]

So then I moved on to using Benzodiazepines and they work great. But studies suggest they weaken the immune system a good bit, and are linked to increased fatal pneumonia risk.

Benzodiazepines have also been linked to dementia and Alzheimer's disease.

 

[sammmy]

"A is linked to B" in medicine means absolutely nothing and does not mean "A causes B or vice versa". There are gazillions factors at play and explaining everything with only one of them, ignoring all other factors and not controlling for them, is nonsense. That's why every 101 Statistics course teaches "correlation is not causation" but few actually understand what it means.

Example: in the past coffee consumption was "linked" to higher cholesterol, heart attacks, and cardiac arrhythmia. Nowadays, after taking into account more factors, such as lack of exercise or smoking, coffee is no longer "linked" to the above.

 

[wondering]

This guy has many great talks on YT and on Joe Rogan's podcast.

 

[rugbyhit]

My .02 cents..been on TRT for almost 4 years now. Had a terrible stretch of no sleep...up at 2am like clock work. Eventually figured out having my E2 on the high side was messing me up. Now, with anastrozole, I'm controlling the E2 and haven't had trouble since. Finding that controlling my E2 for libido, mood and sleep is more important that managing FT

 

[Vman]

My .02 cents..been on TRT for almost 4 years now. Had a terrible stretch of no sleep...up at 2am like clock work. Eventually figured out having my E2 on the high side was messing me up. Now, with anastrozole, I'm controlling the E2 and haven't had trouble since. Finding that controlling my E2 for libido, mood and sleep is more important that managing FT

Just curious, what E2 levels ended up working best for you? And what was your E2 before you started taking anastrozole?

 

[rugbyhit]

Just curious, what E2 levels ended up working best for you? And what was your E2 before you started taking anastrozole?

I was up in the high 80's to low 90's on the e2 sensitive test (normal range 8-35pg/mL)...I do best around the mid 20's to low 30's...this is while running 140mg T per week split in 2 doses, along with 250cc HCG 2x week, and .5mg anastrozole 2x week, so total of 1mg per week. I have a feeling I have a high conversion of T to E.
....routine is to take everything on Monday and Thursday

 

[DragonBits]

I was up in the high 80's to low 90's on the e2 sensitive test (normal range 8-35pg/mL)...I do best around the mid 20's to low 30's...this is while running 140mg T per week split in 2 doses, along with 250cc HCG 2x week, and .5mg anastrozole 2x week, so total of 1mg per week. I have a feeling I have a high conversion of T to E.
....routine is to take everything on Monday and Thursday

I am glad you posted your levels.

Sleep, like libido, is multifactorial.

A lot of things affect sleep, for me, my E2 has never been over 56, and I think that was a mistake by the lab, as when my Tot T was 1400, my E2 was 38.4.

I at times have had serious sleep problems, I know for sure stress of something I have procrastinated over doing will keep me waking up often.

But even without that sort of stress, I suspect low progesterone is a problem for me. But I would think progesterone is not going to work for everyone, that multifactorial problem.

 

[Reason]

First of all, I'm really sorry you're going through this and hope you've found some help.

I haven't had good (natural) sleep at any point in my life for a consistent amount of time. I'm 40. Spurts of 6hrs/night here and there. I probably with physiological/neurological delta-wave disruption or circadian rhythm disregulation. I've been on TRT for 3 years and it has had a mildly positive effect on my sleep, but I still wake up feeling absolutely miserable 6/7 days a week. It's my life's biggest challenge.

Here's what I've learned, personally:

1. Sleep hygiene (what Nelson mentioned) is huge. Starts in the morning with getting sunlight right after awakening to regulate your circadian clock. Other stuff that really matters is light exposure at night, quiet, dark, cool sleep environment, CONSISTENT bed time and routine.
2. Sleep meds are not long-term solutions. Period. I've been on 3-4 different ones and was dependent for years. BAD. The sleep you do get is not restorative and they will stop working. Withdrawal is hell.
3. Very high E2 has disrupted my sleep. I've found my sweet spot (mid 30s) and try to stay there.
4. DHEA, Pregnenolone, GABA, Reishi, Magnesium, etc. all kinda sorta help but they're not cures. I can't take Melatonin as it consistently gives me nightmares.
5. Cannabis was a major help early when I was learning how to create a clean sleep routine. It quieted my overactive mind and I fell asleep fine with it with no noticeable side effects. I live in NY now so I don't have easy access anymore and miss it.
6. Mental health is a major component. My anxiety takes over once my badly-regulated sleep drive starts wearing off around 4hrs into sleep and I wake up and usually can't get deep sleep again. I am currently investigating other things.
7. I can sleep without any aid most nights, but most nights can't get more than 4-5hrs. I feel best at around 8. I sleep like an angel on benzos, but I avoid taking them more than 1x a week.
8. Get tested for apnea if you're overweight, snore, or wake up feeling groggy. It was a small component of my poor sleep (one of many). I get better sleep with my CPAP machine, not good, better.

Best of luck.

 

[Lookingforward]

Doesn't taking DHEA at night inhibit sleep?

 

[wondering]

First of all, I'm really sorry you're going through this and hope you've found some help.

I haven't had good (natural) sleep at any point in my life for a consistent amount of time. I'm 40. Spurts of 6hrs/night here and there. I probably with physiological/neurological delta-wave disruption or circadian rhythm disregulation. I've been on TRT for 3 years and it has had a mildly positive effect on my sleep, but I still wake up feeling absolutely miserable 6/7 days a week. It's my life's biggest challenge.

Here's what I've learned, personally:

1. Sleep hygiene (what Nelson mentioned) is huge. Starts in the morning with getting sunlight right after awakening to regulate your circadian clock. Other stuff that really matters is light exposure at night, quiet, dark, cool sleep environment, CONSISTENT bed time and routine.
2. Sleep meds are not long-term solutions. Period. I've been on 3-4 different ones and was dependent for years. BAD. The sleep you do get is not restorative and they will stop working. Withdrawal is hell.
3. Very high E2 has disrupted my sleep. I've found my sweet spot (mid 30s) and try to stay there.
4. DHEA, Pregnenolone, GABA, Reishi, Magnesium, etc. all kinda sorta help but they're not cures. I can't take Melatonin as it consistently gives me nightmares.
5. Cannabis was a major help early when I was learning how to create a clean sleep routine. It quieted my overactive mind and I fell asleep fine with it with no noticeable side effects. I live in NY now so I don't have easy access anymore and miss it.
6. Mental health is a major component. My anxiety takes over once my badly-regulated sleep drive starts wearing off around 4hrs into sleep and I wake up and usually can't get deep sleep again. I am currently investigating other things.
7. I can sleep without any aid most nights, but most nights can't get more than 4-5hrs. I feel best at around 8. I sleep like an angel on benzos, but I avoid taking them more than 1x a week.
8. Get tested for apnea if you're overweight, snore, or wake up feeling groggy. It was a small component of my poor sleep (one of many). I get better sleep with my CPAP machine, not good, better.

Best of luck.

Have you tried 10mg hydrocortisone first thing in AM?

What do your Thyroid labs look like?

Add exercise to the list of "do's".

 

[CROM]

First of all, I'm really sorry you're going through this and hope you've found some help.

I haven't had good (natural) sleep at any point in my life for a consistent amount of time. I'm 40. Spurts of 6hrs/night here and there. I probably with physiological/neurological delta-wave disruption or circadian rhythm disregulation. I've been on TRT for 3 years and it has had a mildly positive effect on my sleep, but I still wake up feeling absolutely miserable 6/7 days a week. It's my life's biggest challenge.

Here's what I've learned, personally:

1. Sleep hygiene (what Nelson mentioned) is huge. Starts in the morning with getting sunlight right after awakening to regulate your circadian clock. Other stuff that really matters is light exposure at night, quiet, dark, cool sleep environment, CONSISTENT bed time and routine.
2. Sleep meds are not long-term solutions. Period. I've been on 3-4 different ones and was dependent for years. BAD. The sleep you do get is not restorative and they will stop working. Withdrawal is hell.
3. Very high E2 has disrupted my sleep. I've found my sweet spot (mid 30s) and try to stay there.
4. DHEA, Pregnenolone, GABA, Reishi, Magnesium, etc. all kinda sorta help but they're not cures. I can't take Melatonin as it consistently gives me nightmares.
5. Cannabis was a major help early when I was learning how to create a clean sleep routine. It quieted my overactive mind and I fell asleep fine with it with no noticeable side effects. I live in NY now so I don't have easy access anymore and miss it.
6. Mental health is a major component. My anxiety takes over once my badly-regulated sleep drive starts wearing off around 4hrs into sleep and I wake up and usually can't get deep sleep again. I am currently investigating other things.
7. I can sleep without any aid most nights, but most nights can't get more than 4-5hrs. I feel best at around 8. I sleep like an angel on benzos, but I avoid taking them more than 1x a week.
8. Get tested for apnea if you're overweight, snore, or wake up feeling groggy. It was a small component of my poor sleep (one of many). I get better sleep with my CPAP machine, not good, better.

Best of luck.

I recently noticed that I get better sleep if I use anastrozole. Although I am not 100% sure my improved sleep is from lowering estrogen. But I will keep experimenting with it. I’ve always avoided using AI in the past.

This week I have managed to get about 6.5 to 7.5 hours of good sleep per day using 22.5 mg Temazepam and a 1/4 pill of (AI two times per week).

I smoked pot for years and stopped cuz it started to make me paranoid. Did you smoke pot or did you use edibles? Is there a certain brand that works better for sleep? I think it is legal here in FL.

And thanks for the info.​

 

[Gingkohagane]

Melatonin + Glycine do the job. 0.5mg melatonin, 5g glycine. Trials say it improves quality of sleep sufficiently

 

[Reason]

Have you tried 10mg hydrocortisone first thing in AM?

What do your Thyroid labs look like?

Add exercise to the list of "do's".

I've never tried hydrocortisone. Can you explain?

Thyroid is normal-to-optimal, did a full panel last year.

Pandemic ruined my exercise regimen, but I've been lifting for years. Definitely helps, but not a cure.

 

[Reason]

I smoked pot for years and stopped cuz it started to make me paranoid. Did you smoke pot or did you use edibles? Is there a certain brand that works better for sleep? I think it is legal here in FL. ​

High E2 really disrupts my sleep, so I use an AI as needed, but just taking the pill has no immediate effect.

I used to do edibles because they last longer and kept a vape pen on my bedside table in case I woke up anxious in the middle of the night. Would take a small hit and went right back to sleep. The key is to do the smallest dosage you need to get the effect. If I overdo it, I also get paranoid.

As for strains or brands, take a look on leafly.com but mostly anything helps. I liked the Kiva brand of edibles and you probably want chocolates over mints/candy because it will digest and metabolize a bit slower. I also made my own with peanut butter (even slower).

For vaping/smoking I did better with more body high (generally Indicas and hybrids) type strains vs. head/euphoric highs. Every person reacts to strains differently, so experiment.

Again, even cannabis is not a long-term solution. I just appreciated being able to quiet my mind down with something with little-to-no side effects and no hangover vs. say a benzodiazepine which works like magic but has a LOT of downsides.