Need help with sleep management on TRT

[Reason]

I had the EXACT same issue. Still get it once in a while but my current issue is waking up too early. Some of what I'll say below is for the benefit of other forum members with sleep issues as well.

I'm a lifelong insomniac currently getting OK sleep after a horrendous year. What has worked for me was to see a sleep specialist and start a CPAP treatment to help with mild apnea, plus control my E2 (was in the 60s), and I've been taking DHEA/Pregnenolone nightly. TRT can worsen apnea. I also take high-absorption magnesium nightly and drink Reishi tea on occasion. I resort to weed when my mind is racing and I can't fall asleep easily.

What Trents said about sleep hygiene and practices is SPOT ON. Cannot emphasize this enough.

Melatonin is overused and dosages WAY too high in OTC bottles. 3mg to start with is overkill on a nightly basis. You can use it to help re-stablish a good circadian rhythm, but melatonin should not be abused. Good sleep hygiene is much more powerful than melatonin to re-stablish good sleep.

Diphenhydramine and other sedatives or hypnotics (Ambien, Lunesta, etc.) are NOT good long-term solutions to sleep problems. The sleep you get on them is very low quality. I was on Ambien and later Lunesta for years. Not good.

Cognitive Behavioral Therapy for Insomnia, or CBT-I, is more effective than medication and has longer-lasting benefits. Cannot recommend it enough.

My recommendation is to practice sleep hygiene, control your E2, and if symptoms continue, check for apnea. If you're overweight this is very likely the cause.

Good luck!

 

[Gman86]

I have helped several people with the very same suggestions about getting as much sun in the eyes and on the body in the morning up to noon time if needed, and then blue blockers after the sun goes down. I have gotten several reports back that it has helped.

I use these blue blockers
https://www.amazon.com/Uvex-Blockin...YXW9H8QXMHR&psc=1&refRID=X4ETDENWAYXW9H8QXMHR

Exactly! Extremely underrated advice. Sleep is, and will always be the most important aspect of health, by far. I actually have those same glasses. You should look into blublox. It’s very important to not only block blue light, but green light as well. Green light can disrupt melatonin production just as much blue light. The glasses you’re using now are obviously better than nothing, but not much better. If you care about your sleep, look into blublox. You’ll thank me later.

 

[Gman86]

I had the EXACT same issue. Still get it once in a while but my current issue is waking up too early. Some of what I'll say below is for the benefit of other forum members with sleep issues as well.

I'm a lifelong insomniac currently getting OK sleep after a horrendous year. What has worked for me was to see a sleep specialist and start a CPAP treatment to help with mild apnea, plus control my E2 (was in the 60s), and I've been taking DHEA/Pregnenolone nightly. TRT can worsen apnea. I also take high-absorption magnesium nightly and drink Reishi tea on occasion. I resort to weed when my mind is racing and I can't fall asleep easily.

What Trents said about sleep hygiene and practices is SPOT ON. Cannot emphasize this enough.

Melatonin is overused and dosages WAY too high in OTC bottles. 3mg to start with is overkill on a nightly basis. You can use it to help re-stablish a good circadian rhythm, but melatonin should not be abused. Good sleep hygiene is much more powerful than melatonin to re-stablish good sleep.

Diphenhydramine and other sedatives or hypnotics (Ambien, Lunesta, etc.) are NOT good long-term solutions to sleep problems. The sleep you get on them is very low quality. I was on Ambien and later Lunesta for years. Not good.

Cognitive Behavioral Therapy for Insomnia, or CBT-I, is more effective than medication and has longer-lasting benefits. Cannot recommend it enough.

My recommendation is to practice sleep hygiene, control your E2, and if symptoms continue, check for apnea. If you're overweight this is very likely the cause.

Good luck!

What is the highly absorbable form of magnesium you use, and how many mg’s? Thanks.

 

[Gman86]

Well it's right there in his post, he felt worse on no AI; insomnia. You're not looking thru the numbers here.

Just thought it was unusual to see Dr Saya prescribe an ai when someone has a high SHBG and an E2 of 35. I could see an ai maybe being considered if his SHBG was low, or mid range, but for a high SHBG guy? Just seems odd. Insomnia and not feeling well could be from a ton of other things. I highly doubt it’s from an E2 of 35. Just surprised to see Dr Saya pull the trigger on an ai so quickly with his numbers, that’s all.

He clearly knows more than we do though, so I’m sure his reasoning for prescribing an ai in this scenario is justified. Would just love to hear his rationale.

 

[Nelson Vergel]

You may want to review what we have discussed in the past on this common topic

sleep

 

[Reason]

What is the highly absorbable form of magnesium you use, and how many mg’s? Thanks.

Magnesium Bisglycinate, 400mg/day split into 2 doses.

 

[Appassionato]

Since I fall asleep quickly, I put a low dose melatonin (.75 mg), on my nightstand and take it when I wake up. It knocks me out pretty quickly and it's such a low dose that I don't feel groggy in the morning.

That's actually a good suggestion, I have the same problem with waking up in the middle of the night. I've tried almost everything with no success, even time-release melatonin, but taking it when I wake up could do the trick.

 

[DragonBits]

That's actually a good suggestion, I have the same problem with waking up in the middle of the night. I've tried almost everything with no success, even time-release melatonin, but taking it when I wake up could do the trick.

I have had this sort of problem for a long time. Waking up in the middle of the night, or at it's worse, waking up every 2 hours. I think it's related to stress and being a light sleeper. Though I haven't had a cortisol test or sleep study.

I tried Melatonin when I wake up at 2:00 AM, sometimes it works, often it doesn't.

Right now I take l-theanine, gaba (Gamma-Aminobutyric acid), glycine, melation, *** oil, time release Melatonin , Magtein (magnesium) before sleep.

Throw the kitchen sink at it.

I only take a tiny amount of theanine, but ~ 2 grams of gaba, both of which help with stress and relaxation. Gaba for sure has an effect, it lowers my systolic / diastolic BP by about 10-20 points in 10 min. I think theanine works to relax me, but not sure, glycine did seem to increase my dreams, *** oil seems to help a little.

I think the most effective was Magtein and Gaba, and recently I tried 0.125 AI, as I believe if my E2 is higher than normal it also disturbs my sleep. I am sure E2 is higher than normal, but I have no idea how high.

Melatonin "works" to make me sleepy, but that doesn't last long. I get into the habit that I think I need it, but once or twice I didn't use it and I still feel asleep OK.

Over a year ago, I would sometimes eat a bowl of pasta when I woke up at 2:00 AM, sure it works and makes me sleepy, but plays hell with my blood glucose and got my A1C up to 5.8, so that isn't worth it. Now that I am doing lower carb, eating carbs before bedtime isn't in the cards.

I get the feeling if I don't exercise often stress also builds up. Though if I exercise very hard then muscle pain tends to wake me up.

Basically, nearly anything can cause me to not sleep well all night long. So far I don't have a good grip on a "protocol" that works nearly all the time, and I don't know what I can eliminate as not effective.

I tried cortisol manager from Integrative, it didn't seem to have any effect.

I take any supplements like b vitamins or CoQ10 very early in the day so as not to cause a sleep problem.

I use a fitbit charge 3 to track sleep, when I am sleeping good I get !6.5 hours sleep average a week, when I am stressed it drops to 5.5 average.

The watch estimates wake time, rem sleep, light sleep, deep sleep. On a good night I will get 7 hours 13 min, 1 47 min awake, 1 7 min REM, 5 hours light, hour 6 min deep sleep.

The watch says I wake up multiple times, but I am not aware of it, maybe only aware of waking up once or twice.

When I get the time, I will do the sleep study and see what it says.

 

[Appassionato]

I have had this sort of problem for a long time. Waking up in the middle of the night, or at it's worse, waking up every 2 hours. I think it's related to stress and being a light sleeper. Though I haven't had a cortisol test or sleep study.

I tried Melatonin when I wake up at 2:00 AM, sometimes it works, often it doesn't.

Right now I take l-theanine, gaba (Gamma-Aminobutyric acid), glycine, melation, *** oil, time release Melatonin , Magtein (magnesium) before sleep.

Throw the kitchen sink at it.

I only take a tiny amount of theanine, but ~ 2 grams of gaba, both of which help with stress and relaxation. Gaba for sure has an effect, it lowers my systolic / diastolic BP by about 10-20 points in 10 min. I think theanine works to relax me, but not sure, glycine did seem to increase my dreams, *** oil seems to help a little.

I think the most effective was Magtein and Gaba, and recently I tried 0.125 AI, as I believe if my E2 is higher than normal it also disturbs my sleep. I am sure E2 is higher than normal, but I have no idea how high.

Melatonin "works" to make me sleepy, but that doesn't last long. I get into the habit that I think I need it, but once or twice I didn't use it and I still feel asleep OK.

Over a year ago, I would sometimes eat a bowl of pasta when I woke up at 2:00 AM, sure it works and makes me sleepy, but plays hell with my blood glucose and got my A1C up to 5.8, so that isn't worth it. Now that I am doing lower carb, eating carbs before bedtime isn't in the cards.

I get the feeling if I don't exercise often stress also builds up. Though if I exercise very hard then muscle pain tends to wake me up.

Basically, nearly anything can cause me to not sleep well all night long. So far I don't have a good grip on a "protocol" that works nearly all the time, and I don't know what I can eliminate as not effective.

I tried cortisol manager from Integrative, it didn't seem to have any effect.

I take any supplements like b vitamins or CoQ10 very early in the day so as not to cause a sleep problem.

I use a fitbit charge 3 to track sleep, when I am sleeping good I get !6.5 hours sleep average a week, when I am stressed it drops to 5.5 average.

The watch estimates wake time, rem sleep, light sleep, deep sleep. On a good night I will get 7 hours 13 min, 1 47 min awake, 1 7 min REM, 5 hours light, hour 6 min deep sleep.

The watch says I wake up multiple times, but I am not aware of it, maybe only aware of waking up once or twice.

When I get the time, I will do the sleep study and see what it says.

I basically tried everything you mentioned with no success, apart from glycine that I've ordered. I'll try a combo of theanine, glycine and melatonin and see how I will go from there.

 

[DragonBits]

I basically tried everything you mentioned with no success, apart from glycine that I've ordered. I'll try a combo of theanine, glycine and melatonin and see how I will go from there.

If you tried Gaba, did it cause a very odd flushing sensation? I take a teaspoon, and I get a feeling my face is flushed and my bp drops. Just curious if everyone gets that.

Nothing seems to work all of the time.

 

[Appassionato]

If you tried Gaba, did it cause a very odd flushing sensation? I take a teaspoon, and I get a feeling my face is flushed and my bp drops. Just curious if everyone gets that.

Nothing seems to work all of the time.

I've tried it in capsules, both alone and stacked with other supplements in the same capsule.
I felt absolutely nothing, like if I was drinking a glass of water.
The effectiveness of GABA as a supplement is debated, due to the vast majority claiming it can't cross the brain barrier.

 

[Gman86]

The best sleep aid I’ve found is magnesium, hands down. I take a highly absorbable form called Remag. It’s basically just magnesium chloride liquid. Tastes like sh*t, but works great. I had an ex girlfriend that was on trazodone for 10* years to sleep, and she was able to get off of it completely just by taking magnesium before bed. Start low on the dose, and keep going up until you start getting loose stools, then just back down the dose a bit. That’s how to find your tolerance.

The other biggest factors, for me, are making sure I get a good workout in that day, getting sun in my eyes early in the morning for 10-20 mins, and wearing my blublox red tinted glasses a few hours before bed so that my natural melatonin production isn’t disrupted. Unless you’re wearing red tinted glasses before bed, it’s impossible to have healthy melatonin levels at night when your eyes are exposed to screens and lights in your house. The only ways to have healthy melatonin levels before bed are to wear red tinted glasses and/ or use candles to light your house.

 

[Vince Carter]

I get my better nights sometimes when I constantly vary my sleep aids...for instance last night I took 1, 3mg melatonin and did pretty well by my standard but was still tired so it's hard to gauge the actual restful sleep vs. being awake and tossing and turning for a bit.

I've tried to the idea that it's blood sugar that drops at that time of night but having a drink of salt/sugar, nibbling on something or a spoonful of peanut butter but none of that really helps me.

For me I think my Estrogen is playing a part it stays up early in the night but when it breaks is when I wake up and feel hot/warm/sweaty. I have no trouble getting to sleep and I'm pretty wiped out by 6pm and am in bed by 730pm. But the 2-4 AM is my trouble area.

 

[Appassionato]

The best sleep aid I’ve found is magnesium, hands down. I take a highly absorbable form called Remag. It’s basically just magnesium chloride liquid. Tastes like sh*t, but works great. I had an ex girlfriend that was on trazodone for 10* years to sleep, and she was able to get off of it completely just by taking magnesium before bed. Start low on the dose, and keep going up until you start getting loose stools, then just back down the dose a bit. That’s how to find your tolerance.

The other biggest factors, for me, are making sure I get a good workout in that day, getting sun in my eyes early in the morning for 10-20 mins, and wearing my blublox red tinted glasses a few hours before bed so that my natural melatonin production isn’t disrupted. Unless you’re wearing red tinted glasses before bed, it’s impossible to have healthy melatonin levels at night when your eyes are exposed to screens and lights in your house. The only ways to have healthy melatonin levels before bed are to wear red tinted glasses and/ or use candles to light your house.

I've tried 3 forms of magnesium, this ionic liquid one:

https://www.amazon.co.uk/gp/product/B005PFK3YS/ref=ppx_yo_dt_b_asin_title_o09_s00?ie=UTF8&psc=1

plus transdermal magnesium and magnesium bisglycinate. They just helped a bit the first few days and then the effect wore out. At least none of these gave me loose stool, as with magnesium chelate and magnesium citrate.

I read your message about the blubox tinted glasses and I was thinking about buying a pair, but I would like to try again with some melatonin first, when I wake up at night, along with some glycine before bed.
Also, I read that the glasses should wrap around the eyes, in order to avoid having the blue light hitting your eyes from the sides, but I don't know if that's an overkill to be honest.

For me I think my Estrogen is playing a part it stays up early in the night but when it breaks is when I wake up and feel hot/warm/sweaty. I have no trouble getting to sleep and I'm pretty wiped out by 6pm and am in bed by 730pm. But the 2-4 AM is my trouble area.

I have the same issue with waking up warm and sweaty, at the point that last night I had to open the window to get some cold air in, while my wife was covered with a sheet and a throw.
I flagged out that the issue is most likely high E2, as Dr. Saya told me on my first checkup with him, but I keep hearing people on this forum saying that it's actually low E2 to cause the issue, which is the exact opposite of what my blood tests are showing.
When my E2 was low I was having serious anxiety at bedtime and it was impossible to fall asleep, but, when I was eventually falling asleep, I was getting those 5-6 hours of uninterrupted sleep.

 

[DragonBits]

I get my better nights sometimes when I constantly vary my sleep aids...for instance last night I took 1, 3mg melatonin and did pretty well by my standard but was still tired so it's hard to gauge the actual restful sleep vs. being awake and tossing and turning for a bit.

I've tried to the idea that it's blood sugar that drops at that time of night but having a drink of salt/sugar, nibbling on something or a spoonful of peanut butter but none of that really helps me.

For me I think my Estrogen is playing a part it stays up early in the night but when it breaks is when I wake up and feel hot/warm/sweaty. I have no trouble getting to sleep and I'm pretty wiped out by 6pm and am in bed by 730pm. But the 2-4 AM is my trouble area.

If you go to bed at 7:30 PM, let's say you are asleep by 8 PM, 4 AM is 8 hours, 2 AM is 6 hours, maybe you just don't need 8 hours of sleep. I have read adults need between 7-9 hours, you are pretty close already. However, 7-9 hours is likely a flawed study.

But more significantly:

"Although it's a common belief that 8 hours of sleep is required for optimal health, a six-year study of more than one million adults ages 30 to 102 has shown that people who get only 6 to 7 hours a night have a lower death rate. Individuals who sleep 8 hours or more, or less than 4 hours a night, were shown to have a significantly increased death rate compared to those who averaged 6 to 7 hours.
........

The best survival rates were found among those who slept 7 hours per night. The study showed that a group sleeping 8 hours were 12 percent more likely to die within the six-year period than those sleeping 7 hours, other factors being equal. Even those with as little as 5 hours sleep lived longer than participants with 8 hours or more per night. "

University of California, San Diego: External Relations: News & Information: News Releases : Health

So one problem is being convinced we need 8 hours, while that was based on a small study and much larger studies have suggested we need less sleep than 8 hours. Though as always, individual needs vary.

There are several industries (drugs, mattress, fancy pillows, etc) dependent on convincing people their products are magic solutions to a good night sleep.

 

[DragonBits]

The best sleep aid I’ve found is magnesium, hands down. I take a highly absorbable form called Remag. It’s basically just magnesium chloride liquid. Tastes like sh*t, but works great. I had an ex girlfriend that was on trazodone for 10* years to sleep, and she was able to get off of it completely just by taking magnesium before bed. Start low on the dose, and keep going up until you start getting loose stools, then just back down the dose a bit. That’s how to find your tolerance.

The other biggest factors, for me, are making sure I get a good workout in that day, getting sun in my eyes early in the morning for 10-20 mins, and wearing my blublox red tinted glasses a few hours before bed so that my natural melatonin production isn’t disrupted. Unless you’re wearing red tinted glasses before bed, it’s impossible to have healthy melatonin levels at night when your eyes are exposed to screens and lights in your house. The only ways to have healthy melatonin levels before bed are to wear red tinted glasses and/ or use candles to light your house.

I had always thought Remag was the best form of magnesium, though I have never taken it.

However, Magtein magnesium l-threonate has been proven to be the only form of magnesium to cross the blood brain barrier and increase brain levels of magnesium.

They are both expensive.

But based on studies, I would say Magtein is "better" because of the increase in brain levels. I haven't really tried to take 3 caps of Magtein, the recommended daily dose before bed, I will give it a try. I tend to take 1-2 caps a day along with a cheaper magnesium complex. Mostly I take Mg to prevent muscle cramps.

Though I think very cheap forms like mg oxide will also work, it isn't highly absorbable, but take enough for long enough it will likely work for most people. Not for sleep, just to raise cellular / serum levels of Mg. BTW, we likely all know that serum levels of Mg isn't a good indication of cellular levels.

melatonin half life is 20-50 min, so suppressing it before bed only affects going to sleep, not sleep maintenance.

I don't have a problem going to sleep, it's sleep maintenance that a problem.

Now getting on a forum, internet, chat, whatever COULD cause some level of stress which could cause one to wake up during sleep.

I have had times where I wake up thinking about some conversation, debate, controversy that occurred right before going to bed. Even my wife bringing up something important in bed as we are going to sleep can disturb my sleep because I end up dwelling on it and it wakes me up. For her, maybe it helps her because she is thinking about it and "hands it off" to me and her part is "done".

 

[DragonBits]

I've tried it in capsules, both alone and stacked with other supplements in the same capsule.
I felt absolutely nothing, like if I was drinking a glass of water.
The effectiveness of GABA as a supplement is debated, due to the vast majority claiming it can't cross the brain barrier.

That's what I thought you might have been doing.

I usually buy bulk, with Gaba I bought 1 kg about $32. (I do have several supplements I don't use much sitting around because of the "bulk" buy).

I had been taking a teaspoon of Gaba, measuring a teaspoon that is about 2 grams. Way higher than most anyone recommends.

I am cutting back, since taking too much GABA can have what doctors call a "paradoxical reaction" or paradoxical anxiety. Apparently a clinical dose of Gaba is 500 mg.

There is controversy over whether oral gaba crosses the blood brain barrier.

Leaving that aside, I know for sure GABA has a direct, measurable, obvious effect on me. Whether it's a central nervous effect or brain, no idea.

I get a facial flush feeling, my face does turn a little red, and in 10-15 min my blood pressure will come way down. At least 10 points, sometimes 20 points down. At first it was a little scary, so I didn't take GABA for a year, it sat around in the container. (Which does clump up over time due into cakes due to moisture).

Not sure if I only take 500 mg will I get the same reaction, likely I will, yesterday I tried 1/2 teaspoon, I guess a gram, same feeling.

So your dose was likely much less than 500 mg. And maybe not everyone reacts the same way, not sure which.

I guess with amino acids I tend to think they are mostly harmless but maybe I need to pay more attention to mega doses.

 

[drkelp]

I wake virtually every night and usually hard to go back to sleep. Waking at 2-4am doesn't leave time for any supplement to kick in before time to get up really. Been this way for prob 3 years. I turn 58 Saturday so part may be age. Diurnal cortisol tests did show deregulation but nothing seems to help Phosphatidylserine gives me insomnia. Here's a few things I've tried:



unisom(doxylamine succinate)
Diphenhydramine hcl
Periactin(Cyproheptadine)
5htp/tryptophan
Theanine
melatonin
Gaba
HERBS Valerian, Chamomile, hops, passion flower Lemon balm
magnesium(Oral/transdermal)
AMINOS (Taurine Glycine ornithine
Inositol
phenibut
Kava kava

Have blue blockers, sleep mask, grounding pillow, always open to new ideas...

 

[cigpk]

A lot of suggestions here.

I decided to discontinue my anastrazole for now. Hoping that helps with hot flashes in the middle of night . I notice I feel worse on days I take it so I’m just gonna let my e2 float back up to low 30s.

I’ll continue with ZMA for now, although I’ve seen differing opinions on whether zinc aspartate is harmful in the ZMA.

I have no trouble with falling asleep so I donno if melatonin will help. It’s just staying asleep that I struggle with.

 

[Appassionato]

This is a really helpful article by the way, in case someone is interested:

Eliminating the Top Causes of Insomnia | | Julia Ross' Cures

I've been reading it several times during these years.