I suffer from bouts of insomnia due to a physical health condition.
I'm not lying awake at night worrying. My mind is pretty blank but my body is awake.
Even though I'm consistently taking the appropriate treatment regime for this condition, that manages and reduces symptoms, it doesn't mean complete cure or perfect relief. There are a lot of physical health conditions like this.
Anyway after consistently maintaining lifestyle adjustments and supplements (exercise, magnesium etc) to support sleep, after getting to the point of being so sleep deprived I had car accident (no injuries but a split second difference couldve been a different story and the car isn't in a good way!), I finally sought my Dr's help.
She was helpful and gave me a script for some benzos for short term relief and then got the guidelines up on her computer and said "pharmaceuticals are a short term bridge while people seek help to address the underlying issues". This Dr knows my insomnia is a direct result of a physical health condition and I've had no changes in stress, mental health etc that may be contributing.
I asked what the guidance says about how to address long term insomnia thats secondary to otherwise controlled and treated health conditions.
Nothing. That's it. The long term strategy assumes an psychological cause so if you've got hyperthyroidism, pheaocytocytoma or one of the many other conditions where insomnia can rear it's head even if you're treated, the guidelines basically ignore your needs.
For context I live in a country without any of the new fancy drugs like Orexin. Even trazadone and doxepin aren't a thing here anymore. And no cannabis isn't legal here unless you go the medical route which costs basically the same as a weekly shop for a family of 4 here. Even melatonin is tightly controlled and very expensive because you have to get a tiny supply through a pharmacist consult in very small quantities. A box of 30 2mg Melatonin is all you can get, no other strengths available.
The few options that are pushed are off label usage of antidepressants, antipsychotics etc and all of them have weight gain/metabolic issues and cognitive effects that I feel very strongly and aren't actually that effective for sleep either.
Rant over, but i just wanted to share this and see if others have noticed this issue