u/No-Manufacturer1903

Hi fellow insomniacs!

I have had a progressive worsening insomnia for 4 years now. In the beginning I managed with a simple antihistaminer but then as it have progressed nothing helps me get a restful sleep. I am getting 3-4 hours unrested sleep every Other night with 1.5x Max dose lunesta. This has forced me to pause med school and be on sick leave which is real life purgatory when you cant sleep. I have tried every sleep med and CBT-i except benzos as far as I know and nothing has helped. Even Olanzapine, yeah I hate that drug.

I am desperate since it feels like my whole life collapsed in front of me due to insomnia. There seems to be no solution and a life like this with no sleep and subsequent cognitive decline is not worth it.

Even the sleep study done led to the diagnose insomnia which was the worst outcome of all due to the diagnosis vague nature and unknown mechanisms.

Therefore I am asking you guys have anyone here been able to use benzodiazepines for sleep long term lets say the rest or there life ?

Or does anyone have tips regarding as to what can have happened to my brain in order for me to never feel sleepy and never be able to sleep?

Does anyone have a success story with similarities to my situation? How did you fix it?

Best regards
Youre fellow insomniac

Background 4 years ago 2022 one year before begining medical school my sleep deteriorated progressively. Often sleeping 3 hours per night. Then it worsened further and I have tried almost every sleep medication out there includinf AP, AD. Antihistamines and z drugs which helped sometime until I am now tolerant. This resulted. I managed to complete 3 years of medschool with 3 hours of sleep but subsequently I was out on sick leave.

I have done a sleep study showing Very fragmented sleep with many microarousals with only one rem cycle. There where also a LOT om limb movement plmd index 37.

So right now im trying to figure out suitable medications cover every condition although with great difficulty.

For OCD and depression: I Am thinking about trintrllix althoug that seems to impact sleep greatly and give severe sexual side effects. Is there any ssri that does not impact sleep? Is there any effective way to counter Sexual side effect, for example pramipexol? How would the anhedoni a best be treated? Would auvelity treat ocd anhedoni depression better with less sexual sideeffects with possible add on of Memantine?

For insomnia I am thinking about lorazepam and daridorexant or lemborexant.

I would be very thankful for any input on how this best could be approached since the psychiatric care in Sweden from my experience just follows a flow chart of medications and if those doesn’t work they multiple times have told me they don’t know what to do. Furthermore some therapies and newer medications are difficult to get here comparing to the us.