#22

What a Good Night’s Sleep Can Do for Your Heart

Might not be able to access the paywall.

Brief summary:

“The American Heart Association last month added sleep to its list of factors critical to heart health, a list that includes seven others such as diet, physical activity and blood pressure. The recommendation reflects widening scientific consensus on the role sleep plays in helping prevent heart disease. If you don’t get enough uninterrupted sleep, you are more at risk of developing hypertension, Type 2 diabetes and obesity. In a study of nearly 4,000 middle-aged men and women, researchers found more atherosclerosis, a condition characterized by a buildup of fatty plaques in the arteries, in people who slept fewer than six hours a night than in those who got seven to eight hours. The scientists found increased amounts of plaque and in more locations in the participants whose sleep was most fragmented compared with other study participants.Interruptions during sleep matter too. Poor quality sleep interferes with the body’s normal rest and repair cycles, scientists believe, disrupting its ability to manage inflammation, the body’s natural immune response to injury that is damaging if it becomes chronic. That appears to be true even in people who think they’re getting enough sleep, according to research by a group of scientists at Columbia University.”

#23

Related to this threads theme…

#24

Honestly , I think you are doing a lot of the right things. If you have all your sleep hygiene in order and still are struggling with getting good sleep, then I would go see a specialist.
If you are going to do a hot bath/shower/sauna, you may push that to about 2 hours before bed because if your bath/shower/sauna is very intense, it actually can affect your sleep, similar to if you do intense exercises before bed(this would explain why you felt more awake after sauna session)
I think a lot of this depends on what time you are trying to go to bed and wake up? Caffeine has a half life of about 5-6 hours, but it has a quarter life of about 10-12 hours, which may disrupt some of your ability to fall asleep.
I think a big part of being able to fall asleep well at night is having a consistent routine, and avoiding what is called social jet lag which is where we stay up later during the weekend. You want to make sure you are consistent and also just have some sort of “decompressing” routine where you find things that relax you, such as turning off TV/ dimming lights about 2-3 hours before bed, meditating, stretching etc.

I am glad to see more attention being paid to this field!

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#25

A note - I’d worry about titrating melatonin carefully as it is a hormone with multiple effects as @Guywholikessleep can probably talk about much more (including new ones just being discovered) yet supplements can have 10x what’s on the label and I can’t easily find ones with 0.5 mg, USP verified. Supraphysiological levels of melatonin may be harmful in long term use, out of an abundance of caution.

Thus, I don’t touch melatonin currently and rely on signals to have my body control the right amounts. It doesn’t actually help sleep quality much and the first time I slept melatonin - with a random supplement company selling it (cGMP only) - I got groggy while walking up and sleep quality was actually slightly worse.

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#26

Btw, do you know anyone who has followed up on that small gabapentin study for primary insomnia?

I only use 300 mg prn (once a month or two at most) 2 hours before sleep before a highly-stressful and high-anxiety-inducing event that makes it difficult for me to sleep (I have GAD, gabapentin was off-label for GAD with insomnia).

Sleep quality has always been much better as per actigraphy with machine learning (calibrated with PSG) with increased slow wave sleep. Even unintentionally only sleeping 4-5 hours feels like 7-8 hrs, although I always aim for 7-7.5 hrs.

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#27

Not directly related with primary insomnia, I have seen it with other disorders.

https://journals.sagepub.com/doi/abs/10.1177/0883073812463069

It looks pretty promising, but with anything that comes to sleep pharmacology, I think more long term studies need to be done first.

Are you a doctor who has to do shift work or do you have stable/clinic hours?

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#28

Mostly stable clinic hours with extra time after that doing documentation. I never had to do nights with my condition via ADA letter, but I do know some surgery folks on modafinil.

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#29

If you don’t mind me asking, would you say that your GAD causes issues with your sleep, or does lack of sleep cause GAD for you? essentially I am wondering if you feel GAD is a primary factor that causes your sleep deprivation, or do you feel it is secondary, with sleep deprivation being a primary factor causing your GAD?
I currently am trying to figure out epigenetic mechanisms involved in sleep and social defeat stress in mice( SDS mimics all sorts of neuropsychiatric illnesses such as anxiety, depression, PTSD, etc) so I am curious your thoughts based on your experience? I dont know how often you actually have issues with sleep .

#30

No worries at all, I’m not particularly sensitive about my condition.

I suspect it’s a two-way street based on current literature, but GAD is probably the bigger factor for me personally. The reason why I suspect this is I have some periods where I can get enough sleep and still get GAD symptoms (when I was not on medication previously) worsening.

Some more context:

I currently control symptoms once every 2 months of 25 mg psilocybin/psilocin carefully extracted from shrooms sourced from a trusted brick-and-mortar in Canada with CBT and executive coaching with a psychiatrist.

The GAD NNT is 2 for psilocybin with an FDA “Breakthrough Therapy” designation and it may be more efficacious than SSRIs on secondary endpoints.

I had mild to moderate adverse effects from SSRIs with only a moderate effect and I’ve tried everything else, hence I had to resort to felony shrooms to medicate, unfortunately. My psychiatrist is fine with me going this route but he says it’s still a coin flip for others and whether it will get FDA approved.

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#31

Interesting.
How has treatment with psilocybin been?

I actually got involved in sleep research because I wanted to investigate the effects of Psychedelics and sleep. So after talking to some researchers in the psychedelic field( rick strassman, rick doblin, Carhart-harris, David Nutt, etc) I decided to pursue my PhD in circadian rhythms/neuroscience first and then do a Post Doc in a lab that focuses on psychedelics.
On days your due psilocybin have you noticed any affects on your sleep?
When I did psychedelics awhile ago I always noticed I couldn’t sleep due to the stimulatory effects.

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#32

Actually, I noticed no positive or negative effects based on actigraphy so far.

To be clear, I only do it in the early morning and it’s pretty much gone in 6 hours - based on me not seeing vivid colors or the carpet looking “alive” anymore. I suspect it may be like caffeine in coffee. It won’t likely have any effects on sleep if one drinks it in the morning.

I use a tea extraction method that ends up being a quicker conversion to psilocin via dephosphorylation before drinking the extract because I do not want to have longer effects. I don’t think I can sleep well with threshold amounts of psilocin in my system but I never tried.

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#33

Well that would make sense due to the fast half life. Do you feel any fatigue or grogginess the day after your dose?

#34

No grogginess or fatigue. Sometimes I get a mild headache.

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#35

So sorry for your problems. My youngest daughter has some of the same issues. She sees a psychiatrist once a month and fortunately everything is currently under control; anxiety, occasional panic attacks, and depression. Her current meds are working well for her and she is not depressed, but occasionally has panic attacks every few months or so.

I get the fact that you are not too fond of medications, don’t blame you.

Does your use of psilocybin/psilocin include meditations etc?
I know you have probably read everything there is to know about your condition “GAD”
But, have you tried any Yoga, transcendental meditation, etc.?
Unfortunately for me, every meditation technique that I try merely makes me sleepy.

Here is something I came across that includes “mindfulness” You have probably already read it but for those who haven’t:

“Randomized Controlled Trial of Mindfulness Meditation for Generalized Anxiety Disorder: Effects on Anxiety and Stress Reactivity”

I also ran into this when I was searching for places to get a legal dose of psilocybin or LSD under supervision It’s in the Netherlands and the cost is $6K plus for a 5-day retreat, but add to that, roundtrip airfare, it’s a little pricey for me right now. But, think the price is quite reasonable.
(That and the grueling plane trip)

“A Comprehensive Program Including
Preparation, a 5-Day Psychedelic Supported Retreat and Integration”
“This is a legal opportunity to take moderate to high doses of truffles containing psilocybin that carefully creates a safe, intentional, and transformative container consisting of a pre-retreat preparation and integration components essential to activating the full potential for personal breakthroughs.”
https://www.synthesisretreat.com/expansion

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#36

Yes. Actually I stop melatonin all together as I think interact with Rapamycin.

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#37

Thank you - I appreciate the suggestions. It’s well controlled already - I am fortunate to have the best psychiatrists available who have a deep research background, already knew where to look, and was able to balance out brain levels for all the main neurotransmitters with someone who titrated it well. People don’t realize that the best psychiatrists are often experts in pharmacology and medication management for drug-drug interactions. You don’t want to go cheap on it.

I shake my head every time I see an old man think he doesn’t need to talk to a psychiatrist when he clearly needs it and he thinks I’m implying he’s “crazy” when I’m going by purely objective measures. GAD and MDD are way too common.

The hardest part for me is the come down from Focalin XR but it’s relatively manageable with adjuvants and I have been well compensated. It’s actually fairly difficult to find the right people, especially those who are financially challenged. Everyone I know in the support group I’m in had much worse issues with side effects under “algorithmic medicine” - it appears I’m doing the best in it right now - I feel quite close to normal frankly.

I’ve already tried nonpharma approaches DBT/talk/psychodynamic therapy, interoception, yoga, tai chi, ice baths, saunas, mindfulness, breathing exercises, etc. Anything that feels like it has legs.

The only things that work for me are SSRIs/SNRIs+CBT (side effects decrease my quality of life a lot even though they have a moderate effect size, already tried multiple ones), psychedelics+CBT (negligible side effects, but LSD and ketamine are either difficult to source or have longer/undesirable effects with possible nasty adulteration of dangerous NBOMes - I found psilocybin the easiest to source as it’s difficult to fake a mushroom and there is relatively nonexistent drug violence associated with it), diet/exercise/sleep (works but not enough, only an adjuvant), and gabapentin (I’m a responder, but I build tolerance quickly). Sometimes you just can’t fix a biological issue in brain chemistry with nonpharma approaches.

I don’t want to use benzos, buspirone, pregabalin, TCAs, mirtazapine, hydroxyzine, and second-gen antipsychotics like quetiapine. Side effects are worse than SSRIs - I’ve tried most of these before settling on psilocybin.

#38

I use 75mg CBD oil plus I spend 16 minutes on my PEMF mat, seems to help me sleep well

#39

Admittedly this is an old paper, 1977, but that there was a “bitter” argument going on still causes me to doubt the efficacy of psychotherapy. Bottom line: My own daughter was not helped by psychotherapy, medications worked.

Meta-Analysis of Psychotherapy
Outcome Studies
“Scholars and clinicians have argued bitterly for
decades about the efficacy of psychotherapy and
counseling. Michael Scriven proposed to the
American Psychological Association’s Ethics Committee
that APA-member clinicians be required to present
a card to prospective clients on which it would be
explained that the procedure they were about to
undergo had never been proven superior to a
placebo”

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#40

I can tell you as a non psychiatrist but with lots of geriatric psychiatric patient experience - CBT definitely is efficacious. DBT is probably okay to use for borderline personality disorder. Everything else is mostly a question mark.

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#41

" It’s well controlled already"
Does this mean you won’t be going to the Netherlands? :grinning: