Spookily losing sleep — using ZZZyquil. Suggestions welcome.

October 30, 2023 7:27 PM

Title is a bit tongue in cheek, what with it being Halloween tomorrow and all. But yes, fundamentally, I've always been a night owl since high school (20+ years), sometimes sleeping as late as 6-7am and sleeping in as late as 3-4pm during college.

I always struggled with sleeping, even though I pulled all-nighters to reset my sleeping cycle. My college life and early work life was a mess because I kept oversleeping. My sleeping schedule was so out of sync with the majority of the world. Not sure what caused it exactly—I suspect 16-year old me having unlimited access to the Internet and, well, being a bored and curious teenager.

Around 2015, a friend introduced me to ZZZyquil (liquid), which I used. It was truly a miracle. I started by taking it alternating each other night during weeknights only, and the full 30ml dose. The nights I took it, I became super relaxed after about an hour and slept easily; the nights I skipped it, I went back to not sleeping until 2-4am. Eventually, I transitioned to taking it every weeknight, but only 15ml (half dose) so not to become dependent. That worked just fine.

Around ~2021 or so, I started taking ZZZyquil on the weekends, too, so now effectively take it every night (still 15ml), skipping the odd night every now and then. I noticed that ZZZyquil has lost some of its efficiency lately. I'm still able to sleep for the most part, but I'm not in as a relaxed state as I was when I started taking ZZZyquil back in 2015, and I don't fall asleep as fast. If I skip ZZZyquil today, I often can't fall asleep until 4-5am, unless I'm extremely tired. I think the core of my sleeping schedule is still very much a night owl.

I've tried melatonin (pill form) a couple of times but didn't like how it made me feel—had a very odd sleep and it just didn't jive with me. That was maybe 5 years ago, though.

Do you have any suggestions on transitioning away from ZZZyquil? Anything else? Can't do weed/edibles (job), tried chamomile tea and screens off but that didn't help. FWIW, I take the generic Walgreens version of ZZZyquil, which I believe shares the exact same ingredients.

Thanks! And, of course, obligatory YANMD. Have a wonderful and spooky Halloween!

posted by dubious_dude to Health & Fitness (24 answers total)

Look into L-Theanine.

I've historically been a pretty good sleeper, but I do struggle with pretty vivid/upsetting dreams when my life is busy or stressful (and this has ramped up since the start of covid). Bad dreams make me sleep not so great.

I'll take an L-Theanine occasionally on nights when I absolutely have to get a good night's sleep. I'm not sure that it works as a sleep aid for me, but it's been very effective at shutting off whatever part of my brain retains dream stress, which in turn allows me to sleep better. Might have some benefits for you, who knows.
posted by phunniemee at 7:39 PM on October 30, 2023 [2 favorites]

Stopping fighting my body and working nights was the best thing I did but that's not feasible for everyone and not even something I do now.

I take trazadone for sleep which some men avoid due to possible side effects involving long erections which is very rare. For me it works fine, but that is not a side effect I can have.

I was perscribed sleep meds young so I've been on them more than half my life now. I've taken ambien which isn't designed to be used long term anyway, Lunesta, seroquel. Of all of them trazadone works best and consistently without major side effects. Lunesta and ambien have tolerance issues that can develop over time. Seraquel worked when I was very very anxious and had more panic issues but now that I am a much more chill person it felt really sedating and impacted my day to day productivity.

Melatonin I take occasionally, dosing on these products is all over the place but trying a smaller dose o
If available may get rid of some of the groggyness.

Personally I just know how much time I need for trazadone to leave my system and make sure I sleep for 8 hours.
posted by AlexiaSky at 7:43 PM on October 30, 2023

I didn't mention explicitly Lunesta and ambien have fallen out of favor due to addiction potential, and should only be used short term.
posted by AlexiaSky at 7:50 PM on October 30, 2023

Seconding Trazadone. I now sleep through the night and am not groggy in the morning and I don’t remember dreams anymore. Very peaceful! And I can take it every day. I leaned on Tylenol pm and Advil pm and the like before this.
posted by oomny at 8:07 PM on October 30, 2023 [1 favorite]

Trazadone made me a zombie, ymmv. Valerian root and magnesium (500mg) has been my key recently. I still struggle with waking up at 3am, but I can usually get another hour or two before the alarm goes off.

Edited to add: Melatonin will put me to sleep, but when I wake up at 3am there’s no going back to sleep.
posted by sacrifix at 8:41 PM on October 30, 2023 [2 favorites]

Seconding L-Theanine. I find it’s very effective at telling my body to fall asleep. I don’t know how well it helps it stay asleep; i take other prescription meds that keep me asleep and i would not recommend them as the side effects are terrible.

Also there was a time when i found an L-tryptophan supplement to potentially be effective at keeping me asleep, i believe i stopped it because of lack of research on its long term effects.

But L-Theanine is great.
posted by jerome powell buys his sweatbands in bulk only at 8:44 PM on October 30, 2023 [1 favorite]

One suggestion you might hear if you went to a sleep lab is to also work on the waking up part of the equation, for instance by making sure to get sunlight early in the day, or/and using a sun lamp to wake up. The idea is to teach your body a regular sleep/wake (circadian) rhythm, which involves various hormones, some or all of which are affected by bright light or the absence thereof. (Effectiveness may vary.)
posted by trig at 1:57 AM on October 31, 2023

Just so you know, Zzzquil's active ingredient is diphenhydramine (Benadryl). It is the active ingredient in most of the "PM" meds.

What is your caffeine intake like? Do you stop around 2-3pm or are you swilling Panera charged lemonade until 10pm? That may be part of your problem. Also, having to get up to pee kind of interrupts sleep.
posted by dancinglamb at 3:40 AM on October 31, 2023

also work on the waking up early part of the equation, for instance by making sure to get sunlight early in the day

Hello, I am also a night owl. I also have severe recurring depression, which aggravates my tendency to stay up at night and snooze during the day.

To help me regulate my sleep patterns, my therapist and my psychiatrist have prescribed a 10-minute everyday walk at 9 a.m. Doing this is not second nature for someone who agrees with cartoonist Lynda Barry that there is no place like bed: "It is warm. It is cozy. There are no pesterments." Wish me luck.
posted by virago at 4:14 AM on October 31, 2023 [6 favorites]

Magnesium glycinate, 400 mg an hour before bed, has been a life saver with my sleep issues.
posted by ananci at 5:15 AM on October 31, 2023

Not a "proper" answer but knowing what's underlying is often useful: this is called Delayed Sleep Phase Syndrome.
posted by heatherlogan at 5:28 AM on October 31, 2023 [1 favorite]

Melatonin will put me to sleep, but when I wake up at 3am there’s no going back to sleep.

Timed release versions are available which I find alleviates this somewhat without groggyness in the morning. I find it is vitally important to not take any sort of melatonin less than 8 hours before I have to wake up otherwise I'll be a zombie most of the day. Also I take it 30-45 before bedtime.
posted by Mitheral at 5:30 AM on October 31, 2023

Have you tried using an eye mask? I've found that the quality of my sleep is drastically better when I use an eye mask. I'd even say that 6 hours sleeping with an eye mask seems comparable to 8 hours without. The quality of the mask really matters; I use one that's $35 and doesn't put any pressure on my eyelids. As a night owl always struggling to sleep early and wake up early, I find that the deep quality of sleep is what allows a circadian rhythm to set in over time.
posted by many more sunsets at 6:34 AM on October 31, 2023 [6 favorites]

I took ambien for 8 years or so with no addiction or dependence issues. My docs over that time were supportive of continuing what worked for me rather than change due to hypothetical issues. Trazodone made me a zombie for hours after waking, did not try twice. I was thinking about trying pot once it was legalized, sounds like it works well for some.

Eventually my brain just .... decided it knew how to sleep, again, about two years ago. A nice realization! Although with a shifted schedule, I used to be a night owl but now am asleep by 10 and wake up at 6. Very odd. Aging, maybe.

I'm sure you're well versed on all the aspects of sleep hygiene, though it sounds like you could be more regular.
posted by Dashy at 6:39 AM on October 31, 2023

There are many better options than diphenhydramine for sleep, but I do not mean taking unregulated hormones. Stay away from melatonin unless you're going to use it one or maybe two nights for jetlag.

Try the magnesium and L-theanine. You may at least find that the quality of your sleep is better even if it doesn't really put you to sleep.

Over the counter, there's doxylamine succinate, half of one was my usual dose. By prescription, trazodone or hydroxyzine (what I'm on now) help without flattening you.

You should talk to a doctor. There may be medical reasons your sleep is low-quality.
posted by Lyn Never at 6:43 AM on October 31, 2023 [1 favorite]

Just to chime in - L-Theanine acts as a stimulant to a lot of bodies, including mine. I’ve tried various brands, but it might as well be caffeine.
posted by bug138 at 6:57 AM on October 31, 2023

I worked in a sleep medicine clinic for many years. This is not medical advice to you in particular but I had lots of patients who came to me with nearly identical complaints. It sounds like circadian rhythm disorder, delayed sleep phase type. It’s not all that uncommon. All the sleeping aids in the world don’t help DSP. The medications listed about are like band aids for this disorder and may give minimal improvement on sleep onset and total sleep time but most people with DSP won’t experience much benefit from using them.

DSP is usually diagnosed by a sleep medicine clinician. Other sleep disorders (periodic limb movement disorder, sleep apnea, chronic insomnia…) need to be ruled out.
DSP is treated with very small doses of melatonin in a very specifically prescribed manner that is tailored to each unique individual. I can say with nearly 100% certainty you were taking melatonin at a dose at least ten times higher (probably more) than what is used for DSP. At the dose for DSP, people rarely experience side effects. I can’t remember a single patient of mine who had trouble with melatonin at the DSP dose because of side effects. Mostly their trouble was with taking it in the very specific way it is prescribed.

There isn’t really a “problem” with people who have DSP. Meaning, DSP isn’t a diseas but a variation of a normal circadian rhythm. The problem is with living in a world that functions on a circadian clock that is misaligned with the one inside. It’s not a disease, but it can cause a plethora of issues if one is expected to function on a clock other than their internal one.

I think someone above mentioned that they just stopped trying to go against their clock. That’s a legitimate option for some people. Several patients of mine decided to go that route because the rest of their lives were amenable to the change. They were much happier and much more well rested.

In short, go see a sleep medicine doctor if you can. If not, go see your PCP to ask them specifically about DSP.
posted by teamnap at 7:28 AM on October 31, 2023 [6 favorites]

A few thoughts:

- I'm wondering whether conscious exposure to and withdrawal from bright light might help somewhat. I have SAD, which leads to some circadian issues, and it's typically recommended to get bright light in the morning (basically, to make it clear to your body that it's daytime). They actually make specialized lamps for this, which you can find on Amazon, and/or you can go on a morning walk (I do 20-30 minutes). Similarly, I'm wondering whether it might help to avoid light after, say, dinnertime. My understanding is that blue light is the biggest culprit here, so I'd try to keep any evening light exposure in the warmer/red tones and low luminosity. I think most electronic devices have a setting where you can turn off blue light. There are actually also lightbulbs that do the same (I think some change to warmer light throughout the day, and for others, the light gets warmer as it is dimmed?). I find that avoiding bright light in the evening and only using warm lamp light definitely does help me feel sleepier at bedtime. I believe the biochemical basis for this is that light (especially blue light) inhibits melatonin production in the body, if I'm remembering correctly.

- Relatedly, I know you said you already tried melatonin, but I'd try again. Melatonin is the natural way that your body promotes sleepiness. Many of the strengths for sale are really high, which I'd avoid: from what I've read, your body actually uses fairly low levels of melatonin naturally. I take an extended release melatonin, in the lowest dose I can find, which helps me stay asleep. I often pair it with a very low dose immediate release to kickstart the sleepiness. I definitely notice an impact. It feels very different from drugs like ZZZquil: it doesn't feel like an induced or drugged sleepiness, but simply the suggestion of sleepiness that I can lean into if I choose.

- If melatonin doesn't work, there are other options that might be worth trying. I take low-dose naltrexone (LDN) for chronic pain, but it has had a salubrious impact on my sleep. I've also heard of magnesium and possibly NAC being used for this purpose. I'm sure research or maybe a physician could recommend others.

- I also find that exercise can help me feel sleepy in the evening. I notice that I typically feel tired at the standard time when I've walked 3 miles or lifted weights or whatever. I do try to avoid more vigorous exercise after dinner as I notice that it can pep me up, but when I've exercised earlier in the day, I think it helps my sleep.

- I really don't think that taking ZZZquil regularly is a good idea at all. I don't want to scare you, but the main ingredient of ZZZquil, diphenhydramine (and other anticholinergic drugs, for that matter), is linked in some studies with an increased chance of developing dementia (lots of links here). Taking it in rare emergencies is one thing, but taking it regularly or even every night is something else.

- As teamnap mentioned, if none of this works, it might be worth seeing a sleep medicine doctor.
posted by ClaireBear at 7:45 AM on October 31, 2023

I have terrible sleep problems. Trazodone has been a life saver. It has a huge therapeutic range. 25 mg knocks some people out. At my worst I took 300+ mg. Now I take 150 about 15 minutes before bed and generally sleep through the night.
posted by kathrynm at 9:31 AM on October 31, 2023

I second the Magnesium Glycinate before bed. It works so well on me that I need to be in bed before I take it then I'm out. I am also stereotypical nightowl and would naturally stay up until 3-4am.
posted by miscbuff at 11:09 AM on October 31, 2023

0.3mg of melatonin, or *less*.
If you can only find 1mg pills, divide them into quarters.

https://news.mit.edu/2001/melatonin-1017

This is a terrible site, but the explanation ofwhy the dosing of melatonin is always incredibly wrong, is accurate: https://slatestarcodex.com/2018/07/12/did-a-melatonin-patent-inspire-current-dose-confusion/

ZYYYYquil etc, not saying it's a good thing to take, but if you do want it to be more effective again, try taking a medication holiday maybe? Don't take it for awhile and see if that resets you a bit.


For the dsps, an absolutely massive, very bright light for morning light therapy or light glasses where the small lights are right next to your eyes, (the small lamp style lights are honestly kinda toys and won't give 10,000+ lux required), and melatonin are the two main things that will help, but look up zeitgebers and chain as many together as possible?
posted by Elysum at 12:25 PM on October 31, 2023 [1 favorite]

The active ingredient in ZZZquil, Diphenhyramine is linked to dementia.
Maybe do a sleep study and look into whether you may have sleep apnea?
posted by nouvelle-personne at 10:01 AM on November 1, 2023 [1 favorite]

Response by poster: Thanks for all the helpful responses! Will discuss with my PCP and go from there.
posted by dubious_dude at 11:35 AM on November 2, 2023

Melatonin is not a harmless sleep aid.
It resets cycles and is sold at doses way too high even for
Things like jet lag, which melatonin is for.

In short a lot of supplements are less safe than they seem, so glad you’re asking. I’ve used trazodone for years. I sleep but it doesn’t mess me up.
posted by mermaidcafe at 1:15 PM on November 2, 2023