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This text is a little bit of a departure from my standard shopper tech opinions.
Over time, I’ve grow to be fairly obsessive about health, in addition to my bodily and psychological well being.
I’m a giant fan of Garmin, wearables, and health/well being tech typically. I really like analysing all the info they supply and trying to realize some perception into my health and well being.
On the whole, I primarily use my Garmin to realize perception into my health, however I keep watch over the assorted well being monitoring options, as relaxation and restoration are important for peak efficiency.
This text is extra about optimising my sleep and total well-being whereas looking for a stability of medicine that manages my ADHD and improves my sleep high quality.
Not a scientific examine
I’ll preface this by stating that there’s nothing scientific about my testing. I’m a topic of 1, and there are too many variables that impression my sleep.
It isn’t simply the occasions of the day that impact my sleep however my very own way of life selections, which embrace ingesting caffeine and an uncommon routine.
Within the brief time period, I’ve been experimenting with my dosages of Elvanse and decreasing caffeine consumption, in addition to experimenting with medical hashish and Daridorexant.
This text is maybe extra useful for me as I doc what works and what doesn’t work, however hopefully, it is going to present some standard info for anybody with sleep issues. Â
In the long run, I might be able to stabilise issues sufficient that I can collect some extra dependable comparisons between the 2 sleep drugs. Â
Historical past of Insomnia and Psychological Well being
I’ve had a lifetime of sleep and psychological well being points. I’ve had these points since childhood, however they peaked in my 20s.
I used to be an overweight, suicidally depressed alcoholic. Within the house of some years, my adoptive dad and mom died, I used to be financially supporting my grandmother, and I had each of my companies fail spectacularly.
At one level, I used to be solely getting 1 or 2 hours an evening’s sleep, which exacerbated all my different points.
Enhancements By Train, Food plan and Way of life enhancements
In my late 20s, I realised I’d be fortunate to outlive till my 30s not to mention make it via them. In an try to realize management of my life, I made a decision to shed pounds.
I grew to become obsessed to the purpose of an consuming dysfunction, however finally, I overcame the worst of my issues. I misplaced over 100lbs/7stone at one level, dropping right down to 154lbs/11st, however then gained a few stones in muscle (and fats).
Considerably decreasing alcohol, numerous train, and an obsessive routine modified my life.
It wasn’t all nice, although. With my melancholy manageable, my weirdness grew to become extra obvious. I’d wake at 3am, begin work, go to the gymnasium at 9am, eat lunch, nap, and vainly try and get some work executed within the afternoon.  This may be my routine 7 days per week.
I used to be sleeping significantly better; I might go to sleep simply, however I used to be a really gentle sleeper and would absolutely wake after each sleep cycle, which might be round 5 or 6 occasions an evening. This made sleep fairly annoying and never pleasing, however I used to be functioning, and that’s the primary factor.
Mighty Gadget grew to be fairly profitable, and I felt I had discovered my stride, however I used to be depending on my bizarre routine.
Psychological Well being Setback, ADHD Prognosis & Elvanse/ Vyvanse / Lisdexamfetamine
Simply earlier than Covid, I met my organic mom, and Covid labored out nicely for me (so far as world pandemics go). The climate was nice, enterprise was booming, and I used to be attending to know my new household.
Issues modified as soon as the lockdown lifted, and my relationship with my organic household went bitter (besides my brother). There may be blame on either side, and it could appear I’m genetically liable to ADHD and alcohol abuse. My household lack any self-awareness, in order that they do what they need and blame everybody else. I’m painfully conscious of my flaws. Finally, their gaslighting led me to have a psychological breakdown, and I went no contact.
I went to remedy, and my therapist instantly urged I’ve ADHD. I used to be identified a number of months later at nice expense as our failing NHS is used for psychological well being companies.
I used to be prescribed Elvanse or Vyvanse if you’re within the US. That is Lisdexamfetamine, which is a slow-release prodrug of dextroamphetamine.
It really works nice. The concept of taking an amphetamine to handle a dysfunction recognized for hyperactivity appears contradictory, however many individuals, together with myself, don’t really feel the stimulating results of the medicine. It lifts the mind fog and calms the racing ideas in my sleep.
Sadly, regardless that I’m not getting excessive, taking an amphetamine-based medicine is clearly not nice for sleep, and my sleeping issues returned.
One of many points I’ve with Elvanse is that it’s good at masking sleep deprivation (with it being an amphetamine). I discovered that even with a foul night time’s sleep, I’d be OK throughout the day as soon as medicated, however over the course of some days, my total sense of well-being lowered. I’d really feel extra anxious, simply distracted, and irritable. The constructive results of Elvanse would lower, and the detrimental unintended effects of taking a simulant would begin to present.
To handle this downside, I’d cut back my dosage or take breaks each few days to compensate for my sleep, which is suboptimal.
Getting Prescribed Medical Hashish
Medical Hashish grew to become authorized within the UK in 2018. It’s virtually unimaginable to get it prescribed by the NHS within the UK. It’s sometimes used for extreme types of epilepsy and sufferers going via chemotherapy.
It’s comparatively simple to get prescribed by way of personal clinics. They’re keen to prescribe it for quite a lot of problems. Ache-related issues are among the best causes to make use of Hashish, however you may be prescribed for a variety of psychological issues, together with melancholy, nervousness, ADHD and ASD, which I tick all of the containers for.
The one caveat is that you will need to have tried two types of conventional medicine and located them to be ineffective. Â Over time, I’ve been on most antidepressants, none labored, and benzodiazepines a number of occasions, which additionally by no means labored, so I used to be a great candidate and instantly accepted.
I’ve by no means smoked weed or cigarettes, so I used to be began at a comparatively low dose. Some individuals vape 60g monthly, and it might probably go greater, which I don’t perceive how anybody can afford; for me, I used to be prescribed 10g of flower to vape and 10 ml of oil for oral use.
Daridorexant / Quviviq
Hashish oil is usually a bit hit and miss as your tolerance builds up, and I finally grew to become conscious of a brand new sleep drug referred to as Daridorexant, which is offered beneath the model Quviviq.
It is a new class of sleep medicine that isn’t associated to benzodiazepines or different hypnotic sedatives.
It’s classed as an orexin antagonist medicine. Orexin, also referred to as hypocretin, is a neuropeptide that regulates arousal, wakefulness, and urge for food.
Orexin neurons activate totally different mind areas which have important features in wakefulness,, such because the dopamine, norepinephrine, histamine, and acetylcholine techniques. They appear to play a major position in sustaining wakefulness and sleep.
Daridorexant and different orexin antagonists are novel in that they don’t knock you out like a standard sedative however as an alternative cut back wakefulness and assist regulate sleep-wake cycles.
The medicine has been proven to significantly cut back the time to go to sleep (LPS), the time spent awake after falling asleep (WASO), and the quantity of sleep time reported by the themes (TST) in trials.
Daridorexant has a considerably lowered abuse potential compared to benzodiazepines. It may be used as a long-term therapy for insomnia, and it’s claimed that it not solely helps you sleep however offers a great high quality of sleep, which isn’t true for many sedatives. They knock you out, however your high quality of sleep is poor. Â
Daridorexant was permitted for medical use in the USA in January 2022 and within the EU in 2022. Â Within the UK, NICE recommends Daridorexant as a long-term therapy for insomnia however states that it ought to be thought of as a therapy for insomnia solely when you have tried CBTi.
Within the UK, it’s nonetheless very tough to get the NHS to prescribe it, and lots of medical doctors are uneducated about it. So, I as soon as once more needed to resort to costly personal therapies.
Whereas Daridorexant appears like a marvel drug and has been discovered to be protected for long-term insomnia therapy, many individuals report that its effectiveness has waned. Despite the fact that prologued common use is beneficial, many individuals state it turns into ineffective after a number of months.
One of many the explanation why I alternate between hashish oil and Daridorexant is to try to keep away from tolerance points.
Targets and Preliminary Observations
The explanation why I got here up with the thought of this text is the variations in knowledge after I take medical hashish or Daridorexant.
Garmin clearly signifies that hashish lowers my coronary heart charge variability, will increase my resting coronary heart charge, reduces my high quality of sleep and prevents my physique battery charging.
However, subjectively, it really works nicely at getting me to sleep and conserving me asleep.
The information signifies that Daridorexant is healthier. Garmin signifies the standard of sleep is improved, my HRV will increase, and my RHR coronary heart charge decreases.
Subjectively, the standard of sleep isn’t pretty much as good; I’m extra stressed via the night time and get up a bit earlier.
Hashish is extra more likely to go away me groggy within the morning, however I really feel I’m much less sleepy within the afternoon.
Withings doesn’t monitor HRV, and this appears to be accountable for the variations in outcomes. Withings signifies my sleep high quality is healthier on Hashish than Daridorexant, but it surely does point out my RHR is greater.
Throughout this check, I additionally experimented with decreasing my Elvanse dosage and caffeine, which clearly messes up the info.
My purpose is to discover a stability of medicine that permits me to sleep nicely whereas managing my ADHD, my skill to work, my health and total well-being.
As soon as I discover an Elvanse/caffeine combo I’m pleased with, I can hopefully replace this text with extra correct outcomes.
The consequences of hashish on coronary heart charge variability and well-being
It’s well-documented that Hashish impacts coronary heart charge variability.
On this article, they state:
Delta-9-tetrahydrocannabinol (THC) is the first psychoactive constituent of hashish. Acute THC administration can induce CB1R mediated reductions in complete peripheral resistance leading to dose-dependent will increase in coronary heart charge and reductions in coronary heart charge variability (HRV) in awake topics. Nevertheless, the affect of THC on vagal-cardiac modulation throughout sleep is unclear.
Whoop revealed their very own evaluation utilizing nameless knowledge Whoop members who report utilizing marijuana regularly (not less than 10 journal entries previously 90 days).
Their outcomes confirmed a distinction, but it surely was a a lot smaller impression than my situation.
The typical proportion of time spent in gentle sleep rises from 54% to 55%, which implies the share of time in restorative sleep (REM and gradual wave sleep) falls from 46% to 45%. Sleep effectivity and sleep consistency every drop by 1 proportion level as nicely.
Their conclusion is especially vital in my case:
We discovered marijuana use to have a really slight detrimental impression on sleep, resting coronary heart charge & HRV, however no significant have an effect on on RECOVERY.
Affect of Medical Hashish on Sleep
I’ve tried to maintain a log of what medicine I took and the way nicely I slept utilizing the info from my Garmin Fenix 6 Professional and the Withings Sleep Mat.
I’ve solely lately began logging the info and I hope to enhance the general high quality over a time frame. Particularly, I wish to discover an Elvanse dose that fits me and, ideally, give up caffeine.
However for now, I must use the flawed knowledge I’ve logged lately.
I vape hashish each night time earlier than mattress, as it’s good at getting me to sleep; I then take both Hashish oil or Daridorexant with the hope that it retains me asleep when the preliminary hashish wears off a few hours later. It will clearly be extra correct if I didn’t vape and caught to at least one drug.
The outcomes are self-explanatory. The HRV is decrease and RHR greater on the times I take advantage of Hashish. The general sleep high quality is elevated, however the length is across the identical, if not greater.
Because of this, my physique battery is decrease.
Garmin additionally signifies that I get up extra, however subjectively, I observed I get up considerably much less when utilizing Hashish. Earlier than being medicated, I’d get up absolutely 5 or so occasions an evening, with Hashish that’s lowered to a few occasions an evening.
For Withings, the info is kind of totally different. The center charge knowledge correlates. Withings provides you a mean of no resting, however there’s clearly a rise in HR when utilizing Hashish.
Withings don’t monitor HRV, and this appears to be the variable that Garmin makes use of to have a look at the standard of your sleep. Due to this fact, the info from Withings appears extra constructive. There’s a a lot greater sleep rating, which additionally confirms lowered sleep interruptions.
Withings is a sleeping mat, and I are inclined to get off the bed and go to the bathroom after I wake correctly (I’ve had my prostate checked; I believe it’s extra of an nervousness downside). Due to this fact, I believe it’s extra correct to establish the occasions I woke correctly.
Affect of Daridorexant on Sleep
As mentioned earlier on this article, Daridorexant is a novel sleep medicine that doesn’t knock you out as such however reduces wakefulness. This, in concept, ought to result in a greater high quality of sleep, with elevated non-REM sleep, together with slow-wave sleep (SWS) and lowered or maintained REM.
The one different medicine I’m conscious of that improved this are Gamma-hydroxybutyrate (GHB), which has a little bit of a foul popularity, Mirtazapine, which I discovered terrible, and Trazodone and Pregabalin.
The outcomes I skilled seem to match what has been reported.
My HRV is elevated and RHR decrease. Garmin studies improved high quality of sleep and an elevated physique battery.
As a result of Withings doesn’t monitor HRV, it doesn’t appear to have the ability to establish the identical high quality of sleep. Despite the fact that my common sleep HR is lowered, I’m extra stressed, and I believe the standard of sleep is lowered.
Unrelated and fully subjective, I really feel like my health is healthier when utilizing Daridorexant. Particularly, my lungs really feel good.
I’m liable to fairly a good chest when figuring out vigorously, and it generally looks like my lungs can’t sustain with my legs.
With Daridorexant, it typically feels the opposite method round; my lungs really feel completely high-quality, and it’s my legs that tire out first.
General
To date, all I’ve actually established is that Garmin signifies that my coronary heart charge variability is lowered, and my resting coronary heart charge will increase when utilizing hashish to sleep. In distinction, Daridorexant doesn’t seem to impression my HRV/HRM.
This aligns with what’s extensively reported on-line, with research way more scientifically rigorous than my very own experiment.
However the query stays: what are the real-world impacts of utilizing Hashish for sleep compared to Daridorexant?
As I write this, I used Daridorexant final night time, however I really feel groggier in the present day than when I’ve used hashish.
For each drugs, my sleep has improved considerably, and it has allowed me to tolerate Elvanse at as much as 60mg significantly better.
However, the thought of taking one drug to counter one other has all the time made me uncomfortable, and since beginning these drugs, I’ve felt it isn’t ultimate long run; there’s something not fairly proper. Â For this reason I’m attempting to scale back my Elvanse barely, and hopefully, I can discover a more healthy stability of medicine long run.
My testing thus far has been sub-optimal, however I’ll proceed to replace this text as I collect extra knowledge. Sooner or later, I’ll keep the Elvanse dose and solely regulate the sleeping medicine, ideally sticking to at least one medicine for per week at a time to provide higher high quality outcomes.
I’m James, a UK-based tech fanatic and the Editor and Proprietor of Mighty Gadget, which I’ve proudly run since 2007. Keen about all issues know-how, my experience spans from computer systems and networking to cellular, wearables, and good dwelling units.
As a health fanatic who loves working and biking, I even have a eager curiosity in fitness-related know-how, and I take each alternative to cowl this area of interest on my weblog. My various pursuits enable me to deliver a novel perspective to tech running a blog, merging way of life, health, and the newest tech traits.
In my tutorial pursuits, I earned a BSc in Info Techniques Design from UCLAN, earlier than advancing my studying with a Grasp’s Diploma in Computing. This superior examine additionally included Cisco CCNA accreditation, additional demonstrating my dedication to understanding and staying forward of the know-how curve.
I’m proud to share that Vuelio has persistently ranked Mighty Gadget as one of many prime know-how blogs within the UK. With my dedication to know-how and drive to share my insights, I intention to proceed offering my readers with participating and informative content material.
