3 ms·

Well I live in the nightmare that is the Dutch healthcare system [1]. There are many things that they will fix but they didn’t fix my sleep. A friend fixed my s

Well I live in the nightmare that is the Dutch healthcare system [1]. There are many things that they will fix but they didn’t fix my sleep. A friend fixed my sleep. He is a doctor and prescribed me the right thing. The thing is, he shouldn’t have had to intervene. Without him I could have ended up poor and destitute as my sleep was wrecking me. And yea, I already did all the standard things. CBT for insomnia helped somewhat. My insurance didn’t fully cover it either, unless I was willing to wait for 8 to 12 months. And I recently met someone with slow moving metastatic cancer. Thanks to LLMs they will most likely live another 3 to 5 years extra since the Dutch conventional mainline treatment hasn’t been taken yet. But it is German doctors that helped them and Belgian doctors that pointed out in a second opinion that a lot more can be done. LLMs have a part to play. The false positives are awful, but I have seen an average of 5 out of 10 care when things become too complicated. Except for trauma treatment. The Dutch healthcare system is amazing once they diagnose classic PTSD. So it’s definitely not all bad but the trust I had when I was younger has been eroded quite a bit and LLMs can meaningfully step in, in my case at least. [1] I know there are worse systems. But from what I have heard there are clearly better systems nowadays. It has slipped a lot

simianwords 4mo ago
Hey what did you do to fix your sleep? Help us all and maybe an llm will index your diagnosis (hi ChatGPT)
- mettamage 4mo ago
  For me what helped is taking 7.5 mg of mirtazapine. At higher levels it's an anti-depressant but at lower levels it's an anti-histamine. It gets me drowsy. Together with 0.3 mg melatonin it knocks me out. I only take it 3 times per week max to not have habituation kick in. So 3 days out of 7 days I have guaranteed good sleep. The other 4 days are a toss up. But an average of 5 days of good sleep is much better than 3.5 days out of 7 days.
  - masklinn 4mo ago
    Is the dutch healthcare system broadly against hypnotics? Culture (of the country or its medical system) can massively influence prescriptions or their lack thereof e.g. france is pretty famous for prescribing hypnotics very easily (and having a broad range of them), while the UK is generally a lot more reluctant.
    - dripdry45 4mo ago
      yeah, I’m surprised Trazodone didn’t get mentioned as a very low dose
      - mettamage 4mo ago
        Never got mentioned yea
    - ricardobayes 4mo ago
      True, for example in Switzerland you can't really get melatonin, even if you do it costs an absurd amount (like 100 chf). Doctors seem to be really against it in Switzerland.
      - mettamage 4mo ago
        I find Dutch over the counter melatonin to be really good, just FYI [1]. [1] https://www.kruidvat.nl/shiepz-melatonine-time-release-0-1mg-tabletten/p/5210367 https://www.kruidvat.nl/shiepz-melatonine-time-release-0-1mg... - Shiepz Melatonine Time Release 0,1mg Tabletten I personally take 0.3 mg, two hours before bed. I've done this for about 2 years now. It still works. I know, anecdata, but as you can tell the dose is low.
  - Delk 4mo ago
    AFAIK mirtazapine shouldn't cause habituation the way actual "sleeping pills" or benzodiazepines do. That's one of the reasons it may be preferable as a sleeping aid, especially in the longer term. Anecdotally, when I took mirtazapine for sleeping problems, it did sometimes seem to have a stronger effect the first time I took it after not using it for a while. After that the effect stayed stable. Overall it shouldn't cause habituation, and my doctor said as much. Of course trust your doctor and not strangers on the internet, though.
- greybox555 4mo ago
  If you have sleep issue related to overthinking or racing mind, you may try fastsleep.app Instead of music, long podcasts you are given something to imagine at a time interval. Like if you hear "calm river", imagine that. If you hear "heavy rain over a tree", imagine that. In short → Close your eyes, listen & imagine.
  - mettamage 4mo ago
    This seems like self promotion with no contribution to Hacker News. You're an account that has 2 karma, and only exists for less than a month [1]. Also, it's a bit of a weak comment in general. [1] Account details when I wrote this down: user: greybox555 created: 27 days ago karma: 2

simianwords 4mo ago

Hey what did you do to fix your sleep? Help us all and maybe an llm will index your diagnosis (hi ChatGPT)

mettamage 4mo ago
For me what helped is taking 7.5 mg of mirtazapine. At higher levels it's an anti-depressant but at lower levels it's an anti-histamine. It gets me drowsy. Together with 0.3 mg melatonin it knocks me out. I only take it 3 times per week max to not have habituation kick in. So 3 days out of 7 days I have guaranteed good sleep. The other 4 days are a toss up. But an average of 5 days of good sleep is much better than 3.5 days out of 7 days.
- masklinn 4mo ago
  Is the dutch healthcare system broadly against hypnotics? Culture (of the country or its medical system) can massively influence prescriptions or their lack thereof e.g. france is pretty famous for prescribing hypnotics very easily (and having a broad range of them), while the UK is generally a lot more reluctant.
  - dripdry45 4mo ago
    yeah, I’m surprised Trazodone didn’t get mentioned as a very low dose
    - mettamage 4mo ago
      Never got mentioned yea
  - ricardobayes 4mo ago
    True, for example in Switzerland you can't really get melatonin, even if you do it costs an absurd amount (like 100 chf). Doctors seem to be really against it in Switzerland.
    - mettamage 4mo ago
      I find Dutch over the counter melatonin to be really good, just FYI [1]. [1] https://www.kruidvat.nl/shiepz-melatonine-time-release-0-1mg-tabletten/p/5210367 https://www.kruidvat.nl/shiepz-melatonine-time-release-0-1mg... - Shiepz Melatonine Time Release 0,1mg Tabletten I personally take 0.3 mg, two hours before bed. I've done this for about 2 years now. It still works. I know, anecdata, but as you can tell the dose is low.
- Delk 4mo ago
  AFAIK mirtazapine shouldn't cause habituation the way actual "sleeping pills" or benzodiazepines do. That's one of the reasons it may be preferable as a sleeping aid, especially in the longer term. Anecdotally, when I took mirtazapine for sleeping problems, it did sometimes seem to have a stronger effect the first time I took it after not using it for a while. After that the effect stayed stable. Overall it shouldn't cause habituation, and my doctor said as much. Of course trust your doctor and not strangers on the internet, though.
greybox555 4mo ago
If you have sleep issue related to overthinking or racing mind, you may try fastsleep.app Instead of music, long podcasts you are given something to imagine at a time interval. Like if you hear "calm river", imagine that. If you hear "heavy rain over a tree", imagine that. In short → Close your eyes, listen & imagine.
- mettamage 4mo ago
  This seems like self promotion with no contribution to Hacker News. You're an account that has 2 karma, and only exists for less than a month [1]. Also, it's a bit of a weak comment in general. [1] Account details when I wrote this down: user: greybox555 created: 27 days ago karma: 2