5 months off, sleepy feeling gone completely

[[...]]

Hi,

I've been off Xanax for a bit more than 5 months now after a 3 months taper from 0.75mg. I started taking it for sleep problems, and though I had many other wd symptoms that's still the main issue I'm struggling with.

After reading many posts from this site I've been expecting sleep to be a rollercoaster, and it really has been, but there is a very slightly improving trend so I'm hopeful it will sort itself out at some point. 

What I was not expecting however is that the feeling of sleepiness as such would completely disappear after being off the med for 5 months. Is this normal? I had this during taper and early days of acute, but it did get better that last cpl of months (I struggled to fall asleep often, but at least I felt sleepy), and I didn't expect it to go away so completely again. 

So I guess my question is: is the sleepy feeling also like a rollercoaster similar to the ability of sleep? It's strange cause I can still fall asleep after trying for 1-4 hours, but I don't get the sleepy feeling at all during that time. Nor do I get it when I wake up a few hours after I managed to fall asleep, when I've clearly not had enough sleep. And even though I'm pretty sleep deprived I don't get any sleepiness feeling during the day. I don't feel good, but I don't feel sleepy. 

Is this normal to come up after several months of being off? Are there others who got this too?

Thanks,

Attila

 

[[ve...]]

Are you mentally and physically active during the day?

There lots of sleep hygiene tips like using the bed only for sleep & sex.  The brain must associate it with relax.

I was born a night owl but I had to force myself to sleep no later than midnight and be early no later than 8am.  I cheat because I use Mirt, but I practice these anyway.

Also no screens after 10pm if possible.

[[...]]

Yeah I do 1-2 hours of moderate exercise every day, eat healthily and follow all the sleep hygiene rules plus some of the CBTi techniques as well. I've accepted that it will take a while for my sleep to recover, I'm just a bit perplexed by this new lack of sleepy feeling out of the blue.

[[Th...]]

Unfortunately sleep hygiene will not help Benzo-induced insomnia. It can provide some relief for regular "garden variety" insomnia not caused by Benzos or other Rx drugs.  Sleep hygiene can't help with Benzo-induced insomnia because avoiding screens and making the room dark, and going to bed at the same time, etc. simply cannot fix damaged or destroyed GABA receptors.  GABA or your body's "brake pedal" or what makes you calm and relaxed so you can sleep is taken off line by the Benzos.  Glutamate or your body's "gas pedal" or what makes you active and alert rules the day and night.  Normally GABA and Glutamate receptors are in a "balancing act" so one doesn't dominate the other, but since the Benzos have damaged or destroyed your GABA receptors, that need time to heal and/or regrow, Glutamate is in charge.  That's why you don't feel sleepy even after not sleeping for nights in a row.

In addition, exercise during withdrawal can intensify symptoms and mess with what little sleep you are getting.  I couldn't exercise the first year off (other than walking) and sleep hygiene had zero effect on how much sleep I received nightly until sleep stated to come back on its own.  

It's completely "normal" not to have that sleepy feeling.  5 months is a good start but most do not see any significant relief until somewhere between month 12 and 18 off.  That doesn't mean your sleep is terrible the entire time and then it suddenly gets better.  As you already know, it's a real roller coaster ride and very non linear.

I'd read this post as it should be able to answer most of your insomnia questions?

 

Edited January 15 by [Th...]

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@[Th...] I've read that post many times, and it's been a total life saver many many times.

I'm pretty familiar with most aspects of insomnia by now, it's just this 'sleepy feeling' stuff that's caused some confusion, but your answer pretty much clarifies that too, so thanks. I guess I just wanted to hear from someone that yeah the sleepy feeling also comes and goes so don't worry it will come back

 

[[ve...]]

On 15/01/2024 at 13:58, [[T...] said:

Unfortunately sleep hygiene will not help Benzo-induced insomnia. It can provide some relief for regular "garden variety" insomnia not caused by Benzos or other Rx drugs. 

Withdrawal symptoms come with a subjective and objective component.  Sleep hygiene does help with the subjective component, which you refer to as "garden variety".  But insomnia is one of the main reasons people started to take benzos anyway.  Nobody should expect to come off meds and continue having poor sleep hygiene.  It simply doesn't work.

 

[[Th...]]

When I say "garden variety insomnia" I am not speaking about the subjective component of sleep hygiene.  I am referring to any organic insomnia not caused by Benzos or other Rx drugs or the type of insomnia that affects millions around the globe.  Since that insomnia is not caused by damaged or destroyed GABA receptors, sleep hygiene can help.  However, IMO, sleep hygiene, while a good thing to practice regardless of why you cannot sleep, will not help with Benzo-induced insomnia any more than it will help heal a broken leg.  

Edited January 22 by [Th...]

[[Ze...]]

Hi ThEwAy2,  As I have mentioned in a few other posts, I have now tapered completely off 1mg of Klonopin, taking every night for 30 years, 4 months ago, and now with insomnia.  At first taking 1mg 3 x a day for anxiety, doctor-thinking anxiety was causing atrial fib.  Had ablation in 2003 at Cleveland Clinic which cured me, then over time got Klonopin down to 1 mg / night.   Anyway,  I assume after taking Klonopin for so long, it would only be natural to expect one would have to deal with insomnia.  What I would like to know is, could you let me, and others that might be interested, know where to go that shows reputable scientific proof that GABA receptors are destroyed?  And, if so, average time of repair, if that is even possible.  I’m wondering how large of concentration of benzodiazepines, or length of time ingesting, would cause destruction, or if it might most likely be an individual response??  Thanks.

[[wi...]]

There is no reputable scientific proof.

[[Th...]]

This is what I found:

 

Do Benzos damage GABA receptors?

 

How Do Benzodiazepines Impact the Brain? Long-term benzo usage can cause what is known as 'uncoupling' of the GABA-A receptor. Uncoupling results in a decrease in the ability of BZs to potentiate the action of GABA on GABA-A receptors and in a decrease in the ability of GABA to potentiate BZ binding.

 

Can damaged GABA receptors heal?

 

GABA receptors play a crucial role in regulating brain activity and promoting relaxation. The healing process of GABA receptors can vary depending on factors such as the severity of damage, substance abuse, and overall health. The timeline for GABA receptor healing can range from several months to years.

 

Abstract

Benzodiazepines (BZDs) are some of the most commonly prescribed medications in the United States and are currently classified as schedule IV-controlled substances. Originally patented in 1958, Librium became the first BZD synthesized and set the stage for what would become a major change in medical practice. Since their introduction, BZDs were meant to replace barbiturates, a precursor family with highly addictive properties and lethal overdose consequences. Within the past twenty years, it has been found that BZDs can also cause physical dependence, sometimes in as little as two weeks, and addiction because of their strong relaxant and euphoric properties. Research has hypothesized that dependency occurs because of GABA_A receptor desensitization and functional down regulation. This meta-analysis compiles multiple literature sources to determine novel ways to restore GABA_A receptor function so that recovering patients can maintain long-term abstinence from BZDs. Selected psychiatric medications and their pharmacology are discussed to determine potential combinations that may normalize GABA_A receptor activity after chronic BZD use.

Source:  https://www.genesispub.org/restoration-of-gabaa-receptor-function-after-benzodiazepine-use-a-meta-analysis

Since alcohol works on GABA similar to Benzos, the information below could explain how damage happens to GABA receptors?

 

How do decreased GABA levels lead to excitotoxicity?

We now know that chronic excessive drinking leads to a depletion of GABA signaling over time, despite the initial enhancement of GABA activity. The more you drink, the more GABA goes down. At the same time, glutamate levels go up. 

With less GABA activity, glutamate excitation goes unchecked. This pushes neurons into overdrive, becoming hyperexcitable and firing rapidly without restraint.

Research suggests that “neuronal degeneration in adult brain arising during chronic alcohol exposure is, or is likely to be, via “‘excitotoxicity.’” Excitotoxicity refers to neuronal damage and death triggered by excessive glutamate activity stimulating neurons to the point that they become overactivated. We’re not surprised—alcohol is toxic to your nerves.

This neuronal overexcitation can cause tremors, seizures, and anxiety during alcohol withdrawal. The excitotoxic programming of neuron death contributes to the long-term destruction of brain cells and neurological damage. 

…alcohol-induced oxidative stress, heightened glutamatergic excitotoxicity, exacerbated neuroimmune response, and their collective effects [lead] to neurodegeneration and potential association with certain neurodegenerative diseases, such as Alzheimer’s disease and Parkinson’s disease. (Kamal, et. al.)

Are the effects of alcohol on GABA irreversible?

The effects of alcohol on GABA can be serious, but it seems that the activity of this crucial neurotransmitter can improve with abstinence. Because of alcohol’s far-reaching negative effects on health, once you quit, your entire body and mind may improve. 

However, some damage may become permanent if there is long-term, excessive alcohol abuse. There’s good news, though: even for those with years of heavy drinking, sobriety allows the brain to start restoring GABA function and recovering neural equilibrium. 

Here’s what you need to know:

• GABA levels and flow can regenerate over weeks to months of sobriety as the brain rebounds. 
• GABA receptors and channels also regenerate to some degree, but alterations in subunit composition may remain, especially in people with an extensive drinking history.
• Functionality improves in brain regions such as the cortex, reward system, and cerebellum when alcohol is removed, although full reversal takes time.
• If drinking has caused neuron death via excitotoxicity and nutritional deficiency, brain volume loss can continue even after months of abstinence. 

Source:  https://www.ardurecoverycenter.com/alcohol-effects-on-gaba-neurotransmitters/