Sleep issues, Mirtazapine

[nadine6301]

In July started on hrt for endless symptoms of peri, but mainly headaches daily and terrible sleep. Patches 50 and utrogestan, alot of symptoms alivated thankfully but the sleep issues are continuing !! Horrendous insomnia, can barely function some days. I understand it is a common issue but please please advise what helps if anything....
I think my hrt maybe needs looking at, maybe testerone...but my gp has given me mirtazapine anti depressants which apparently can help with sleep 😴
I'm reluctantly trying them because I'm.at my wits end with this, I'm only 4 days in and am not seeing any improvement yet...anyone got any experience with these and can advise when/ if I should see an improvement..so fed up not sleeping. I'm not expecting miracles but even five hours straight would be great. Instead it's constant waking and not being able to get back to sleep or when I do sleep it's like I'm.constantly in r.e.m but its like I'm aware I'm dreaming, not fully asleep. Very odd feeling..
Really feel my hrt should be addressed but gp seems very reluctant to try ..I'm aware hrt doesn't fix everything and I'm grateful to have less headaches, brain fog, aches etc but no sleep is so debilitating. I also follow a strict sleep hygiene. No caffeine, no alcohol, no screen time. Moderate exercise and daylight, healthy eating etc
What more can I do..please could do with some sound advice and guidance. Thanks all !

Sorry your sleep is rubbish, it's totally debilitating I know.

Ive only tried mirtazapine a couple of times, mainly because I felt fuzzy on them the next day. Also they gave me constipation.

I take amitriptyline ( primarily for nerve pain) but they do help me to sleep. Maybe ask the GP if you can try those instead? They start at 10mg and you can work your way up, if necessary.

Some might you would be better tweaking your HRT and that is something you could try. Personally, no type or dose of HRT has assisted with my poor sleep.

Have you tried magnesium glycinate, epsom salts? Valerian tea?

Best of luck 🤞

HRT helped enormously with my sleep. It was an unexpected benefit because my sleep had bedside so disordered that I didn't even realise it was an issue. So my instinct would be to try adjusting HRT before going into strong drugs, with the issues of habituation, groggy tomorrows etc.

Long Covid gave me dreadful insomnia. My GP's first port of cash was to give me amytriptiline (not sure of the spelling). Dreadful. Did not help me sleep, made me groggy the following day, gave me such a dry mouth that I woke even more.

Long Covid clinic suggested melatonin. Excellent! Not perfect, I don't sleep well every night, but vastly vastly better than before. No side effects, no morning-after.

There are anti histamines that make you groggy (travel sickness tablets), but, as with all sleeping drugs, there are issues using them for that purpose long-term.

@nadine6301 I suffered from the exact same sleep issues and it was totally debilitating.

I found amitriptyline to be good for my sleep, but ultimately only increasing my oestrogen properly helped. I am now on the 2mg tablets

I tried mirtazapine when going through a bad patch and they really helped with my sleep. However I was so hungry when I was on them and need to lose 3 stone, not gain anymore, so I stopped. I since discovered they are an appetite stimulant!

My current regime is HRT and10mgs of amitriptyline for my mood and sleep.

I will never sleep as well as I used to before menopause however!

When you say your HRT needs looking at, what did you have in mind to change to or increase?
Why is your GP not playing ball with this idea?

ps
Ah- you've only been on HRT since July- so just over a month?
It needs time- up to 3 months.
If that doesn't help, you can increase your patch to 75mcgs and then 100mcgs.

Are you using Utrogestan daily or 12 days a month?
And are you taking it at bedtime (as instructed) as it does act as a sedative.

@JinglingSpringbells
Yes started hrt beginning of July so early days but I guess as other symptoms have been helped I was really hoping the sleep would be better but no improvement at all!
Yes take utrogestan for 12 days and it does help getting to sleep just can't stay asleep. Some nights I'm awake 1 hr after falling asleep. Utterly exhausted!
Upping my patch was my next thought but gp seems reluctant to try, just says stick with...easier said than done ! She also tried me on melatonin which did nothing for me.
@Sortmylifeout52
Amitriptyline was suggested to me by others which I had mentioned to gp but was advised it has recently had it license changed and they can no longer prescribe for sleep...just pain relief and depression.
Also have by my bedside antihistamines for the sedative effect and zopiclone sleeping pills ( all prescribed by gp over last two months) I drink sleep tea which contains valerian and take magnesium but not glycinate..assuming this has to be taken at night.
Unfortunately I was hoping for a quick fix to all of this but I now know it is definitely a journey and that hrt won't and can't fix it all. I think I will definitely push gp to go one up on my patches or maybe try gel?
For those of you use amitriptyline or mirtazapine ( for sleep) please can you advise how long it took to see any kind of progress and what dose you are on..gp prescribed 15mg but I'm halving mine to 7.5mg ( worried I was going in too much too soon ) Thank you all for your advice, it really helps!

My GP has prescribed phenergan/promethazine hydrochloride 25mg and it has helped immensely. Previously, had about 4-5 hours of broken sleep, now have 6-7 hours (without waking up).

@nadine6301 hi was just coming on here to see how your sleep panned out on the mirtazapine in the end ? I have been started on for sleep but needing a zopiclone to get me to sleep - it's not very good sleep and it's making me very anxious . What did you settle on in the end ?

@rubyslipperss I'm sorry you are having sleep issues too, it really is awful! I was very reluctant to start the mirtazapine, however I did and it was the best thing I did. It helped tremendously, I was prescribed 15mg dose which I believe is the lowest. I do however snap these in half and take 7.5mg. My mood also improved massively, either the sleep helping or the additional benefits of taking an anti depressant.
I was loathe to try them but they were the best choice in the end. Give them a go, I hope you get some restful sleep very soon !

Thanks so much for reply I found it so reasuring and I'm glad you have found that they help you . I spoke to my GP and forgot to ask about the benefits of taking them at 7.5 mg . Did you ask your GP or did you just do yourself? What are the benefits for you? Thanks :)

@rubyslipperss I read alot before taking or doing anything the gp suggests. Both my gp and the pharmacist said I should stick to the dose prescribed.
However I read that the lower the dose of mirtazapine the best sleep effect it has, in my case it's worked well. I also chose to do this as I considered that I may have to increase over time, starting real low gives you space to do this.
The gp's are clearly guided by their training but I alway listen to what I think and feel.
Give them a go, I really hope you find them as beneficial as I have.

@nadine6301 thanks maybe I'll try that then .
For now I have got nytol also so I'll give those a try instead of the zop.
I can't wait for things to settle down!