Diagnosed with ADHD as a kid. Insomnia started in college and hasn’t really gone away. I discovered doxylamine works, but I recently learned that these older antihistamines increase the risk for dementia and that the effect is cumulative. Age related mental deterioration is literally my worst fear, more than just straight up dying, so I’ve been trying to quit, even though I’m sure it’s already too late since I’ve been taking them on the regular for 20 years.

There was a period of abouta year where the insomnia was so bad I was taking two Unisom per night, once right before bed and again around 3 AM (it’s always 3 AM that I wake up and can’t go back to sleep). This was around 2014-2015. Since then I’ve had to medicate on average once every other night at best.

I’ve tried a couple other meds. I’ve tried melatonin (usually as a gummy) but I habituate quickly. Anti-anxiety meds didn’t really do anything and muscle relaxants just relaxed my muscles, not my brain. Magnesium doesn’t seem to help either.

AFAIK I have good sleep hygiene, consistent bedtime even on weekends, only use the bed for sleep, actually this goes for the entire bedroom, no desk or computer etc. I’m early to bed and early to rise (hence my username), going to bed around 8:30 and (ideally) getting up between 5 and 5:30.

I’ve tried a few things besides meds, a weighted blanket helps a little but not much (I’m also allergic to something in it, so I have to have a top sheet between me and the weighted blanket and a comforter above otherwise my nose and eyes run. I’ve tried music, spoken word (usually audio books or calm YT videos in the background), white noise, complete silence. The trick with the books/vids is they can’t be so engaging that they keep me awake, but they can’t be so boring that they just become noise that can’t out-compete my brain. I’ve even written my own little short stories and converted them to audio.

I’ve tried exercising. I like walking, so I often go for long treks around my neighborhood. I also have one of those half-a-bikes that you can use while sitting on the couch. It’s great when watching videos or playing games. But effect on sleep is mixed. I also have arthritis in my left knee that gets worse if I exercise, so after a day or two I have to take an extended break until the pain goes away. I’ve seen a doctor about it and gone to physical therapy, but it remains.

Alcohol sometimes helps, but I absolutely don’t want to self-medicate with booze. It will not end well.

Stress going on in my life obviously makes it worse, so there are times of relatively low stress where I can get a whole night in. I had a streak of about 2.5 months that just ended where I slept well consistantly thanks to having dropped a certification program that I wasn’t passing despite 8 attempts at the exam. But now the uncertainty of where my career is going now that all my certs are expired as well as a general midlife crisis and good ol’ existential dread have moved in.

And of course there’s the stress caused by the insomnia itself. It starts with one bad night, I feel crappy the next day, then the next night I start worrying that I won’t sleep again, making me feel even worse the next day, and it’s a positive feedback loop.

So that’s my situation. I’ve seen similar questions asked here and elsewhere and there doesn’t seem to be a solution, unless someone can refute the antihistamine-dementia connection.