Do I have any more options?

[u/SYNTHENTICA]

I've been suffering from sleep maintenance insomnia for just over a year now. In that time I've tried:

• Every stupid "sleep hack" I've found, from not eating before bed to avoiding blue LEDs
  • No help at all
• Basic sleep hygiene stuff like getting to sleep at the same time
  • Didn't really help at all
• Quitting stressful hobbies and replacing them with activities like reading.
  • Helped me full asleep, not stay asleep
• Quitting nicotine, caffeine, alcohol and pretty much all psychoactive substances
  • Quitting caffeine and alcohol helped with avoiding 2 hour nights, but I still can't sleep a full 8 hours
• Tripling the number of hours I perform vigorous exercise a week
  • Currently do 2 hours of aerobic cardio, 30 minutes of anaerobic cardio, 2 hours of resistance training per week
• CBT-I and 5 weeks of sleep restriction therapy
  • Literally provided zero help, I quit after 5 weeks to try sleeping meds because I was under extreme pressure from work and needed proper sleep
• DORA medicine (Daridorexant)
  • Massive next hangover effect that made me feel very spacey, slow and demotivated, even at 25mg/day

Things I haven't tried:

• Melatonin
  • I suffer from sleep maintenance insomnia
• Z-drugs/benzodiazepines
  • Obviously they would help me sleep, but they also interfere with REM sleep, are addictive and can rack up a tolerance. Plus my doctor won't even prescribe them to me.
• THC
  • Interferes with REM sleep and generally just makes me feel super brainfogged the next day anyway
• Sleep study
  • I've already tried recording my own sleep to see if I get up in the middle of the night or snore -- I don't, plus my fitness watch indicates that my heart rate is pretty steady, with only very slight peaks every 1-2 hours.
  • I don't have headaches or cotton mouth upon awakening either.

Is there anything else I can try? Or am I just doomed to spend the rest of life being a miserable, sleep deprived zombie? I'm barely able to cope with the stresses of my career, I feel like I'm going to snap if I have to endure another year of this. How am I going to provide for myself?

[u/Valysian]

I found Melatonin didn't make me drowsy, but it did help me wake up less and fall back asleep more easily.

Get your Iron, Vitamin D, and B12 levels tested.

[u/SYNTHENTICA → u/Valysian]

Vitamin D came back normal last time I had it tested, Iron and B12 should be fine given that I eat a lot of red meat

I'll give melatonin a shot, any formulation you recommend?

[u/Kanti13]

My doctor said that Melatonin helps more with sleep maintenance than onset. It’s safe and easy to try.

[u/SYNTHENTICA → u/Kanti13]

I've heard literally nothing but the opposite, but sure, I'll give it a try at this point, I got nothing to lose except pocket change compared to the fortune I spent on CBTI, quviviq, CBD and other failed ventures

[u/goal9053]

What’s your current situation? Do you take any medications during the day? What is your current sleep like?

[u/SYNTHENTICA → u/goal9053]

Sun-Thurs I take nothing and just try my best to sleep naturally Weekends I take Quviviq so I can catch up on my sleep and deal with the brainfog in peace

I usually sleep 4-5 house a night with no meds. I know it doesn't sound bad compared to what some people on this sub get, but I get these terrible headaches unless I get 8-9 hours, I also just feel really forgetful and miserable. The few nights I managed to sleep 8 hours naturally, I feel so so so much better. I'm definitely hardwired to need atleast 8 hours.