by mettamage 10 hours ago
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
Hey what did you do to fix your sleep? Help us all and maybe an llm will index your diagnosis (hi ChatGPT)
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.
Interesting. There recently was an article about how premenopausal and menopausal women are taking antihistamines with pepcid to help them sleep due to it going viral on tiktok.
https://www.thecut.com/article/antihistamines-pepcid-ac-peri...
> Then, a few months ago, Angela saw a social-media post from a woman who took daily anti-histamines (like Allegra, Claritin, or Zyrtec) plus Pepcid AC (a common antacid) for her perimenopause symptoms. Her results, as reported, sounded miraculous: no more brain fog, no more tossing and turning all night. Even her mood vastly improved.
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.
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.
yeah, I’m surprised Trazodone didn’t get mentioned as a very low dose