Duloxetine is very talented at destroying sleep.  Some people may experience insomnia as a side effect of just taking Duloxetine. Others may experience insomnia as a withdrawal symptom when tapering too fast, stopping cold turkey, or just tapering gradually. 

Beware medication and dietary supplements for insomnia

When you’re tossing and turning at night, it can be tempting to turn to supplements or prescription drugs for relief. But before you do, here’s what you need to know: There are many dietary and herbal supplements marketed for their sleep-promoting effects. Although they may be described as “natural,” be aware that sleep remedies can still have side effects and interfere with other medications or supplements you’re taking. 

Please look at our supplements and foods to avoid page and check possible drug interactions among duloxetine any supplements you want to take for insomnia.  You may well find many interactions. 

Managing insomnia

This article from www.helpguide.org and sets the scene for a good night’s sleep: a quiet, comfortable bedroom and a relaxing bedtime routine. Both can make a big difference in improving the quality of your sleep.It might be worth following some of the links.  Keep looking until you find what works for you.

Make sure your bedroom is quiet, dark and cool.

Noise, light, a bedroom that’s too hot or cold, or an uncomfortable mattress or pillow can all interfere with sleep. Try using a sound machine or earplugs to mask outside noise, an open window or fan to keep the room cool, and blackout curtains or an eye mask to block out light. Experiment with different levels of mattress firmness, foam toppers and pillows that provide the support you need to sleep comfortably.

Stick to a regular sleep schedule

Support your biological clock by going to bed and getting up at the same time every day, including weekends. Get up at your usual time in the morning even if you’re tired. This will help you get back into a regular sleep rhythm.

Turn off all screens at least an hour before bed

Electronic screens emit a blue light that disrupts your body’s production of melatonin and combats sleepiness. So instead of watching TV or spending time on your phone, tablet, or computer, choose another relaxing activity, such as reading a book or listening to soft music.

Avoid stimulating activity and stressful situations before bedtime

This includes checking messages on social media, big discussions or arguments with your spouse or family, or catching up on work. Postpone these things until the morning.

Avoid naps

Napping during the day may make it more difficult to sleep at night. If you feel like you have to take a nap, limit it to 30 minutes before 3 p.m.

Drinking too many liquids

Waking up at night to go to the bathroom becomes a bigger problem as we age. By not drinking anything an hour before sleep and going to the bathroom several times as you get ready for bed, you can reduce the frequency you’ll wake up to go during the night.

Alcohol

While a nightcap may help you to relax and fall asleep, it interferes with your sleep cycle once you’re out, causing you to wake up during the night.

Big evening meals

Try to eat dinner earlier in the evening, and avoid heavy, rich foods within two hours of going to bed. Spicy or acidic foods can cause stomach trouble and heartburn which can wake you during the night.

Caffeine

The American Academy of Sleep Medicine recommends that you stop drinking caffeinated beverages at least six hours before bedtime. People who are sensitive to caffeine may need to stop even earlier or completely eliminate caffeine. 

Relieving anxiety that keeps you from sleeping

The more trouble you have with sleep, the more it starts to invade your thoughts. You may dread going to sleep because you just know that you’re going to toss and turn for hours or wake up at 2 a.m. again. Or maybe you’re worried because you have a big day tomorrow, and if you don’t get a solid 8 hours, you’re sure you’ll blow it? Agonizing and expecting sleep difficulties only makes insomnia worse. Worrying about getting to sleep or how tired you’re going to be floods your body with adrenaline, and before you know it, you’re wide-awake.

Learning to associate your bed with sleeping, not sleeplessness 

If sleep worries are getting in the way of your ability to unwind at night, the following strategies may help. The goal is to train your body to associate the bed with sleep and nothing else—especially not frustration and anxiety.

Use the bedroom only for sleeping and sex

With many of us working from home now, it can be difficult to avoid, but if possible don’t work, use your computer, or watch TV in your bedroom. The goal is to associate the bedroom with sleep alone, so that your brain and body get a strong signal that it’s time to nod off when you get into bed.

Move bedroom clocks out of view

Anxiously watching the minutes tick by when you can’t sleep—knowing that you’re going to be exhausted when the alarm goes off—is a surefire recipe for insomnia. You can use an alarm, but make sure you can’t see the time when you’re in bed.

Get out of bed when you can’t sleep

Don’t try to force yourself to sleep. Tossing and turning only increases your anxiety. Get up, leave the bedroom, and do something relaxing, such as reading, meditating, or taking a bath. When you’re sleepy, go back to bed.

Challenge worries and thoughts that fuel insomnia

It’s also helpful to challenge the negative attitudes about sleep and your insomnia problem that you’ve developed over time. The key is to recognize self-defeating thoughts and replace them. Remember, learning how to stop worrying takes time and practice. You may find it helpful to jot down your own list, taking note of the negative thoughts that pop up and how you can dispute them. You may be surprised at how often these negative thoughts run through your head. Be patient and ask for support if you need it

Many people with insomnia are able to fall asleep at bedtime only to wake up a few hours later. They struggle to get back to sleep and often lying awake for hours. If this describes you, the following tips may help:

Stay out of your head

Hard as it may be, try not to stress over your inability to fall back to sleep, because that stress only encourages your body to stay awake. To stay out of your head, focus on the feelings in your body or practice breathing exercises. Take a breath in, then breathe out slowly while saying or thinking the word, “Ahhh.” Take another breath and repeat.

Make relaxation your goal, not sleep

If you find it hard to fall back to sleep, try a relaxation technique such as visualization, progressive muscle relaxation, or meditation, which can be done without even getting out of bed. Even though it’s not a replacement for sleep, relaxation can still help rejuvenate your mind and body.

Do a quiet, non-stimulating activity

If you’ve been awake for more than 20 minutes, get out of bed and do a quiet, non-stimulating activity, such as reading a book. Keep the lights dim and avoid screens so as not to cue your body that it’s time to wake up.

Postpone worrying and “brainstorming”

If you wake during the night feeling anxious about something, make a brief note of it on paper and postpone worrying about it until the next day. Then it will be easier to resolve. Similarly, if a great idea is keeping you awake, make a note of it on paper and fall back to sleep knowing you’ll be much more productive after a good night’s rest.

Relaxation techniques that can help you get back to sleep

Abdominal breathing

Breathing deeply and fully, involving not only the chest, but also the belly, lower back, and ribcage, can help relaxation. Close your eyes and take deep, slow breaths, making each breath even deeper than the last. Breathe in through your nose and out through your mouth.

Progressive muscle relaxation

Make yourself comfortable. Starting with your feet, tense the muscles as tightly as you can. Hold for a count of 10, and then relax. Continue to do this for every muscle group in your body, working your way up from your feet to the top of your head.

Mindfulness meditation

Sit or lie quietly and focus on your natural breathing and how your body feels in the moment. Allow thoughts and emotions to come and go without judgment, always returning to focus on breath and your body.

These audio meditations can help.

Alternative ways to deal with insomnia – peer suggestions

This wonderful list is sourced from members of Cymbalta Hurts Worse. Thank you to the many contributors! These suggestions focus on natural ways to manage sleep.

• Avoid coffee and caffeine. Don’t eat too soon before bedtime.
• I use several Young Living oils for sleep in rotation.
• I use a sleep talk by the Honest Guys called Perfect Deep Sleep from Youtube.
• I dim the house lights and start reducing movement a while before bed.
• Warm bath with 2-4 cups of Epsom salts and either relax oils or pain support oils
• Deep breathing and muscle-relaxing once I hit the bed
• Try your best to avoid fixating on sleep. This tends to worry you more. Like calculating hours of sleep if you were to fall asleep right now etc.
• EFT (emotional freedom tapping)
• Ocean Waves on the Calm app. For me it’s like taking a relaxing walk along the beach.
• I use organic chamomile/lavender tea… and also EFT.
• Get a decent amount of sunlight throughout the day.
• Exercise regularly, no matter how hard.
• Relax without electronics before bed.
• Eat clean and healthy.
• A weighted blanket helps so much.
• Take vitamins /supplements in the morning (they provide energy all day).
• Too hot at night? Uncover your feet and point a fan at them.
• Clean and organize your bedroom. If possible, paint it a calming color such as blush or seafoam green.
• Keep a journal at your bedside. Write down all the stories and uncomfortable feelings. This allows your mind and spirit to process and let go of them.
• Get a good book to enjoy reading at night.
• Hanky panky with your loved one
• Wear blue light blockers 2 hours before bedtime
• Magnesium cream on bottoms of feet or oral Magnesium Glycinate
• A walk outside during the day
• Essential oils
• I just got a new cell phone and I always get a screen protector. The one I got this time has a blue light filter on it.
• I bought blue light blocker glasses … and they have made a big difference.
• Try chronotherapy to get back on track. And number 1 for me is forcing myself out of bed the same time every day, regardless of sleep the night before.
• Morning workouts are best.
• Do not overlook the temperature in your room. Humans wake when temperatures start to rise, so set your furnace and air conditioning so that you hardly heat up at all before your alarm goes off.
• Adjustable bed was a game changer for me.
• I love dōTERRA essential oils. I use a mixture of Balance and Serenity.
• I have found sleep hypnosis audio very effective in helping me go to sleep. Download podcasts or find them on Youtube.
• Only use very low lights several hours before bed and avoid screens. Avoiding blue light is important but so is the intensity of the light, even if it’s warm light, because this interferes with melatonin production.
• A sleep doctor recommended getting 1.5 hours of sunlight a day without sunglasses. This helps sleep by letting your brain know it is daytime.
• For people that live in colder, dark climates, there are lights you can sit in front of that simulate sunlight.
• Weighted blankets can be a good part of the plan. I have one and love it.
• No food a few hours before bed. Especially no sugar or chocolate. Keeps me awake.
• Phone on flight mode! When you wake up don’t check the time, just start to read something on a dark Kindle or do meditation/breathing.
• I always keep my Kindle and phone on airplane mode at night…and yes, breathing exercises are quite helpful, too.
• I have found listening to audiobooks extremely helpful for my sleep issues. I have wireless headband earphones that are flat and totally comfortable to lie on. I put on my book with a 30 minute sleep timer (I use Audible) and rarely hear that 30 mins …
• I do the same with the radio; catch-ups are good. And also music, soothing meditation or reiki chanting or similar.
• When my insomnia was at its worst, I downloaded an app called “rain sounds”. It’s a selection of rain sounds in different environments. I still use the “evening lake” setting when I have trouble sleeping.
• Complete darkness
• Listen to wholetones healing music or audio Bible with music in the background.
• Meditate.
• Dr. Wayne Dyer and the recommendations of his teachers. I’m listening, working on them all … Search his name to find books, videos and lots of ideas.

Additional References

The more you read, the more you know, the more you understand … the more chance you have!

https://withdrawal.theinnercompass.org/coping/withdrawal-induced-insomnia-z-list-tips

https://www.verywellmind.com/withdrawal-insomnia-tips-22376

This article from the Wall Street Journal is available if you have a subscription.  There is an audio link which seems to be free. Why not give it a try? Can’t Sleep? Here Are Some Surprising Strategies That Actually Work

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