Apologies for giving you a boring canned answer when you are sleep-deprived and looking for help. But I swear these things really helped me.

Number one: think about getting a sleep study done by an actual sleep doc (pulmonary doc or neurologist). This was life changing for me. Don't go to a chiropractor or whoever the fuck and get a CPAP machine.

Also, and this is important: Have you looked into tips for "sleep hygiene"? None of them are a quick fix like Xanax, but they can be powerful when used together.

These include things like:

• going to bed and getting up at the same times every day. this means getting up at your normal time, even if it's a weekend, even if you didn't sleep well that night, just make yourself do it
• when sleeping....making sure the room is dark, cool, and quiet (ear plugs are a big help here). by cool, I mean 68-69F (about 20C).
• cutting way back on caffeine and/or eliminating it...and absolutely no caffeine after lunch (the older we get, the longer it takes to metabolize caffeine)
• not looking at any glowing screens (TV, phone, computer, tablet, etc) before bed time... for at least 15-30 minutes
• avoid eating / drinking a couple of hours before bed time
• using your bedroom only for sleeping and for sex

And when you have trouble sleeping, it's a very good idea to get out of bed, go to a different room (one that is not too bright) and do something boring like read a text book for 15-20 minutes then go back to bed and try again.

When we stay in bed and aren't sleeping, we're training our brain that it's OK to do that. You want to beat it into your subconscious brain that the bed / bedroom is for sleeping.

doc doesn't want to perscribe you xanax because xanax will stop working and this fucks up many other things in the process

Here is my best suggestion and it is serious. NO CAFFEINE after lunch. Period. No naps. Go to bed early every night at the same time. Wake up early to start your day. Drink lots of water every day.

Do not hop on the xan, your doctor knows what they are talking about.

Proper meditation training, and I'm not talking about some quick-fix youtube video.

I'm talking about weeks or months of training, like you'd do at a gym for your body. Just sit down, and focus on not thinking. You're going to fail a lot as your mind tries to wander, but keep practicing until you can do it for longer and longer. Do this before bed each night, and don't stimulate yourself in any way (no electronics, no book, no talking, no eating) between the meditation and the sleeping.

Also, trying to have a routine for your bedtime is excellent. Make it into a ritual so your brain gets used to it. Meditate, Go get a glass of water, Put it on your bedside table in the same spot, then go pee, remove and put your clothes in the hamper, climb into bed, get into your preferred sleeping position, and then I usually continue the meditation and I'm out before I know it.

Do this process slowly, there's no rush. Calm everything. It takes time to complete, but it's still faster than laying awake for hours like I used to.

Sounds like hokey bullshit, but it works amazingly. It's like counting sheep on steroids (to continue the gym metaphor)

Are you seeing a family doctor, or a sleep specialist? You want the latter, and a sleep study.

The classes of drugs that might help are imperfect at best, I'd be partial to a benzo before e.g., Ambien or related, given the inherent risks of sleepwalking and worse with those drugs.

So I have some experience with this and have a few things I want to tell you:

Consider a dedicated sleep study. If you have sleep apnea, medication will not fix your problem and some medications may actually make it worse.

Xanax (an anxiety medication) and Ambien (a sleep medication) are very similar drugs with respect to their mechanism of action. Xanax binds to a specific group of receptors to cause anxiolytic effects and happens to also make you sleepy. Ambien binds to a subset of those same receptors to make you sleepy, but don't have the strong anxiety reducing effect. If Xanax works for you, Ambien should theoretically have a similar effect. In practice, it doesn't tend to work as well because anxiety can keep you awake. If that has been your experience with Ambien, think about taking some steps to address anxiety even if you don't think it's that bad. Yoga, counseling, meditation, whatever. There are also guided breathing audio sessions designed to put you to sleep in apps like Fitbit and calm that may be helpful.

You can also supplement a prescription sleep aid with something non prescription, which is what I do. I take Ambien, and to keep my dose low I supplement with melatonin, tryptophan, and valerian root when I need an extra kick into sleepiness. I've heard CBD is also quite effective for this. Magnesium reportedly also helps with restful sleep, but get a sleep formulation because magnesium in the wrong form causes diarrhea.

Don't underestimate sleep hygiene. For a long time I had the attitude of "I have real sleep problems, basic stuff like cutting back caffeine is not going to help." The thing is, when taken together, that kind of stuff actually can help tremendously. I scheduled a month where I went hardcore on sleep hygiene. Strict caffeine limits, no late caffeine or exercise, don't do anything on your bed but sleep and sex, wake up at the same early time every day even when you don't have to, limit screens before, bed... I mean ALL of it. I found that it actually really helped. In combination with medication it might be a life saver. Might be worth doing your own experiment with it.

Good luck!

Listening to a slightly boring audiobook has been the most consistently effective method I've found. Also, I had to give up caffeine.

What, specifically, have they tried? Did you try trazodone? I don't think Xanax is the solution you think it may be even though it worked for you.

Is the issue falling asleep or staying asleep? Do you have an idea of what prevents you from falling asleep? What do you think about when you're in bed falling asleep? What is your natural sleep cycle timeline? In other words, when do you naturally get sleepy and if given no restrictions, when would you wake up? How is your sleep hygiene (really, not just what you tell people)?

Do not, I repeat, do not go in there asking for Xanax or you will be labeled a drug seeker permanently. A doctor is not going to give you Xanax for this, full stop. They're going to ask all of the above questions and try other avenues first. If they suspect an anxiety disorder they will move up that avenue and you may need a benzo but you have to be under care for a while and basically prove you're trustworthy.

I have massive sleep problems too but you don't have enough information in your post to give any other advice other than the standard sleep hygiene stuff you've already been told.

There are no effective long term sleep medications except possibly THC. They’re all habit forming and you will get a tolerance, which will make sleeping impossible when you stop taking them. Benzodiazepines are garbage drugs and you will get addicted taking them for sleep. I had a nasty habit for years and kicking it was one of the worst things I’ve had to do. Please do not get involved with benzos.

If the Xanax is helping that much, you might have to start considering that maybe your sleep issues are anxiety, or other mental health problem, related. Try to enlist the help of professionally trained psychologist. Sometimes lay therapists could help, but the pros can diagnose and team with psychiatrists to prescribe medication. However, depending on the severity of the issue, you might not even need meds. Cognitive behavioral therapy is usually extremely effective at dealing with anxiety, PTSD and related issues that can cause sleep deprivation. Mental health is complex and reaching for drugs out of desperation can go really really bad really fast, making thing worse in the long term despite a brief short term relief.

I don’t have an answer and it may not apply to you but Benzos like Xanax are dangerous man.

Like it was nearly the end of me, yet I still get nostalgic for them. Be careful is alls I’m saying.

Don't know if you tried this. The only thing that stops me from sleeping is my own brain

Military sleep method

Sleep is a multifaceted problem. It can be dietary, it can be psychological.

If there is a mountain with a trailhead near you... And I mean like at least 3 miles out, so 6 miles round trip. And I mean at least 1500ft of vertical gain...

Have a day with no caffeine. Eat small snacks during the morning/day. Hike that mountain. No breaks allowed. Go as slow as you need to go in order to not stop. Go as fast as you can. Bring plenty of water.

After, eat a huge dinner. Lots of carbs. Like a spaghetti pizza or something insane on the carb front.

Take a CBN supplement about 2-3 hrs later.

Stop using your phone at this time. Read a book for an hour. Go to bed.

If you struggle after all of this, see a specialist. Because that's fucked.

Like, even if you're massively anxious, and your diet sucks... You'll be out like a light. Unless there's other issues.

Yeah it's hard to help because you didn't go into the nature of your sleep issues, but I had wicked bad insomnia for about 2 decades and sleep great now. CBD/weed helped immensely as well as getting a white noise machine.

Edit: also look up binaural beats and try delta waves. You'll need a good set of over the ear headphones and you need to just lie in bed in the dark playing it. You can also try yoga nidra, which if you haven't heard of it is not actually yoga. It's a form of meditation that you do lying in bed that can help with falling asleep.

weed

Do a sleep study when it's possible, OP. If it's sleep apnea, a proper CPAP therapy can definitely help.

Do you drink a lot of caffeine and sugary drinks?

Go camping together. Nothing fancy, just a weekend at a park with a small tent and backpacks.

Let your team know you’ll be unreachable. Once there, phones off. No working. Just walk and talk, rest and eat, explore your surroundings, focus on what and who is in front of you.

You may not sleep well on night 1, but you will on night 2, especially if you covered some ground that day. The morning after night 3, however, will be the most well-rested you’ve felt in a some time. The effect carries to subsequent nights, then eventually wears off, but can give you the chance to restructure your days for better sleep in the long term. Use as needed.

In addition to good sleep hygiene and trying to get a sleep study as others have suggested, a white noise machine that you turn on only at bedtime is great as a “go to sleep” signal for your brain. It also should make you less likely to wake up from noise during the night.

I take gabapentin at night to help me sleep, and it works pretty well. It’s non addictive so I’m not worried about dependency. But it works well for me because of what’s stopping me from sleeping (nerve pain). Without pinpointing why you can’t sleep well it’s going to be hard to treat it.

Here's what worked for me when I was an insomniac.

Tune out. Turn off the news. Block it from your life. Disengage from all politics.

Meditate at least once per day. Start out with one minute of meditation and increase the time as you get better at it.

Try to get some physical exercise every couple of days if you can. Bodybuilding works great, but it's a difficult habit to form if you're a depressed insomniac.

Turn off all electronic screens at least 2 hours before bed time.

Use incandescent or color temp adjusting LED lights for warm lighting in the evening. Turn light intensity down a couple hours before bed.

No caffeine after 3 pm. None! That includes chocolate.

Eat a balanced meal a couple hours before bed.

Drink chamomile and valerian root tea an hour before bedtime, take 5 mg of melatonin, and then go to bed.

Go to bed an hour before you need to be asleep and start reading. Read something boring. The Bible often works for me, but you can pick whatever makes you sleepy.

Get a white noise machine if there is background noise where you sleep.

Don't lay in bed at any other point during the day. Don't have a TV in the bedroom. The bed and bedroom needs to be a place of sleep and rest. Keep it sacred.

It takes some discipline and it certainly requires changing your habits, but that worked for me. In 2020 I was getting less than 2 hours of sleep per night, and I lost 15 pounds. I felt like I was literally dying all day, and I probably actually was. I implemented all of those changes and my sleep returned. I slept like crazy for a long time, getting caught up. Now my sleep schedule is pretty healthy, and I feel safe saying that I've mostly cured my chronic insomnia. Good luck to you!

I have really terrible insomnia too. Then I tried my friends Pregabalin, and oh boy. Never had such a restful sleep.

It is a bit habit forming, but if you keep it to just before bedtime it's a wonderful sleep aid, and much less risky than Xanax.

It's not without its risks of course, and some people are better with it than others, but might be worth asking your doctor about. They prescribe it for almost anything where I'm from.