Is mirtazapine effective long-term at increasing sleep duration?

[DavidGraaff]

I habitually sleep for about 6.5 hours, which is at the low normal side. The polysomnography confirmed the sleep duration. I did wake up frequently, maybe because of the measurement material, although for the rest my sleep was quite normal.

The first neurologist I visited said that a mild dosage of 7.5 mg of an anti-depressant: mirtazapine, might work to increase the sleep duration.
However, the second neurologist said this wasn't true.

I kept being very lethargic and sleepy during the day. So after about half a year I went to my general practitioner and he also prescribed it to me. Especially in the beginning, I felt it worked, and even slept for more than 8.25 hours.

I called my pharmacist/chemist, and according to her there are theoretically reasons it might work, but no evidence to confirm the idea. She clearly must have access to better databases and sources than I have.

Then again, via google scholar I tried to find the sources, and I saw that indeed the sample sizes were like from n=5 till about n=20; so very small and therefore not very conclusive. But maybe there is larger studies to which I don't have access.

I know Ambien and other sleep medication, if they even work at all and not just sedate you, work for about a week and then you are habituated and the effect is gone.

I definitely experienced an improvement in my sleep duration, and also after 2 months I still slept for longer than 7 hours. I do have the refutations of the second neurologist and pharmacist in my mind, and it could be a placebo as well. Also because of its sedative effects, I can imagine, I could just be dazed out for the first half hour after I wake up, and might wrongly perceive this as sleep. Only a polysomnography could truly tell if you are sleeping.

Because of the vagueness and contradictions, does anybody of you know if there are larger studies that show any conclusive evidence on the effect of mirtazapine on sleep duration for the long-term?

If not are there any other sleep medications that work long-term or is it just impossible?

Kind Regards

[morpheus1514]

Your best answer on this will come from your doc, as that person has examined you and knows your unique med history and underlying conditions.  That said, you should consider the possibility your sleep is being disrupted by nonmedical issues, which are very common.  Drugs can't treat those.   For that the gold standard is use of a full CBT sleep training system, might ask your doc about using one of those.

[DavidGraaff]

Or is it also to nearly impossible to have chronic sleep deprivation if you don't force yourself to sleep shorter with an alarm clock, and do your brain and body always take the sleep it truly needs?