I just thought I should mention that I can track the start of my N24 problems in recent years to when I tapered off and stopped talking mirtazapine (Remeron), in the summer of 2023. I don't think it's really an option for me to go back on it right now because of my other meds (lisdexamfetamine, venlafaxine) or else I'd try it again, because my sleep cycle is free-running and life is unstable.

Mirtazapine is technically an antidepressant but it's also a strong hypnotic which made me fall asleep very reliably. I haven't worked since 2018, but you can see until 2023 I was pretty regular in my sleep cycle even without having to get up for work. It's since become completely ungovernable. Getting to sleep on a schedule seems to be the thing I can't do... getting up regularly is possible, but when I get less and less sleep every day, I eventually got a breaking point.

I'd warn people though that mirtazapine made me ravenously hungry before I fell asleep (which is why I finally quit it) and it's infamously very difficult to quit. Probably worth checking up on if you're interested.

Finally plotted data - 3 weeks from when she was managing to keep to a schedule during the school year (48 hr axis), then 4 weeks basically free-running in summer (24 hr axis). This summer she is in a period of autistic burnout and she’s literally unable to force herself to a 24 hr schedule at the moment, which made free-running an easy choice for us I suppose.

Any suggestions on what to talk to the pediatric sleep specialist about? Kid is 11 and I’ve suspected n24 for years but never had such strong data before.