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General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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chunkyfrog
 
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Re: Klonopin (benzos for insomnia)

Postby chunkyfrog on Sun Dec 22, 2013 8:45 pm

I suspect there would be fewer problems if doctors took the time to titrate dosages to each individual patient to find the lowest effective dose.

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Re: Klonopin (benzos for insomnia)

Postby RandyJ on Sun Dec 22, 2013 8:52 pm

A good thread on melatonin use can be found here: viewtopic.php?f=1&t=92313&p=851286&hilit=Melatonin+dosage#p851276

In it, I posted:

"The tricky thing about melatonin (which is a hormone, not a drug) is that you can't know if you have a deficiency without a blood or urine test.

If you are deficient, a corrective dose would be between 0.3 mg to 1mg.

Since commercial melatonin is available in up to 3 mg dosage, a dose of 1 to 3 mg could flood your body with up to 10x normal dose of excess melatonin (depending on your level of deficiency), resulting in side effects from restlessness to anxiety, etc.

Another issue is that there is a lot of cheap, substandard melatonin out there. I would research a good pharmaceutical grade brand before purchasing."

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Ruinednose
 
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Re: Klonopin (benzos for insomnia)

Postby Ruinednose on Sun Dec 22, 2013 8:53 pm

chunkyfrog wrote:I suspect there would be fewer problems if doctors took the time to titrate dosages to each individual patient to find the lowest effective dose.



i agree with this 100%

i jut wish i could sleep like i did a few months ago. sleep super deep and very satisfing

SuddenlyWornOut45
 
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Re: Klonopin (benzos for insomnia)

Postby SuddenlyWornOut45 on Sun Dec 22, 2013 8:54 pm

I can speak from experience on this. Youre a dumbass if you rely upon klonopin as an insomnia drug. I started out years ago on 1 mg klonopin, for psychiatric purposes one of which was "insomnia." That turned into 2 mg klonopin after two or three years as 1 mg lost its effectiveness (you develop tolerance to ALL controlled substances over time if you take them regularly).

After close to eight years on and off 2 mg klonopin (mostly ON), my psychiatrist upped my dosage to a whopping 4 mg. After about a year at 4 mg klonopin, that heavily lost its effect and now Im still on 4 mg years later and I'd say the anti-anxiety/anti-insomnia effect I get from 4 mg is not as much as 1 mg gave me when I was new to klonopin.

Also, all benzos such as klonopin suppress slow wave sleep and deep stage sleep. Benzos will keep you in a shallower stage sleep stage, even if you use CPAP compliantly.

Klonopin is also NOT FDA APPROVED for "insomnia." It is approved for 1) epilepsy (at high doses) and 2) panic disorder. Its used off label for just about everything under the sun here in the USA, to include Generalized anxiety and "insomnia."

There are formally FDA approved drugs for insomnia that are much "cleaner," such as Ambien. There are many others. These are classed not as benzos but as "hypnotics." Look it up if you dont believe me. Ambien is formally classified as a "hypnotic" not as a benzo or a barbituate. There are at least one or two insomnia meds that are not even controlled...if I had to use a drug for insomnia, thats what I'd be using because if its not controlled it wont lose its effect over time.

I doubt I would ever been put on klonopin if I had been put on CPAP before I was put on klonopin.

May I go on regarding the benzo klonopin? If prescribed for psychiatry reasons, you should take the stuff if you need it. If prescribed by a sleep medicine specialist for insomnia, I'd be looking for a new sleep medicine physician, myself.

Eric

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Re: Klonopin (benzos for insomnia)

Postby SuddenlyWornOut45 on Sun Dec 22, 2013 8:56 pm

That is true once you become addicted to it. Benzo withdrawal has been described as...psychotic feeling. Its awful, feels like pure pain. Honestly, klonopin withdrawal is severely physically painful.

Eric

SleepyBobR wrote:When you stop, you might not sleep at all...

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Re: Klonopin (benzos for insomnia)

Postby SuddenlyWornOut45 on Sun Dec 22, 2013 9:03 pm

BTW, klonopin and all the benzos are heavily associated with testosterone suppression.

Get a prescription for generic ambien if you need an insomnia drug. Its "cleaner" and does not destroy critical slow wave sleep (deep stage sleep). Also, ambien is even less controlled than klonopin. If I remember right, klonopin is schedule IV. I think Ambien is schedule V, its addiction properties are next to nothing. Ambien is also not associated with ED or low T, unless you take the stuff every night at higher doses for weeks or months. Even then its not as bad as klonopin or other benzos.

Who prescribed klonopin for you and for what reason? Generalized anxiety or insomnia, primarily? Did a sleep doctor rx it to you or a GP or a mental health doctor rx it to you. I ask because it would be unusual for a sleep apnea patient to get prescribed klonopin around the same time they were put on CPAP.

In all honesty, the things you describe on here sound as if your quality of medical care is poor. Or you are not telling the forum EVERYTHING. Do you have some psychiatric issues going on besides low T and sleep apnea?

Eric

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Re: Klonopin (benzos for insomnia)

Postby SuddenlyWornOut45 on Sun Dec 22, 2013 9:05 pm

Slow Wave Sleep is when androgens such as testosterone are secreted during sleep in males. At your age, you are still getting plenty of SWS. If you take a drug like klonopin that suppresses slow wave sleep, its a no brainer you are gonna have low T and have ED problems.

Man, I cannot fathom having taken a drug like klonopin at your age. Wow, I feel bad for you. What a waste of youth.

Eric

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Re: Klonopin (benzos for insomnia)

Postby Ruinednose on Sun Dec 22, 2013 9:10 pm

i told him about my on and off sleep maintanence insomnia and he said to take this as needed 15 mins before bed on those nights. at 0.5 mg. i also told him about my mild anxiety issues and he said this builds up in the system and it has definetly helped me out with that.

I didn't know about the sleep stage and deep sleep supressant,,,,i actually dont appreciate the doctor didnt tell me about that.

i guess i will ask him for a different route for the insomnia thing.
i just wanna sleep deep and sound thats, all. remember i don;t have osa, just UARS or really SDB

but i will definetly get into this with my doc

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Re: Klonopin (benzos for insomnia)

Postby SleepyBobR on Sun Dec 22, 2013 9:16 pm

Ambien and the other Z drugs are much like benzos and work on the same GABA receptors. Personally, I'd stay away from them as well but many people take them, apparently without difficulty. They are not as bad as Klonopin and the other benzos like Xanax but that may be damning with faint praise as addiction and tolerance are still a problem. Have you tried OTC anti-histamines sleep aids or valarian? They may work for you. That said, the best sleep aid, imo, is no sleep aid.

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Re: Klonopin (benzos for insomnia)

Postby SuddenlyWornOut45 on Sun Dec 22, 2013 9:48 pm

Uh, thats not true. While both are depressant medications, Ambien and similar FDA approved anti-insomnia drugs are classified here in the USA as "hypnotics." Whereas here in the USA, klonopin, valium, xanax and other anti-anxiety/mild anti-epileptic drugs are formally classified as benzos.

I dont know what ambien and similar meds are classified as in Canada or elsewhere. Additionally, there is at least one FDA approved insomnia drug that works on melatonin. It came out five or six years ago here in the USA, it is not a controlled substance, is not scheduled and not physically addictive anymore than say, aspirin. I tried it a few times but did not stick with it. It has no anti-anxiety properties. It might not be available in Canada, I have no idea.

The drug companies down here have been real careful about putting new insomnia drugs out since around the Ambien time (late nineties) that are in biotech terms, "very clean." That do not interfere with sleep architecture very much and do not cause sedation the next day. Ambien and other hypnotic insomnia drugs fit that, benzos do not fit that description.

Ambien does not interfere with slow wave sleep, klonopin does interfere with slow wave sleep. Additionally as I mentioned earlier, ambien is scheduled lower than klonopin and the addiction potential is low compared to benzos.

My need for insomnia drugs dissipated a lot when I got on CPAP. I did still need the benzos to be an adjunctive drug to help control my hypertension and frankly, to control daytime generalized anxiety. Klonopin is an effective anti-anxiety drug and lets face it, if you have bad panic or generalized anxiety problems, klonopin can really help and is a good drug.

I just prefer to use drugs that are "on label" as in, formally FDA approved. If my probem is insomnia, Id rather take a hypnotic like Ambien. If my problem is anxiety, I'd rather take a benzo like klonopin. There ARE people out there who do have severe and chronic anxiety and panic attack problems for whom long term benzo use is sometimes recommended. Again, this is coming from an American medical "what is standard here in the USA" perspective and not from a Canadian medical system perspective.

Eric

SleepyBobR wrote:Ambien and the other Z drugs are much like benzos and work on the same GABA receptors. Personally, I'd stay away from them as well but many people take them, apparently without difficulty. They are not as bad as Klonopin and the other benzos like Xanax but that may be damning with faint praise as addiction and tolerance are still a problem. Have you tried OTC anti-histamines sleep aids or valarian? They may work for you. That said, the best sleep aid, imo, is no sleep aid.

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Re: Klonopin (benzos for insomnia)

Postby 49er on Mon Dec 23, 2013 5:25 am

Ruinednose wrote:I find the .5mg Klonopin my doctor gave me for insomnia is great.
Its low dose and you take it 15 mins before sleep.
You wake up slight hungover, but u get deep sleep and comfort relaxation and 0 anxiety

ANyone else use sleep aids?
IF so what is your experience with them, prefferably something light weight and not very addictive.


Ruined Nose,

Forgive me as I don't remember your history but have you ruled out all underlying causes for your insomnia? Because if you haven't, using sleep aids will feel like a revolving wheel that doesn't move.

In my case, I am convinced that nasal obstruction issues are a big factor in my inability to tolerate pap therapy and stay asleep on the machine. So for me, taking sleep aids would simply be a bandaid solution that would turn out to be a very frustrating situation.

Best of luck.

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Re: Klonopin (benzos for insomnia)

Postby SleepyBobR on Mon Dec 23, 2013 6:07 am

Eric, what is it in my comment that you are saying isn't true? Ambien and the other Z drugs are not benzos but act in much the same way on the GABA receptors in the brain. They are hypnotic drugs as are the benzodiazapines that are used to induce sleep. Benzodiazapines all have a common molecular structure (different from the Z drugs), all are anxiolitic and all have hypnotic properties. They vary in their half lives from very short to very long. The z-drugs all have short half lives to avoid morning hangover but can cause intra-dose withdrawal anxiety as a result in many people.

I wouldn't ever use any of these drugs because of the potential for dependency and the withdrawal issues that many people encounter when trying to stop taking them. That said, I don't have any problems getting to sleep so it's easy for me to say. YMMV.

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Re: Klonopin (benzos for insomnia)

Postby Sludge on Mon Dec 23, 2013 6:22 am

SleepyBobR wrote:Eric, what is it in my comment that you are saying isn't true? Ambien and the other Z drugs are not benzos but act in much the same way on the GABA receptors in the brain.

Apparently, as far as the FDA (and other laymen) are concerned, zolpidem is not a benzodiazepine based on it's general classification ("non-benzodiazepine").

However, and from a pharmacological viewpoint, since it's action on BZ-1 receptors is so specific, I would propose to reclassify zolpidem as a benzodiazepine and all the other stuff as "crap".
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Re: Klonopin (benzos for insomnia)

Postby SleepyBobR on Mon Dec 23, 2013 6:24 am

Yes, that is what I said. The Z-drugs are not benzos.

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Re: Klonopin (benzos for insomnia)

Postby Sludge on Mon Dec 23, 2013 6:39 am

SleepyBobR wrote:Yes, that is what I said. The Z-drugs are not benzos.

And yet, one could pharmacologically argue that they are:

zolpidem in vitro binds the BZ1 receptor preferentially
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