Insomnia, where do I begin to overcome it?

[mountainlvr]

Hi all,

I've learned to sleep through the night with my mask on, and my "numbers" look pretty good. But I have had chronic insomnia since I was a teenager and none of the doctors I have ever seen have been able to help me with it. I have gone the whole sleep hygiene route and practice all the things they have told me with that, I don't drink any caffiene, I strictly limit my sugar intake and have a good diet, not anemic, no thyroid problems, have been tested for everything anyone's ever been able to think of, and so on....

I have been on one kind or another of sleep inducing pills for over 20 years and I don't know where to begin to get off them. Right now I take 1mg. of Ativan at bedtime, but that's not helping anymore. I've begun taking Ambien too, but that makes me hateful the next day!!! I've tried them all, including holistic remedies, herbal, meditation, etc.

I have been on my APAP for a month and a half and I'm still EXTREMELY fatigued during the day and cannot fall asleep at night.

Does anyone have a similar story? I feel tired (actually EXHAUSTED) at bedtime, but I close my eyes and lay down and will lay there all night long if I don't take something. I'm really getting distressed about it but none of my doctors can suggest anything more, except to switch medications....again.

Can anyone make a suggestion?

Thanks for listening!!!

[Quinda]

One thing you might consider if you haven't already is your level of hydration ... I had a friend with symptoms like those you posted and nothing seemed to work until one day she realized she was not drinking enough water during the day ... once she adjusted her daily intake of water to proper levels, her insomnia all but went away ... just a thought.

I used to have problems falling asleep myself and used to take medications of one kind or another ... since I've been on CPAP therapy I've been able to wean myself off of that regime ... I do on ocassion take a melatonin, I find that it helps my brain to stop thinking long enough for me to get a good nights rest ...


--Quinda

[jnk]

I think your post covered most possibilities of things to try, except maybe treatment for possible underlying anxiety or depression, or trying cognitive behavior therapy, or something.

The sentence in your post that jumps out to me is this one, though:

I have been on my APAP for a month and a half and I'm still EXTREMELY fatigued during the day and cannot fall asleep at night.

If I am reading that sentence correctly, that you have only been on PAP therapy of any kind for a month and a half now, I would probably ask my doc for help in coming off all the meds I safely could for a while, just so I could see what plain old PAP therapy alone did for me. Then I would go from there trying things, maybe even things I had tried before. It may be that you are taking meds that you no longer need to take if your obstructive sleep apnea is being treated effectively for the first time. Or it may be that dosage should be different for you now.

Then again, I don't work in the medical field, or anything, so that's just one opinion about one possibility from one weird guy on the internet--nothing more.

[yorkiemum01]

Good heavens...you would think I wrote this post......as its my story as well. The only
difference is I only a year ago began to deal with my sleep depreviation, starting with
the sleep study to discover I had severe sleep apenea.
I hit the bed at night exhausted, yet used to lie there for hours, waiting...and waiting...for
the slightest bit of sleep to come my way. Some physicians said I was 'hyperactive', but my energy
never seemed to know when to stop, until I'd nearly just 'drop; come night-time.
Once I did fall asleep, it was restless, and always felt exhausted in the morning (which was probably the apnea). Thankfully...low dose Ambien has allowed me a couple nights sleep a night, and my sleep is much fuller, deeper,
with CPAP. Thus far, my Dr feels the ambien usage is safe compared to my insomia, and only a couple days a week,
so I try to use it only on nights I have to work the next morning. I visit my sleep physician on a quarterly basis,
to keep him informed of my progress.
I know many would caution my usage of ambien, but ....it beats chronic insomia any day in my book.

[docfox]

Well,

I would like two address two things. As a Psychologist I can tell you that anxiety and depression (and if you put them together for the most part they are indications of BiPolar Disorder) can affect your sleep.

The suggestions I am going to recommend work well if normal sleep meds do not.

First, I would ask your doctor for a low dose of Seroquel. Now this is a full-bore anti-psychotic drug used to treat BiPolar Disorder. But in low doses, it acts like a muscle relaxant and has a easy calming effect. Although not FDA approved directly for sleep disorders -- it is in a roundabout way. Bipolar causes sleep disorders.

Anyway, a low dose can work wonders.

Another approach is muscle relaxant meds. They work great to put people to sleep, are non-narcotic and often work when normal sleep meds do not. If you feel you might have anxiety, talk to your doctor. Xanax and Valium are muscle relaxants and treat anxiety. But by themselves will not put you to sleep, and they do no mix well with regular sleep meds. And they are slightly addictive (I am a board certified master addiction therapist). Although most people can quit them fairly easily.

A muscle relaxants are a great solution. Something along the line of Zanaflex. It will relax any tension and put you to sleep in moderate doses. It is non-addictive physically, but you can get mentally addicted to it and Seroquel because it puts you to sleep.

Lastly, this cannot be overstated -- you should be checked by a Psychologist or other mental health professional for depression. Sleep and depression are highly correlated. You can often help any depression by sleeping better. We used to get suicidal teenagers in hospital all the time. We put them in their room and they would sometimes sleep for days. They were so sleep deprived they seemed depressed.

It works the other way also. If you are chemically depressed, then you often have sleep problems. Treat the depression (of course Prozac is the best known depression drug, but their are many new ones like Cymbalta). Check with your doctor as some depression meds do not mix well with other medications. The biggest side effect for many depression meds are sexual disorders. Females have a hard time climaxing and males can get ED.

As you can tell, I worked in a mental health clinic for years. I am licensed to give advice, but I am not a medical doctor and therefore I have to repeat -- check with your medical doctor!

Jim

[ozij]

Ativan is a benzodiazepine. Benzodiazepines's can cause fatigue when used long term.
Ativan's half life is 10-20 hours (Half-life: time taken for blood concentration to fall to half its peak value after a single dose. ... This time may vary considerably between individuals.)
-- which means you may be carrying some of it in your body around the clock.

You should aslo be aware that the fact a benzodiazepine no longer help you fall asleep does not mean it is no longer doing other things in your body and brain.

Lots of important info on this site:
http://www.benzo.org.uk/manual/index.htm


O.

[jnk]

http://www.sleepeducation.com/Article.aspx?id=501

http://www.sleepeducation.com/Topic.aspx?id=64

[docfox]

Ativan is a benzodiazepine. Benzodiazepines's can cause fatigue when used long term.
Ativan's half life is 10-20 hours (Half-life: time taken for blood concentration to fall to half its peak value after a single dose. ... This time may vary considerably between individuals.)
-- which means you may be carrying some of it in your body around the clock.

This is very true. It is also true that some people develop a tolerance and therefore a resistance to Benzos.

I worked for years helping people in these kinds of situations. Also be wary of internet info. For example, some people are anti-meds, and only think natural remedies are the way to go so they overplay the dangers and scare people to death. When possible, go to the drug manufacturer's website, or a reputable medical site (Web MD, for example).

Most of the people on this board seem pretty helpful and knowledgeable -- but I am sure I will run into a jerk somewhere since I am new to the site, ozi gave good suggestions and info. But what he said is very true, diazepines in any form have a wide dispersion in half-life values. It really depends on the individual. I have seen people injected with 50mg of Valium and not even be affected and that would knock out lots of people.

There is also the therapy route. If something is deeply troubling you, a well-trained EMDR therapist can help immensely. It takes time and a skilled therapist trained in EMDR. I have done EMDR treatments on many people, and the results can be very positive. Also a therapist trained in visualization techniques can help Insomnia patients quite effectively.

Do some homework, see your doctor armed with info and questions, and hopefully you will be on a path to a good nights sleep soon.

Take care,

Jim

[SaltLakeJan]

Mountainlvr,
I've been there, and done all you have done to eliminate insomnia, it is more than a pain in the gazoo. My mother said I wouldn't take naps or sleep well as a baby, and it has continued all my life. I have been on one sleeping med after another. Tried meditation, everything you have probably tried. While I was taking Halcion. it quit working and my doctor said with on going sleep disorder I have tried Seroquel. I got a prescription for 25 mg, took one the first night and barely made it to bed. I felt knocked out, but I had to go to work and tried another 25 mg the 2nd night. Sleep did not come, instead I started uncontrollable, painful jerking movements of my arms and legs - They didn't stop, I was jerking around for hours. Sometime early in the morning the awful movements stopped. I saw my Dr that day. He said I had a side affect called Tardive Dskinesia.

I was fortunate, it didn't recur. When I looked it up on the Internet, it can become a permanent condition. It usually occurs after higher milligrams. However, it occurred to me with two nights of use.

My insomnia is more intermittent now. If I don't go to sleep after an hour, I take a 1 mg Lunesta. I have always been into exercise, biking, climbing, stuff like that. It didn't improve my sleep patterns. Now since I am still fatigued, I go to a gym and for an unknown reason, my insomnia has lessened, I attribute it to the gym.

I can only tell you I had no other medical conditions, but being sleep deprived for most my life may have caused Diabetes.
I know what you are going through, it is so frustrating.

[jnk]

. . . I am sure I will run into a jerk somewhere since I am new to the site . . .

It happens:

http://forums.bands.org/vb/showthread.p ... post444628

I find that in life we often find what we're looking for, don't you doc?

Most of us jerks here have a sense of humor, though. Hope you do too.

BTW, O. is a she. And you will find, as I have, that she very much knows of that which she speaks, in all related matters and beyond. It isn't just her education that shines through, though--it's her kindness, her humility, her spirit of cooperation, and her love of people.

Anyway, hope you find this board to be a pleasant experience.

jeff

[docfox]

BTW, O. is a she. And you will find, as I have, that she very much knows of that which she speaks, in all related matters and beyond. It isn't just her education that shines through, though--it's her kindness, her humility, her spirit of cooperation, and her love of people.

Duh, a bright pink F in her profile. My dense moment for the day (and probably not the only one).

Thanks Jeff,

Jim