Help please: Sleep disturbances, clomazepam and SAD

[Jay Aitchsee]

Cnew, I think you'd be wise to hold off on the clomazepam as you said. From my research it appears: Clomazepam is fast acting, has a long half-life, most likely addicting, is highly sedating, but inhibits deep or slow wave restorative sleep. Depression seems to be a possible side effect of longer term use - possibly due to the negative impact it has on sleep architecture.
With clomazepam in high enough dosage, you are likely to fall asleep quickly, sleep through the night, but wake feeling unrefreshed and "hungover".
If you google "clomazepam and Sleep", I think you'll find many references supporting the foregoing.
A better choice, in my opinion, if one needs to take a sleeping pill, is Ambien. Although, it too, can have unpleasant side effects, especially if used with alcohol, or in large doses. Ambien is fast acting, sedating -but does not interfere with sleep architecture, has a short half life which means less of a chance of a drug hangover but more of a chance it won't maintain sleep through the night. Ambien is thought to carry a risk of dependency but not addiction. A technique professed by some is to take a low dose (5-10mg) of ambien at bedtime followed by a smaller dose (2.5-5mg) if ealy waking is a problem. The second dose adjusted so as to not leave a hangover.

Jay

[cnew]

The decision whether to use pharmacologic sleep aids is highly individual. That said, clonazepam isn't the best choice, IMO. For trouble initiating sleep, The z-drugs

http://en.wikipedia.org/wiki/Z_drugs

are more effective and safer.

I don't have any problem getting to sleep.

For trouble maintaining sleep, OTC Benedryl, low dose trazadone or doxepin, or extended release z-drugs are more effective and safer than clonazepam, again JMO.

Maybe I'll try benedryl (Simply Sleep) is just benedryl, isn't it? Thanks for your comment.

[cnew]

Cnew, I think you'd be wise to hold off on the clomazepam as you said. From my research it appears: Clomazepam is fast acting, has a long half-life, most likely addicting, is highly sedating, but inhibits deep or slow wave restorative sleep. Depression seems to be a possible side effect of longer term use - possibly due to the negative impact it has on sleep architecture.
With clomazepam in high enough dosage, you are likely to fall asleep quickly, sleep through the night, but wake feeling unrefreshed and "hungover".

The doctor prescribed what he said was a very low dose of clomazepam. Indeed, I had to split the tiny pill in half to get the dose he wanted me to take. The idea was that the long half-life of the drug was supposed to help me stay asleep. That said, the first night I tried it, I was awake at 2:30 AM, an hour earlier than the night before when I didn't take it! I have not taken it since because a) it didn't work as hoped and b) the pharmacist counseled me that Medicare doesn't pay for it because it causes people to fall.

A better choice, in my opinion, if one needs to take a sleeping pill, is Ambien. Although, it too, can have unpleasant side effects, especially if used with alcohol, or in large doses. Ambien is fast acting, sedating -but does not interfere with sleep architecture, has a short half life which means less of a chance of a drug hangover but more of a chance it won't maintain sleep through the night. Ambien is thought to carry a risk of dependency but not addiction. A technique professed by some is to take a low dose (5-10mg) of ambien at bedtime followed by a smaller dose (2.5-5mg) if ealy waking is a problem. The second dose adjusted so as to not leave a hangover.

Interesting. I may try that. Thank you for the suggestion!

[Pugsy]

I also have fragmented sleep. Mine is due to pain. I fall sleep fine but wake often with each toss and turn in bed due to pain.

Ambien helped me sleep through the pain. There are 2 forms plain Ambien to help get to sleep and for me was enough to help me stay asleep. Ambien CR is a controlled release form and directed for staying asleep. It is also very pricey and not sure if Medicare insurance plans will pay for it.

Last Dec the doctor and I decided to try low dose of amitryptline to see if it would help me sleep a little better (sleep through the pain). We are talking ultra small dose. Like 10 or 20 mg. While in much larger doses it is given for depression/anxiety...in the small dose it is given for pain.

Not saying that pain is your problem but just saying that the side effects to amitryptiline is drowsiness and it does allow me to sleep through the night with minimal wake ups. So it can also be used as a mild sleep aid. Very benign in the very small doses. Minimal to none hangover the next day unless I forget to take it early.

Might be something to consider.

[dtsm]

The 0.25 mg dose of clomazepam [clonazepam, aka klonoprin] that you're taking is very very small. Yes, it can potentially be addictive if abused but at your dosage I wouldn't worry about it. But I am surprised your sleep doc prescribed this as it's contra-indicated for sleep apnea. It won't hurt you per se......

I suggest going back to doc and getting something else. You could try Ambian, or if you can sleep a few hours with cpap and then wake up, ask doctor for something to take when you awake in the middle of the night, a short lasting sleep medication. I forget the name of it but my brother uses it; he's been on cpap for 5+ yrs and now gets up sometimes wide awake at 4 am. So he takes this new med that let's him sleep another 2-3 hrs.

Good luck.

[M.D.Hosehead]

Maybe I'll try benedryl (Simply Sleep) is just benedryl, isn't it? Thanks for your comment.

Correct. In the US, all OTC sleep aids contain diphenhydramine 25 mg., the same as Benedryl. It's the only one approved for OTC.