Trading excessive exhaustion for insomnia??

[SnoozyQ]

Ok, now that I have my funny out of the way...

As I have mentioned, I have stopped taking Ativan to sleep and started 200 mg of Provigil today ( previously 100 mg did nothing for me). I can work my way to 400 mg per day if needed. I can already tell a difference....wow.

But, I CAN'T SLEEP.
I went to bed last night at 11:45 (watching a basketball game ) and stayed WIDE awake in bed until 4:15am, when I dozed on and off until 6:30am. (I was like a kid on Chirstmas without the fun part--can I get out of bed? Is it time to get up? I can't lay here anymore.) I got up 30 mins late, but I still got up and came into work. I felt that I *should* stay and bed and sleep....but didn't feel sleepy enough to do so.
So stopping the Ativan seems helping with feeling like hell during the day, but it's really doing a number on sleeping. I really don't want a new prescription to add to the mix....and melatonin stopped working for me before Ativan.

Did I just trade pure exhaustion for my old friend insomnia?

[BlackSpinner]

Ok, now that I have my funny out of the way...

As I have mentioned, I have stopped taking Ativan to sleep and started 200 mg of Provigil today ( previously 100 mg did nothing for me). I can work my way to 400 mg per day if needed. I can already tell a difference....wow.

But, I CAN'T SLEEP.

Did I just trade pure exhaustion for my old friend insomnia?

Give yourself time to get your system adjusted to the new meds and a new routine established. One night does not make for a trend as everyone always says. It takes a while to break in new habits too.

[kteague]

Working with impaired sleep is hard, so I can see you want (and need) this fixed ASAP. I just want to encourage you to keep in mind a long range goal of fixing as much of the root cause as humanly possible so as to minimize over time the necessity for medications. They can be a long and slippery slope fraught with side effects. I'm not against meds - I take a boatload. Just have experienced the "take a pill to fix what the last pill caused" cycle.

How much of a role is Provigil playing in the insomnia compared to the lack of Ativan? I'm wondering if adding the Provigil and stopping the Ativan in a close time frame might muddy the waters and make it unclear which is the bigger issue. (And all this while adjusting to CPAP - that's a lot of adjusting.) As BlackSpinner said, it can take some time to see a pattern develop. It took me ages to get some sort of regularity to my sleep, but I had limb movements complicating the matter. Even so, getting the brain to let go of bad habits can be challenging in any area of life, bad sleep being no exception. Be nice if we could all be those who provide the right environment and sleep just happens.

I'm not sure where things stand with you getting a workup on other possible contributors. I did see that your thyroid was tested. Did you decide against the MSLT for now? When you do sleep, how broken or restless is it? I'm sorry I can't give you answers, I remember the frustration of having my options for sleep time confined by responsibilities. Keep that great sense of humor - it'll help you through this.

[harry33]

get comfortable in bed, you dont have to lie on your back
sleeping pills IMO are quite OK for a while
have daytime naps using CPAP, try to sleep in an armchair using CPAP

[SnoozyQ]

I know what you mean...one pill fixes this, but causes this....have another pill....blah.

I did postpone the MSLT until after this one month trial of higher dose Provigil. I figured this would be easier to see if it's working or not--I'm running out of medical time off at work and I need this figured out sooner than later. So a one month trial, vs 3+ additional months of studies,reports,adjustments,etc made sense to me for now.
I think maybe the missing Ativan symptoms are exacerbated by newly introduced Provigil. I'm not fully used to either one, and I after doing some reading on Provigil's "life span" in the body (15 hours?!), perhaps I took it too late yesterday. Still, the insomnia is there without the Ativan (prior to starting Provigil)...I really want my body to regulate on it's own as far as learning to go to sleep...but I can't lie in bed that long awake every night! When I do sleep, I tend to wake every 2 hours or so.

I just want to sleep/rest when I go to bed, feel good when I get up and during the day.......is that so hard??? LOL

[carbonman]

Did I just trade pure exhaustion for my old friend insomnia?

Drugs are not the answer to insomnia.
This is about your mind, not your body.
I don't know how a doctor thinks a person can take
a stimulate during the day and then sleep at night.
Between the two drugs you mention, your brain is on
a roller coaster ride.

I would suggest you read Barry Krakow's book
Sound mind, sound sleep
Sleep Dynamic therapy techniques could me much more helpful.

It might be more helpful to seek out a cognitive
behavioral therapist instead of a drug doctor.
It is a given that CBT is not easy....but,
in the long run, doing the CBT work could actually prove
to be easier and more effective than years of druging your brain.

[nobody]

Everyone is different, but just FYI, I tried provigil once and felt so wired I stayed awake for 48 hours. I think it has a very long half life/elimination life in the body. It may not be the right med for you!

Ok, now that I have my funny out of the way...

As I have mentioned, I have stopped taking Ativan to sleep and started 200 mg of Provigil today ( previously 100 mg did nothing for me). I can work my way to 400 mg per day if needed. I can already tell a difference....wow.

But, I CAN'T SLEEP.
I went to bed last night at 11:45 (watching a basketball game ) and stayed WIDE awake in bed until 4:15am, when I dozed on and off until 6:30am. (I was like a kid on Chirstmas without the fun part--can I get out of bed? Is it time to get up? I can't lay here anymore.) I got up 30 mins late, but I still got up and came into work. I felt that I *should* stay and bed and sleep....but didn't feel sleepy enough to do so.
So stopping the Ativan seems helping with feeling like hell during the day, but it's really doing a number on sleeping. I really don't want a new prescription to add to the mix....and melatonin stopped working for me before Ativan.

Did I just trade pure exhaustion for my old friend insomnia?

[trytryagain]

I also take provigil 200 mg in the morning for excessive sleepiness especially while driving. Some days I go without. Before CPAP, just a few months now, I would take an occasional ativan type (alprazolam) medication for anxiety and to help me sleep. My sleep doctor said no more of that type of medication as it can effect your apneas. I tried melatonin it was just okay. Now I am taking 5 htp SR. It seems to be helping without any feelings of being drugged. I wouldn't recommend a medication for anyone, just letting you know whats working for me.

[cflame1]

If you're interested JSkinner posted a link where you can listen to Dr. Park interview Dr. Krakow on insomnia... I downloaded it... seems interesting.