Cannot Sleep - Meds?

[Sanity_Is_Not_Statistical]

G'Morning (as it is, once again) 1 AM and I have not been able to fall asleep.   For 2 months now I have gotten 2 -3 hours a night.  I really am at my wits end.  I did see my doctor and he gave me a prescription for Alprazolam (.5 mg) but when I researched all the side effects I was too frightened to take it.   That was this evening (10 PM) and here I am, still not able to fall asleep.  

The issue that seems to be the largest contributor to at least my initial inability to fall asleep is nasal congestion due to allergies.   I am taking a  prescription medication for that, but it does not seem to help much.  Although, in truth, I only seem to have the breathing / congestion issue at night when I am trying to fall asleep.   During the day I have few issues with it.

So, my question:  Have you taken, or are you taking Alprazolam and if so does it help you sleep?   I am desperate for some relief and, not to be melodramatic here, but, I have often over the last month thought that I would die if I could not fall asleep.  That (of course) has not happened but the sheer panic of the thought keeps me not only awake but also fearful of laying down and attempting to fall asleep.  

Thank you for any feedback you can provide.

[Gretta96]

I agree, alcohol will make you feel worse.  

Can you buy Zyrtec D w/o a prescription?  If you had a side effect from it the doctor can't do much but recommend something else.  Do the benefits of taking Zyrtec D outweigh the side effect?

Good luck, I hope you find sleep soon :)

[nursegirl6572]

You didn't let anyone down...you have to do what works for you..these are YOUR decisions.  We were just trying to give you advise and our opinions.

A few things of concern:

"Perhaps a nice glass of wine will help the Alprazolam "kick-in".   Not a good idea I am sure, but right now, I don't think I have much to lose, "

You're right, it's a bad idea...horrible in fact.  Benzos and alcohol are both depressants, or"downers".  they will add to your feelings of depression quite significantly, not to mention, you're new to taking benzos...mixing them could have disastrous results.  PLEASE do not do it.

"I don't expect answers from anyone here - many of you have already been so helpful with suggestions, they just don't seem to have worked for me.   So why post?"

Sweetie, with all due respect, you haven't given anything a chance!  These things take TIME to improve.  You're ready to throw the towel in, and really, you haven't even tried everything you can try.  I understand that you're frustrated, but come on hon!  You have to be a little more patient!

It goes without saying that if you're feeling suicidal, you need to seek help ASAP.  That's nothing to mess around with.

Stop, breathe, regroup, and make a game plan.  Then, give it time and be patient.  This isn't going to be magically better overnight.  And again, I cannot stress enough about the alcohol and benzos...SUCH a bad idea.  Honestly, I would stay away from the alcohol all together, as it will only exacerbate your anxiety and depression...it does that quite drastically.  If you want to help yourself, you need to make a conscious effort to stay away from the things that will make you feel worse.

Hang in there...kep us posted.

[Sanity_Is_Not_Statistical]

Well I have let myself and others who offered advice here down.   I succumbed to taking the Alprazolam tonight as I was having trouble sleeping again and just could not take it.  I really did not want to take a drug, but was having what I think would be a full blown panic attack; hot flashes, afraid to go to bed to sleep for fear of choking (from draining from the allergy issue) and just, well a mess.   Funny thing, I took it two hours ago (it is now 12:03 AM) and while at first it did make me sleepy here I am wide awake.  

I can say I am a bit more relaxed, but still feel anxious about falling asleep.  I think I know what brought this on.  I called my doctor two days ago as he asked me to check in with him on who the allergy med worked.  It worked great but I was out.   He never called back.   Called him the next day as I took Zyrtex-D and it worked but there was a side effect that I experienced.   No call back.  Spoke with his office today and he was (and had been in) but told the office to tell me to try regular Zyrtex.   I am so upset and worried.  What did I do to make my doctor mad at me?  And if he will not help me address the allergy issue what hope do I have for ever getting rid of (what I think) is the root issue of my not sleeping / fear of falling asleep?

I hate feeling like this - upset,  anxious and fearful.  I have never thought about "ending it" but tonight, I just feel so helpless and don't want to face more nights like this.   I don't expect answers from anyone here - many of you have already been so helpful with suggestions, they just don't seem to have worked for me.   So why post?  Well, perhaps just to think out loud in the hope that it helps me return to my normally rational train of thought.  So far it isn't working.

Perhaps a nice glass of wine will help the Alprazolam "kick-in".   Not a good idea I am sure, but right now, I don't think I have much to lose, and what happens, well, happens - it can't be any worse than what I am experiencing now.

[Sanity_Is_Not_Statistical]

NG:

Thank you for the great insights and taking the time to post your tips.  Some of them are right on target to some of the bad habits that I know I should avoid (like tea late at night - even more caffeine than coffee :-( ) .  

Also thank you for your comments and insight on how much sleep is enough and when to worry about it.    Along those lines I was surprised how relatively well I was functioning / have been functioning on the 2-3 (4 on a good night) hours that I was getting, yet was very concerned anyway as we are told we "need" 8 hours a night.  

Finally, an update:  

I did not take the sleep aid.  I had really intended to, but as I thought more about it I was more concerned about becoming dependent upon it than I was worried about the loss of sleep.  That was Thursday night (5/2) and Friday the medication for the allergies seemed to finally start to work; I fell asleep within 30 min of getting into bed (!) and slept a full 5 hours.  Saturday and another good night of 6 hours.  Alas, tonight, Sunday, I am out of the medication and once again am up and unable to sleep.  My fault.   I should have called my doctors after hours line to request a refill.   The only good thing is that I am fairly certain that this medication will work and that I will, once allergy season is past, be able to get off it as I do dislike having to take anything.

So, tonight, reply to the great group of folks here, read a bit and hope that I am able to get to sleep by, say 2 AM.  Thanks to your input I am not going to worry to much about that, and perhaps that will even allow me to "be out" by 1 AM :-)

All the Best

PS: I have never had allergies this bad, but have a new member in the house, a rescue cat.  I am not a "cat person" but have become quite attached to her, and her to me it seems.  I even like (ok, love) her as much as my dogs.   I would hate if it turns out she is the cause but fear it may be the case as she sheds (a lot!) and she just loves to get up into my face for a long cuddle / petting session late at night.  Sigh.  

[nursegirl6572]

TIPS FOR INSMONIA:


1.  Avoid any and all stimulants (caffeine, nicotine, energy drinks, etc) as much as possible, especially within 4+ hours of bedtime.

2.  Exercise is a great way to induce sleep, as it releases natural endorphins.  Even a brisk evening walk will help.  Your exercise should be an hour or more before your bedtime..you don't want to exercise right before bed.

3.  Try to avoid eating a heavy meal close to bedtime.  If you're hungry, stick to a light snack an hour or more before bed.  Avoid ALL fluids 3 (or more if you can) hours before bed.  Nothing worse than finally getting to bed and have mother nature wake you up!

4.  Stick to a consistent bedtime and a consistent bedtime routine.  Even on days when you don't FEEL tired at your bedtime, try to stick to your routine...that conditions your body and brain.  Pick a reasonable time.  If you work 3-11:30 and get home at 12, a reasonable time isn't 12:30, as you would need time to unwind after getting home.

5.  Create an environment conducive to sleep and relaxation.  Your bedroom and bed should be an inviting place that you look forward to retiring to.  Keep the room clean and clutter free, keep dust levels down.  Keep your bedding washed with clean or fresh smelling scents.  Choose comfy, non-binding clean smelling PJs.  ALL of our 5 senses affect our mood, and also our sleep.  If you have a quiet room, but your sheets smell like feet (lol), that won't be very relaxing.  Keep the room DARK.  Keep weather in mind.  In the summer, you would only need a light sheet or blanket, in the winter, heavier blankets are necessary to keep you comfy.  Again, back to the senses...if you create a bed that keeps you too hot or too cold, that will interfere with your sleep.  Keep a glass or bottle of water at your bedside, in case you awaken with that dry mouth and need for a drink.  This way you don't have to get out of bed to get something to drink.  Light soothing music or white noise machines for LOW (not blaring) background noise can be helpful.  Try to avoid using TV as a background noise, as our brains are still working while asleep, and the things you hear from the TV could affect your anxiety levels and even dreams.  Basically, sleeping with sounds of "The Chainsaw Massacre" in the background won't lead to happy thoughts.  ;0)  A warm bath or shower is great before bed...dry your hair.  Never go to bed with wet hair.  NOT comfy!

6.  Ignore the urge to get out of bed.  Even when you're feeling frustrated, try to remain in bed, reposition yourself, adjust your sheets, read a book if you are not falling asleep, but the more up and down you do, the harder it is to get and stay asleep it is.  The same goes for nighttime awakening.  If you DO fall asleep and wake up in the middle of the night, ignore the urge to get out of bed...again, reposition yourself, adjust the sheets, and try to go back to sleep.  When you get up out of bed, you're waking yourself more.  If you stay lying in bed, you are not as awake.  If nature calls...go to the BR, and get right back to bed..no snacking, no smoke breaks (I'm bad at this...lol).  Those things are murder for sleep.  Get up...go potty, right back to bed.

7.  When you DO manage to finally start on a consistent routine, you'll find things that help and hurt your sleep.  Take note of them and adjust your regimen as needed.  Sleep patterns will change, and life happens, so sometimes, adjustments need to be made. Consistency is TRULY the key..I cannot stress that enough.

8.  Listen to your body.  For a while, while your sleep is lousy, you will feel tired at odd times of the day.  Your body is telling you it needs rest, so heed the wanring...take a nap.  Lie down on the sofa, and catch a 1 hour (or less) nap.  Don't nap for hours at a time, that will interfere with your nighttime sleep.  An hour is the perfect amount of time for a refresher.  Also, don't nap in bed.  Once you're conditioned, your bed should be for nighttime sleeping only.  

Hope these tips help some...I know these are the things I do that help me get some decent sleep.  It's not always foolproof, but it works pretty well.    If you are going days without any sleep, definitely see your doctor.  Sleep depivation is a whole other ballgame, it can be dangerous.

Best to you...sweet dreams!

[nursegirl6572]

Ahhh, insomnia.  I'm all too familiar with it, and yes, it stinks.  A lot of times, just worrying about if you're going to sleep, and being over focused on it will cause even more insomnia.  Sounds like that may be part of the problem for you.

I agree with paxiled about using sleep aids as a remedy for insomnia.  There are a few occasions when I think on a very limited basis, a prescription sleep aid (or even an OTC one) is warranted.  That would be if a person is truly not getting ANY sleep to the point where it becomes dangerous.  If a person hasn't slept in days, then something needs to happen.  Other situations may be if someone is going through an extrmely traumatizing time, due to a loss, or something similar, where their emotional stability is on the line, and they are very vulnerable emotionally.  People in those situations need to sleep.

MOST times, insomnia has an underlying cause, whether it be stress, anxiety and depression, a medical condition like sleep apnea or a chronic pain condition for example, sinus and allergy issues, GERD, etc.  The MOST important thing I think, is to get to the bottom of those underlying issues and address THOSE.  That will obviously help to make sleep come much easier.  Also, people often have horrible nighttime sleep routines (I'm one of them)...from drinking coffee in the evening, sleeping on the couch, etc.  Those issues can be gradually changed too, often with a great deal of improvement of the insomnia.  It takes time to change our patterns and habits, and adopt a more sleep friendly routine, but it does work quite well, so I would recommend trying some things in that department first also.  I will post some personal tips that have helped me a lot in a moment.

The other issue I think people get hung up on is how much sleep a person "needs".  Some people are convinced that if they don't get 8-12 hours consistently every night, they are having insomnia.  MOST adults don't need 8-12 hours of sleep a night, and a lot of people function quite well on what would be considered "not enough" sleep (ie 5-6 hours).  The QUALITY of sleep is also very important.  If a person gets 4 hours of very restful sleep, chances are, that is sufficient for them.  On the contrary, if a person tosses and turns for 12 hours, they may be left to feel tired.  Just some things to think about as you move forward.  If you're getting even 3-4 hours of sleep, you may be tired until you can make some changes, but it shouldn't affect you drastically.  The body has an amazing ability to adapt to those kinds of changes.

So, I think again, it's important that you address the possible underlying contributing factors...which for you seem to be some anxiety (which seems to be reactive based on your worry about sleep), and the sinus/breathing issues.  If you decide to use a medication to help you sleep, then I would recommend limiting the use as much as possible...only here and there (which it seems like that is the plan anyway from what you've indicated).  

Using a sleep aid (even a "natural" one) for more than a couple of weeks regularly will actually make the insomnia worse, as you will experience rebound insomnia.  I'm going to post my list of suggestions for you in the next reply (it's pretty long)....I would recommend REALLY trying hard to adapt your current routine to include some of those...your goal is to find a routine that is consistent, and create an environment that is sleep friendly.  After doing that for a week or two, you really should notice some improvements.  

If you are managing to get a few hours of sleep at night, you're probably not as sleep deprived as you think.  No doubt you'll feel tired, but you're working to improve that.  Just try to be patient and not have super high expectations of the amount of sleep you SHOULD be getting right now.  The more you are worrying about the sleep issues, the worse your sleep will be.

I'll post my list now...hope it helps.  Good luck to you...sending you wishes for some Zzzzzzs!

[Gretta96]

Let us know if it helped, I hope it did.

[Sanity_Is_Not_Statistical]

Thank you all for your feedback.  

I do think I will try taking the Alprazolam  tonight. as I have to try something to get some sleep.  Once again last night I fell asleep at 2 AM and use up at 6 AM.  That was better than most nights, and I do credit the extra hour to having taken the step of posting here.  It did, oddly, calm me a bit.

Cj29:   To your point I was even a  bit leary of posting here as what I had been getting from trolling the different sites (WebMD amongst them) on the Net did, indeed, "scare the crap" out of me.   My doctor only give me 15 pills with the instructions to "take as needed", so he certainly doesn't expect me to use it long term.  As I said above, I think I will try it tonight and then give my doctor a call to talk about the "whys" of  this drug and more importantly to get direction on how to break this sleepless cycle without having to use any drug.

Greta96:  Thank you for relating your experiece.   I hope that you are able to work through your stress and come out the other side in a much better place.  Hopefully you have someone with whom you can share and who can give you the support you need.   For myself, I have family (in another State) that I have thought of calling and talking to but, and I am being very candid here, I do not want to let them think that I am so weak that I can't overcome something as simple as falling asleep at night.  They would not understand as I do have a good job, a nice home, pets that love me ( they are a big help at night - nothing like 3 dogs and a cat to cuddle with when you are panicing) .  The response would be, well what are you worried about, just get it together - now how is the cat getting on with the dogs?        

Paxiled: Interesting question.  I suppose it may be a bit of which came first, the anxiety or the lack of sleep?   I can say that I have been very anxious since the onset of my sleeplessness.   So much so that I start to get keyed up with worry as early as 8 or 9 PM.  Of course that in itself (the worry) is a ccertain sign that I indeed will not be able to get  to sleep. So which came first, was / am I prone to panic attacks and the lack of sleep has just brought it to the surface?   Perhaps, but I also have had stress points in my life (very few of them, thankfully) where I had what I am sure would be classed as a panic attack but never for an extended period of time such as now.  I think I can recall 3 such episodes in my life - each brought on by a very stressful event.   That said, I have had many stressful events, as we all do, where I did not have such a reaction.

Again, thank you all for your insghts and advice, they are truly appreciated!

[Paxiled]

My own opinion is that benzos aren't good sleep remedies, as they interfere with REM sleep.  This is an anti-seizure and anti-anxiety med with a side effect for some people of making them tired for awhile, but you're not reporting anxiety.  If you take it regularly, it is an addictive drug, and if you have a regular sleep problem but not a regular anxiety problem I wouldn't take it.  But I'm a cautious guy about drugs, I'd always try everything else first.  If this really is a sinus problem, that's what you should be addressing, and I'd do it with natural remedies and dietary changes to see if you have allergies -- wheat and dairy are the biggest culprits -- long before I'd go on any drug.  Do you suffer from anxiety, or just a sleep problem?

[Gretta96]

I would try it.  I have a prescription for ambien and Xanax for sleep.  The ambien puts me right to sleep and if I wake up in the middle of the night I will take one Xanax (.25mg) and I will go back to sleep.  I've not had any issues with it.  I am going through a pretty stressful time right now personally and I have to be able to sleep.  Some people do become addicted to Xanax, but it really doesn't do much for me except help me sleep.

[cj29]

I have taken it in the past and it has worked pretty well for me.  Benzos like these are generally prescribed short term and on as needed basis.  Of course there are potential side effects to anything we put into our bodies, but I tolerated it pretty well.  In my experience, I just followed the doc's instructions for the med and I didn't really have any issues.  I believe that I was on it a month or so and it helped me when I initally experienced panic and anxiety.  Remember, that while the internet is a great tool, it can scare literally scare the crap out of you with all the information that is available and in many cases not even applicable to you, which can cause more problems than it is worth....keep us posted!