Sleep Aid Help

[anxietycat]

Hello All-

For about 3 weeks I have been dealing with anxiety related insomnia.  I never had problems sleeping before and all of the sudden one night I just couldn't sleep at all and stayed up all night.  It went downhill from there.  After about 3-4 days of not sleeping well, my doc called in some ambien 5 mg.  I was terrified to take them and went two days without sleeping before I forced myself to take one.  I slept 4-5 hours the first time.  Ever since then (about 12 days)  i have been taking Ambien nightly, but i have found it does not work well at all. It will make me go to sleep but I will only sleep about 3-4 hours and if I'm lucky I can get another 1-2 after, but most of the time not.  I also feel like the ambien is making my anxiety 100x worse the next day.  

I got Ambien CR 6.5 mg from my doc as well as Lunest 2 mg.  I am eager to try these two with hopes they will help to keep me asleep throughout the night, but I am also scared that they just won't work and I will be left laying there.  I have read a lot online about the generic CR not working well and I've also read a lot about Lunesta not working well.  Also, I am concerned with the CR bc it's only 6.5 mg and the lunesta is only 2  - will that be enough? I guess I just won't know until I try, but I am so hesitant to try on a work night when I know I have to be up for work the next morning.  Any advice?  

[birdie0907]

Your pharmacist will be familiar with it. I couldn't get it to work, but lots of people obviously do. My pharmacist said Benlyn (or something like that) has the same stuff in it plus some other stuff for colds but is still cheaper - your pharmacist can go over that with you but be sure to explain what doc has you on now etc. and/or ask doc about it.

[nursegirl6572]

INSOMNIA TIPS:

While it is frustrating, some of the best advice I've seen is to try to allow the sleep to come back as naturally as possible, which is best for the long run.  If you're going to try anything, I agree that a more natural supplement would be the best choice.  I would personally not advise taking a prescribed insomnia med, for a few reasons...one, because obviously there are some risks involved.  These are some very potent medications, and everyone reacts differently to them.  The biggest reason is because, depending on how long you would take one of these meds, you will have to deal with rebound insomnia when you stop taking them.  The rebound insomnia is often bad enough that it makes the initial insomnia look like a walk in the park.  Insomnia meds should be limited to the shortest course possible, to avoid dependency, and the rebound insomnia issues.

That being said, I am a professional insomniac.  ;-)  I have struggled with my sleep for YEARS, not due to addiction, but due to many other factors (anxiety, depression, shift work).  While I don't always get the best night sleep...I've learned some tricks of the trade that sincerely do help.  Before turning to potent meds, I would advise you to exhaust all other methods, including the more natural or OTC remedies (which, you should also limit as much as possible, because rebound insomnia will occur with those too, after enough regular use).

Here are some tips to help with your sleep:

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.  Please be patient for a while too...your body is getting back to normal, and that takes some time.  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]

It's very tough to deal with insomnia.  Just be very cautious with sleep aids, try to keep your usage to a minimum, or just take it occasionally rather than nightly.  If you take it regularly for a while and decide to stop taking it, you'll experience rebound insomnia, which will likely make your original insomnia look like a walk in the park.  I would personally recommend trying a more natural sleep remedy, like Melatonin before trying the heavier hitting Rx meds.  Just my opinion.

Obviously you've identified that anxiety is the culprit here.  What are you doing to address that?  Truly, the BEST way to treat insomnia is to try to figure out the underlying cause, and address that as best you can.  

In the meantime, I'm going to copy/paste a post for you that I've saved for this topic.  This was posted originally in the addiction forum, as insomnia is a big problem for people during detox, so if you see any references to addiction, that's why.  The info is the same regardless.  If you really make a concerted effort to adopt some of these habits, and keep up with it consistently, it will help.  It may not totally eradicate the insomnia, but it will make a difference.

Hope you see some improvements soon.

[anxiety860]

I would talk to your doctor before trying that though.

[anxiety860]

I would take birdie0907 advice on this.  If all fails you can try melatonin? can buy it at a local drug store.

[birdie0907]

I take zopiclone 10  mg for sleeping every night, which is 1/7 the recommended dose if you are using it for depression, which is its primary use. The doxep site said no one knows why it works, but it has done the trick for 10 years for me. It is easy for me to quit it, which I have done numerous times for periods up to 2 months, however it isn't worth it for me because I only get normal sleep 5 days out of 7 when off it, even after 2 months abstinence.

[birdie0907]

Did your doc give you the extended form? If not, perhaps you should advise doc about waking up after a few hours. I found this info about it.
http://www.drugs.com/ambien.html

Ambien is used to treat insomnia. The immediate-release tablet is used to help you fall asleep when you first go to bed. The extended-release form, Ambien CR, which has a first layer that dissolves quickly to help you fall asleep, and a second layer that dissolves slowly to help you stay asleep.

Your doctor will determine which form of Ambien is best for you."