Insomnia

[Angrboda]

I've had insomnia since at least high school. Typically, it will take 4-6 hours to fall asleep without drugs. And lately, for no particular reason, every 3-4 days, I just won't sleep. (I won't even try; I'm not tired or fatigued, and seem to have little after-effect from the lack of sleep.) From the way you describe your symptoms, I'd highly recommend seeing a sleep specialist to diagnose just what your insomnia is. It's not clear to me from the way you describe it, and different causes lead to differing treatments.

I, like Shell, am best suited with benzos. Unfortunately, doctors are reluctant to prescribe them for me, and the best one for me, is almost not prescribed at all anymore. (Side effects of depression hangover and suicidal ideation.) Failing that, I have also used ambien, and if you are one of the many without side effects that lead to quitting the therapy, it works wonderfully (or did for me, anyway). Unfortunately for me, I do crack addled shit in the night and gradually develop a problem remembering the things I did the day before. So now I'm taking seroquel for sleep. (Quietipine, an anti-psychotic with sedating properties.) The downside is, it can cause tardive dyskinesia, and for me, if I take too little, I don't sleep; too much, and I'm dead and groggy half the next day; there is no "just right" dose for me. Another alternative which springs to mind is the antidepressant trazodone. It is reasonably effective and works well for some. However, as an older tricyclic, it has significant anti-cholinergic side effects. (Dry mouth, etc.) A couple of other methods which I haven't tried or haven't used successfully. Melatonin; best taken 1-2 hours before bedtime, avoid tv and computer screens before bedtime after taking [I haven't confirmed this, so YMMV]; I've heard some concerns about the reliability of the potency of OTC melatonin, but haven't been able to confirm their validity. The other is Valerian root, which I have no knowledge of. Beyond that, there are other anti-psychotics that are also sedating, but I couldn't help you there.

Beyond drug therapy, there are a number of things that, depending on your particular kind of insomnia, can greatly alleviate your symptoms. These generally fall under the category of "sleep hygiene". First, don't consume any caffeine after 12 o'clock noon. If you can, cut out all caffeiene. (You might want to consult a physician first, as abrupt caffeine cessation can have serious side effects for some.) Second, incorporate 15-30 minutes of light exercise into your day. Third avoid exciting things near bedtime. Fourth, develop a routine to where you have a daily structure that you follow; predictability in daily routine frequently results in predictability of fatigue and sleep. Be active; if you're not doing much, find something to do that, if not wears you out, at least uses up some energy during the day. And I'm told, but haven't confirmed, that lcd light before bedtime can delay the onset of the melatonin cycle. (That from my new psychiatrist; I think it's a crock of shit, but there's no way you're taking my computer away from me at ANY time of the day.) Normally prescribed for seasonal affective dosorder, light therapy may be of benefit to some. (And there are relatively inexpensive light boxes available now in the $100 and under category. To be effective, they should be used regularly, calibrated properly for lumens (versus distance), angle (above and downward, not upward), typically used in the morning, and used at the same time each day. And different ones use different light spectrums.)

Anyway, I'm rambling. Best of luck.