Insomnia

[Napoléon]

Sorry, I just gotta post this:

http://www.youtube.com/watch?v=rMROOGQj5aM

[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.

[frankiej]

I have never really considered whether I have insomnia... It can often take me many hours to get to sleep, but I just accepted that as something I can't help. I don't mind really. Lack of sleep isn't something that bothers me much. I just read manga or draw until I realise that it is almost 6am.

Getting so high that moving at all seems like a gargantuan effort helps.

[cratehorus]

If you think you have insomnia go to the doctor, insomnia is not the same as, having trouble falling asleep. If you do not have any problems with your sleep cycles or circadian rythms your fine, don't use prescription medication for no reason. Most likely you only need to improve your sleep hygeine

http://www.sleepfoundation.org/article/a...ep-hygiene

[Jackalope]

All the suggestions about sleeping tablets... Its not that easy in the uk. You can't buy anything stronger than an ibuprofen(advil?) without a visit to the doctor, his recommendation to drink warm milk and to try counting sheep, then a return visit 2 weeks later before they will finally prescribe anything.

I myself have terrible insomnia which is only abated by smoking weed, which (ridiculously) is easier to obtain than sleeping tablets...

As someone with raging chronic insomnia, I can sympathize with the difficulty in obtaining help from your physician. This week has been rough: two nights where I could not get to sleep before 5am, and one where it was not until after 6. When the alarm goes off at 7... Well, I find myself telling myself "if I can fall asleep now, I'll be able to get by on two hours of sleep". It takes a toll mentally and physically.

Sleeping pills, meh. I have atypical reactions to z-drugs like ambien and other hypnotics like Lunesta. Let's just say they don't put me to sleep, and I have undesirable psychiatric side effects from them.

As a result, in addition to trying a number of non-chemical therapeutic techniques, my doctor had me try a number of off-label drugs. A year on atypical anti-psychotics, another year on benzodiazepines, months on gabapentin, trazodone... The list goes on. Some were ineffective, some had intolerable side effects, oh yeah, then there was getting over benzo dependency - fun stuff. Overall, I would have to say that what was best was a low dose of trazodone (as low as 25mg), it's a sedating antidepressant, not habit forming, very inexpensive, and fairly tolerable as far as side effects are concerned.

Aside from that, what's worked reliably for me is a small amount of weed, sometimes with liquor (only one drink). I actually don't care much for getting high much anymore, but it sure helps right before bedtime. It's not half bad for anxiety as well.

I do note that although I do live in a state where medicinal marijuana is legal, insomnia and anxiety are not on the list of state-approved conditions, as of the last time I checked. Screw em, I get mine outlaw style.

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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.

I have two words for Seroquel (which I took for over a year): "Never again." My experience with it was similar to yours - there is no just right dose, and any dose that would get me to sleep, I would sleep too long and I would be brain damaged until dinner time. I couldn't function at work.

It also happens to be insanely expensive (my RX was $350/month until my deductible was met).

I'd try Trazodone first if I knew then what I know now. The dry mouth is bothersome but a hell of a lot better in my estimation than the side effects I had from Seroquel.

For tough cases or where apnea is suspected, a sleep study can be helpful too if you can get your insurance to cover it. I learned quite a bit when I had one done a couple of years ago - particularly that in my case, that I didn't get more than about 15 minutes of sleep between wake cycles (I woke 34 times in less than 6 hours), without a single apnea event.