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Meds, Medical Conditions, and Treatment >> Meds, Medical Conditions, and Treatment

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cotybear
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Reged: 01/30/04
Posts: 52
Loc: south east
need help sleeping suggestions needed please
      #135240 - 02/07/04 11:02 PM

Sorry if this shows up twice i tried to post first time and it never showed up even after i logged out and back in so i'm trying again. I have severe insomnia which i have had 5-6 years but is getting a lot worse recently for years i have only been sleeping 3-4 hours per night but recently it has got to the point that i am sometimes going 3-4 days on 2-4 hours sleep it is really starting to bother me bad. I have tried ambein 10mg which will work the first few times but only allow me 3-4 hours sleep per night, sonoma 0 help, elavil 25mg don't phase me, so i have went back to the cheaper otc equate liquidjels (walmart brand) but i am up to 5 of them at a time and they are still not working and quite honestly i am afraid to take anymore than that at one time and i try not to take them every night only on the nights there is nothing on tv and i am just tired of pacing the floors. I feel like pulling my hair out i want to sleep like a normal person. Does anyone have any suggestions of what to try i want something that will flat knock me out with in 1 hour that is fast acting and long lasting i want to sleep 6 or more hours a night and i don't even care at this point if they have the dreaded "hangover" effect the next morning. If anyone has any suggestions about something that may help with my insomnia PLEASE let me know.

Thanks

Cotybear


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jonysuede
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Loc: Long Island, N.Y.
Re: need help sleeping suggestions needed please [Re: cotybear]
      #135251 - 02/08/04 12:27 AM


You could try a easily available med. Trazodone(desyrel) or
I take Remerom SolTabs they dissolve on your toughe.


Jony Suede



--------------------
I have mixed feelings about Ambivalence


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neofate
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Reged: 10/30/02
Posts: 158
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Re: need help sleeping suggestions needed please [Re: cotybear]
      #135256 - 02/08/04 01:02 AM

Sleep, often taken advantage of and, to some of us, ever elusive.

First off, to really get a handle on what advice to give I would need a little more information on your daily life. Anyhow, I will try to fill you in on what I can.

I'll start with the basics:

Sleep hygeine:

Your body operates on a circadium rhythm, or cycle. If this rhythm is disturbed, then so will your sleep. To further clarify; Your brain, operating within this rhythm, releases melatonin, among other chemicals, to signal "sleepy time". With this release comes the onset of "tiredness/sleepiness", and with it you lay down and gently fall into the first of your sleep phases.

However, the KEY to this cycle is your wake time. You MUST keep a consistent awakening time EVERY day. I cannot stress this enough. This applies double if you are having sleep issues, obviously. The circadium rhythm is set and balanced in large part by how regular and what time you arise.

For example, if you just fall asleep when "you can" then this cycle is perpetually interrupted leading you into a false sense of unfounded insomnia. If one were to fall asleep at 10pm and arise at 6am, then the next night fall asleep at 12am and arise at 8am, then 2am and 10am , and on and on .. the cycle would be further interupted and virtually resetting itself 2 hours ahead.

The same goes for if you were to fall alseep at 4am, and arise at 2pm, then fall asleep at 2am, and arise at 8am. It interupts this sleep cycle.

Your body will physically urge you to go to sleep, with obvoius signs, and, believe it or not, it will attempt to awaken you at the hour in which this cycle is set.

Now, as I said before, the key is to keep a consistent WAKE time. This is like setting your internal alarm clock, not only to awake, but to signal your brain to release the appropriate chemicals to allow you to fall asleep.

So, regardless of how much sleep you actually do get, if ANY, set a time to get out of bed. Ideally in the morning. Stick to this time, do not "sleep in" even one day, as this will interupt the cycle and lead to more insomnia.

The actually setting of this cycle isn't a one day thing, it can take a week or more for your body to balance itself again. This may apply to you, or you may be arising at the same time everyday, in which case there are other alternatives.

Another thing to keep in mind, is to stay out of the bed at all times, except for when you intend to go to sleep, and of course other adult matters

Excersize can be of great benefit to insomniacs, only if done at the right time. If you excersize late in the afternoon it CAN cause you to have insomnia that evening. However, a good brisk walk/jog in the morning should help out that evening. Another factor that applies to the outdoors is the SUN! Your body further adjusts itself based upon the amount of sunlight the retina's take in. So, taking that extra effort to get a good 30minutes of "outdoor" exposure will go a long way.

-The even make special lights that immitate the suns wavelengths for people with sleep disorders-

Again, I do not know your situation in any intimate detail, but alot of the time your lack of sleep perpetuates itself.

In other words, you thinking about not being able to fall asleep only places the sleep you desire that much further from happening.

I know it is pretty much impossible to stop yourself from being anxious about not getting enough sleep for "x" event tommorow, and this is normal on occasion, however when it becomes an everyday thought process feeding on itself it requires some intervention.

This intervention can and should include the sleep hygiene I have discusssed.

Now, onto medication:

This is what everyone wants, the one "magic" pill to put them into blissful sleep without a hitch.

I'm sorry to say, this pill doesn't exist =(

If and when it does, as our knowledge of brain chemistry furthers, the person/company that comes up with it is going to be filthy rich.

Anyhow, until that day , a careful examination of what is available is necessary.

Basically all your over the counter sleep remedies are going to use the ingredient

Diphenhydramine - Aka - Benadryl.

This will cause you to become drowsy, and is very helpful to use on "occasion" but definitely not to use regularly.

As you have discovered, none of these OTC sleeping pills work with any consistency. Including Ambien, this medication has worked miracles for many, but once again people DO develope a tolerance to it's effects that cannot be beaten by constantly upgrading the dosage.

The fact of the matter is, the sleeping pills are not meant for chronic insomnia.

The medication I have seen work the best for the "long-term" is Clonazepam - aKa Klonopin. This is a long-acting Benzo, Same catagory as "Xanax, Valium, etc.." This drug has a very long half-life, meaning it will stay in your system for quite a long time. I would recommend seeing your local PCP and requesting a trial of Klonopin to see just how it works. You may find that you drift off to sleep the very first time you take it.

The only hitch to this is the fact that it is a scheduled medication, like most that are really effective, and could be hard to be prescribed. Also, that it is potentially addicting. However, in the scenario of a multi-year case of chronic insomnia I don't see how being "dependent" on a controlled dose of Klonopin is going to be worse than the insomnia itself. People simply cannot function without sleep, and this needs to be addressed.

Personally, I would have you see a Sleep-specialist. Someone who knows exactly what you are going through, and has seen it a million times. He/she will know what medication will be most effective, and how to keep your sleep managed for the long-term. Refer back to the sleep hygiene.

Coty, I could write a book on the subject, but I really can't throw every possibilty out there in hopes you will grab what is needed out of it to find your answer. I do hope this helps, and if you need any further clarification, or information don't hesitate to ask

Take care,


--------------------
-/\/eofate
"Life is 10% what happens to you, and 90% of how you react to it."


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surfer1
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Reged: 06/22/02
Posts: 99
Re: need help sleeping suggestions needed please [Re: neofate]
      #135257 - 02/08/04 01:12 AM

one word to describe your post
awesome


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2muchpain
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Re: need help sleeping suggestions needed please [Re: neofate]
      #135265 - 02/08/04 02:27 AM

Terrific post, neofate.

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zazen
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Loc: SF Bay Area
Re: need help sleeping suggestions needed please [Re: cotybear]
      #135268 - 02/08/04 03:03 AM

I had problems falling and staying asleep years ago.

A doctor gave me 1mg x 20 sample of Xanax and that ended my problems. In 5 years i've gone from 1mg to 2mg nightly and still don't need higher doses.

Like yourself i've tried everything - ambien, otc stuff, herbs, melatonin, etc. None of them worked. It's the anxiety that's keeping you awake.

Why not check out Norcoworldwide.com and get a consultation then perscription for 60 x 1mg Xanax (also called alprozolam). From my experience the generics work as well as the originals.

Good luck.


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Lisa1967
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Reged: 10/29/02
Posts: 123
Re: need help sleeping suggestions needed please [Re: zazen]
      #135276 - 02/08/04 05:28 AM

I think most,if not all of us here can relate to sleeping problems,whether they originate from stress,pain,or anxiety.I am suffering from all 3 I used to take 1 10mg of valium b4 bedtime,and it worked like a charm.I took it for years,and never ever had to increase my dosage. If you read mine& ReelXforU's post on Xanax w/d's,you will see that I STRONGLY urge you NOT to try Xanax,but maybe a less "potent" benzo.
I had to stop taking the valium due to my husbands addiction.I stopped cold turkey,and had VERY little effects. The worst was the rebound insomnia,which went away after about 2 weeks. I still have insomnia,and nothing will ever come close to a valium for sleep to me,but I currently take 50mg of elavil(25mgs just doesnt cut it) I have tried ambien,and it just gave me horrid nitemares. Benedryl works occasionally-IF I take 50mgs. I mostly suffer from chronic pain,and if I can fall asleep,and stay asleep thru the pain,I am a happy camper
Good luck-I hope you find just the right thing to help YOU sleep!
Lisa


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Whatsnew
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Reged: 09/27/03
Posts: 205
Loc: S.E. USA
Re: need help sleeping suggestions needed please [Re: Lisa1967]
      #135316 - 02/08/04 11:04 AM

Cut out all caffiene. You will probably have to taper, but it WILL work wonders. Another thing: read in bed,(nothing exciting). For reasons I won't get into the Bible seems to work very well. Wish you well.
D

--------------------
DBs member since Feb. '03


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misspiggy
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Reged: 02/02/04
Posts: 80
Loc: North Idaho
Re: need help sleeping suggestions needed please [Re: Whatsnew]
      #135319 - 02/08/04 11:20 AM

I have horrible insomnia as well, I think it is due to stress and perhaps slight ADHD but I have been taking sonata which helps slightly. I don't wwant to get all "herbal" on you but I also take 3 mg of sublingual melatonin, 3 1000 mg of valerian root at the same time as the sonata (about 1 and a half hours before bed time) Also I HAVE to read before bed or I will NEVER fall asleep. These things help me quite a bit and are fairly cheap and not too bad on your health. Also I usually wake up at least once in the middle of the night and I take 3 more melatonins and I fall back asleep within 20-30 minutes.I hope this helps!!
Tawnya


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dsmmcm
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Reged: 11/08/03
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Re: need help sleeping suggestions needed please [Re: misspiggy]
      #135328 - 02/08/04 11:46 AM

Sonata has a half life of about three hours. If you take it 1.5 hours before bedtime, you are wasting it. Sonata should always be taken at bedtime. Taking it so early could additionally be dangerous for many people. Sonata hits many people "hard"-- drowsiness, dizziness, etc., you can find yourself walking into walls....
D


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misspiggy
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Reged: 02/02/04
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Re: need help sleeping suggestions needed please [Re: dsmmcm]
      #135336 - 02/08/04 12:07 PM

I actually do go to bed after I take the sonata, I just read until I get drowsy, it takes about an hour and a half. Believe me, i would love to fall asleep before then, I am not trying to waste it. anyways I was just trying to help based on my own experiences. The sonata is given to me by a friend, if I had insurance I would go to the doctor and get something stronger.

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dsmmcm
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Re: need help sleeping suggestions needed please [Re: misspiggy]
      #135343 - 02/08/04 12:32 PM

I would still strongly recommend that you take your sonata one hour after you go to bed and read another 1/2 hour. In that 1/2 hour the sonata should have peaked in your blood stream and you should be good to go.
D

Edited by dsmmcm (02/08/04 12:44 PM)


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misspiggy
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Reged: 02/02/04
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Re: need help sleeping suggestions needed please [Re: dsmmcm]
      #135347 - 02/08/04 12:47 PM

Point taken, Thanks

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bhamdave
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Re: need help sleeping suggestions needed please [Re: cotybear]
      #135368 - 02/08/04 02:16 PM

Just a few suggestions: (Sorry this is so long)

Set a rigid sleep schedule seven days a week . "Sleep is an unavoidable interval in the 24-hour day," says Merrill M. Mitler, Ph.D., director of research for the Division of Chest, Critical Care and Sleep Medicine at the Scripps Clinic and Research Foundation in La Jolla, California. "We insist on people trying to be as regular with their habits as possible."

The key is to get enough sleep so you can make it through your day without drowsiness. To help achieve that goal, try to get to bed at the same time each night so you can set your system's circadian rhythm, the so-called body clock that regulates most internal functions. Just as important is arising at the same time each morning.

Set a sleeping time of, say, 1:00 to 6:00 a.m. If you're sleeping soundly through that 5-hour period, add 15 minutes each week until you get aroused in the middle of the night. Work on getting through that arousal before adding another 15 minutes. You'll know when you reach the point where you've had enough sleep—you'll wake up refreshed, energetic, and ready to take on the day.

If you wake up during the night and can't get back to sleep in 15 minutes, don't fight it, says Dr. Mitler. Stay in bed and listen to the radio until you're drowsy again.

Again, be sure to wake up at the appointed hour in the morning; don't sleep in trying to pick up on "lost" sleep. That goes for the weekends as well. Don't sleep late on Saturday and Sunday mornings. If you do, you may have trouble falling asleep Sunday night, which can leave you feeling washed out on Monday morning.


Don't waste your time in bed . As you grow older, your body needs less sleep. Most newborn babies sleep up to 18 hours a day. By the time they're 10 years old, that usually drops to 9 or 10 hours.

Experts agree that there is no "normal" amount of sleep for an adult. The average is from 7 to 8 hours, but some people operate well on as few as 5 hours, others need up to 10 hours. The key is to become what experts call an efficient sleeper.

Go to bed only when you're sleepy, advises Edward Stepanski, Ph.D., director of the Insomnia Clinic at the Henry Ford Hospital's Sleep Disorders and Research Center in Detroit, Michigan. If you can't fall asleep in 15 minutes or so, get up and do something pleasantly monotonous. Read a magazine article, not a book that may engross you. Knit, watch television, or balance the checkbook. Don't play computer games that can excite you or perform goal-oriented tasks such as the laundry or housework.

When you feel drowsy, go back to bed. If you can't fall asleep, repeat the procedure until you can. But remember: Always wake up at the same time in the morning.

Set aside some "quiet time" before bed . "Some people are so busy that when they lie down to go to sleep, it's the first time all day that they've had the chance to think about what happened that day," says psychiatrist David Neubauer, M.D., of the Johns Hopkins University Sleep Disorders Center at the Francis Scott Key Medical Center in Baltimore, Maryland.

An hour or two before going to bed, sit down for at least 10 minutes or so. Reflect on the day's activities and try to put them into some perspective. Review your stresses and strains, as well as your problems. Try to work out solutions. Plan tomorrow's activities.

This exercise will help clear your mind of the annoyances and problems that might keep you awake once you pull up the covers. With all that out of the way, you'll be able to program your mind with pleasant thoughts and images as you try to drift off to sleep. If, for some reason, cold reality begins to seep into your conscience, shut it out by saying, "Oh, I've already dealt with that and I know what I'm going to do about it."

Don't turn your bed into an office or a den . "If you want to go to bed, you should be prepared to sleep," says Magdi Soliman, Ph.D., a professor of neuropharmacology at Florida A&M University College of Pharmacy. "If there's something else to do, you won't be able to concentrate on sleep."

Don't watch TV, talk on the phone, argue with your spouse, read, eat, or perform mundane tasks in bed. Use your bedroom only for sleep and sex.

Avoid stimulants after twilight . Coffee, colas, and even chocolate contain caffeine, the powerful stimulant that can keep you up, so try not to consume them past 4:00 p.m., says Dr. Mitler. Don't smoke either; nicotine is a stimulant, too.


Say no to the nightcap . Avoid alcohol at dinner and throughout the rest of the evening, suggests Dr. Stevenson. And don't fix a so-called nightcap to relax you before bed. Alcohol does depress the central nervous system, but it also will disrupt your sleep. In a few hours, usually during the middle of the night, its effects will wear off, your body will slide into withdrawal, and you'll wake up.

Question your medication . Certain medications, such as asthma sprays can disrupt sleep. If you take prescription medication routinely, ask your doctor about the side effects. If he suspects the drug could be interfering with your sleep, he may be able to substitute another medication or adjust the time of day you take it.

Examine your work schedule . Research has shown that people who work on "swing" shifts—irregular schedules that frequently alternate from day to night—have problems sleeping, says Mortimer Mamelak, M.D., director of the sleep laboratory at Sunnybrook Hospital, University of Toronto Clinic. The stress of an up-and-down schedule may create jet lag-like tiredness all the time, and sleep mechanisms can break down altogether. The solution: Try to get a steady shift, even if it's at night.

Eat a light snack before bedtime . Bread and fruit will do nicely an hour or two before you hit the hay, says Sonia Ancoli-Israel, Ph.D., a psychologist and associate adjunct professor of psychiatry at the University of California, San Diego, School of Medicine. So will a glass of warm milk. Avoid sugary snacks that can excite your system or heavy meals that can stress your body.

A caution: If you're older, don't drink a lot of fluids before bed; you might wake up later in the night when bathroom duty calls.

Create a comfortable sleep setting . "Insomnia can often be caused by stress," says Dr. Stevenson. "You get into bed and you're nervous and anxious and the nervous system is aroused and that impairs your ability to sleep. Soon, the bedroom becomes associated with sleeplessness, and that triggers a phobic response."

You can help change that by making the bedroom as comfortable a setting as possible. Redecorate with your favorite colors. Soundproof the room and hang dark curtains to keep out the light.

Buy a comfortable bed. It doesn't matter whether it's a coiled-spring mattress, a waterbed, a vibrating bed, or a mat on the floor. If it feels good, use it. Wear loose-fitting sleeping clothes. Make sure the bedroom's temperature is just right—not too hot, not too cold. Be sure there's no clock within view that can distract you throughout the night.

Turn off your mind . Keep yourself from rehashing a stressful day of worries by focusing your thoughts on something peaceful and nonthreatening, says Dr. Stevenson. Play some soft, soothing music as you drift off, or some environmental noise, such as the sound of a waterfall, waves crashing on a beach, or the sound of rain in a jungle. The only rule: Be sure that it's not intrusive and distracting.

Use mechanical aids . Earplugs can help block out unwanted noise, especially if you live on a busy street or near an airport, says Dr. Ancoli-Israel. Eyeshades will screen out unwanted light. An electric blanket can help warm you, especially if you're a person who always seems to be on the brink of a chill.

Learn and practice relaxation techniques . The harder you try to sleep, the greater the chances are that you'll end up gnashing your teeth all night rather than stacking some zs. That's why it is important to relax once you're in bed.

"The one problem with insomnia is that people often concentrate too much on their sleep, and they press too hard," Dr. Stevenson says. "The key to successfully falling asleep is to reduce your focus and avoid working yourself into a frenzy."

Biofeedback exercises, deep breathing, muscle stretches, or yoga may help. Special audiotapes can teach you how to progressively relax your muscles.

It may not come easy at first, but as Dr. Neubauer says, "It's like dieting; you must work on it all the time. It will take time to get results, but if you stick with it, it will pay off."

Here are two techniques doctors have found particularly successful.

Slow down your breathing and imagine the air moving slowly in and out of your body while you breathe from your diaphragm. Practice this during the day so it's easy to do before you go to bed.
Program yourself to turn off unpleasant thoughts as they creep into your mind. To do that, think about enjoyable experiences that you've had. Reminisce about good times, fantasize, or play some mental games. Try counting sheep or counting backward from 1,000 by 7s.


Take a hike . Get some exercise late in the afternoon or early in the evening, suggest Dr. Neubauer and Dr. Soliman. It shouldn't be too strenuous—a walk around the block will do just fine. Not only will it fatigue your muscles, but it will raise your body temperature. When that begins to fall, it may help induce sleepiness. Exercise also may help trigger the deep, nourishing sleep that the body craves the most for replenishment.

Try sex before bedtime . For many, it's a pleasurable and mentally and physically relaxing way to let loose before settling down to sleep. Indeed some researchers have found that hormonal mechanisms triggered during sexual activity help enhance sleep.

But again, it depends on the person, according to James K. Walsh, Ph.D., a clinical polysomnographer who runs the Sleep Disorders Center at Deaconess Hospital in St. Louis, Missouri.

"If sex causes anxiety and creates problems, it's not such a good idea," he says. "But if you find it enjoyable, it can do a lot for you."

Take a warm bath . One theory held by sleep experts has it that normal body temperatures play off the body's circadian rhythm. Those temperatures are low during sleep and at their highest point during the day.

Along those lines, it's thought that the body begins to get drowsy as its temperature drops. Therefore, a warm bath taken about 4 or 5 hours before bedtime will raise that temperature. Then, as it begins to fall, you'll feel more tired, which will make it easier to fall asleep.


This is taken from MotherNature.com

More info like this and others can be found here:
http://www.mothernature.com/Library/Bookshelf/Books/47/1.cfm










--------------------
AIDS
It's not YOUR problem (I hope that)
It's not MY problem (I know that)

But it is still OUR problem and WE know that!







Edited by bhamdave (02/08/04 02:21 PM)


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yawkaw3
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Re: need help sleeping suggestions needed please [Re: cotybear]
      #135373 - 02/08/04 02:28 PM

Hi coty,

Ever try Restoril? I didn't read all the replies to this thread, so I don't know if it's been mentioned. Very good benzo for sleep, available from OP's.

I think your situation is beyond just improvements in sleep hygiene- the first thing you need to do is see a doctor, and if neccessary, go to a sleep specialist for a polysomnography. You really need to rule out a biological cause for this or some other illness causing it- chronic insomnia is not as common as most people think, and there are a lot of reasons for it. If depression and anxiety are causing it, then that's what needs to be treated and the sleep will even itself out- though sleep meds in the meantime until the meds start working is not a bad idea.

Really, dependence on sleep meds is the last of your worries if you are a true chronic insomniac. Doctors are hesitant to give out sleep meds to just anyone, they're taught to watch out for people who actively solicit sleep meds. But you need to sleep- talk to a doctor and stress how you are wondering if there isn't some other cause for your insomnia that should be looked into. If he doesn't give you what you want, ask for a referral to a sleep specialist. You will probably encounter Restoril somewhere along the way, it's a great drug.

-yawkaw


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joesentme
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Re: need help sleeping suggestions needed please [Re: cotybear]
      #135375 - 02/08/04 02:36 PM

I have to agree with brit. Valerian works very well, and does not give you the 'hangover" like Xanax and Valium do. There is also a mexican herb, called Tila, that works very well. I don't know if you can buy it in the U.S. though, I buy it in Mexico.

J


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Curtisd3
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Re: need help sleeping suggestions needed please [Re: cotybear]
      #135389 - 02/08/04 03:58 PM

There is also an herb called Skullcap (very legal and available in any herb store) which is made into a not-so-good tasting tea, but it's very relaxing. I also take Xanax (1/2mg twice during daylight and 1mg before going to bed). I sleep nicely nightly. A lot of people worry about addiction, but I'm a recovering alcoholic sober 7 years and I had to ask myself whether the hell I was living in sober was worth the risk of Xanax. It was. I've taken it for two years with the same dosage for a year. It's a question you'll have to ask yourself. Personally, I think I'll be on medication for the rest of my life, which is fine. I got into a lot of trouble with alcohol and none with prescribed medication--both perfectly legal--it's all in how they're used.
I hope you find your answers!
Curt


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misspiggy
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Re: need help sleeping suggestions needed please [Re: Curtisd3]
      #135426 - 02/08/04 07:23 PM

I like to drink chamomile tea at night as well, very relaxing.

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cotybear
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Re: need help sleeping suggestions needed please [Re: cotybear]
      #135468 - 02/08/04 10:37 PM

I appreciate all the posts and suggestions and look forward to trying some of them however here i am again tonight 3 walmart sleeping pills in and no sleep in sight. I think a sleep clinic would be a good ideal considering how long this has gone on but pretty sure in a small rural area that i'm in doesn't have one near by i haven't heard of one anyway. I know the setting my internal clock to wake up everyday at the same time won't work because back years ago when the insomnia first started i was working a 1st shift and had to get up every morning that i worked at 5a and wasn't getting to sleep until 2-3a and that is when the insomnia hit me i got to where i couldn't sleep past 5a every morning even on mornings i didn't have to work and i wanted to sleep in so bad but there i was every morning still dark outside and nothing on tv. That is when i first started to notice the insomnia admittedly i was working a very high stress job in a hard core collection agency which must have been what trickered it but since then i have left that job went to one less stressful and for years thought ok i'm just one of those people that can function on 2-4 hours sleep a night but in the last 6 months i have started going days on that 2-4 hours and now it is bothering me. the funny think is that the way i get those 2-4 hours sleep during those severe episode is i sleep in intervals like 15-30 mintes at a time then up 30mintes to an hour then sleep again 15-20 mintes it's weird and when i'm in those episode the sleep i am getting isn't restful at all. Anyone else that has sleeping problems have those nights? I am going to try some of your suggestions and again thanks for the help.

Thanks

Cotybear


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