Insomnia...I need help!

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No Worries!
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Date Joined Sep 2011
Total Posts : 225
   Posted 11/24/2011 3:55 AM (GMT -6)   
Hello everyone,

I can't sleep! I struggle to keep my eyes open all day and I feel sleepy, but as soon as I try to lay down and go to sleep I can't. I even have a prescription for Ambien 12.5 mg and except for once or twice during the week, it doesn't work!

Whenever I do finally manage to pass out, I don't seem to get enough sleep. I wake up in pain and feeling exhausted and I can't function. My wife gets very angry when she is giving my my marching orders in the mornings and I can't keep my eyes open. What can I do to finally get some sleep?

Thanks,

Charles

Retired Mom
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   Posted 11/24/2011 4:51 AM (GMT -6)   
Hi Charles. I'm right there with you on this one. I even take the ambien (20 mg) per night. I realize that is double the normal dose, but even that doesn't do it most nights. I can "pass out" most of the time and then I'm either up (like today from 1 AM) or I'm dreaming HORRIBLE dreams. Either way, it doesn't make for a very good rest.

I'm also with you on the sleepy in the chair thing during the day. I use my heated throw on my back and start to type on the laptop and almost immediately fall asleep. I've even dropped the thing off of my lap a few times. Now my DH tries to keep an eye out and takes it away from me as I start to drift.

I wish I had an answer for you, but I'm obviously up too.

One thing that you mentioned was pain when you wake....I do the same thing, but find that getting up at 2:30 or so on a good day and taking two Ultracet and they trying to rest again helps with the morning pain. Then I get up and start the bigger meds by say 5:30 AM. Of course, I started early today because resting is impossible.

I hope you find the answer.

Perhaps your wife should take a glance at the board when she feels like some extra reading. It may give her a different perspective on the anger if she sees how much you want to rest and be able to contribute the next day.

Happy Thanksgiving!
TLIF L5-S1/failed, Pituatary disorder w/HGH deficiency, Fibro, Failed Bladder Surgery & Nissen, GERD, OCPD, GAD, MDD, CFS, TMJ, Migraines, Pre-glaucomic, HBP, Idiopatic Reactive Hypoglycemia w/Diabetic reaction to HGH, Bi-lateral CTS (surgery related trigger finger), Edema, Tarsal Tunnel Syndrome, Peripheral Neuropathy, Plantar Fascitis, Tibular Tendionitis, Adult Onset Flat Feet & much more.....

Jim1969
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Date Joined Jul 2009
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   Posted 11/24/2011 5:08 AM (GMT -6)   
A few different suggestions.

You should have a good idea how long your pain meds last during the day. Set your alarm for about 30 minutes before they wear off and take them. Keep the meds and a glass of water by the side of your bed so you don't have to get up and hopefully can go right back to sleep.

Let you doctor know that the Ambien is not working well. There are other sleep medication that can be tried or a different dose or maybe even adding in a muscle relaxer (if you don't already take one) might help.

You can also try adding in Melatonin which is available OTC to your sleeping pill.

about 30-45 minutes before bed you can try taking a warm shower or learn some relaxation and/or meditation techniques to calm your mind and body as much as possible.

Some herbal teas can be useful in helping relax. Just make sure they are caffeine free.

Before going to bed make sure the fitted sheet is pulled tight and wrinkle free. I know if I don't do this I will wake up in a lot more pain and a lot sooner than I want.

You can try experimenting with pillows. For example I have found a firm pillow under my knees if I am sleeping on my back or a "body" pillow for me to half lay on and elevate my top leg just a bit when I am on my side reduces pain.

If your sleeping pill seems to take a long time to kick in and/or seems to be working too long into the next day try taking it a little earlier.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.

Retired Mom
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Date Joined Feb 2010
Total Posts : 1753
   Posted 11/24/2011 5:18 AM (GMT -6)   
Hi Jim,

Not to hyjack a post, but I was reading your imput and noticed that you mentioned the sheets and the pillows. I have to say that they make a great deal of difference in my waking pain level. I also have to be careful what bed clothes I wear to sleep in because binding causes horrible pain too.

Those were good points!
TLIF L5-S1/failed, Pituatary disorder w/HGH deficiency, Fibro, Failed Bladder Surgery & Nissen, GERD, OCPD, GAD, MDD, CFS, TMJ, Migraines, Pre-glaucomic, HBP, Idiopatic Reactive Hypoglycemia w/Diabetic reaction to HGH, Bi-lateral CTS (surgery related trigger finger), Edema, Tarsal Tunnel Syndrome, Peripheral Neuropathy, Plantar Fascitis, Tibular Tendionitis, Adult Onset Flat Feet & much more.....

spinal soldier
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Date Joined Dec 2009
Total Posts : 687
   Posted 11/24/2011 11:09 AM (GMT -6)   
Ambien can cause rebound insomnia after a short time sometimes. Amitriptyline, Nortriptyline, Trazadone, or something like Zanaflex or Clonidine added in might help. then you have some benzodiazepines like Dalmane, Halcion, Restoril, Pro-Som, that are FDA approved for insomnia, Klonopin, or Ativan help some people.
L4,L5,S1 bilateral Laminectomies, Foraminotomies 2002
L4-S1 PLIF with instumentation 2008,

current Rx: MScontin 100mg q8hrs. , dilaudid 8mg q6hrs. prn, oxymorphone IR 10mg q6 ,vistaril 50mg prn nausea, Lyrica 150mg 2x,Adderall 20mgs 1x A.M. 10mg PM prn, Soma 350 mg 3X, Elavil 25 HS, diazepam 10mg bid prn, Supplements: CO-Q10 100mg, Vitamin D 1000IU, Fish-Oil1000mg EFA, B-Complex50 3x/day, ALA

misterkatamari
Regular Member


Date Joined Jan 2011
Total Posts : 374
   Posted 11/24/2011 11:39 AM (GMT -6)   
I have the exact same problem, Charles!

I am on Restoril, and it worked wonders for me at first but now I am back to being sleepy all day and wide awake and unable to sleep at night. My doctor increased the Restoril, but still no dice. Then he had me take 3mg of Melotonin at the same time, and so far it has actually really helped! I take my Restoril and Melotonin an hour or two before going to bed, and I can actually sleep better now. I still wake up at times, but its likely due to my physical issues not my sleeping disorder.

cogito
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Date Joined Oct 2010
Total Posts : 932
   Posted 11/24/2011 12:04 PM (GMT -6)   
Hi Charles,

I've tried nearly every sleep aid on the market: ambien, sonata, rozerem, lunestra, restoril, etc., etc..

One thing to consider is the half-life of each. Ambien and sonata have only about 2hr half lives. My experience, like yours, is that I would wake up in a few hours. Because of that, the company started selling a time release version (Ambien CR). It released a second dose after a few hours to help you make it through the night. If ambien gets you to sleep, consider the CR.

I've now, after about eight different meds, have settled on xanax. It isn't ideal as valium would be better for muscle relaxation, for instance. But I can't be tired when I first wake up and so need something with a short half-life, but long enough to keep me asleep for 6-8hrs. Personally, I've found xanax (or ativan) the best options.

Tolerance, however, develops to all of these, and benzodiazepine dependence can be a significant problem. I take just .25mg of xanax, and have been doing so (or a similar doze of other benzos) for nearly 7 years. I might use something three nights in a row if needed, but then am fine to stop and not use anything for three nights... or whatever my pain (and stress) demand.

For me at least, at very low doses, I don't get dependent.

One thing to worry about with some of the non-benzo sleep aids (including ambien) is memory loss. A number of them interfere with memory development (as do some benzos like versed for instance) and I found when I took ambien, I would have an hour or so before bed that I could not recall the next day. My wife had the same experience.

Jim and Retired Mom also made some comments about your sleep environment. Let me encourage you in this direction as well. Try to read or just veg out an hour before going to bed -- no stimuli. Then make your sleeping environment as comfortable as possible. I've gone through nearly every type of pillow on the market. If you don't have one that is comfortable, let me suggest a medium density latex pillow. I prefer them to even down. Also, nice (and freshly laundered) sheets makes going to bed a pleasure. Quality 500+ thread count sheets are about $50 during a good sale, but since 1/3 of your life will be in bed, I think it is work finding the best sheets, pillow, etc. for a good night's sleep. Beware that some claim to have high thread counts but are crap (my default brand is Wamsutta, and buy the sateen (extra smooth) 100% cotton).

A proper mattress is also important, especially for CP sufferers. I also have a white noise generator and black-out curtains.

So, in addition to a med change, look around at your bedroom and ask yourself what can be done to optimize it for a comfortable night of sleep.

misterkatamari
Regular Member


Date Joined Jan 2011
Total Posts : 374
   Posted 11/24/2011 12:49 PM (GMT -6)   
cogito said...
Tolerance, however, develops to all of these, and benzodiazepine dependence can be a significant problem. I take just .25mg of xanax, and have been doing so (or a similar doze of other benzos) for nearly 7 years. I might use something three nights in a row if needed, but then am fine to stop and not use anything for three nights... or whatever my pain (and stress) demand.

For me at least, at very low doses, I don't get dependent.




I don't mean to off topic here, but can benzodiazepine tolerance/dependence work together when you take more than one benzos? As in, do the drugs have a combined effect, like to quicken the dependence or tolerance? I take Xanax and Restoril, so just wondering.

Post Edited (misterkatamari) : 11/24/2011 11:08:09 AM (GMT-7)


No Worries!
Regular Member


Date Joined Sep 2011
Total Posts : 225
   Posted 11/24/2011 5:01 PM (GMT -6)   
I want to first wish everyone a Happy and pain free Thanksgiving! Also, thanks to all who have posted their ideas and suggestions to help me deal with this issue. I thought 12.5 was the strongest dosage of Ambien available? I don't take any pain meds during the night once I've passed out, except when (not if) I wake up In pain before I plan on waking up. I will ask my PM doctor for something else to help me sleep. I do have a horrible memory loss since taking ambien and Roxicodone, so I definitely want to stop taking Ambien. I recently stopped taking the Roxicodone and besides next Monday I'm having a Drug Pump implant. I'll keep everyone informed about the Drug Pump on that post and my insomnia issue here.

Take care!
Say what you mean and do what you say. Integrity and Pride are never taken away... They are given away. Stay true to yourself and embrace Karma!

cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 932
   Posted 11/24/2011 5:05 PM (GMT -6)   
I am guessing that each benzo adds to tolerance. But they are typically classed into hypnotics, anxiolytics, and anti-convulsant (plus some as muscle relaxants too). These correspond with different sub-group receptors. Most if not all benzos effect all the sub-groups, but each benzo will target them in different degrees. So, Xanax will increase tolerance for all, but for anxiolytic the most.
Likewise, Restoril for all, but hypnotic the most.

If you are wondering whether the tolerance is magnified (rather than just the sum of the two) by two benzos taken at once, I suspect not, but that is a guess.

Apparently, there is a drug that is supposed to be able to reverse tolerance: flumazenil
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .25-.5mg ativan as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

NiNi53
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Date Joined Mar 2011
Total Posts : 816
   Posted 11/24/2011 5:53 PM (GMT -6)   
Hi, and happy thanksgiving to all.
 
I am going to try every suggestion on here because in the last 3 months I have been having a awful time sleeping.  I have had insomnia a long time, but for a while it was under control, I was only not sleeping maybe once for twice a week.  For the last 3 months it has been brutal.  I have tried to think what I could be stressed about, because sometimes that had alot to do with it.
 
Now it seems I am stressed because I dont know why I am stressed.  Its making me crazy, if I dont get some sleep soon, I am afraid I will just drop.  So I am going to try all the things, like the sheets, reading, anything, I take valium already but it appears my tolerance is getting to high, they are just not working anymore, if I keep taking more and more I do not want to overdose accidently, but they are 5mg and I am taking 5 at a time.  I wont take anymore than that.  I actually stopped taking them at all as they werent working.  I did it slowly so I did not have withdrawal symtoms from benzos, othey are as bad a narcotic withdrawals.
 
So, again I am going to give anything I can a try, cause I cant do this much more.
 
Ok, thats enough for now, I know one thing, I am not alone.
 
Kathy
degenerative disc disease, fibromyalgia, osteoarthritis, neuropathy, lumbar laminectomy july 1998 no help, rechargeable neurostimulator unit low right back w/lead wires to left side and right leg unit not working just sitting there.i am 57 years young in may will turn 58. i have 2 grown daughters, 25 and 29. i have 2 grandchildren, 9 year old grandaughter and 5 yr. old grandson

cogito
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Date Joined Oct 2010
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   Posted 11/24/2011 6:04 PM (GMT -6)   
Kathy,

You might want to consider a different benzo for sleep, such as Restoril. Or just Ambien CR. As noted above, there's cross-tolerance. But since there are various types of benzo receptors, your tolerance for Valium does not fully cross over to the hypnotics.

Personally, I need to sleep well, both for general energy and for mental health. When I go without enough sleep for a few days, I end up getting very anxious and am easily frustrated. Regarding sheets, I should have added that there are some very crappy sheets out there claiming to be high quality. Most of what I've bought online is like that. So, I prefer going to bed, bath and beyond and checking them out before buying.

For white noise, I prefer a very basic small fan. I've tried a few white noise generators, but the fan suits me best.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .25-.5mg ativan as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

No Worries!
Regular Member


Date Joined Sep 2011
Total Posts : 225
   Posted 11/24/2011 10:39 PM (GMT -6)   
You guys sound like pharmacists! Hahahaha. I don't know what you are saying about the meds. I just know tha the ambien 12.5mg is not working for me any more! I don't set my clock to take pain meds around the clock...I take my last pan meds at 11:31 pm and nothing more, unless I wake up (if sleep or pass out) in the middle of the night with pan.

I had PT last night with Dry Needling and I have this ncredible pain in my upper left shoulder blade area that seems to also bent going through my chest on my left side. Besides the insomnia, this pain kept my company all last night and today. I still feel like someone stabbed me with a rusty, dull butter knife! I hit myself in the head with a pan once, but it didn't knock me out. I just had a bump and a headache to add to my back pain, hahahahaha! I'll try anything to get sleep! I'm sitting in bed beside my sleeping wife. It's amazing how fast she falls asleep and I can't even find a comfortable, pain free position to lay in so I can attempt to sleep. It's funny,mi watch my wife sleep mainly throughout the entire night and she still wakes up after 8 hours sleep and tells me I kept her awake or disturbed her sleep somehow, Hahahaha! I have to laugh or I'd go mad and cry. I hope my PM doctor can give me something non-addicting to help me sleep. Good night, good morning and good day to everyone!

sos007
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Date Joined Nov 2011
Total Posts : 615
   Posted 11/25/2011 6:15 PM (GMT -6)   
Dear What's....Oh there is nothing worse than watching someone sleep...and you can't. My husband also falls a sleep the minute his head hit the pillow. I understand your frustration and I hope your PM can give you something so you can get some sleep. keep us posted....here's hoping you have a good night sleep soon.



Take care, Amy



Chronic pain(nerve), fibro, and mild depression

spinal soldier
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Date Joined Dec 2009
Total Posts : 687
   Posted 11/25/2011 7:53 PM (GMT -6)   
Dalmane or flurazepam is a benzodiazepine that is approved as a hypnotic and has a half life into next week. low dose Seroquel seems to work on treatment resistant patients.

bayoub2
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Date Joined Sep 2006
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   Posted 11/26/2011 5:18 PM (GMT -6)   
I would like to add a sleep study could be in order. I thought my pain and fibro kept me from refreshes sleep, and they still do sometimes. But sleep study also showed 2 other problems, sleep apnea and PLMD. I try to use my cpap and klonopin for plmd and 2 or 3 nites a week, I get a good night's sleep, comparatively speaking. I do have to take a hydro at 5am many ams.

Good luck
Maggie
"We never realize how strong we are, until being strong is the only thing left"
Major Depressive Disorder, ptsd, fibromyalgia, chronic pain, l3/4, L4/5 gone, bursitis arthritis sciatica


welbutrin HBP meds seroquel hydrocodone magnesium potassium multi vit

spinal soldier
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Date Joined Dec 2009
Total Posts : 687
   Posted 11/26/2011 7:42 PM (GMT -6)   
bayoub2 brings up a good point, if you have treatment resistant insomnia you should have a sleep study. i was going to mention a pain mang. doctor told me when all else fails Chloryl Hydrate or Noctec works.

No Worries!
Regular Member


Date Joined Sep 2011
Total Posts : 225
   Posted 11/28/2011 1:22 AM (GMT -6)   
Hello! In about 7 hours I will have my Drug Pump Implant surgery. It's now 12:57am and I can't sleep as usual. I'm not nervous about the operation, I just can't sleep. I've tried almost every suggestion given above and its still difficult to sleep. I plan to ask my doctor for something other than Ambien to help me sleep.

RetiredMom, I don't want to give the impression that my wife doesn't love me, care for me or worry about me, because she does...in her own way. She would never read my posts or anything related to my operations,medical conditions or the CP I have. She completely broke down crying and was scared the last time I was in the hospital suffering from a spinal headache that left me violently throwing up and unable to eat or drink for three days. By the time I made it into the hospital for my 2nd blood patch I had lost 10 lbs, I was dehydrated and suffering from withdrawals, because I couldn't even hold water and my pain meds down. I know she cares and loves me, but she gets frustrated not being able to help me and having to watch me suffer everyday.

She also gets a little angry with me, because it seems to her that I am lazy and I don't contribute much to both the finances and taking care of the house. I used to be able to do everything, carry everything, fix everything, pay for just about everything. She works all day during the week days and comes home tired and cranky. I try to see things from her perspective and let her anger and false accusations roll off my shoulders. It's been extremely difficult for me having to come to the realization that I can no longer do the things I used to do. Lately I've had more downs than ups, but I often remind myself that my glass is always half full! Things will get better, cuz they couldn't possibly be much worse!

Happy Zzzzzzzz!

Charles

sos007
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Date Joined Nov 2011
Total Posts : 615
   Posted 11/28/2011 4:41 PM (GMT -6)   
Charles....good luck today, I hope all goes well. Hopefully the doctor can give you something to help you sleep, life looks diffrently without sleep, I think once you get sleep you will feel better.

I also remember what I used to be like and have struggles with accepting I can never be that person again, it's tough thats for sure. I trust God has his own plans for us and I come to terms to leave it up to him or her. This is very hard on our spouses and I am sure quite frustrating because they would love to help us. but there is not anything they can do but love us. I am sure this is not always an easy task.

Hope to hear from you as soon as you are up to it, in the meantime take care and I hope you get sleep soon.

Bless you, Amy
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