# Sleep



## CrankySpice (Mar 19, 2012)

Sleep is such an important part of our health. I have to confess that I used to take it for granted -- I always slept well. 

However, since January I've acquired a form of insomnia that keeps me from sleeping more than 4 hours at a time. No matter what I did (nap or not nap, stay up later, get some exercise, all the typical "improve your sleep" strategies) I still couldn't sleep more than 4 hours at a time. In bed at 10, up at 2. In bed at 12, up at 4. It is taking its toll both physically (I'm exhausted all the time and just recently starting feeling achy all the time, like I'm coming down with something) and mentally. 

My PCP and I discussed a sleep study when I had my yearly physical at the end of January (when it had been only a few weeks) but since we both felt it was anxiety related (I have several anxiety disorders) about an upcoming event, we decided to pass on the study. Particularly since I don't have any of the typical markers for apnea (aside from being fat) and I'd previously slept quite well.

However, now that it has been months and the anxiety-producing event has come and gone, I'm still having the same sleep problem. I just started taking Trazadone (sp?) 3 days ago. I'm still waking up after 4 hours, but now I'm able to at least doze in and out or fall back to sleep for an hour or two until a more decent hour. But the sleep after the 4th hour still isn't a restful sleep. I'm hoping that my body will adjust and it will just take some time for the med to work properly. Does anyone else have experience with this medication? Or other meds to help you STAY asleep? Most sleep meds are designed to help you fall asleep (Ambien, etc) and there seem to be very few to help you stay asleep.

I just want to sleep!!


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## Miss Vickie (Mar 19, 2012)

Crankyspice, I have the same problem. I can fall asleep pretty well, but staying asleep has been a problem for me. It started when I began working night shift, and then when I switched back to day shift (YEARS ago!) I still wake up after four hours.

Two things help me and I alternate between them. Ambien CR is an extended release version of Ambien that is absorbed slowly over time; I've found that it works pretty well. The other medication I use sometimes if anxiety is the issue is extended release alprazolam (Xanax). Depending on whether your provider feels comfortable prescribing it, it can also be helpful. The downside is obviously that Xanax is addictive. 

Helps this help??


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## BigBeautifulMe (Mar 19, 2012)

Do that sleep study!  Nothing will give you better answers than that.


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## CrankySpice (Mar 19, 2012)

Miss Vickie said:


> Crankyspice, I have the same problem. I can fall asleep pretty well, but staying asleep has been a problem for me. It started when I began working night shift, and then when I switched back to day shift (YEARS ago!) I still wake up after four hours.
> 
> Two things help me and I alternate between them. Ambien CR is an extended release version of Ambien that is absorbed slowly over time; I've found that it works pretty well. The other medication I use sometimes if anxiety is the issue is extended release alprazolam (Xanax). Depending on whether your provider feels comfortable prescribing it, it can also be helpful. The downside is obviously that Xanax is addictive.
> 
> Helps this help??



I'll ask my doc about both after I give the Trazadone a fair run. I've been on regular release Xanax for anxiety and used it to fall to sleep when I went through a brief period of having panic attacks shortly after going to bed. I've had Xanax prescribed on an "as needed" basis for a few years now, and most of the time my scrip expires before I've even gotten through the first fill, which my doctor knows, so becoming addicted shouldn't be a problem. Thanks for the suggestions!


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## CrankySpice (Mar 19, 2012)

BigBeautifulMe said:


> Do that sleep study!  Nothing will give you better answers than that.



I'm considering it -- we'll see after I've given this med a chance. I really REALLY hate the idea of sleeping anywhere but in my own bed since I'm an extremely conditioned sleeper (have to have sheets/blankets/pillows JUST SO or I can't sleep). I'm also a nighttime tosser/turner like you wouldn't believe (I've actually fallen out of bed in my sleep a couple of times) so I worry I'll pull off all the wires and such. And lastly -- it's such a teeny bed! ha! Why can't they do sleep studies in queen sized beds??


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## BigBeautifulMe (Mar 19, 2012)

Believe me, I understand!  Been there, done that. I'm also a "princess and the pea" sleeper - everything has to be perfect. lol. I also used to have the same problem... falling asleep and staying asleep. Hope this med works wonders for you! It's really hard to never ever feel rested.


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## CastingPearls (Mar 20, 2012)

Regarding your med question, I did a sleep study (because sleep apnea appears to be a family trait) but I don't have it. I *do* have lifelong insomnia and an anxiety issue called 'racing thoughts' and am agoraphobic when very stressed out. I take Ambien CR 12.5 to sleep, and 1 mg of Xanax for the racing thoughts (and occasional agoraphobia) and to 'stay asleep' and am still able to wake up if I have to (say an emergency) and not feel groggy, nor do I have any of the strange 'sleep-shopping, driving, eating' side-effects others have reported. I also don't feel tired in the morning which people report with OTC sleeping aids.


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## CrankySpice (Mar 20, 2012)

CastingPearls said:


> Regarding your med question, I did a sleep study (because sleep apnea appears to be a family trait) but I don't have it. I *do* have lifelong insomnia and an anxiety issue called 'racing thoughts' and am agoraphobic when very stressed out. I take Ambien CR 12.5 to sleep, and 1 mg of Xanax for the racing thoughts (and occasional agoraphobia) and to 'stay asleep' and am still able to wake up if I have to (say an emergency) and not feel groggy, nor do I have any of the strange 'sleep-shopping, driving, eating' side-effects others have reported. I also don't feel tired in the morning which people report with OTC sleeping aids.



Hmm, another vote for Ambien CR. I will definitely have to talk to my doc about that one if this med doesn't work out. It's still just making me "dozey" after 4 hours of sleep -- so not a restful sleep. I'm going to try like the devil not to take a nap today to see if that helps tonight.


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## Dr. Feelgood (Mar 20, 2012)

I deeply sympathize with everyone who suffers from insomnia. I have noticed that I need less sleep as I grow older; I generally wake around two or three, and after a wakeful hour or two, I go to sleep again. This works fine for me, but many people are not so lucky. I suspect one of the villains is the modern work schedule, whereby everyone is expected to sleep for eight hours straight so they can work for eight hours straight. In the Middle Ages, when folks rose and went to bed with the sun, it was common for _everybody_ to get up in the middle of the night, putter around, have a meal, and go back to bed. Sometimes they would even drop in on the neighbors and have a party before returning to their slumbers. And everyone who's been refreshed by a nap knows that sleep is just as efficient in bits and pieces as in big chunks. If you find yourself waking up at night, and you can adjust your schedule to catch forty winks at odd times (what my medical friends call "sleeping like a doctor"), all may not be lost. Incidentally, a doctor once told me that two hours of rest is roughly equivalent to one hour of sleep. And if you're locked into a rigid schedule ... well, I guess there's always Ambien.


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## auntiemoo (Mar 20, 2012)

Hi Cranky - I don't know how old you are however I started with this when entering menopause. I wish I could sleep four hours at a time - I only average about 2-3 hours before waking up and like you, no matter how tired I am or how late I go to bed I will wake up in 2-3 hours. Fortunately I can usually go back to sleep but will repeat the pattern all night.


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## Surlysomething (Mar 20, 2012)

CrankySpice said:


> Hmm, another vote for Ambien CR. I will definitely have to talk to my doc about that one if this med doesn't work out. It's still just making me "dozey" after 4 hours of sleep -- so not a restful sleep. I'm going to try like the devil not to take a nap today to see if that helps tonight.


 

You might not be taking a high enough dosage of the Trazadone.


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## CrankySpice (Mar 20, 2012)

Dr. Feelgood said:


> I deeply sympathize with everyone who suffers from insomnia. I have noticed that I need less sleep as I grow older; I generally wake around two or three, and after a wakeful hour or two, I go to sleep again. This works fine for me, but many people are not so lucky. I suspect one of the villains is the modern work schedule, whereby everyone is expected to sleep for eight hours straight so they can work for eight hours straight. In the Middle Ages, when folks rose and went to bed with the sun, it was common for _everybody_ to get up in the middle of the night, putter around, have a meal, and go back to bed. Sometimes they would even drop in on the neighbors and have a party before returning to their slumbers. And everyone who's been refreshed by a nap knows that sleep is just as efficient in bits and pieces as in big chunks. If you find yourself waking up at night, and you can adjust your schedule to catch forty winks at odd times (what my medical friends call "sleeping like a doctor"), all may not be lost. Incidentally, a doctor once told me that two hours of rest is roughly equivalent to one hour of sleep. And if you're locked into a rigid schedule ... well, I guess there's always Ambien.



I'm an avid napper (always have been) but I find I feel most rested if I can get a straight 8 to 10 hours of sleep at night. I'm one of those people who needs 10 hours of sleep a night, been that way all my life. (If it's 8, I make it up with a 2 hour nap.)



auntiemoo said:


> Hi Cranky - I don't know how old you are however I started with this when entering menopause. I wish I could sleep four hours at a time - I only average about 2-3 hours before waking up and like you, no matter how tired I am or how late I go to bed I will wake up in 2-3 hours. Fortunately I can usually go back to sleep but will repeat the pattern all night.



I don't think I'm quite there yet unless it is early menopause. A possibility, but unlikely since it doesn't run in my family. I think it was originally anxiety related and then segued into habit and now it's how my body "thinks" I should be sleeping. I hoping the trazadone helps break that habit. With it, I can fall back to sleep, too. But without it, I'm wide awake after 4 hours.


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## BubbleButtBabe (Mar 21, 2012)

I use to take 50mg of Trazadone a night for over a year and it helped at first..I guess my body got use to it because now it doesn't work for me..Right now I take 2 Tylenol Pms at night to sleep and I get at least 6 hours of sleep with them..

auntiemoo is right if you have early onset menopause then it will cause you to have insomnia..I went from sleeping 7-8 hours a night to sleeping between 3-4 hours a night..None of my family had early menopause but I did..It wouldn't hurt to have a blood test and see how your hormone levels are..


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## CrankySpice (Mar 21, 2012)

BubbleButtBabe said:


> I use to take 50mg of Trazadone a night for over a year and it helped at first..I guess my body got use to it because now it doesn't work for me..Right now I take 2 Tylenol Pms at night to sleep and I get at least 6 hours of sleep with them..
> 
> auntiemoo is right if you have early onset menopause then it will cause you to have insomnia..I went from sleeping 7-8 hours a night to sleeping between 3-4 hours a night..None of my family had early menopause but I did..It wouldn't hurt to have a blood test and see how your hormone levels are..



That's the same dosage I'm on. I can't take OTC sleep meds because they have the opposite effect on me -- I get stimulated and can't fall to sleep. My doc said some people are just like that (lucky me). He also told me that OTC sleep meds are just benadryl repackaged, which I found interesting.

Looks like I'm going to need to visit the doc for another chat. I stayed up all day yesterday (lol...I know, I know, but I'm home all day so it is SO easy for me to give in and take a nap), went to bed late (waited until I was super tired) and still the same...four hours of solid sleep then a couple hours of "dozey" sleep. sigh. Plus now I'm having trouble falling to sleep, which I think is just anxiety related because I'm so worked up about actually sleeping. Vicious cycle.


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## toni (Mar 21, 2012)

I suffered from insomnia for over two years. I endured an extremely traumatic event. After the stress of that event subsided, the insomnia lingered. I went to a quite a few doctors and none of them prescribed sleep meds because they said "I looked too happy to be suffering" and they didn't want to risk an addiction. Then I started treating myself with Tylenol PM. After reading long term use caused liver problems, I stopped. That is when I found liquid melatonin. It has worked wonders for me. I take it and sleep 7-8 hours a night. It is a miracle. I am happy to say I have not experienced a sleepless night for months. 

I use this one: http://www.amazon.com/Sleep-Soundly-Melatonin-2-Ounce-Bottles/dp/B002VPEE7M/ref=sr_1_8?s=hpc&ie=UTF8&qid=1332363882&sr=1-8


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## CrankySpice (Mar 21, 2012)

Thanks for the tip, Toni! I'm sorry you suffered so long without relief.


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## Miss Vickie (Mar 22, 2012)

Melatonin can be really helpful for people who are sensitive to it and it can help you re-set your biological clock after traveling or working nights. When I tried it they didn't have the extended release, so I had the same problem I have with all sleep aids except the ER ones -- I wake up in the middle of the night. But if they have an extended release version now, that's great!

One thing you might talk to your provider about is a product called Rozerum. Rozerum is a melatonin agonist, so it helps your body use your own melatonin. It works well for our patients who can't tolerate the hypnotics like Ambien, or who can't do benzo's like Xanax. It works pretty well, without the side effects from Ambien and Lunesta.


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## MissAshley (Mar 22, 2012)

My problem is I can't get a constant sleeping pattern. I work shirt shift, but only every other day. On days I work, I sleep during the day. On my days off, I have to be awake during the day to get my errands done.


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## CrankySpice (Mar 22, 2012)

I think I need to declare the trazadone a failure. I went to bed at 1am last night and was wide awake at 3:30. I'm going to call my doc and see if we should up the dosage or move on to something different. Thanks for all the suggestions. 

Ashley, I feel for ya. It's tough not having a regular sleeping schedule.


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## MissAshley (Mar 22, 2012)

CrankySpice said:


> I think I need to declare the trazadone a failure. I went to bed at 1am last night and was wide awake at 3:30. I'm going to call my doc and see if we should up the dosage or move on to something different. Thanks for all the suggestions.
> 
> Ashley, I feel for ya. It's tough not having a regular sleeping schedule.



Thanks. I totally just realized I said "shirt shift"...meant third shift.


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## CastingPearls (Mar 22, 2012)

Miss Vickie said:


> Melatonin can be really helpful for people who are sensitive to it and it can help you re-set your biological clock after traveling or working nights. When I tried it they didn't have the extended release, so I had the same problem I have with all sleep aids except the ER ones -- I wake up in the middle of the night. But if they have an extended release version now, that's great!
> 
> One thing you might talk to your provider about is a product called Rozerum. Rozerum is a melatonin agonist, so it helps your body use your own melatonin. It works well for our patients who can't tolerate the hypnotics like Ambien, or who can't do benzo's like Xanax. It works pretty well, without the side effects from Ambien and Lunesta.


I wish melatonin worked for me. Valerian capsules did for a while although they stink like hell and god forbid you don't swallow them with enough water. I've tried the melatonin, catnip, valarian combos available OTC as well as Sleepytime tea and meditation. Lunesta did nothing for me at all. Might as well have been a placebo.

Right now I'm taking a Singulair which is an allergy and asthma med taken at night because it makes you drowsy (it seems decongestants are really iffy with me as well and this is a last resort) the Ambien CR and the Xanax. And yet there are nights I can't sleep at all. But most of the time, they do work and I sleep all the way through.


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## CrankySpice (Mar 26, 2012)

I spoke with my med management doc this morning. He doubled my dose of the trazodone (so 100 mgs) and said if that doesn't work, it's still within safe parameters for me to add another 50 mg the following night. If THAT doesn't work, then we'll try a different med.

Keeping my fingers crossed that one of those two dosages works for me. I've been a mess this last week. My memory is completely shot, I get distracted at the drop of a hat and I can't even maintain a conversation without completely losing my train of thought. I'm at the end of my rope.


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## BubbleButtBabe (Mar 27, 2012)

Good luck,I hope it worked for you..My dr. wouldn't up my dosage,he was afraid I would be dependent on them..


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## CrankySpice (Mar 28, 2012)

BubbleButtBabe said:


> Good luck,I hope it worked for you..My dr. wouldn't up my dosage,he was afraid I would be dependent on them..



Thanks, BBB. The first night at 100mg, I slept three hours, woke up, but then slept another three hours. So I felt like that was a big improvement.

But last night, I only slept 4 hours. Tossed and turned for half an hour then gave up and got up. sigh.

Hmmm...I'm not sure why your doc wouldn't up your dosage, since it is not addictive and has no long term side effects, so it is safe to take long term. That's one of the reasons my doc prescribed it (plus it doesn't interfere with my other meds). Is the Tylenol PM still working for you?


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## BigBeautifulMe (Mar 28, 2012)

I'm not saying this necessarily applies to anyone in this thread, but I think any thread on the topic of sleep needs this link:

http://www.cpaptalk.com/wiki/index.php/Symptoms

That link takes you to a great wiki page on my favorite cpap message board, cpaptalk.com. 

Almost everyone knows people with apnea can snore at night (though not all do), suffer from daytime fatigue and lethargy, and their bed partners may hear them choking or gasping at night. However, some of the symptoms of sleep apnea can be counter-intuitive or unexpected, like *insomnia, memory loss, procrastination, weight gain, acid reflux, diabetes, grinding your teeth, and needing to urinate at night*. I also used to have a lot of drowning and suffocation dreams, personally.

I know, I know, this is my personal crusade and I'm always posting about it, but it's because there are just SO many undiagnosed people out there, and I know how much treatment can improve one's life from personal experience.

I personally was diagnosed with sleep apnea not because I slept a lot (though many folks with sleep apnea do), but because I had insomnia. I had a really hard time falling asleep and staying asleep. In fact, I was on sleep medication and sedatives to do just that. 

My doctor insisted I have a sleep test. I fought him for some time because I had had a sleep test for apnea at age 18, and it had been negative. Finally I agreed -- wham, I have VERY severe sleep apnea, and have apparently had it for all of my life. Sleep tests only measure how you sleep that one particular night, and it IS possible (though rare) to have one and not get accurate results, which is what happened to me at age 18. I went years without being treated when I could have been. 

If anyone sees themselves in this list of symptoms, feel free to post or PM me here and I'll be happy to make suggestions to you of excellent resources to get you started on your journey.


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## BubbleButtBabe (Apr 3, 2012)

CrankySpice said:


> Thanks, BBB. The first night at 100mg, I slept three hours, woke up, but then slept another three hours. So I felt like that was a big improvement.
> 
> But last night, I only slept 4 hours. Tossed and turned for half an hour then gave up and got up. sigh.
> 
> Hmmm...I'm not sure why your doc wouldn't up your dosage, since it is not addictive and has no long term side effects, so it is safe to take long term. That's one of the reasons my doc prescribed it (plus it doesn't interfere with my other meds). Is the Tylenol PM still working for you?



I don't know why he wouldn't...I go to a clinic that changes Drs ever 2 months and it is hard to keep up with them since they keep changing my meds! Yes the Tylenol still works but I do not try to take to many since they are bad for my liver...

BigBeautifulMe,I have had insomnia for years..I use to work evenings then went to nights and that is when it started..It got worse when my Mom was sick and I would get up at night to take care of her..I then hit menopause full on and that kept it going..Menopause has the biggest complaint about insomnia I have ever seen...


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