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Sleep Disorders Message Board


Sleep Disorders Board Index


Hello,
I have suffered from insomnia on and off for the past five years. I underwent two sleep studies to evaluate any sleep disorders that may be contributing. One study, done in 2008, showed I had sleep apnea. This was done at a small, local hospital and the first test had to be repeated because they told me their equipment wasn't working. I was prescribed a CPAP, but was given no instructions or support on using it, tried for a few months, but after much frustration, gave up. In 2009, I had a repeat study at a sleep center specializing in sleep studies. The sleep center found I did not have sleep apnea, so I still feel a little confused about which test to believe, although I'm inclined to believe the latter, as it was done in a more professional setting. I do snore, but my husband has not reported me to experience episodes where he notices I stop breathing. I am 33, 5'8" and weigh 130 lbs.

In the past I took Ambien and Ambien CR for sleep, but weaned off those in order to cut back on the number of medications I was taking. Recently, I was prescribed a new antidepressant (an MAOI), which has the first major side effect as insomnia. I've been on the AD for 3 months now and haven't slept a full night since. I am often awake until 3 or 4 in the morning and then will fall asleep for a few hours. Or, if I am very exhausted, I can fall asleep around 11, but will re-awake around 2 for a few hours, and then fall asleep for another few hours. I take 1 mg of Klonopin before bed, as well as 75 mg of Lyrica, but neither of these medications seems to have any effect. Prior to starting the AD, they did make me drowsy and helped with sleep.

My psychiatrist re-started me on the Ambien, but that had virtually no effect. She recently switched me to 15 mg of Restoril, which has helped slightly more, but not much. She suggested trying 30 mg of Restoril, and that has helped more (I still take the Klonopin and Lyrica as well). I am concerned about becoming dependent on these benzodiazepines for sleep, as I know one has to just keep increasing the dosages in order to sleep. Unfortunately, because of my depression, I do not have the option of switching to another AD.

I have good sleep hygiene. I sleep in a dark room, with no TV, white noise at night, no animals sleep with us. We have a Tempurpedic, king-size bed. I read before bed and listen to a progressive relaxation program on my iPod designed for insomnia that does help relax me. I do not drink alcohol, but I do smoke. I eat well and avoid liquids and sugar (if I do indulge) several hours before bed. Because of chronic pain and depression, I have not been able to exercise regularly, but am trying to incorporate stretching and movement into my day.

I spoke with my trusted pharmacist about OTC options, specifically melatonin and 5-HTP. She said to avoid the 5-HTP has it interacted with my AD and said the melatonin would likely not do much if the Restoril wasn't helping. I've tried valerian and Benadryl, as well. I feel at a loss about where to go from here.

My only thought came during a migraine. I had to take 25 mg of promethazine for nausea, which was at about 7 pm. I had the soundest sleep I had experienced in months, which I have noticed at other times when taking the promethazine. I am wondering if this is something that could safely could be used as a sleep aid, without the type of dependence or need for dosage increase as with the benzos. Have others utilized this medication for this purpose?

Thanks,
Marie





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