![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by linkadge on June 15, 2012, at 15:51:07
My doctor convinced me to try a strict regiment of sleep hygine. This stuff is worse than useless and is an insult to my suffering. I am sleeping less now (<4 hours a night). At least before I took naps to take some of the edge off.
Linkadge
Posted by Phillipa on June 15, 2012, at 16:33:41
In reply to sleep hygine doesn't work, posted by linkadge on June 15, 2012, at 15:51:07
How long have you been trying this as would think it would take over a month to truly see a benefit. What is wrong with a nap? And what did you do when working was it a problem then also? Phillipa
Posted by 49er on June 16, 2012, at 8:52:26
In reply to sleep hygine doesn't work, posted by linkadge on June 15, 2012, at 15:51:07
> My doctor convinced me to try a strict regiment of sleep hygine. This stuff is worse than useless and is an insult to my suffering. I am sleeping less now (<4 hours a night). At least before I took naps to take some of the edge off.
>
> Linkadge
>
>
>
Hi Linkage,As one who is having sleep issues for various reasons, I think the phrase, "sleep hygiene" is an overused tired cliche. Don't misunderstand me, some of the practices are useful. But when that is spouted as advice come heck or high water, I find it quite annoying.
What issues are you having? Sorry, I haven't been visiting the board.
Also, are any of the meds you are on possible culprits?
49er
Posted by Raisinb on June 16, 2012, at 19:24:34
In reply to sleep hygine doesn't work, posted by linkadge on June 15, 2012, at 15:51:07
No, it doesn't, not for people with long standing and or severe insomnia. It's like giving you a band aid when you need major surgery.
Posted by linkadge on June 16, 2012, at 19:43:50
In reply to Re: sleep hygine doesn't work » linkadge, posted by Raisinb on June 16, 2012, at 19:24:34
Think I've reached the end with this psychiatrist too. I don't know I expect something different from different doctors. They can only prescribe the same crap.
Just kind of caught back in a funk of hopelessness. Can't sleep - won't take meds.
Tired of ami-trippen'
Linkadge
Posted by sigismund on June 16, 2012, at 21:17:23
In reply to Re: sleep hygine doesn't work, posted by linkadge on June 16, 2012, at 19:43:50
No luck with trimipramine?
I have had limited success with that at 12.5 to no more than 25mg an hour or two before sleep time.
It is more humane than ami, but then again the time I took ami I took 25mg and it was awful.
Sleep hygiene? Yeah, I was never impressed.
Posted by Hugh on June 17, 2012, at 14:54:02
In reply to sleep hygine doesn't work, posted by linkadge on June 15, 2012, at 15:51:07
I agree. And it's annoying to see the same articles published about it again and again. "Just follow these simple rules and you'll sleep just fine." What garbage. By far the best book I've read on the subject is Insomniac by Gayle Greene. It's not a how-to book on sleeping. Greene is a lifelong insomniac, and she writes about her struggles with insomnia and the science of sleep.
There is a sleeping pill with a completely different mechanism of action that might be available by the end of the year. It's called suvorexant. Instead of inducing sleep by increasing GABA levels, it's an orexin receptor antagonist, so it turns off wakefulness.
Posted by linkadge on June 17, 2012, at 15:11:58
In reply to Re: sleep hygine doesn't work » linkadge, posted by sigismund on June 16, 2012, at 21:17:23
I'm a bit scared of trimipramine. Unlike amitriptyline, trimipramine is genotoxic.(not to scare you off)
Posted by linkadge on June 17, 2012, at 15:13:57
In reply to Re: sleep hygine doesn't work, posted by Hugh on June 17, 2012, at 14:54:02
I've just reached that unspoken moment when the doctor throws all the traditional crap at you then its "hint hint...this is somehow your fault...please go away so that I can treat those who respond"
Posted by Raisinb on June 17, 2012, at 15:29:42
In reply to Re: sleep hygine doesn't work, posted by linkadge on June 17, 2012, at 15:13:57
Boy do I hate it when their own inadquacy and lack of knowledge means that your illness is all your fault.
Posted by g_g_g_unit on June 18, 2012, at 3:24:42
In reply to Re: sleep hygine doesn't work, posted by linkadge on June 17, 2012, at 15:13:57
> I've just reached that unspoken moment when the doctor throws all the traditional crap at you then its "hint hint...this is somehow your fault...please go away so that I can treat those who respond"
Just curious, but have you ever consulted with a Professor or someone at a medical school who might have an interest in complex and/or treatment-resistant cases? Is this option available to you?
My p-doc's never given up on me, and when he's reaching for ideas, he tends to refer me to someone higher up.
Posted by sigismund on June 18, 2012, at 21:07:55
In reply to Re: sleep hygine doesn't work, posted by linkadge on June 17, 2012, at 15:11:58
>, trimipramine is genotoxic.(not to scare you off)
Always good to know. It is the replacement for gabapentin which shot my PSA up from the low 2s to the high 6s. I had stopped it a month before and asked for another PSA. It was down to 2.9 by then. Biopsy revealed 3 out of 16 samples to have low grade prostate cancer.
It would be nice to have some safe and effective drugs.
Posted by novelagent on June 19, 2012, at 0:39:06
In reply to sleep hygine doesn't work, posted by linkadge on June 15, 2012, at 15:51:07
Have you tried seroquel? It knocked me out cold when I took it years ago. I'm going to beg my doc to try it tomorrow, because I'm startibg a job soon as suddenly not being able to sleep until 2 if I'm lucky won't pass... and my doc is a lame resident, so ambien isn't even worth bothering to ask.
> My doctor convinced me to try a strict regiment of sleep hygine. This stuff is worse than useless and is an insult to my suffering. I am sleeping less now (<4 hours a night). At least before I took naps to take some of the edge off.
>
> Linkadge
>
>
>
Posted by chumbawumba on June 20, 2012, at 18:00:37
In reply to Re: sleep hygine doesn't work, posted by novelagent on June 19, 2012, at 0:39:06
Seroquel for sure, when you absolutely, positively have to sleep. The downside is if you take it for a long time and stop your insomnia will be hell.
Posted by novelagent on June 21, 2012, at 14:14:24
In reply to Re: sleep hygine doesn't work, posted by chumbawumba on June 20, 2012, at 18:00:37
> Seroquel for sure, when you absolutely, positively have to sleep. The downside is if you take it for a long time and stop your insomnia will be hell.
>
my doc gave me 50mg of trazodone, and it sufficed-- I've been having good sleep on it.
Posted by phidippus on June 25, 2012, at 18:17:53
In reply to Re: sleep hygine doesn't work » linkadge, posted by g_g_g_unit on June 18, 2012, at 3:24:42
What do you use to help you sleep?
Eric
Posted by g_g_g_unit on June 27, 2012, at 23:38:07
In reply to Re: sleep hygine doesn't work » g_g_g_unit, posted by phidippus on June 25, 2012, at 18:17:53
> What do you use to help you sleep?
>
> EricClonazepam, though I'm required to take it about an hour before bed to fall asleep. If that doesn't work, I might add a tiny (0.25mg) dose of Melatonin. for sleep onset. Regardless, my quality of sleep on Parnate is quite poor at present.
I like Cyproheptadine because it's short-acting, but the 5-HT2C antagonism worsens my OCD.
I've used Mangosteen (a 5HT-1 antagonist) in the past with some success, but it's too weak to overcome Parnate's effects.
Glycine (2-3mg) can also be helpful, but again does nothing on Parnate.
Posted by g_g_g_unit on June 27, 2012, at 23:43:31
In reply to Re: sleep hygine doesn't work » phidippus, posted by g_g_g_unit on June 27, 2012, at 23:38:07
I forgot to add Clonidine. I read that, above certain doses (usually 0.1mg) it both increases and decreases NE. This has been consistent with my experience, and my psychiatrist mentioned that a few of his patients complained that they felt more edgy and uncomfortable prior to falling asleep.
I've found that tiny doses (0.025mg--i.e. 1/4 of a tablet) decrease NE without any untoward effects. This provides a pleasant pre-bed sedation, though can also leave me feeling mildly depressed the next day.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.