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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by raisinb on February 10, 2008, at 12:52:31
I have had very recalcitrant insomnia for six years or so. Mostly, I just take an Ambien or a Lunesta every night, unless I don't have enough hours in the night left. A few days ago my Lunesta ran out, and the insurance won't cover a new pack for another ten days (they'll only cover 60 tabs within a 90 day period).
I haven't slept in three days. I have tried everything--meditating, running until exhaustion, drinking, Theraflu, and melatonin. Nothing works except a lot of alcohol, which just makes me more tired (and sick) in the end. I try the sleep hygiene measures, but I am so cranked up with anxiety about the whole thing that I just disintegrate when night comes, whether I have been staying out of bed or not.
OTC sleep aids like Sleepinal put me out, but they give me a terrible, depressive, groggy hangover for the entire next day and it's just not worth it.Today I'm unable to do anything or handle the slightest stressor and I can't stop crying.
I finally broke down and paid 90 bucks for 15 Lunesta, which I can't afford, but I am just so frustrated. It seems like I can't remember any time when I could just go to sleep. Does anyone have any wisdom?
Posted by stargazer2 on February 10, 2008, at 13:33:20
In reply to insomnia can be so rough, posted by raisinb on February 10, 2008, at 12:52:31
So without the Lunesta nightly there is no other solution? Can you get a presciption for Ambien too and alternate them?
Have you had a sleep study ever or been worked up for other conditions like depression? Sometimes insomnia can be the only depressive symptom. Some of the AD's are very useful for promoting sleep.
What is your daily schedule like...what hour do you wake up, what are your usual daytime activities, do you take daytime naps, what time do you go to bed, hours of sleep when you are on lunesta?
Insomnia is a very complicated diagnosis, just curious about what workups you've had and what are your daily routines.
Stargazer
Posted by raisinb on February 10, 2008, at 18:06:17
In reply to Re: insomnia can be so rough, posted by stargazer2 on February 10, 2008, at 13:33:20
I can get some more Ambien, but I switched to Lunesta because the Ambien wasn't working so well.
I have never had a sleep study and I don't know a lot about them, but wouldn't it just show that I can't go to sleep at night?
I get up around six, usually, and go to bed around nine thirty or ten (the Lunesta takes up eight or nine hours, so I make sure I have them).
I'm sure that I'd qualify for a diagnosis of depression during five or ten days a month, but it's transient, and overall I'm happy with my moods when I make sure to exercise and meditate and be productive. I would rather not be on antidepressants. If I have to be on meds, what I really need is just to control my sleep.
> So without the Lunesta nightly there is no other solution? Can you get a presciption for Ambien too and alternate them?
>
> Have you had a sleep study ever or been worked up for other conditions like depression? Sometimes insomnia can be the only depressive symptom. Some of the AD's are very useful for promoting sleep.
>
> What is your daily schedule like...what hour do you wake up, what are your usual daytime activities, do you take daytime naps, what time do you go to bed, hours of sleep when you are on lunesta?
>
> Insomnia is a very complicated diagnosis, just curious about what workups you've had and what are your daily routines.
>
> Stargazer
Posted by stargazer2 on February 11, 2008, at 9:11:03
In reply to Re: insomnia can be so rough, posted by raisinb on February 10, 2008, at 18:06:17
Who prescribes the Lunesta, your internist? It is really never recommended to take sleeping pills every night as a routine thing, since that creates a vicious circle of always needing to take them and that is not usually recommended. Your prescription would say prn, not nightly but unless your doc says to not take them nightly, you wouldn't know that. Overtime it can affect your thinking and memory which can cause other long term issues.
You really should see a sleep specialist and have a sleep study, since you may have sleep apnea or a disturbance with your sleep cycles that can be corrected rather than taking Ambien nightly, even though this is what you have done for a long time.
There are really mild AD's like Trazadone that are used for sleep so that would be a med to take every day and perhaps only use the Lunesta prn, as needed, which would be less often than daily, ideally only once or twice a week.
Has your doc that is prescribing the lunesta ever suggested a sleep study? I would ask about it. Does your doc know you take Lunesta daily and does he think this is the best way to handle your insomnia?
Just curious about how insomnia is diagnosed and treated today. I know that giveing a sleeping pill to someone nightly only increases the odds that they will become relient on it rather than using it occasionally. Most docs will give the prescription once or twice to get someone through a period of insomnia, but not to use as a routine med to treat insomnia, that`requires a specialist to work up a case that is intractable.
If I had insomnia, I would want a workup for it to see what other factors are involved and make sure I was treating it the best way.
Stargazer
Posted by raisinb on February 11, 2008, at 16:00:50
In reply to Re: insomnia can be so rough, posted by stargazer2 on February 11, 2008, at 9:11:03
No, my doctor's never suggested a sleep study. She's not the most hands-on doctor, though, so maybe I should ask her about it. But I'm pretty certain that I'd never be able to sleep without meds when I was also in a strange environment, hooked up to stuff. I'll ask her what she thinks.
I will ask her about the Trazodone, though. It might be an option.
Posted by stargazer2 on February 11, 2008, at 16:30:33
In reply to Re: insomnia can be so rough, posted by raisinb on February 11, 2008, at 16:00:50
I did reaad that Lunesta can be given nightly so what you're doing is not prohibited. Also there are various doses of Lunesta...what dose are you on? And is your doc a specialist? Does she just write you a new script every month or few month? Does she know you take it nightly?What is the reason your insurance only pays for a limited amount of pills if the med is one you can take daily?YOur doc could ask the insuror for more pills if there is a reason for it and it can be given daily. Do some research on Lunesta about its usage and suggested frequency of use. If it does sate it cna be taken daily than I don't see a reason your insuror woudn't cover this as a daily med as prescribed by your doc.You have alot of options for treatment of the insomnia. Good luck.Stargazer
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