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Cannot sleep well at nigh. Used zolpidem but not getting prescription here. Suggest?

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I don't sleep well at night--like right now--and have used zolpidem in the past but have just moved to a new city and don't have insurance. I'm hoping to be able to get a prescription so I can get some sleep.
Posted Tue, 30 Jul 2013 in Sleep Disorders
Answered by Dr. Ashish Mittal 25 minutes later
Thanks for your query.
I appreciate your efforts for medical consultation in so much distress.

Important aspects of your query are:
•     29 year old male
•     Known case of depression, anxiety, OCD, insomnia
•     Complaints of: poor sleep in night.

In treatment of insomnia, we treat the cause of insomnia. Common causes of insomnia in your case may be:
-Poor sleep hygiene
-Excessive stress
-Substance use if present
-Primary insomnia

In your history you already mentioned about anxiety and depressive disorder, which is frequently associated with poor sleep. It is better to get evaluated for depression, anxiety and OCD, as these disorders are chronic disorder. You may also require treatment for these condition, which will help you in sleep also.

Zolpidem is used for sleep only for short term. In long term use it may lead to addiction. Due to that it is dispensed only after printed and real prescription of doctor. Online prescriptions will not help you.

Irrespective of cause, below principles of sleep hygiene which will help you in long term:
•     Fix a bedtime and an awakening time. Do not be one of those people who allows bedtime and awakening time to drift. The body "gets used" to falling asleep at a certain time, but only if this is relatively fixed. Even if you are retired or not working, this is an essential component of good sleeping habits.
•     Avoid napping during the day
•     Avoid caffeine 4-6 hours before bedtime. This includes caffeinated beverages such as coffee, tea and many sodas, as well as chocolate, so be careful.
•     Avoid heavy, spicy, or sugary foods 4-6 hours before bedtime
•     Exercise regularly, but not right before bed. Regular exercise, particularly in the afternoon, can help deepen sleep.
•     Use comfortable bedding.
•     Find a comfortable temperature setting for sleeping and keep the room well ventilated.
•     Block out all distracting noise, and eliminate as much light as possible.
•     Reserve the bed for sleep. Don't use the bed as an office, workroom or recreation room. Let your body "know" that the bed is associated with sleeping.
•     Practice relaxation techniques before bed. Relaxation techniques such as yoga, deep breathing and others may help relieve anxiety and reduce muscle tension.
•     Don't take your worries to bed. Leave your worries about job, school, daily life, etc., behind when you go to bed. Some people find it useful to assign a "worry period" during the evening or late afternoon to deal with these issues.
•     Establish a pre-sleep ritual. Pre-sleep rituals, such as a warm bath or a few minutes of reading, can help you sleep.
•     Getting Up in the Middle of the Night :Most people wake up one or two times a night for various reasons. If you find that you get up in the middle of night and cannot get back to sleep within 15-20 minutes, then do not remain in the bed "trying hard" to sleep. Get out of bed. Leave the bedroom. Read, have a light snack, do some quiet activity, or take a bath. You will generally find that you can get back to sleep 20 minutes or so later. Do not perform challenging or engaging activity such as office work, housework, etc. Do not watch television.
•     A Word About Television: Many people fall asleep with the television on in their room. Watching television before bedtime is often a bad idea. Television is a very engaging medium that tends to keep people up. We generally recommend that the television not be in the bedroom. At the appropriate bedtime, the TV should be turned off and the patient should go to bed. Some people find that the radio helps them go to sleep. Since radio is a less engaging medium than TV, this is probably a good idea.

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Wish you good health.
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