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Suggest Treatment For Chronic Insomnia

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Posted on Tue, 26 May 2015
Question: I go through stretches of insomnia. I was hospitalized because of it once, Sometimes I'm so tired I want die. And sometimes pills make it worse. Please help.
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Answered by Dr. Seikhoo Bishnoi (1 hour later)
Brief Answer:
Combination of medicines and behavioural therapies will help in good sleep

Detailed Answer:
Hello thanks for asking from HCM for your health related queries

I can understand your concern. You have main problems of insomnia and this has resulted in symptoms like tiredness and you want to die. A lot of individuals with persistent insomnia develop symptoms like depression. They develop significant stress due to insomnia which further make insomnia worse. So in most of cases of insomnia combination of behavioural therapies and medicines results in best outcome.

In behaviour therapy individual is made to realise that sleep is a spontaneous phenomenon. The more an individual tries to sleep the worsen insomnia becomes. So to break that cycle of "insomnia-stress-insomnia" you have to improve your sleep hygiene.

- Try to fix your time to go to bed.

- Avoid taking tea, coffee or even alcohol in evening times. These substances result in worsening of symptoms.

- Before going to bed, warm water would prove useful in sleeping.

- Avoid watching TV or reading books from bed. Use your bedroom only for sleeping and don't do anything that can stimulate brain on bed.

- Keep your bedroom dim lighted in evening time.

- Don't try to sleep on bed. Don't think about not getting good sleep as this worsens insomnia. If you fail to get good sleep within 15 minutes of going to bed then get up and try to distract your mind.

- Take light meals in evening. Even a glass of plain lukewarm milk helps to sleep in evening.

- Relaxation exercises in evening help in good sleep.

Try to improve your sleep hygiene. If symptoms still persist then visit a doctor for medicines. In insomnia with depressive symptoms medicines like hypnotics can help in good sleep. Benzodiazepines as Lorazepam, Clonazepam etc can help to provide a good sleep. But it is not advisable to take these drugs regularly for long periods of time because of abuse potential. As your complaints of insomnia are severe and causing stress so medicines like Mirtazapine, Trazodone etc can help you. These medicines help to provide good sleep and also don't cause dependence. These medicines help to improve symptoms of depression and will reduce your stress. These medicines are better tolerated and shouldn't make your symptoms worse. When taken daily these will help you to come out of insomnia. Please visit a doctor for detailed evaluation and prescription of these drugs.


Thanks, I hope this helps you. Please feel free to ask again for more doubts.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
Dr.
Dr. Seikhoo Bishnoi

Psychiatrist

Practicing since :2007

Answered : 5193 Questions

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Suggest Treatment For Chronic Insomnia

Brief Answer: Combination of medicines and behavioural therapies will help in good sleep Detailed Answer: Hello thanks for asking from HCM for your health related queries I can understand your concern. You have main problems of insomnia and this has resulted in symptoms like tiredness and you want to die. A lot of individuals with persistent insomnia develop symptoms like depression. They develop significant stress due to insomnia which further make insomnia worse. So in most of cases of insomnia combination of behavioural therapies and medicines results in best outcome. In behaviour therapy individual is made to realise that sleep is a spontaneous phenomenon. The more an individual tries to sleep the worsen insomnia becomes. So to break that cycle of "insomnia-stress-insomnia" you have to improve your sleep hygiene. - Try to fix your time to go to bed. - Avoid taking tea, coffee or even alcohol in evening times. These substances result in worsening of symptoms. - Before going to bed, warm water would prove useful in sleeping. - Avoid watching TV or reading books from bed. Use your bedroom only for sleeping and don't do anything that can stimulate brain on bed. - Keep your bedroom dim lighted in evening time. - Don't try to sleep on bed. Don't think about not getting good sleep as this worsens insomnia. If you fail to get good sleep within 15 minutes of going to bed then get up and try to distract your mind. - Take light meals in evening. Even a glass of plain lukewarm milk helps to sleep in evening. - Relaxation exercises in evening help in good sleep. Try to improve your sleep hygiene. If symptoms still persist then visit a doctor for medicines. In insomnia with depressive symptoms medicines like hypnotics can help in good sleep. Benzodiazepines as Lorazepam, Clonazepam etc can help to provide a good sleep. But it is not advisable to take these drugs regularly for long periods of time because of abuse potential. As your complaints of insomnia are severe and causing stress so medicines like Mirtazapine, Trazodone etc can help you. These medicines help to provide good sleep and also don't cause dependence. These medicines help to improve symptoms of depression and will reduce your stress. These medicines are better tolerated and shouldn't make your symptoms worse. When taken daily these will help you to come out of insomnia. Please visit a doctor for detailed evaluation and prescription of these drugs. Thanks, I hope this helps you. Please feel free to ask again for more doubts.