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Suggest Treatment For Severe Insomnia

Posted on Mon, 13 Jul 2015

Question: What are your recommendations for dealing with insomnia?

Answered by Dr. Kathy Robinson (1 hour later)

Brief Answer:
behaviors first, then meds

Detailed Answer:
Hello,
The first thing to look at is sleep behaviors. Here are some suggestions.
It is important that you do not take naps during the day. Caffeine should be limited to no more than one serving and it should be in the morning. Exercise like walking 30 minutes every day but not before bedtime. Do not eat within 3 hours of going to bed. Once you go to bed do not use any electronics. Do not drink any alcohol, it disrupts the sleep cycle.
if you need a medication, safe ones to try are 5-HTTP to help you get to sleep, phosphtidyl serine to help maintain sleep, or melatonin which can help both initiating and maintaining sleep. These are supplements but you should not start any supplement until you check with your doctor and get their approval.
I wish you the best.
Dr. Robinson

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Kathy Robinson (2 days later)

I already do everything that Dr. XXXXXXX suggested. I have recently reviewed my medications and found that Simvastatin has a side effect of insomnia. My doctor is switching me to atostatin which I will be starting to take tonight. Other than that I do not know what to do.

Answered by Dr. Kathy Robinson (9 hours later)

Brief Answer:
side efffect

Detailed Answer:
Hello,
It is great that you are doing all the things above to help with sleep. If the 5-HTTP, phosphtidyl serine and melatonin do not help your sleep then perhaps it is due to a side effect of your medications. If the insomnia does not change with a change in medications then it may be time to talk to your doctor about some stronger sleep medications. Also remember that we need less sleep when we are older, 5-6 hours is plenty for many of us over 60 years old.
Regards,
Dr. Robinson

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Kathy Robinson (14 hours later)

Thanks Dr. XXXXXXX for your answer. I forgot to mention that I already take 6mg. of Melatonin at night along with a cup of Peppermint Tea. I wondered if I should be taking more Melatonin but I didn't want to take too much. Since I am in AA recovery for 31 years, I will not take any sleep medications. All of those meds are addictive and would cause me to relapse. Is there a safe amount of Melatonin that I can take that will help me to get to sleep and still not be too much? I would appreciate hearing back from you.

Answered by Dr. Kathy Robinson (9 hours later)

Brief Answer:
6mg of melatonin is enough

Detailed Answer:
Six mg of melatonin is the maximum I would recommend. However, I do want to tell you that there are some of the antidepressant medications that used at low dose can help with sleep and they are not addictive in any way. Some examples are trazodone and elavil. I never recommend any of the addictive sleep medications for anyone.
I hope you get some relief soon,
Dr. Robinson

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Kathy Robinson (13 hours later)

Thank you for getting back to me and I will take that information to my doctor. I also am living with my daughter and she has a question. She's been in full menopause for almost 5 years. Every month when her daughters, who don't even live with her, have their menstral cycles working on them, she gets all the symptoms and can pinpoint the day they are going to get their period within a day or two. She wants to know why this is happening because it is just weird and because of being in menopause why would she get these symptoms in the first place? Have you ever heard of this before?

Answered by Dr. Kathy Robinson (1 hour later)

Brief Answer:
can't explain that

Detailed Answer:
I have heard of women who live together cycling together, but never when they don't live together and are postmenopausal. Sorry I do not have an answer for that one.
Dr. Robinson

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Kathy Robinson (20 hours later)

Thanks Dr. XXXXXXX .do you have any colleagues in the OB/GYN field who might have an idea about this?

Answered by Dr. Kathy Robinson (7 minutes later)

Brief Answer:
I do not

Detailed Answer:
I do not but I think you can do a specialist consult on this site and ask to speak with a gynecologist.
Regards,
Dr. Robinson

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar