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What Causes Difficulty In Initiating Sleep?
Question: Hello Doctor,
Thanks so much for clearing my queries in the past.
Offlate I am finding it difficult to initiate a sleep, once I fall asleep its XXXXXXX but just initially its getting difficult to fall asleep, Once I am asleep its good for 5,6 or may be 7 hrs, but initially its difficult to fall asleep.
Just a brief background, when I try to fall asleep my brain automatically thinks all non sense things, I am not tensed or not taking any tension its just that it keeps something or the other, I check my BP its normal it never exceeds 126/85, my heart beat is also under control, 62 - 85.
I can jog for 15 - 20 mins, Brisk walk for 30 mins and climb 7 storeys of building to run out of breath, my diet is also good, less salt and almost no oil.
I have done my ECG and Echo as well to rule out the Cardiac issues, I have asked multiple questions regarding the Cardio to all the cardiologists on the portal, everything came back normal in terms of Cardio, I do have mild asthma but I dont think that its an issue since at night I am not asthmatic or gasping for air, breathing has never been an issue for me.
But my nature of job is day shift at times and night at times, could you please advise me some tips on falling asleep, I tried Melatonin it worked for a while, it helps me to sleep longer but not helping me to initiate sleep, clearity of mind may be an issue.
At the moment its not that major that I cannot sleep at all but at times I struggle to sleep, Please advise good tips or medications if any.
Thanks so much for clearing my queries in the past.
Offlate I am finding it difficult to initiate a sleep, once I fall asleep its XXXXXXX but just initially its getting difficult to fall asleep, Once I am asleep its good for 5,6 or may be 7 hrs, but initially its difficult to fall asleep.
Just a brief background, when I try to fall asleep my brain automatically thinks all non sense things, I am not tensed or not taking any tension its just that it keeps something or the other, I check my BP its normal it never exceeds 126/85, my heart beat is also under control, 62 - 85.
I can jog for 15 - 20 mins, Brisk walk for 30 mins and climb 7 storeys of building to run out of breath, my diet is also good, less salt and almost no oil.
I have done my ECG and Echo as well to rule out the Cardiac issues, I have asked multiple questions regarding the Cardio to all the cardiologists on the portal, everything came back normal in terms of Cardio, I do have mild asthma but I dont think that its an issue since at night I am not asthmatic or gasping for air, breathing has never been an issue for me.
But my nature of job is day shift at times and night at times, could you please advise me some tips on falling asleep, I tried Melatonin it worked for a while, it helps me to sleep longer but not helping me to initiate sleep, clearity of mind may be an issue.
At the moment its not that major that I cannot sleep at all but at times I struggle to sleep, Please advise good tips or medications if any.
Brief Answer:
lifestyle changes & zolpidem will help
Detailed Answer:
Hello,
You can try the non medicating measures like-
1. Fix timings of sleep and wake up...but in your case of shift duty this is the main issue...settle for daytime job if possible. Shift timings confuse mind and it cant settle to sleep...
2.take light dinner and avoid post meal tea or coffee.
3. Best is to avoid tea ..coffee..or alcohol..after 4pm.
4. Donot see tv or XXXXXXX when unable to sleep. Try to read a boring book or just listen to soft music when you cant sleep..
make your bedroom a noise free sleep area...dark and comfortable.
5. Dont look at the watch again and again when you cant sleep. Get up and read a book. Trying hard to sleep is never going to help and checking time only irritates making sleeping more difficult.
6. Please take a warm water bath before sleeping or just soak feet in warm water for 5-10min.
7. A glass of milk always helps in sleeping coz it gives serotonin..so get yours!
Give me two answers to help me check -
Are you anxious these days ...(not sad)?
&
Do you take any kind of medicine or steroids for asthma or anyother problem?
You are very correct that its not your physical issue but your mind which dosent let you sleep...
zolpidem 5-10 mg helps in sleep initiation. It is safe and non addicting. You can take it on sos basis. Melatonin is of not much use in your case.
Wish you sound sleep!!
Feel free to ask more queries for clarification.
Dr. Manisha Gopal
MD Neuropsychiatry
lifestyle changes & zolpidem will help
Detailed Answer:
Hello,
You can try the non medicating measures like-
1. Fix timings of sleep and wake up...but in your case of shift duty this is the main issue...settle for daytime job if possible. Shift timings confuse mind and it cant settle to sleep...
2.take light dinner and avoid post meal tea or coffee.
3. Best is to avoid tea ..coffee..or alcohol..after 4pm.
4. Donot see tv or XXXXXXX when unable to sleep. Try to read a boring book or just listen to soft music when you cant sleep..
make your bedroom a noise free sleep area...dark and comfortable.
5. Dont look at the watch again and again when you cant sleep. Get up and read a book. Trying hard to sleep is never going to help and checking time only irritates making sleeping more difficult.
6. Please take a warm water bath before sleeping or just soak feet in warm water for 5-10min.
7. A glass of milk always helps in sleeping coz it gives serotonin..so get yours!
Give me two answers to help me check -
Are you anxious these days ...(not sad)?
&
Do you take any kind of medicine or steroids for asthma or anyother problem?
You are very correct that its not your physical issue but your mind which dosent let you sleep...
zolpidem 5-10 mg helps in sleep initiation. It is safe and non addicting. You can take it on sos basis. Melatonin is of not much use in your case.
Wish you sound sleep!!
Feel free to ask more queries for clarification.
Dr. Manisha Gopal
MD Neuropsychiatry
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks so much doc for a quick reply :)
I do not take any steroids or anything, I do take ventorlin inhaler for the asthma once or may be twice a day at XXXXXXX when I feel asthmatic, but the asthma has not gone out of control.
Anxious absoleutely yes, I am anxious these days with my health, like I feel is something is wrong when I dont get sleep and it makes me more anxious and I keep thinking, but at night when my brain is blank I try to sleep, while doing so thoughts start creeping, any thoughts it can be, it can be as stupid as flying airplane :) or driving a car :)
But still when I check my bp and heart rate during anxiousness its always good, heart rate is 60 - 75 and bp is below 115/77
I do not take any steroids or anything, I do take ventorlin inhaler for the asthma once or may be twice a day at XXXXXXX when I feel asthmatic, but the asthma has not gone out of control.
Anxious absoleutely yes, I am anxious these days with my health, like I feel is something is wrong when I dont get sleep and it makes me more anxious and I keep thinking, but at night when my brain is blank I try to sleep, while doing so thoughts start creeping, any thoughts it can be, it can be as stupid as flying airplane :) or driving a car :)
But still when I check my bp and heart rate during anxiousness its always good, heart rate is 60 - 75 and bp is below 115/77
Brief Answer:
can change salbutamol?
Detailed Answer:
Hello,
I think your inhaler can be the agent which is increasing your anxiety or atleast not letting your mind settle down. It has salbutamol which can lead to tremors and restlessness...so, if possible you may try different agents. Need to talk to your doctor for the same.
You can try to take zolpidem 5-10mg for some days 15min prior to bed time. This is a sleep inducer and will put you to sleep in next 10min. Taking this for week or ten days will help mind to become used to falling sleep. Then it can be reduced to 5mg and finally stopped.
along with zolpidem you shoud definitely try to follow non medicative measures as told previously.
wish you luck.
Dr. Manisha Gopal
MD Neuropsychiatry
can change salbutamol?
Detailed Answer:
Hello,
I think your inhaler can be the agent which is increasing your anxiety or atleast not letting your mind settle down. It has salbutamol which can lead to tremors and restlessness...so, if possible you may try different agents. Need to talk to your doctor for the same.
You can try to take zolpidem 5-10mg for some days 15min prior to bed time. This is a sleep inducer and will put you to sleep in next 10min. Taking this for week or ten days will help mind to become used to falling sleep. Then it can be reduced to 5mg and finally stopped.
along with zolpidem you shoud definitely try to follow non medicative measures as told previously.
wish you luck.
Dr. Manisha Gopal
MD Neuropsychiatry
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Shall I consult a doctor to prescribe zolpidem as it may not be available without prescription ?
Yep for salbutamol I will consult my physician.
Yep for salbutamol I will consult my physician.
Brief Answer:
yes, prescription will be helpful
Detailed Answer:
Hello,
Sometimes in cases of emergencies chemist may give you few tablets. But if you have the prescription it is much better.
You can discuss the problem with your physicin and he can write zolpidem for you.
Good luck
feel free to ask more queries for clarification
Dr. Manisha Gopal
MD Neuropsychiatry
yes, prescription will be helpful
Detailed Answer:
Hello,
Sometimes in cases of emergencies chemist may give you few tablets. But if you have the prescription it is much better.
You can discuss the problem with your physicin and he can write zolpidem for you.
Good luck
feel free to ask more queries for clarification
Dr. Manisha Gopal
MD Neuropsychiatry
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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