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Any suggestions for difficulty falling asleep despite taking Xanax?

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Addiction Medicine Specialist
Practicing since : 2002
Answered : 1486 Questions
I am taking xanax 0.25 mg three times daily as prescribed my dr. However after about three weeks on the medication,I wake up in the middle of the night and can't go back to sleep. I don't want to take sleeping pills. Do you have any suggestions.
Posted Tue, 4 Mar 2014 in Mental Health
Answered by Dr. Preeti Parakh 35 minutes later
Brief Answer: Change Xanax to longer acting agents. Detailed Answer: Hi, Welcome to Healthcare Magic! Since you are taking Xanax thrice daily, I guess you are taking it to control anxiety, though you have not mentioned it. It also induces sleep, but since it has a short duration of action, the blood levels fall after a few hours and that disturbs sleep. This problem can be taken care of, without adding any other medicine, by just changing Xanax to a longer acting medicine like Klonopin. It will have the same effect on anxiety and being longer acting, will not cause a break in your sleep. Since both medicines belong to the same class of drugs, I do not expect your doctor to have any qualms in changing the prescription. Apart from medicines, some other measures can also help improve your sleep. 1) Avoid napping during the day as it can disturb the normal pattern of sleep and wakefulness. 2) Avoid stimulants such as caffeine, nicotine, and alcohol too close to bedtime. While alcohol is well known to speed the onset of sleep, it disrupts sleep in the second half as the body begins to metabolize the alcohol, causing arousal. 3) Exercise can promote good sleep. Vigorous exercise should be taken in the morning or late afternoon. A relaxing exercise, like yoga, can be done before bed to help initiate a restful night's sleep. 4) Food can be disruptive right before sleep; stay away from large meals close to bedtime. 5) Ensure adequate exposure to natural light. Light exposure helps maintain a healthy sleep-wake cycle. 6) Establish a regular relaxing bedtime routine. Try to avoid emotionally upsetting conversations and activities before trying to go to sleep. Don't dwell on, or bring your problems to bed. 7) Associate your bed with sleep. It's not a good idea to use your bed to watch TV, listen to the radio, or read. 8) Make sure that the sleep environment is pleasant and relaxing. The bed should be comfortable, the room should not be too hot or cold, or too bright. These measures are called sleep hygiene and some of these may help you. I hope this clears up things for you to some extent. Please feel free to ask if you need any clarifications. Best wishes. Dr Preeti Parakh MD Psychiatry
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