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Getting headache and have sleeping problem. Temporary relief by eliwel. Any permanent cure?

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Practicing since : 2003
Answered : 2190 Questions
Hello doc. I am 53 ys old, i had sleep problem, I used to wake up early in the morning arround 2 2.30 am and i used to be awake till morning. This continued for many months and i used to have head aches after that. So i consulted a doc. and he precribed me Eliwel-10 for 3 months. I used to get good sleep when i took the tabs. Now after stopping it, after some time, again i am having same old sleeping problem. should i continue the tablets. Please help.
Posted Fri, 1 Mar 2013 in Sleep Disorders
Answered by Dr. Jonas Sundarakumar 33 minutes later
Hello and welcome to Healthcare Magic. Thanks for your query.

Difficulty in sleeping (known as "insomnia" ) can be due to a variety of causes. Some of the problems causing insomnia are:
- Stress
- Anxiety
- Depression
- Poor sleep habits
- Other medical problems, chronic pain, etc.

Eliwell (Amitryptilline) is a sedative antidepressant. You have mentioned that your sleeping problem became better after starting Eliwel and you were doing alright for about 3 months while on the medication. However, any sedative medication, when stopped abruptly can cause a "rebound insomnia".

In such cases a gradual reduction of the medication and following of strict sleep hygiene techniques can help overcome the problem. In addition, if there are any underlying problems which could be causing the insomnia, like stress or anxiety or improper sleep habits / environment, then these factors have to be addressed appropriately.

In the current situation, I would suggest that you can take half a tablet of Eliwel for the next one month and then try stopping it. In the meantime, you have to follow strict sleep hygiene techniques, so that your body is able to gradually get back to the natural sleep rythm.

- Fix a specific bedtime and an awakening time. Do not allow bedtime and awakening time to drift.
- Avoid napping during the day.
- Avoid coffee, tea or any caffeinated drinks or alcohol 4 hours before bedtime.
- Avoid heavy, spicy, or sugary foods for dinner. Have a gap of at least 1 hour between dinner and bedtime.
- Exercise regularly, preferably in the early evening, at least 4 hours before bedtime.
- Set up a comfortable environment which is dark, quiet and disturbance-free. Block out all distracting noise, and eliminate as much light as possible.
- Reserve the bed for sleep only. Don't use the bed for studying, working or for other rectreational activities.
- Try a light snack before bed. Warm milk and foods high in the amino acid tryptophan, such as bananas, may help you to sleep.
- Practice relaxation techniques before bed. Relaxation techniques such as yoga, XXXXXXX breathing and others may help relieve anxiety and reduce muscle tension.
- Don't take your worries to bed. Leave your worries about studies, work, 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.

Wish you all the best.

Dr. Jonas Sundarakumar
Consultant Psychiatrist
Above answer was peer-reviewed by
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