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Suggest treatment for insomnia

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Posted on Thu, 10 Dec 2015
Question: Hey there...
I'm a Mech. Engg. student in the final year.
I'm having troubles in sleeping lately.. I consulted a doc. She said I'm stressed out about something.
I dont think so thats the case.. I'm taking clocit 5 and estam 5 as advised... Can you tell me whats going on
with me .... Why am I not able to sleep properly... Everyday is like a waste as I dont get up fresh... Hope to hear from you.. Thanks!!
doctor
Answered by Dr. Chintan Solanki (51 minutes later)
Brief Answer:
need evaluation for insomnia, provide more info

Detailed Answer:
Hello,

Thanks for writing to us.

You are suffering from sleep disturbance (insomnia).

Insomnia (sleep disturbance) is of two types:

1. Primary: There is problem of only sleep disturbance and no other physical or psychological problem is there. In this case treatment for sleep problem is needed.

2. Secondary: There is some underlying physical or psychological problem which is responsible for sleep disturbance. In this main treatment is done for underlying problem.

I recommend first my patients to follow some measures called 'sleep hygiene' which would help in sleep. You can find the same in below link.

sleepfoundation.org/ask-the-expert/sleep-hygiene

Drinking a cup of warm milk before going to bed helps in 30-40% of patients and they do not need medicines as per my clinical experience.

Let me know more so I can guide you further.

- What is your age and sex?

- Since when are you suffering from sleep disturbance?

- How did problem start? Was there any incident or gradually?

- Is there difficulty in sleep onset, fragmentation of sleep or early morning awakening?

- What was the schedule and duration of sleep before the problem started? How much reduction in sleep from previous?

- Do you have any stress in life (it can be social, economical,relationship, study/work or emotional)?

- Do you have any physical illness?

- Any day time sleepiness is there?

- Let me know content of your drugs. Estam 5 is escitalopram likely and it is an antidepressant. Clocit may be clonazepam but it should not be 5 mg, it should be 0.5 mg.

- Which doctor did you consult, physician or psychiatrist?

I will be happy to help further after your response.
Regards,
Dr.Chintan Solanki.



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki (27 minutes later)
Thanks for that detailed response, Sir.
I'm 21 yr old boy..
As far as your questions are concerned... I dont think there is any stress at all in my life.. No problem with my friends, studies, or family... But ya now its seriously effecting my studies... My memory is becoming weaker.. I feel that .... Just one think I would like to tell you my physician said that I want to do lots of stuff.... I mean regarding my studies only...
Sir to be XXXXXXX I wanna work hard, real hard to give this life a meaning...
But I'm not able to now....
My insomnia started 2 yrs ago... but somehow I dealt with it.... But now its costing me as I'm working to my potential for my career..
2 yrs ago... ya I was a bit disturbed when all my school friends just moved away for no reason... but I was fine... I took it... Other than that there is nothing that concerns me.... After that I decided to just be on my own and have been pretty good... my academics is really good... In my free time I do think about stuffs that can be created... I mean something new... Thats all I can tell you about me..
I consulted a physician... When she couldnt help it out... she advised me to meet a psychiatrist... and the psychiatrist suggested Clocit5 and Estam 5 as you said...Clonazepam 0.5mg & escitslopram oxalate..
Coming to my problem... I get sleep but my mind is active... am not dreaming but fully conscious... not at all good sleep...
Another thing I do have red chilly allergies... if it got to do anything with it...
I wanna be myself.... I 've been better ... help out doc!!!


doctor
Answered by Dr. Chintan Solanki (12 hours later)
Brief Answer:
you need lifestyle modification with relaxation techniques

Detailed Answer:
Hi XXXXXXX

Thanks for information and sorry for delayed response.

Your will to achieve more in career and other areas of life is likely not allowing to sleep you soundly. Person needs time for oneself and for leisure activities apart from study/work. You do not have many friends. You need to modify your lifestyle.

Spare some time for meditation, yoga, exercise, sports or other leisure activities which you can enjoy.

As such you do not have depression or stress but you are involved in thought more than the required in daytime so thought process continue in night also.

If you are getting enough quantity of sleep and quality is deteriorated, first step is follow sleep hygiene and follow the recommendation by me. As such there is no role of medicines.

You can go to psychologist/psychiatrist for counseling and behavioral therapy after evaluation of detail lifestyle.

All the best. Feel free to discuss further.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki (39 minutes later)
Sir, thanks for taking time for understanding me & real thoughtful response.

I agree with you I dont make too many frineds.. I dont enjoy much talking to others.. There goals and aspirations are different... Everyone around seems light headed... If you know what I mean...It does not mean I feel I'm better or superior than others.. I just dont find anything common in people... I had friends before but distanced myself from them as my school friends moved out of life for no reason... And just felt like its going to happen again and saw no point in making new.... Anyways thats what I thought initially... But I've changed and learned that people are important in life.. I'm trying to change from from being an introvert to friendly one but I hate it when I've to just pretend that I'm interested in someone or something when I'm completely not... I wanna be true to myself and others.. Dont wanna be phony.... I guess you get it..

But I've been meditating ever since I was a kid.. My father inculcated that habit into me and I kinda of started enjoying it and still practice it... I also like athletics... I was a long distance runner in my 2nd yr..

But the problem I see here is, if I dont think much as you say I do... I dont think I can ever be what I wanna be... I mean you know what its like out in the real world... I dont wanna be a mediocre... I'm not saying I'm too determined or narrow minded... But just I know I can do much, much more than I am doing now.... Just not in my right mindset and not working to my full potential...

How should I approach life then so that I'm happier after all this...
doctor
Answered by Dr. Chintan Solanki (18 hours later)
Brief Answer:
to bring out potential one should be relax

Detailed Answer:
Hi,

Thanks for clarifying. Sorry again for delayed response.

It is difficult to mention detail approach here as it needs lots of discussion with you. You are somewhat aware about your problem that is good. To succeed in life one must not think always. Our brain also needs rest. Just imagine if you run 20 km at a stretch you have to take rest otherwise there will be pain but if you will go slowly with intermittent rest for 20 km there will be no/less pain. Likewise to think/work effectively our brain needs relaxation and rest.
For rest sleep is necessary. Sleep is a function of body and almost one third of the life of human being passed in sleep.
Sleep has different stages like NREM and REM. NREM is restorative sleep which is essential for relaxation of brain. When person has more REM sleep he/she does not feel fresh and that is likely happening in your case.

You are not able to feel human relationship with bottom of the heart and that means you are over involved in your career advancement.

As I mentioned previously you need some counselling. There should be time management in which work while you work (or study while you study) and play while you play. In your case I guess your mind is preoccupied with always study or career related thoughts. This should not be there. Even giving attention to other areas of life may help you to work/study better.

I appreciate your ambitions and it is right that each of us is different. To bring out our potential we need to work hard but that should not be done at cost of health, relationship, social life or without human touch.

You are not happy only because you feel that only success can give happiness. But no scientific evidence support that.

You have already opened up your mind and moving forward. I think with professional counseling you can change your attitude in positive direction more.

Hope this answer will be helpful.

If still any query there, I will be happy to answer. If not, you can close the discussion and if feasible give your feedback and rating so I can improve my service. In future you can contact me directly on this site if you wish with this link:
XXXX
by clicking on 'Ask me a question' on same page.

All the best dear XXXXXXX


Above answer was peer-reviewed by : Dr. Yogesh D
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Dr. Chintan Solanki

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Practicing since :2007

Answered : 2406 Questions

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Suggest treatment for insomnia

Brief Answer: need evaluation for insomnia, provide more info Detailed Answer: Hello, Thanks for writing to us. You are suffering from sleep disturbance (insomnia). Insomnia (sleep disturbance) is of two types: 1. Primary: There is problem of only sleep disturbance and no other physical or psychological problem is there. In this case treatment for sleep problem is needed. 2. Secondary: There is some underlying physical or psychological problem which is responsible for sleep disturbance. In this main treatment is done for underlying problem. I recommend first my patients to follow some measures called 'sleep hygiene' which would help in sleep. You can find the same in below link. sleepfoundation.org/ask-the-expert/sleep-hygiene Drinking a cup of warm milk before going to bed helps in 30-40% of patients and they do not need medicines as per my clinical experience. Let me know more so I can guide you further. - What is your age and sex? - Since when are you suffering from sleep disturbance? - How did problem start? Was there any incident or gradually? - Is there difficulty in sleep onset, fragmentation of sleep or early morning awakening? - What was the schedule and duration of sleep before the problem started? How much reduction in sleep from previous? - Do you have any stress in life (it can be social, economical,relationship, study/work or emotional)? - Do you have any physical illness? - Any day time sleepiness is there? - Let me know content of your drugs. Estam 5 is escitalopram likely and it is an antidepressant. Clocit may be clonazepam but it should not be 5 mg, it should be 0.5 mg. - Which doctor did you consult, physician or psychiatrist? I will be happy to help further after your response. Regards, Dr.Chintan Solanki.