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Taking Syndol And Hydrocortisone. Have Partial Hydroxylase Deficiency. Suffering From Sleeplessness. Side Effect Of Hydrocortisone?

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Posted on Mon, 25 Jun 2012
Question: Have been taking 2 syndol daily now for 4/5 years as it helped me sleep. I also take 20mg of hydrocortisone at eight in the morning for my condition which is partial hydroxylase deficiency. The hydrocortisone was keeping me awake at night hence the fact that I took the syndol. What can I safely take as I feel that I do need something to help me - am finding one that 2 syndol are not doing the trick as they used to and am not sleeping again. I am a 42 year old female. I have been taking hydrocortisone since I was 20.
doctor
Answered by Dr. Gyanshankar Mishra (29 minutes later)
Hi,

Hi thanks for posting your query.

After going through your query, I would like to comment the following:

1. You seem to be suffering from steroid induced insomnia, as a result of long term steroid therapy for congenital adrenal hyperplasia.

2. Syndol caplets contain four active ingredients, paracetamol, codeine phosphate, doxylamine succinate and caffeine. It is recommended for Short-term (up to three days) treatment of acute, moderate pain which is not relieved by paracetamol, ibuprofen or aspirin alone. Thus it is not meant for insomnia. The effect of sleep associated with it could be due to the presence of codeine in it. It has drowsiness as one of its known side effects! Thus you should not take syndol for sleep. Please consult your physician regarding this.

3. For steroid induced insomnia you may take a sleep medication of the benzodiazepine group (eg. alprazolam) or non benzodiazepine group l(eg. zolpidem), under prescription from your physician. For this you need to visit a psychiatrist, get your self evaluated and treated accordingly. Please do not self medicate yourself.

4. Also you should follow certain sleep hygiene measures , that will help you sleep better:

Sleep hygiene:

I. Avoid
1. Avoid alcohol: It can initially make you a bit drowsy, but has the potential to aggravate heartburn thereby causing nocturnal awakening.
2. Avoid caffeine: Avoid all caffeine containing products at bed time. It is present in coffee, tea, cola, and chocolate.
3. Avoid using your bed for any other activities like watching Television, eating food,etc.

II. Adjust
1. Sleep schedule at night: Maintain a strictly regular sleep schedule (Follow the same time every night) and keep daytime naps to the minimum which may cause disturbance in your wake-sleep cycle (Circadian Rhythm).
2. Get enough sleep: The typical requirement is 6 to 8 hours of sleep per night.

III. Add
1. Create a “sleep-friendly” environment: Minimise light and noise coming from exteriors; use comfortable bed and pillows; do not sleep in a room that is too warm.
2. Exercise: Maintain an exercise program – It could be long walk or visit to the gymnasium (during daytime), but never do it close to bedtime.
3. Relax before going to bed: Do not think too much before retiring to bed; you may take a warm bath, spend some time reading a book, or may meditate and finally wind down.
4. Light snack: You can enjoy a glass of milk or carbohydrate-rich snack (low in sugar) prior to going to bed.

Following these measures will definitely help you with a good night’s sleep.

I hope I have answered your query. I will be glad to answer any follow up queries.

Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Gyanshankar Mishra

Pulmonologist

Practicing since :2003

Answered : 600 Questions

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Taking Syndol And Hydrocortisone. Have Partial Hydroxylase Deficiency. Suffering From Sleeplessness. Side Effect Of Hydrocortisone?

Hi,

Hi thanks for posting your query.

After going through your query, I would like to comment the following:

1. You seem to be suffering from steroid induced insomnia, as a result of long term steroid therapy for congenital adrenal hyperplasia.

2. Syndol caplets contain four active ingredients, paracetamol, codeine phosphate, doxylamine succinate and caffeine. It is recommended for Short-term (up to three days) treatment of acute, moderate pain which is not relieved by paracetamol, ibuprofen or aspirin alone. Thus it is not meant for insomnia. The effect of sleep associated with it could be due to the presence of codeine in it. It has drowsiness as one of its known side effects! Thus you should not take syndol for sleep. Please consult your physician regarding this.

3. For steroid induced insomnia you may take a sleep medication of the benzodiazepine group (eg. alprazolam) or non benzodiazepine group l(eg. zolpidem), under prescription from your physician. For this you need to visit a psychiatrist, get your self evaluated and treated accordingly. Please do not self medicate yourself.

4. Also you should follow certain sleep hygiene measures , that will help you sleep better:

Sleep hygiene:

I. Avoid
1. Avoid alcohol: It can initially make you a bit drowsy, but has the potential to aggravate heartburn thereby causing nocturnal awakening.
2. Avoid caffeine: Avoid all caffeine containing products at bed time. It is present in coffee, tea, cola, and chocolate.
3. Avoid using your bed for any other activities like watching Television, eating food,etc.

II. Adjust
1. Sleep schedule at night: Maintain a strictly regular sleep schedule (Follow the same time every night) and keep daytime naps to the minimum which may cause disturbance in your wake-sleep cycle (Circadian Rhythm).
2. Get enough sleep: The typical requirement is 6 to 8 hours of sleep per night.

III. Add
1. Create a “sleep-friendly” environment: Minimise light and noise coming from exteriors; use comfortable bed and pillows; do not sleep in a room that is too warm.
2. Exercise: Maintain an exercise program – It could be long walk or visit to the gymnasium (during daytime), but never do it close to bedtime.
3. Relax before going to bed: Do not think too much before retiring to bed; you may take a warm bath, spend some time reading a book, or may meditate and finally wind down.
4. Light snack: You can enjoy a glass of milk or carbohydrate-rich snack (low in sugar) prior to going to bed.

Following these measures will definitely help you with a good night’s sleep.

I hope I have answered your query. I will be glad to answer any follow up queries.

Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB