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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Taking Melatonin Due To Difficulty Sleeping. What Else Can I Try?

Hi I m a 24 year old female and I ve had this unbelievable problem with falling asleep for the last 4 year and day by day it gets worse. I ve tried over the counter meds and prescription but nothing seems to really help, although I ve been taking melatonin for the last week or so at 3mg up to 4 even 5 tablets to help me fall asleep and it still takes a long time, not saying its hasn t helped a bit with my severe sleep disorder but my problem still continues. I find myself laying in bed with my body completely exhausted and just waiting to get some rest but my mind is very active thinking so much even about trying to sleep most of the times it causes me migraines that it became another reason why I can t fall asleep and my mind is still racing. I have no problems when I m asleep I do wake up easily to the slightest sound or light but can maintain my sleep if I m deep in it and I don t want to wake up, I just can t fall asleep it s like my brain doesn t want to shutdown until utterly drained of any energy or power to think or function, sometimes I stay up 2 to 3 days at a time until I can get 7 or more hours of sleep, it s exhausting I haven t felt a normal peaceful sleep since I was maybe 10 or 13, I honestly tried meditation , relaxing music, hypnosis , exhausting myself with runs or working out my body by cleaning and labour , complete silence, no light, getting myself dissy to a point I can t even open my eyes or be on my feet , reading, writing, meds prescribed or over the counter nothing is giving me that serene healthy sleep. I don t even remember what sleep is, can you help with my problem of falling asleep? via Mo+ (http://nopal.us)
Wed, 13 Mar 2013
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Psychiatrist 's  Response
Hi there, thanks for asking. The problem you mentioned is called chronic insomnia. The methods you used are related to sleep hygiene or behavioral technics (relaxation, etc). Sleep hygiene improved 30 percent of insomniacs and relaxation (plus bed restriction which means you should not stay in bed more than 20 minutes awake in any condition) improves another 30 percent. Another 40 percent of them should take cognitive behavioral therapy for 8 to 12 weeks to solve their problem. I wish you a good health.
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Psychiatrist Dr. Seikhoo Bishnoi's  Response
Hello
Welcome to Health Care Magic

You have problem of primary insomnia. You are taking melatonin and no significant improvement noted. I will advise you that there is no use to take multiple doses of melatonin, as it is a sleep hormone drug, it improves sleep by improving sleep cycle in sleep centers in brain. If you will take multiple drugs, the excess amount will be only metabolized. Recently a newer drug which is an improvement of melatonin only has been launched. It is Ramelteon, it has been proved to be more efficacious than melatonin and it has no abuse potential. You can try it after advise of your doctor.
You have early as well as middle insomnia or difficulty in sleeping as well as multiple awakening in night. Medicines like Zolpidem extended release can be used in such cases, as they have very low abuse potential. Other drugs like benzodiazepine can also be used, but only under supervision of a psychiatrist as they have very high abuse potential. So visit a good psychiatrist for proper evaluation.

One more thing I will advise you to improve your sleep hygiene-
- Fix your time for sleep, and go to bedroom only when you have to sleep.
- Don't even think about sleeping on bed as repetitive thoughts about further worsen insomnia.
- Take warm water bath in evening
- Don't use bedroom for study or watching TV. Use bedroom for sleeping only.
- Don't talk on phone while on bed.
- Frequent change in position of bed in bedroom will also help.

So try these things at home and visit a psychiatrist for proper evaluation of sleep.

Thanks

Dr. Seikhoo Bishnoi
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Taking Melatonin Due To Difficulty Sleeping. What Else Can I Try?

Hi there, thanks for asking. The problem you mentioned is called chronic insomnia. The methods you used are related to sleep hygiene or behavioral technics (relaxation, etc). Sleep hygiene improved 30 percent of insomniacs and relaxation (plus bed restriction which means you should not stay in bed more than 20 minutes awake in any condition) improves another 30 percent. Another 40 percent of them should take cognitive behavioral therapy for 8 to 12 weeks to solve their problem. I wish you a good health.