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Dr. Bob is Robert Hsiung, MD,
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Posted by KaraS on September 18, 2005, at 23:58:09
In reply to Re: Meds are screwing up my sleep cycle » KaraS, posted by Sarah T. on September 17, 2005, at 22:58:58
Hi Sarah,
Thanks for your support.
> I'm so sorry that you're having such a difficult time. I'm even more sorry that I don't have much to suggest because I suffer from very similar problems. My circadian rhythms have been whacky for years. The only things that seem to help me are exercising early in the day, and doing that on a regular basis, and having to be some place (such as a job or school) on a regular basis. I think the most important things are regularlity and consistency.
I'm going to try to exercise early in the day (if/when I'm able to get up then). I wish I had something to get up for - like a job or school. I'm worried now that I turn my alarm off without thinking about it or remembering it, that I might not get up even on those times when I have to.
> I have read that vigorous or fairly vigorous exercise suppresses melatonin for about 12-13 hours in some people. That seems to be true for me. The timing of my exercise seems to have more to do with when I get sleepy than when I've woken up that morning. If I get up at 7 a.m. but don't exercise until 2 or 3 in the afternoon, I'm unable to sleep until about 2 or 3 in the morning, no matter how tired I am.
>
> Are you taking Dexedrine now? How late is your last dose? For some reason, when I was on Dexedrine, it didn't affect my sleep cycle much. Again, the timing of my exercise seemed to have more to do with my ability to fall asleep than anything else. So, you're still on Doxepin. Are you still on that very low dose? How late do you take it? Do you think you'd be less groggy if you took it earlier the night before?
I haven't been taking the Dexedrine as I have been waiting to get my sleep cycle under control. I'm not sure whether it would stimulate me or put me to sleep so it's hard to add it to the mix now.
> I wish so much that I could help you. The only thing that seems to help with problems like this is military-like discipline regarding one's schedule. It helps to HAVE to be some place in the morning, no matter how gruesome the thought. Or, perhaps, it's best to find a job with later hours, such as a second shift job or nearly second shift. I once had a job that was from 1 p.m. to 9 p.m. I liked those hours. When I've had second shift jobs, I've never, ever been late, and I've never had difficulty getting to work. I truely believe that some people are night owls and others are larks, so it may turn out that we shouldn't try to fight who we are. Maybe we have to accept that we're night owls and adjust our lives accordingly. I don't think I've reached that stage of acceptance yet. I'm still trying to fit in with the larks.I'm sure I'm an owl but I'd settle for being on a nighttime schedule. Right now I'm not just late, I'm totally irregular in the hours I've been keeping.
I don't know what the answer is but just listening to me and offering your support helps a lot. Thank you!
K
Posted by KaraS on September 19, 2005, at 0:05:26
In reply to Re: Meds are screwing up my sleep cycle, posted by yxibow on September 17, 2005, at 23:04:20
> I think that part of the problem is the meds I'm taking. The doxepin makes me so groggy.
>
>
> That is very natural, at least initially, it should get better over time.
I've been on this medication off and on for many, many years now. Right now I'm only taking a small amount of it for anxiety and sleep. I know that it's not going to get any better than this unfortunately.
> I think that the beta blockers I've been taking are making the situation worse because I no longer can use caffeine to keep me awake longer.
>
> Initially some beta blockers (I'm assuming you're probably taking propranolol) can cause both CNS depression, increase depression, and cause low blood pressure (which is basically what the drug does in the first place).
I'm taking atenolol which is cardio-selective. I'm also taking a small amount of it. I don't think it's adding to the depression but it may be.
> I think I need to take something instead of doxepin for my anxiety and insomnia (which I have without the doxepin in my system). I'm so frustrated with this situation. I don't know if there's anything anyone can say but I needed to rant about it.
>
>
> I think you should discuss your chronic insomnia (something I'm well aware of personally, and something I know affects both anxiety and depression) with your doctor, and see if a better medication can be used besides doxepin. Doxepin (Sinequan) can be a very sedating tricyclic antidepressant. I would look to the newer sleep agents such as Ambien (which can be taken for longer terms despite what it may indicate) or Ambien CR. Also the one actually approved for long term usage, Lunesta, can be used, but be aware that it can and has given a number of people (including me) a wierd metallic taste when it takes effect -- for most all people this dissappears by morning. The third in this benzodiazepine-related class is Sonata, although that tends to be much more subtle for people, even more subtle I think than Lunesta, and does not always work for everyone.
>
> If your doctor is uncomfortable with these medications, which I personally think are the best solution for insomnia (taking medications intended exclusively for it), there are other choices. There are the benzodiazepines Restoril (temazepam) and the one with a worse reputation but I dont think is particularly different, Halcion (triazolam).
>
> If your doctor does not like any benzodiazepine or benzodiazepine-related medications, you can either a) find another doctor, or there are the third alternatives, drugs used for their side effects, besides Doxepin, there is Trazodone, an old antidepressant related to nothing else. One can get used to it though and get up beyond the normal sleep dosages; that depends on the individual.
Yeah, I do need to discuss this with my pdoc to see if I can find something else to deal with my anxiety and perhaps a sleeping pill for the insomnia. I couldn't take trazadone so it will need to be one of the others that you've mentioned.> I hope that helps, and I know insomnia can be a frustrating situation. Hopefully one of these medications, combined with consistent sleep times and other sleep hygiene methods, will give you some peace.
>
> My 2c.
Yes it does help. Thank you for taking the time to answer my post. I appreciate your "2c".K
Posted by KaraS on September 19, 2005, at 0:07:21
In reply to Re: Meds are screwing up my sleep cycle » KaraS, posted by Ilene on September 17, 2005, at 23:54:32
> I used to keep my light box plugged into a timer and next to my bed. It really worked when I was having sleep cycle problems.
>
> I.
Hi Ilene,Where did you get the timer and how did you know how to hook it up?
Thanks,
Kara
Posted by KaraS on September 19, 2005, at 0:10:13
In reply to Re: Is losing sleep worth the payoff??????????????, posted by UgottaHaveHOPE on September 17, 2005, at 23:58:58
> thats really what it comes down to ...
>
> is the medicine that you are taking helping you? if it is, what is more important to your overall health, better sleep or the results of the medications.
>
> i feel for you, kara, because i, too, have a messed up sleep schedule and am often groggy the entire day. but my pdoc told me to ask myself: "is it worth the payoff?" is it worth having my anxiety which ravaged me for years greatly reduced? for me, YES, YES, YES!
>
> you will have to decide for u.
Yes, this grogginess and sleep cycle irregularity is definitely better than the insomnia and the horrible anxiety... but hopefully I can figure out some way to cover those and still have a normal sleep/wake cycle and be able to function during the day!
Posted by KaraS on September 19, 2005, at 0:17:51
In reply to sleep is number 1., posted by linkadge on September 18, 2005, at 16:26:14
> I don't care what doctors say. Do not put up with insomnia as a side effect of antidepressants. Attack the insomnia as agressivly as you would attack the depression itself. THe depression will not get better long term if the insomnia doesn't.
>
> In hindsight the insomnia was the biggest factor that kept me from improving.
>
> I would say trust your gut. Don't let a med interfere with sleep, eating, concentration etc.
>
> The body is a system and a whole. And it needs to be treated as such.
>
>
> Linkadge
Yes definitely, but without these meds I don't sleep at all and am extremely anxious. Finding meds that can allow sleep and thinking clearly and cover anxiety and depression is not easy (as you know). I guess I just have to keep trying to find some combination of medications (along with other kinds of help) that will take care of all of my issues without making me groggy and mentally slower. In the meantime, at least I'm sleeping.k
Posted by Sarah T. on September 19, 2005, at 0:24:19
In reply to Re: Meds are screwing up my sleep cycle » yxibow, posted by KaraS on September 19, 2005, at 0:05:26
Hi Kara,
I'm sorry if you've already mentioned this, but I've forgotten why you couldn't take Trazodone. I couldn't take it either. I have a paradoxical reaction to it.
S.
Posted by Sarah T. on September 19, 2005, at 0:31:58
In reply to Re: Meds are screwing up my sleep cycle » Sarah T., posted by KaraS on September 18, 2005, at 23:58:09
Hi Kara,
You said that you are worried you might turn off the alarm without remembering it, etc. I worry about that, too, so you know what I do? You're probably going to think this is excessive. . .I have five alarm clocks. I have a few electric ones and a few battery-operated ones as back ups. The electric ones are louder and even more annoying than the others. I place them all around the room so I have to get out of bed to turn them off. My father used to suggest putting a metal alarm clock on a plate so it would make a lot of noise. I hate my alarm clocks. I'd like to throw them all out the window.
S.
Posted by UgottaHaveHOPE` on September 19, 2005, at 2:06:44
In reply to Re: sleep is number 1. » linkadge, posted by KaraS on September 19, 2005, at 0:17:51
oh yeah, no doubt about it, if you dont get your sleep, it may send your entire day into a tailspin. it does with me every time. sleep is the first step of the day. if you dont get it, yikes.
my problem with the meds is that they make me toooo groggy. i am too sleepy. but again, my pdoc said is it worth it? can you put up with sleeping good but being groggy all day and having your anxiety reduced at the same time? YES SIR. that was the easiest decision of my life. i have GOT to have my sleep!
Posted by KaraS on September 19, 2005, at 6:17:10
In reply to Re: Kara, ques about Trazodone » KaraS, posted by Sarah T. on September 19, 2005, at 0:24:19
> Hi Kara,
>
> I'm sorry if you've already mentioned this, but I've forgotten why you couldn't take Trazodone. I couldn't take it either. I have a paradoxical reaction to it.
>
> S.Nausea. I was on Trazadone for over two months and the nausea never went away. I was so bummed because it worked for sleep without increasing my appetite.
Posted by KaraS on September 19, 2005, at 6:30:15
In reply to Re: Kara, regarding alarm clocks - ugh! » KaraS, posted by Sarah T. on September 19, 2005, at 0:31:58
> Hi Kara,
>
> You said that you are worried you might turn off the alarm without remembering it, etc. I worry about that, too, so you know what I do? You're probably going to think this is excessive. . .I have five alarm clocks. I have a few electric ones and a few battery-operated ones as back ups. The electric ones are louder and even more annoying than the others. I place them all around the room so I have to get out of bed to turn them off. My father used to suggest putting a metal alarm clock on a plate so it would make a lot of noise. I hate my alarm clocks. I'd like to throw them all out the window.
>
> S.
NO, I definitely don't think that 5 alarm clocks is crazy. I have used three until recently when one of them broke. I had them strategically placed as well. For one of them I have to get up out of bed. I tried putting one in the living room but I didn't hear it. Maybe I should get a couple more of them and place them on the other side of the room. It's worth a shot anyway.I had a friend come to visit last year. She said that my alarm clocks would go off and I would be sleeping through it. They were plenty loud too. I guess that explains why my alarm clocks were running so late. :-) Now I have one of them set for the radio to come on very loudly. I don't think I have ever slept through that though. I hate them too.
Posted by KaraS on September 19, 2005, at 6:39:39
In reply to Re: Let me clarify: Sleep is definitely No. 1, posted by UgottaHaveHOPE` on September 19, 2005, at 2:06:44
Posted by linkadge on September 19, 2005, at 10:44:52
In reply to Re: sleep is number 1. » linkadge, posted by KaraS on September 19, 2005, at 0:17:51
Of course some sleep is better than no sleep. For me, insomnia wasn't too big an issue untill I started AD's.
I noticed the longer I took them, that the crappier the quality of my sleep became, and the longer I actually needed to stay in bed.
On the 5th year of celexa, I was sleeping upwards of 14 hours a day, and it wasn't sleep at all.
The biggest problem was the fact that since I didn't get deep sleep, I wasn't awake during the day which made me significantly dumber, and consequently more depressed and anxious.
Linkadge
Posted by linkadge on September 19, 2005, at 10:50:58
In reply to Re: Let me clarify: Sleep is definitely No. 1, posted by UgottaHaveHOPE` on September 19, 2005, at 2:06:44
I am not saying you should change things.
I just know for me, that being groggy during the day was unacceptable. The more groggy I was the dumber I became in class.
The dumber I was in class the more anxious I was, and the less I slept.
It was a bad cycle, and the meds I was on were simply not helping to break it.
Linkadge
Posted by Ilene on September 19, 2005, at 12:57:52
In reply to Re: Meds are screwing up my sleep cycle » Ilene, posted by KaraS on September 19, 2005, at 0:07:21
I probably got the timer at a hardware store, and it was easy to set up. It has a clock dial, and you put little pins in at the times you want it to go on and off. You plug the light box into the timer, and the timer into the outlet.
I.
Posted by Sarah T. on September 20, 2005, at 0:27:21
In reply to Re: sleep is number 1., posted by linkadge on September 19, 2005, at 10:44:52
Hi Linkadge,
First, I have to comment on your phrase, "I wasn't awake during the day which made me significantly dumber." In order for you to be "dumber," you'd have to be dumb. You are not dumb. You are so smart!
Secondly, I know what mean though. I've had the same problem with poor sleep on AD's. I actually function better on just a few (3-5) hours sleep with NO meds than on 7 or 8 hours with meds. When I started taking ssri's, I noticed I had to spend MUCH more time in bed. On Celexa, I had to spend AT LEAST two extra hours in bed beyond my usual amount because, on Celexa, I would wake up in the middle of the night every night for about two hours. Nothing, absolutely nothing, would put me back to sleep except the passage of time (those two hours). During those couple of hours, I would also get very hungry, but it wasn't a healthy kind of real hunger that I usually have when I'm hungry. It was sort of a gnawing, edgy feeling in my stomach. I would eat, but the food wouldn't make that edginess or anxiety go away. Ugh! I don't know how I ever took that medicine.
Posted by KaraS on September 20, 2005, at 6:57:25
In reply to Re: sleep is number 1., posted by linkadge on September 19, 2005, at 10:44:52
> Of course some sleep is better than no sleep. For me, insomnia wasn't too big an issue untill I started AD's.
>
> I noticed the longer I took them, that the crappier the quality of my sleep became, and the longer I actually needed to stay in bed.
>
> On the 5th year of celexa, I was sleeping upwards of 14 hours a day, and it wasn't sleep at all.
>
> The biggest problem was the fact that since I didn't get deep sleep, I wasn't awake during the day which made me significantly dumber, and consequently more depressed and anxious.
>
>
>
> Linkadge
>
That's a good point. Sometimes meds that allow us to sleep don't give us quality sleep and so we still feel tired and not very sharp during the day. Other times the meds themselves prevent sleep. It's so hard to get on an antidepressant that allows one to sleep well and doesn't interfere with daytime abilities.k
Posted by KaraS on September 20, 2005, at 6:59:02
In reply to Re: Meds are screwing up my sleep cycle » KaraS, posted by Ilene on September 19, 2005, at 12:57:52
> I probably got the timer at a hardware store, and it was easy to set up. It has a clock dial, and you put little pins in at the times you want it to go on and off. You plug the light box into the timer, and the timer into the outlet.
>
> I.
>
Thanks so much. I'll definitely check it out.k
Posted by linkadge on September 20, 2005, at 13:07:30
In reply to Re: Meds are screwing up my sleep cycle » Ilene, posted by KaraS on September 20, 2005, at 6:59:02
Of course you're not looking for somebody to tell you to get off your meds.
As far as other recomendations, I would try the trazedone with some ginger root.
I have recommended ginger root to number of people who get nausia from serotonergic medications.
It is very good at preventing nausia, and it is a mild sedative in itself. If the only problem with the trazedone was nausia, then it might be worth a shot.
Ginger root blocked the nausia I got from celexa.
(I was vomiting)Take care
Linkadge
Posted by KaraS on September 20, 2005, at 21:17:58
In reply to Re: Meds are screwing up my sleep cycle, posted by linkadge on September 20, 2005, at 13:07:30
> Of course you're not looking for somebody to tell you to get off your meds.
>
> As far as other recomendations, I would try the trazedone with some ginger root.
>
> I have recommended ginger root to number of people who get nausia from serotonergic medications.
>
> It is very good at preventing nausia, and it is a mild sedative in itself. If the only problem with the trazedone was nausia, then it might be worth a shot.
>
> Ginger root blocked the nausia I got from celexa.
> (I was vomiting)
>
> Take care
>
> Linkadge
>I've tried ginger in capsules and it hasn't helped with the nausea I sometimes get from CFS. Are you saying that it hs to be from the root?
Posted by tizza on September 21, 2005, at 3:01:38
In reply to Re: Meds are screwing up my sleep cycle » linkadge, posted by KaraS on September 20, 2005, at 21:17:58
I totally understand insommina, it drives you nuts. I'm on efexor xr and yes it has reduced my anxiety but I find it really hard to sleep. I'm still taking valium for anxiety and was taking mogadon for sleep but my pdoc has decided to switch my sleep med to Imovane (sister to Lunesta) not avaible in the US, either is mogadon (benzo) which is an excellent sleep aid but does make you groggy in the morning for the first few times you take it and does't leave that vile metallic taste in your mouth like Imovane and Lunesta. I have tried a few anti psych's for sleep and couldn't get out of bed at all, Zyprexa and Seroquel turn me into a total zombie. It's just so hard to find a good sleep aid and a good nights sleep is the key for a healthy new start. Hope I was of some help
Posted by gromit on September 21, 2005, at 11:20:38
In reply to Re: Kara, regarding alarm clocks - ugh! » Sarah T., posted by KaraS on September 19, 2005, at 6:30:15
Hi Kara,
> NO, I definitely don't think that 5 alarm clocks is crazy. I have used three until recently when one of them broke. I had them strategically placed as well. For one of them I have to get up out of bed. I tried putting one in the living room but I didn't hear it. Maybe I should get a couple more of them and place them on the other side of the room. It's worth a shot anyway.
I read somewhere, maybe in a book by Dr Amen that he had several clients who had commercial burglar alarms installed because nothing else would work! When I was a kid my dad would have to shake me awake in the morning.
> I had a friend come to visit last year. She said that my alarm clocks would go off and I would be sleeping through it. They were plenty loud too. I guess that explains why my alarm clocks were running so late. :-) Now I have one of them set for the radio to come on very loudly. I don't think I have ever slept through that though. I hate them too.It can be next to my bed full blast and it might take an hour to wake me up. I have to put it across the room and play rap music or something else I can't stand. Lately I just wake up enough to pop an adderall and I get up easily when that starts to kick in.
Rick
Posted by linkadge on September 21, 2005, at 13:18:26
In reply to Re: Meds are screwing up my sleep cycle » linkadge, posted by KaraS on September 20, 2005, at 21:17:58
No no, the stuff you took was probably a ginger root extract. If it didn't work for you then thats ok.
Have you tried seroquel ? At low doses it can be very good for sleep, and posess very few antipsychotic like side effects.
Linkadge
Posted by grammy on September 22, 2005, at 2:37:16
In reply to Re: Kara, ques about Trazodone » Sarah T., posted by KaraS on September 19, 2005, at 6:17:10
Me, too - I had to quit taking it because of the nausea. It really helped with the sleeping and I hated to get off of it, also. Carole
Posted by KaraS on September 25, 2005, at 2:03:47
In reply to Re: Meds are screwing up my sleep cycle, posted by tizza on September 21, 2005, at 3:01:38
> I totally understand insommina, it drives you nuts. I'm on efexor xr and yes it has reduced my anxiety but I find it really hard to sleep. I'm still taking valium for anxiety and was taking mogadon for sleep but my pdoc has decided to switch my sleep med to Imovane (sister to Lunesta) not avaible in the US, either is mogadon (benzo) which is an excellent sleep aid but does make you groggy in the morning for the first few times you take it and does't leave that vile metallic taste in your mouth like Imovane and Lunesta. I have tried a few anti psych's for sleep and couldn't get out of bed at all, Zyprexa and Seroquel turn me into a total zombie. It's just so hard to find a good sleep aid and a good nights sleep is the key for a healthy new start. Hope I was of some help.
Thanks. I'll probably be trying a benzo or Ambien or Lunesta eventually.
Posted by KaraS on September 25, 2005, at 2:19:20
In reply to Re: Kara, regarding alarm clocks - ugh!, posted by gromit on September 21, 2005, at 11:20:38
Hi Rick,
> I read somewhere, maybe in a book by Dr Amen that he had several clients who had commercial burglar alarms installed because nothing else would work! When I was a kid my dad would have to shake me awake in the morning.OMG, what a riot! I can just imagine having that burglar alarm installed in my apartment. I imagine my neighbors wouldn't be very happy about it. Actually, even if one lived in a house, it had better be a long distance from any other house if a burglar type alarm is installed.
If your dad had to shake you to wake you up, then you must really understand what I'm dealing with.
> It can be next to my bed full blast and it might take an hour to wake me up. I have to put it across the room and play rap music or something else I can't stand. Lately I just wake up enough to pop an adderall and I get up easily when that starts to kick in.Hmmmm. Those are two good ideas. I never considered loud music I didn't like. Also, if I can get the Dexedrine to be stimulating then popping one of those would be a great solution.
Thanks.K
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