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Re: Insomnia - what works for you?

Posted by King Vultan on September 1, 2004, at 16:46:45

In reply to Insomnia - what works for you?, posted by owensmar on September 1, 2004, at 15:09:37

> Some of us were discussing insomnia issues under the thread Ambien vs. Ativan. We thought it's probably a pretty big issue for a lot of us on this board so wanted to broaden the discussion to insomnia in general.
> What meds work for you (preferably without too many side effects or tolerance/dependence issues)?
> Is your insomnia categorized by the inability to fall asleep or inability to stay asleep?
> How do you avoid the tolerance issue?

I take an MAOI and can fall asleep but have problems with waking up throughout the night. I avoid the tolerance issue by alternating sleeping meds. I take a sedating OTC antihistamine one night and Halcion (triazolam) the next. For the antihistamine, I was using 2 x 25 mg Benadryl (diphenhydramine), which works okay but not great, but am now trying Unisom tablets, which contain 25 mg doxylamine succinate. I took one pill the other night and was surprised to find that this med is apparently much more anxiolytic than is Benadryl; apparently, antihistamines can be skewed either towards being sedative/hypnotic or being anxiolytic, just as is the case with the benzodiazepines. Still, the Unisom tablets seemed to work for sleep also, as the very pronounced calming effect seemed to keep my thoughts from racing in the middle of the night, which seems to be my big problem as far as getting back to sleep. I must say I seemed a bit more hung over the next day than I do with the diphenhydramine and was only going to try half a pill tonight.

I have never had to use more than half of a 0.25 mg pill of the Halcion, which perhaps helps me to avoid tolerance also. I do think Restoril/temazepam is probably a superior sleep med based on what I've read, but I haven't tried it. Halcion's half life is so short it really isn't the best choice for people who have trouble maintaining sleep. I think it works for me because I also use a sleep/relaxation CD played all night on repeat; this helps to keep me in a relaxed state so that when I wake up it isn't so difficult to fall back asleep.





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