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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Azurebluesky on June 23, 2004, at 6:51:25
My problem is sleep anxiety, GAD and agoraphobia, although the biggest problem is sleep anxiety. Last year I had the worst experience of my life with sleep anxiety, I had a month and a half of not sleeping, getting up the next day with unbelievable anxiety from the minute I woke up..the hour or so I did actually manage to sleep I experienced terrible dreams, night sweats etc. I would be horribly anxious all day thinking about whether or not I was going to sleep, and as a consequence the thought of actually going to bed would throw me into a spiral of mega-anxiety and I couldn't sleep.
I felt utterly alone and terrified, and eventually it began to erode at my sanity until all I could think about was suicide, it just seemed endless. Eventually, after seeing various doctors of a period of two weeks on a daily basis, during which I was prescribed Zimovane (knocked me out for about three hours max), One of the Pams (can't remember which, probably Temazepam...knocked me out a little longer, but felt grotty and panicky all the next day), Cipralex (sent my anxiety through the roof, seriously thought I was going to explode with all the panic!), and Diazipam (did nothing except give me a bad stomach).
Eventually I discovered this web site, and can honestly say it was my salvation. I read all the posts about various treatments before deciding that Remeron/Zispin was the one for me. It put a cap on my anxiety straight away and I slept through the night. Eventually I returned to normal and could function and actually enjoy life.
I dropped myself down from 30 to 15mg and was fine with that for nearly a year until a couple of weeks ago when for some reason I couldn't sleep...starting up the whole horrendous anxiety/not sleeping cycle again. I upped my dose to 30mg and I'm slowly making my way back to normality, sleeping a little more each night.
What I was wondering is, has anyone else experienced chronic sleep anxiety? How did you cope with it? and what drugs did you try? The reason I'm asking is because of Remeron's notorious weight gain issues, I've put on around 20 pounds and just can't lose it.
Btw, at the height of my anxiety my body felt like it was being scrubbed by wire wool and my lungs felt as though they were full of ice!! Anyone else experienced that?
Thanks for listening....hope someone can help.
Posted by King Vultan on June 23, 2004, at 17:01:14
In reply to Can anybody help, trouble with sleep anxiety..., posted by Azurebluesky on June 23, 2004, at 6:51:25
Well, I don't have a problem falling asleep, but as I know some others do, I have trouble falling back asleep in the middle of the night after I've woken up. In my case, anyway, sleep anxiety does kick in at this point because there have been so many times that I haven't been able to get back to sleep in that situation that I tend to feel a little anxious about it. I've noticed my thoughts will also race from one subject to another, which I think contributes to the problem.
As I've mentioned before, what I've recently started doing to help combat my MAOI insomnia, which mainly consists of waking up throughout the night, is to use a sleep/relaxation CD. The one I use is designed to generate delta waves in the brain, which helps you sleep better. I am also alternating every other night between using 50 mg Benadryl and 0.125 mg Halcion, but I would say the sleep CD is probably just as important as the drugs.
Alternatively, you can try to approach this from a cognitive behavioral standpoint, perhaps trying to come to terms with your anxiety through therapy or perhaps with insights gained from a self help book. I would also suggest you might want to explore ways to relax, meditation, etc. What it comes down to is that you want to divert your attention from your anxiety to something else where you have the opportunity to relax and fall asleep. Even doing something as simple as slowly counting backwards from 100 can help you relax and induce sleepiness. If you would then care to supplement with drugs in a more relaxed/less anxious state, I believe you would find them to be more effective.
Todd
Posted by King Vultan on June 24, 2004, at 12:32:34
In reply to Can anybody help, trouble with sleep anxiety..., posted by Azurebluesky on June 23, 2004, at 6:51:25
Recognizing it may take you some time to deal with this problem, other drugs you might consider in the meantime that are similar to Remeron but may not have quite the same propensity for weight gain are the tricyclic antidepressants doxepin and trimipramine (Surmontil). Both of these are powerful antihistamines, which will aid sleep and tend to have a calming effect, and the Surmontil, in particular, is noted for having some unique pro-sleep qualities. Remeron is a powerful antihistamine also but, in addition to that, has a powerful blockade of 5-HT2 (serotonin-2) receptors that further increases appetite (beyond that of the antihistaminic effect itself, which is often very significant). The two tricyclics have these 5-HT2 blockades as well, but they are weaker in comparison to Remeron's, at least according to the data I have available.
Todd
Posted by Azurebluesky on June 26, 2004, at 5:02:58
In reply to Re: Other drugs, posted by King Vultan on June 24, 2004, at 12:32:34
Hi Todd, many thanks for taking the time out to reply, I found your posts really helpful, in fact I went out and bought a relaxation cd...and I do think it helps. Regarding the medication...Surmontil sounds interesting, I think I might bring it up with my Doc, although he gets distinctly narky when I make my own suggestions! Anyway, thanks again.
Posted by jeopardy on June 26, 2004, at 12:54:30
In reply to Can anybody help, trouble with sleep anxiety..., posted by Azurebluesky on June 23, 2004, at 6:51:25
For a great nights sleep I take 5 or 10mg amitriptyline 4/5 hours before bedtime. This won't make you tired but once you get to sleep it will put you into that great stage 4. I do take a small dose of xanax .25mg or.5mg to make me fall asleep. If you take the amitriptyline too late in the evening it does tend to leave a hangover. I take it about 12 hours before I want to get up. If i'm getting up at 6am I take it at around 6pm and go to bed around 10pm. This works perfect for me. I used to be a terrible sleeper but now I actually look forward to going to bed.
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