Hello.
Thank you for your query at DoctorSpring.com
I have gone through your question in detail and I can understand what you are going through.
Its very common for sleep disorders to creep up after some stressful events. The kost common reason is anxiety associated with the event leads to neurotransmitter level changes which take time to settle down. Now you have already tried plenty of options. But other than what you have tried i would sugest you following few options.:
1. You may take clonazepam at 2 mg in night. Unlike ambien which is only a sleep inducing drug, clonazepam reduces anxiety as well.
2. Quetiapine in low doses like 25 mg will also be very effective. Its priparily an antipsychotic but is a good hypnotic as well. Both of them can be used together.
3. You need to start some aerobic exercises. That will make you tired and also release the feel good hormones ' endorphines'.
4. Relaxations exercises like yoga or meditation before the sleep is also a good way of getting the sleep.
Try using these three techniques and I guess you should be getting a good sleep.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help .
Wish you good health,
Kind regards
Dr. Srikanth Reddy M.D.
Patient replied :
Thank you very much for your response, it’s greatly appreciated. The oddest part is, I used to sleep totally sound and never remember waking up and could function better on less sleep even, pre surgery. I also recall having more dreams, pre surgery. It seems since that time my sleep cycle has been completely changed. I had leg surgery back in 2004 but that never disrupted my sleep once I recovered. What is very curious is why after the surgery did this all change.
My workout and calories are carefully planned as well, as to maintain my weight. I do work out early evening with weight lifting and cardio but I always have worked out at night and I find that I’m more tired when I try and sleep if I work out that night compared to when I don’t.
I’ve always been one to make sure things were resolved before bed and tend to plan out my next day, but I’ve always done that and pre-surgery that hasn’t bothered me. I did change jobs recently (July 2014) and that has definitely helped with me being able to get up in the morning. The atmosphere at the new job is much better. There is more responsibility and maybe stress, but I look forward to getting my work done. I’ve never been diagnosed with depression or anything but there are times where I feel…indifferent I guess and just don’t care. But I thought that stemmed from constantly being tired and frustrated that I can’t sleep the way I used to. Would any of those medications you mention affect my weight?
I also take Zantac in the mornings, sometimes at night. I tried the Omeprazole but that caused severe weight gain for me. Since I stopped that and went back to Zantac, the weight came right off again. All I take daily is Xyzal 5mg (allergy), Zantac 150, and Buspar 10mg. I’ve also been trying Ambien CR 12.5. It helps a bit but nothing like normal. I can tell it helps fall asleep quicker and instead of waking up every 1-2 hours without the pill, I only wake up every 3-4 hours when taking the Ambien. So it doesn’t completely knock me out. Also during my sleep studies, the doctor did say it seemed like I wasn’t hitting REM sleep for as long as I should have. Maybe a 1/3 of the time of what is considered “normal” I also had higher peak values coming out of sleep.
Hello
Thanks for all the additional information.
As I mentioned earlier, its difficult to predict how the body is going to respond to a stressful situation. Earlier you were well after the surgery, but this time after surgery you had sleep disturbance issues. Ambien is a very good drug and I would have suggested you the same, but the fact that it has not helped you, suggests that the other three mentioned options of quetiapine, clonazepam , and yoga may help you. The medicines quetiapine or clonazepam may have weight gain issues as happened in few of my patients but weight gain is not a rule. You may try taking them for a few weeks and if it causes weight gain then we can think of some other options.
Mostly after you start getting your sleep, we may even discontinue the medicines.
Kind regards
Dr. Srikanth Reddy