For me there are a few factors. One is simply an 18 year relationship with my pdoc; she can see I'm exhausted right now and she knows it's not normal for me to be this tired or not sleeping well. Another is that I'm on clozapine which is known for being very sedating and it doesn't make me sleep so I'm also on a high dose of gabapentin (most people divide my dose into 3 doses; I take it all at once). Lately I've needed 1-2 PRN doses on top of that and occasionally PRN klonopin which she knows I try hard to avoid. With all that sedation I've still not been getting a full night of sleep at all and it's been going on for months.

Another factor is that I don't ask for or take these meds easily. It has been 10 years since I was last prescribed a sleeping pill and there have certainly been times in there I've not slept well but adjusting my med doses or PRN doses have helped. This time nothing else has helped. I only got 10 pills and I'll take 4-5 of them and then wean off.

My pdoc also knows that my life has been extra stressful lately with the death of a loved one not that long ago and a potential move to another city along with COVID and some other things that are too complex to describe right now.

The biggest thing though is the relationship with my pdoc. She trusts me and I trust her. I don't know how I'll stand it when she retires.