coping with insomnia

My sleep has deteriorated significantly since menopause and some severe stressors and a trauma that all happened close together. My therapist and psych nurse say I have insomnia caused by generalized anxiety and ptsd. I am trying to do EMDR but I am so tired from lack of sleep I can hardly even drive to the therapist, let alone get through a session. I have tried everything natural and still my sleep has gotten worse. I get drowsy, fall asleep and then suddenly am awake again. Over and over. As my sleep deteriorated, I began to have flashbacks and panic attacks. I tried trazodone 25mg at bedtime. It worked so-so for a few months. Now it no longer works. Hypnotics don't work. In the past month I have taken xanax at bedtime more nights than not. If I don't take it I am lucky to get 2 hours of sleep. My primary and my sleep doc think I should just take the xanax every night. I see a psych nurse who wants to switch me to klonopin every night. I have never taken anything like this before and it scares me. But the lack of sleep is unbearable. Has anyone successfully taken a benzo for sleep for more than a few weeks or months? I am taking .5 mg of the xanax and 25 mg of trazodone about an hour before bed and then going to bed when I am very sleepy. I am very sensitive to meds so I don't want to take more. Either the xanax has made me forget or I am not startling awake when I take it. I tried no xanax last night and got zero sleep and am a wreck. I wonder if anyone has any thoughts about these meds, especially for longterm use.

Thank you.

hi juniper
the Xanax is an antianxiety. if it is keeping you asleep I would surmise that is is anxiety that is waking you up or preventing you from sleeping. LOTS of people regularly take benzos on a daily basis and at a much higher dose. the difference between Xanax and klonipin isn't much. I have heard that klonopin doesn't enter your system as fast and it has a longer half life but don't quote me. my pdoc tried to give me benzos for sleep but they don't work so it is a routine practice. my personal concern with benzos is that they are addictive. I used to take klonopin for my anxiety, one a day, for a year as my pdoc told me to. then I found out they were addictive so I said I didn't want to do that anymore and I stopped. that wasn't wise. I had to start taking them again and wean myself off cutting them in half and half and half again till I was just taking little grains but I still went thru withdrawals over the months I was doing that. and I was only taking .05 which I think is the lowest dose. so now I take buspar for my anxiety which isn't addictive and keeps most of my anxiety at bay. I save klonopin for when it is really rough. welcome to psych central. you will find we have several forums where you can post about your concerns and receive feedback from other members. you will get a lot of support here. again, welcome

Thanks, Kaliope. I'm worried right now because I am exhausted and need to take a xanax but the more I read, the less I think I should. I'm so tired I can't think straight.

It sounds like your sleep problems began at menopause. You migbt do well to have your hormones checked and to read about the use of natural progesterone.

If your sleep problems began after a traumatic stress, you may be depletes of GABA. Benzos work on gaba receptors. Instead of taking addictive medicine you can replenish your GABA levels with he ami.o acid GABA in powd3r form (i like Billie Jay Sahleys protocol and her informative little books. Or you ca. Raise GABA even more naturally with an hour of yoga a day. (sorry, no print source for that one but it has worked for me, for ptsd in a very stressful environment with physical pain as Well).

I would ditch the psych nurse and therapist. You could roll a sevwred head into a "psychiatric professionals" office and get It filmes back to you with a dx and rx, thats how much they think about the body's role in psychiateic conditions.

Mental health minions confused my doctors by charting that I had borderline traits and probably bipolar. Yeah right. I developed a personality disorder at the age of fifty and have severe mood swings every twenty eigbt day right before my period. Ridiculous people.

Do your own reading about natural remedies for trouble related to menopause and the role of GABA in ptsd and sleep.

I once tried SSRIs and benzos and trazadone and sleep medicines in all kinda of combinations. Cash out of pocket. For more than a year. Nothing worked. Unless I washed it down with whiskey. I could have died from the amounts I drqnk. I quit It all in disgust and eventually tried GABA. All trauma hurts. PTSD kills. It kills through sleep deprivation, psychosis, suicide and alcohol abuse. Sometimes Ir kills through violence and sometimes reckless accident and sometimes our prison system. GABA can fix all that. Thats my soapbox story. If Its real PTSD you dont need your feelings validated and if Its menopause you dont need benzos. You need to bring your body back to Its.own balance.

You can get your feelings validated if you want. It dont hurt nothing. But its not how you get some natural drugfree sleep.

Check out Peter Levinex David Berceli and Bessel van ser Kolks endorsement of yoga for ptsd too.

Thanks. I am going to look into the hormones thing. Meanwhile, I think I am hooked on the xanax and am a wreck. I can't stop it because I can't sleep without it. I am wondering if I should switch to klonopin because it has a less abrupt action.

I don't think your situation is so much an 'either/or' thing as it is a combination of things.

I was early onset menopause beginning when I was 43. Lucky for me that was right around the same time I went 'bonkers' and was diagnosed with PTSD.

Insomnia became my constant companion, which I attributed more to the menopause than the PTSD though there were times when my PTSD would not allow me to 'turn my brain off' long enough to get to sleep. I barely functioned during that time. The good news is, it does get better. I literally and figuratively 'sweated' out the whole menopause ordeal because I didn't want to take hormones - real, artificial, or natural. I'm glad now I made that decision because in the long run it has paid off.

As to benzodiazepams, I have tried Ativan, Xanax, and am currently taking Klonopin. The Ativan really messed with my short term memory, so I stopped after a few months. I took Xanax only on an as needed basis when I first began EMDR because it made me too sleepy. I now take Klonopin 1 mg twice a day. I started at .25 mg a day and have slowly over the last year worked up to the 1mg dose. It works great for my anxiety and if I am having trouble sleeping i.e. ' I can't turn my brain off to save my ever-lovin' life' syndrome, I wait and take the second dose closer to bedtime.

I say do whatever works, and if taking the Xanax at bedtime helps, stay with it. If at some point it doesn't work anymore, try switching to Klonopin and see if that helps.

Unfortunately this stuff is a lot of trial and error because what works for one person, doesn't work for another. It sucks, I know, but well worth the effort when you finally find the combination that works for you. I have a concern myself about the length of time I have been taking Klonopin, and at my next pdoc appt. I intend to discuss it with him to see if it's time to switch to something else.

Can I ask you about your sleep doc experience?

Did your sleep doc try a natural route before putting you on medication? My sleep doc took me OFF everything and said I was only allowed to take melatonin while I was getting my sleep under control. She worked with me for a few hours during my initial consultation and I walked away with a list of about 10 things I had to do every day in order to get my sleep back on track. A number of them were basic sleep hygiene things, but others were tailored to my exact situation. Is this how your sleep doc helped you, or did he/she just give you medication?

Drugs can be dangerous for sleep as our bodies "forget" how to sleep and we become dependent. This is what happens with benzodiazepines. I was on Klonopin for a very long time, and unknown to me, I became dependent on them as my doctor just pushed my dose higher and higher when I complained of it not working. (This was when I foolishly trusted doctors and took anything I was given without question.) My body literally hit an abrupt tolerance, and they no longer worked for me. (We're talking quadrupling the dose and I wouldn't even get drowsy.) The next month was h*ll as I didn't sleep more than an hour a night, and it was only twilight sleep. I was lucky in that my withdrawal symptoms only lasted a month. Check out the benzo buddies website and you'll read PLENTY of horror stories about people who were still having withdrawal symptoms a year after coming off those darn drugs. So no, I don't recommend benzodiazepines as a nightly sleep aid.

Natural progesterone *may* help you if its hormonal. I am only in my 30's but have used a natural progesterone cream for PMS help. WHOA! That stuff knocks you out if you take a little too much (which isn't hard, as every system seems to need a different amount of it).

I wish you the best. I know how much no sleep stinks!

Sorry, I lost track of this thread. With insomnia, I lose track of a lot!

I didn't find the sleep doc to be all that helpful, but then I live in a semi-rural area and we don't have very good doctors here. Of course, I got the typical sleep hygiene stuff. I was already doing all of that. I learned that trazodone can aggravate restless leg syndrome, so I am weaning off of that. I learned that sleep restriction is popular with sleep docs and that it just about killed me and did no good at all. I learned that I really needed a prescribing psych nurse because sleep docs have no clue about ptsd. I learned that different prescribers have their own favorite drugs and tend to prescribe them to everybody.

I have been taking the xanax for sleep now for about a month, and, yes, I am dependent on it. But I was sleeping 1-2 hours/night without it. I tried everything under the sun before I tried the xanax. I was near complete collapse from lack of sleep. Actually, I was collapsed, just not dead yet. I was losing weight (and I am already thin). I was having flashbacks and panic attacks like I had never had before. I was out of options. Take the xanax or die. I took the xanax.

Now I can eat and sleep and think. I am working on improving my health (diet and exercise) and improving my ptsd symptoms. Then I will think about what my long-term sleep plan is. For now, I am just so relieved to have my brain back!

Hope you are sleeping well these days, too!