Hi all. I have tried multiple sleep aid prescriptions. Ambien has been found to be the best but, for me it lasts about 2 hours and a 1/4 mg of Xanax is necessary to maintain some sedation with continued broken sleep. All in all I get about 4 fours of broken sleep a night. A prescription sleep med called Silenor has been on the market since 2010 and is dosed at 3 and 6 mg. It's active chemical is doxepin which is an H1 histamine antagonist. Doxepin is also used in an antidepressant called Sinequan but at a 25 - 150 mg daily dosage. Sinequan is generally prescribed with graduated dosages and when stopped must be decreased slowly. Silenor's patent is for 3-6 mg and prescribed ONLY for sleep. Sinequan is not prescribed at low dosages.

As my treatment is provided by the VA I am unable to get Silenor due to the cost of appx. $200 a month. Doxepin can be prescribed at 10 mg and comes in a gel capsule.

Has anyone used doxepin at this low dosage and experienced an improvement their sleep?

In addition I have moderate apnea. I do not use the CPAP as I cannot get somnolence so the mask will keep me awake even with the Ambien. My goal is to get somnolence with the doxepin and start using the CPAP.

Thanks

[thecrankyone]

I am currently taking it, but I don't have the bottle so I am not sure of the dosage. It does knock me out though most nights. Some nights it doesn't seem to work at all, other nights it knocks me right out.

[Skeezyks]

I don't have the sleep difficulties it sounds like you have, Herculepoirot. But I frequently either can't get to sleep, or I wake up in the middle of the night (needing to go pee) & then can't go back to sleep. When I do, I get up & do walking meditation. I walk throughout the quiet, darkened house around-&-around. I focus light attention on each foot as it touches the floor. Thoughts come & thoughts go. Periodically I chant. (See my Signature statement below.) Sometimes I'll walk for as long as two hours. I enjoy this so much that when I haven't done it for a couple of nights I miss it. I am fortunate that I don't have to work. So if I'm up for 2 or 3 hours or so during the night, I can sleep in a bit the next morning.

Originally Posted by Skeezyks

I don't have the sleep difficulties it sounds like you have, Herculepoirot. But I frequently either can't get to sleep, or I wake up in the middle of the night (needing to go pee) & then can't go back to sleep. When I do, I get up & do walking meditation. I walk throughout the quiet, darkened house around-&-around. I focus light attention on each foot as it touches the floor. Thoughts come & thoughts go. Periodically I chant. (See my Signature statement below.) Sometimes I'll walk for as long as two hours. I enjoy this so much that when I haven't done it for a couple of nights I miss it. I am fortunate that I don't have to work. So if I'm up for 2 or 3 hours or so during the night, I can sleep in a bit the next morning.

Thanks Skeexyks: My VA therapist has educated me on mindfulness and breathing exercises. I have tried this but not in a consistent manner as you. The biggest stumbling block is the mental inability to stay focused on basically nothing. When lying in bed I find that when my breathing is deeper the more relaxed I am and thus less anxious when arising. The number of hours actually sleeping stays the same at four hours and get up and walk to the kitchen to look at clock. Whenever I do a walk about thru the apt my mind speeds up as does my heart rate and then comes all the critical and negative thoughts which prevents a return to bed. There is no doubt after years of insightfulness that I think too much. A trait that is good but is bad. As Poirot says it is the gray matter which is important. I have been able to discard much guilt and useless thoughts but exchanged it for isolation and solitude in an effort to defend my physical, mental and property. As time goes by my worst habit of smoking seems to be slowly coming to an end. I do believe there is a correlation between insomnia and smoking. Of course with COPD the breathing is harder. Oh well, seems as though I'm rambling. Thanks for listening and have a Merry Christmas.

[Skeezyks]

"The little gray cells..."

[TheWell]

I take ambien and doxepin. The doxepin is 10 mg. The ambien helps me fall asleep but the doxepin helps me stay there. I've been sleeping better since adding the doxepin.

[reader1587]

Originally Posted by Herculepoirot

Hi all. I have tried multiple sleep aid prescriptions. Ambien has been found to be the best but, for me it lasts about 2 hours and a 1/4 mg of Xanax is necessary to maintain some sedation with continued broken sleep. All in all I get about 4 fours of broken sleep a night. A prescription sleep med called Silenor has been on the market since 2010 and is dosed at 3 and 6 mg. It's active chemical is doxepin which is an H1 histamine antagonist. Doxepin is also used in an antidepressant called Sinequan but at a 25 - 150 mg daily dosage. Sinequan is generally prescribed with graduated dosages and when stopped must be decreased slowly. Silenor's patent is for 3-6 mg and prescribed ONLY for sleep. Sinequan is not prescribed at low dosages.

As my treatment is provided by the VA I am unable to get Silenor due to the cost of appx. $200 a month. Doxepin can be prescribed at 10 mg and comes in a gel capsule.

Has anyone used doxepin at this low dosage and experienced an improvement their sleep?

In addition I have moderate apnea. I do not use the CPAP as I cannot get somnolence so the mask will keep me awake even with the Ambien. My goal is to get somnolence with the doxepin and start using the CPAP.

Thanks

The lower dosages I think are just so the manufacturer can sell them under patent (as opposed to generic) hence the higher costs...if you look for a compounding pharmacy near you (usually small ones, not the big chains like Walgreen's) you could ask them if they would create and supply you with something in the dose you want (so like taking a 25mg and pulverizing it and reforming into 5 5mg ones).

Originally Posted by TheWell

I take ambien and doxepin. The doxepin is 10 mg. The ambien helps me fall asleep but the doxepin helps me stay there. I've been sleeping better since adding the doxepin.

TheWell is deep. I don't know how I missed your post. I tried the doxepin alone but it was useless. However your suggestion I hadn't considered. Will attempt and let you know.

Thanks