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  1. #21
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    Default Sleeping pills - who knows about them?

    Ok cool!
    As you are benzodiazepine naive (in the medical sense) I'd start on something like temazepam. Diazepam is long acting and may give you a hangover effect the next day.
    Who is taking care of your ADHD? I assume its a psych? They are the best person to go to regarding this.

  2. #22
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    Default Sleeping pills - who knows about them?

    Xanax is extremely addictive. I wouldn't go down that road if you can help it..

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    halloweendee  (21-11-2012)

  4. #23
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    I went through years of not sleeping then years of sleeping pills. Heavy ones. Which I took more than prescribed to keep the desired effects. It was so hard to get off and I ended up having a 10 day stay in a detox clinic with people on hard drugs. After coming off them I realised I'd been living in such a clouded state!

    After I came off I still couldn't sleep and ended up seeing a sleep psychologist and getting a sleep study done. Not much turned up in the sleep study but the psychologist ran a "sleep school" which was kind of helpful.
    Maybe try something like that?

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    Usthreegirls - Could you briefly explain the sleep studies you had done? And maybe what a 'sleep school' entails?
    The study I was going to do is where they strap electrodes to your head and monitor brain activity during the night. Is this what you had done?

    Halloweendee - Thanks

    Bunnylover - I'm aware that certain meds are highly addictive, I plan on going down this road with extreme caution.

    4underfour - What does 'benzo naive' mean (in the medical sense)?

    My GP has government authority to prescribe Dex Amphetamine, and so I don't need to see a psych or specialist for this. You could say she just provides medical maintenance.
    What's funny is that benzos (which are an additive substance) doesn't have the bureaucratic red tape involved in prescriptions, where as Dex Amphetamines are government regulated and require authority. I find this rather strange!

  6. #25
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    Default Sleeping pills - who knows about them?

    I'm prescribed 2mg extended release melatonin by my psychiatrist for diagnosed delayed sleep phase disorder.

    Reading what you've said this sounds like you may have the same thing. I always thought I've had insomnia my whole life, trying to go to bed before midnight is impossible. Some nights I'm up to 4 or 5am. I now know I do not have insomnia, I have a disorder where the my body clock and the make up of my brain are wired differently to 'societal norms' of sleeping patterns. Taking melatonin is one part of manipulating my natural state to conform to a more manageable routine.

    First steps are to ask your gp or psych for a sleep journal, or make one yourself. Put down the 24 hrs in a day and make note of the exact times you attempt to go to sleep and when u actually do fall asleep as well as how many times you way up and when and other things like consumption if caffeine, nicotine and alcohol, as well as exercise. I did this for 2 weeks as well as a few more fortnights to see the patterns.
    If you want to do a sleep study in a clinic they are def going to ask you to complete this so if you do it yourself first you are saving urself some time and providing evidence, as doctors hear ppl say they can't sleep all the time but they will b more open to listen if they can see the patterns on paper.

    Also the key to melatonin working is NOT to take it when you are going to bed or near there. I'm prescribed to take it 12 hours before I'd like to or need to be up the next day. So if I want to be up at 11am I should take it at 11pm. Gradually over time you shift this back slowly. It's a long process. You will also have it drummed into u by any psych or sleep specialist the importance of exposing your eyes to bright natural light upon waking. Bright natural light is what triggers your body to produce its own melatonin. If you stay inside a lot like me, this is counterproductive. If you can't do that, getting a special light box and using that in the morning on your face may be the way to go. Watching tv, using laptops and phones etc in the evening also works against you as they emit blue light. I struggle a lot with this and have found it very difficult to follow the routines set out by my psych. I don't like sitting outside in the morning when I'm tired and I love watching tv late at night. It's a daily struggle!

    Over the counter melatonin is rubbish. It has a whiff of it in it. You need prescription strength melatonin. No need to go to a compounding chemist. You can now get a drug called Circadin, most chemists should carry this prescription, I use Chemist Warehouse. It's $38.40 for 30 2mg pills. Melatonin is not covered under the PBS unless you are over 50 and for a different issue. You can claim a portion from private health funds if u have cover.

    In a pinch I have prescriptions for Zopiclone (Imovane) and Zolpidem (Stillnox). But they lose their effectiveness if u use them more then a couple of times a week. Sometimes I don't feel they have any effect at all (this is a hallmark of delayed phase sleep disorder, your body will work against anything u do to try to force it to sleep b4 it's ready).

    http://en.m.wikipedia.org/wiki/Delay...phase_disorder
    Last edited by 3cats1pug; 20-11-2012 at 12:37.

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    MagicMud  (21-11-2012)

  8. #26
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    Benzo naive means that you haven't taken them before. If people have taken them for a while they become tolerant (which means they need to take increasing doses to have the same effect) and dependent (which means you will have negative effects if you don't take them).

    Ok this is just my opinion but I feel you need to see a psych for both the ADHD and the sleep issues. Basically you are taking an upper, then expecting to be able to sleep normally at night. These issues are just too much for a gp to handle, especially in a 15 min appt. I assume you saw a psych at some stage to diagnose the adult ADHD?

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    Catrules - Wow! Thank you for all of that information! I suspect I may have a sleep phase disorder thing going on as well, rather than insomnia.
    I will start keeping a sleep journal.

    How does a sleep study work? Are you required to sleep at a clinic at any point? Or is it all based on the journal or other verbal information?

    How much time do you need to spend in bright light in the mornings? I too work inside a lot, and I can't stand sunlight first thing in the mornings as it hurts my eyes and gives me a headache (does this happen to you?)
    I let my dog out every morning, and am in the sun for maybe 2-3 minutes first thing. I also have large windows in my studio which lets in a lot of natural light (diffused with a light curtain).

    Do you find (prescription) melatonin to be more effective than other drugs, in general? By that I mean does melatonin reduce the need for other stronger medication to be used?
    Since you've been diagnosed have you managed to achieve an earlier sleep time? Sorry for all the question, I'm just very curious!

    4underfour - Oh ok. I'd never heard that phrasing before. By the way, I'm not benzo naive, I was prescribed Diazepam about 18 months ago, but for stress issues, not sleep issues. I only use it very occasionally though, perhaps once every 1 - 3 months, sometimes less. However it's never worked very well on me, I've required a rather large dose from the get go (which makes me even more hesitant to use it). I do not have a tolerance though, the same amount still works as effectively (which is poorly!)
    My Dr couldn't explain why it doesn't work very well on me, and suggested the next step up, drug-wise, was an anti-psychotic (I think) but it had weight gain side effects, so I declined (my metabolism is already shot).
    You seem to be benzo savvy, do you have any opinion as to why Diazepam wouldn't work (barring tolerance)?

    I was diagnosed with ADHD at 14 by a child psychiatrist. I was then under the care of a pediatrician until I was 19. At 20 I went to see an adult ADHD psychiatrist for care, but he sent me away saying there was no need for me to see him for maintenance and advised me to seek out a GP who would agree to take over authority.
    For quite a long time, I thought my sleep issues were a result of my medication. However I spent 2 years on half dose Dex amphetamine (due to TTC) and my sleeping patterns went completely to hell. Sleep was so much worse with less Dex (boggles the mind). I concluded that Dex may have an impact on sleep, but it certainly isn't causing the issue. I've had major sleeping issues long before I was on any medication at all.
    I do think just having ADHD is contributing to bad sleep, due to my brain having no natural 'quiet' state. But I don't think it is the sole cause either. After saying all of that, I think you are right. It's probably WAY too much for a GP to deal with.

  10. #28
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    Default Sleeping pills - who knows about them?

    Quote Originally Posted by MagicMud View Post
    Catrules
    How does a sleep study work? Are you required to sleep at a clinic at any point? Or is it all based on the journal or other verbal information?

    How much time do you need to spend in bright light in the mornings? I too work inside a lot, and I can't stand sunlight first thing in the mornings as it hurts my eyes and gives me a headache (does this happen to you?)
    I let my dog out every morning, and am in the sun for maybe 2-3 minutes first thing. I also have large windows in my studio which lets in a lot of natural light (diffused with a light curtain).

    Do you find (prescription) melatonin to be more effective than other drugs, in general? By that I mean does melatonin reduce the need for other stronger medication to be used?
    Since you've been diagnosed have you managed to achieve an earlier sleep time? Sorry for all the question, I'm just very curious!

    However it's never worked very well on me, I've required a rather large dose from the get go (which makes me even more hesitant to use it). I do not have a tolerance though, the same amount still works as effectively (which is poorly!)
    My Dr couldn't explain why it doesn't work very well on me, and suggested the next step up, drug-wise, was an anti-psychotic (I think).
    You seem to be benzo savvy, do you have any opinion as to why Diazepam wouldn't work (barring tolerance)?
    You need 20-30mins of bright light on your face when you wake up. The key is having in your eyes. I've never managed this step. My psych wanted me to go for a walk when I wake up (but I have anxiety issues about leaving the house) or sit outside in the garden (my rat bag pug dog bites me!). I have gotten a chair to put by the one window we have with any bright natural light but to be honest it's a struggle to even sit there for 30 mins. When I wake up I just want to lay in bed for awhile.

    The sleep journaling was done thru my psych. She diagnosed me based on the journaling and my history. She has offered to send me to a specialist sleep clinic but I haven't bothered as I am confident in her diagnosis and suggestions to improve my sleep quality. Good psychs know a lot about sleep as its very important if you have other mental health issues in your life (I have bipolar 2).

    When I stuck to the the routine and took the 2mg melatonin at the exact right time and kept the journal (it helps you focus on maintaining a routine) I was able to shift my sleep from a 4am sleep time to a 1am sleep time. I was able to maintain this for 2 weeks. I've since lapsed and gone back to my old ways, in part from sporadic use of the melatonin (forget to take it). Not keeping the journal has really let me slip back into the old pattern. I intend to get back into the schedule after Xmas.
    I haven't been using any other sleeping pills. I'm a stay at home housewife and can keep irregular hours so I just go to bed late, get up late and accept it. I arrange my lifestyle round my sleeping patterns (no appointments b4 midday, socialize and shop etc in late arvo or night). For a regular working person I understand this is impossible.
    My psych said to me that ppl with this disorder often structure their whole life around their sleeping patterns without realizing they have this disorder. Ppl get themselves into professions that operate at night (hospitality etc) or do shift work. The ppl who have it and try to fight it are gonna have problems their whole life. She has said never to think of yourself as lazy etc because ppl will label you that because you aren't up when the rooster calls! It's not fair on you.

    As to the diazepam being ineffective. I have the same problem (been prescribed it b4 for anxiety and also as a muscle relaxant for chronic jaw pain). I need a huge dose to notice any effect, if any. It has now been suggested by my psych that there is an enzyme involved in the processing of this drug and others like it (pain pills etc) that can in some patients render these medications ineffective.
    Quick google search found this article

    http://www.aafp.org/afp/2007/0801/p391.html

    You may want to suggest being tested to see if you are one of these patients. I may do so in the future. I'm not sure how well known this is or if testing is widely available. My psych has mentioned it and showed me a pamphlet. I may go down this road if my jaw pain gets worse and I want evidence to be prescribed a higher dose of diazepam.

    I would steer clear of the anti psychotics if I were u. Your doc most likely was thinking of something like Seroquel or Zyprexa. These two newer anti psychotics have sedating qualities. Some ppl take low doses of seroquel to aid sleep. I have tried both and in my experience they are way more trouble then it's worth. They WILL make u gain wait (I gained 8kg in 6 days on Zyprexa), I gained 15kgs total in 2 months on these medications and have only managed to lose 5kgs being off them (I wasnt eating more, it's a metabolism issue). They are also very expensive, up to $200 for a two week prescription, as they are only funded on the PBS for diagnosed bipolar 1 disorder. (I paid for the Zyprexa but got around 6 months supply of seroquel as free samples thru my psych).
    In hindsight they did make me sleepier and I was going to bed earlier, but I also had daytime sleepiness and had to take a 1-2 nap at around 4-5pm every day without fail. I have since taken no naps since being off these medications.

    Let me know if u want any more advice. I've been thru the rigmarole of docs and meds this year so know quite a lot about different medications and seeing a psych. If it helps, I'm now medication free (apart from the melatonin) and expect to be discharged from my psych back to my gp's care within the next month or so. So it is possible to get your situations sorted out once u see the right ppl.

  11. #29
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    Default Sleeping pills - who knows about them?

    You are probably just naturally resistant to benzodiazepines. Which means that you would probably have to take high doses of any benzo you try. But there is nothing wrong with that. But just be aware that benzodiazepines might not work too well for you.
    I wonder if you can somehow research a psychiatrist or even psychologist that specialises in sleep issues. A psychiatrist would be best as they can also manage your ADHD meds, not to mention prescribe you something to kick start good sleeping habits. As your gp obviously has an interest in psych they should know a good shrink.

    Good luck, I can't imagine having insomnia, it would be the pits.

  12. #30
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    [QUOTE=MagicMud;6917210]Usthreegirls - Could you briefly explain the sleep studies you had done? And maybe what a 'sleep school' entails?
    The study I was going to do is where they strap electrodes to your head and monitor brain activity during the night. Is this what you had done?

    yes it is the one with the electrodes. Def worth getting done if you can.

    The sleep school was run by a psychologist specialising in sleep. It was lots of relaxation, sleep diary stuff, sleep hygiene...that kind of thing. It was helpful to learn about sleep behaviours


 

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