Only seem to last a month at a time...

[Banned]

Well, after a month I had to go back on my sleeping pills. I'm only taking a half-dose so I'm hoping it will be easy when I try to wean off them yet again.

Anyone else have an on-off relationship with sleeping meds? I'm under a ridiculous, ridiculous amount of stress right now so I'm thinking that's why I need them, and hoping that when all this blows over at the end of the month I might be able to wean off them again . Either that, or I guess I'm a lifer .

 

[Daniel E.]

BTW, some sleeping pills such as antihistamines may have mostly only a placebo-like effect after a number of days of continued use due to an increase in one's tolerance for them:

Tolerance to Daytime Sedative Effects of H1 Antihistamines : Journal of Clinical Psychopharmacology

 

[Banned]

I don't know what the active ingredient in mine are. It's Imovane, Zopiclone, whatever you want to call it.

I'm wondering if it's more psychological than anything - I'm so used to taking them that I panic if I don't. It's like a...well, I was going to say sedative effect, but...

I do take my Cipralex at the same time so if it's a matter of just "needing" to take a pill, you'd think the fact that I took my Cipralex would be enough. I wonder how things will be once I get through this month. I think bed time too is just a stressful time for me - it's when I usually get all worked up and my mind races and I can't stop it. It's when I get all my awesome ideas that usually gt me in trouble later on mg:.

(According to wikipedia, Imovane is a non-benzodiazepine hypnotic agent )..))

 

[Daniel E.]

Oh, okay. Yeah, that drug doesn't have the same problem with people developing tolerance:

Zopiclone: is there any dependence and abuse potent... [J Neurol. 1997] - PubMed - NCBI

Comparative tolerability of newer agents for insomnia. [Drug Saf. 2009] - PubMed - NCBI

Anyway, a mindfulness approach can help with both accepting the distress of waking up as well as accepting the train of automatic negative thoughts at night:

The Role of Acceptance and Mindfulness in the Treatment of Insomnia | Association for Contextual Behavioral Science

If you are doing anything in the hopes of avoiding negative thoughts, that seems like avoidance behavior. In other words, how you relate to your thoughts is more important than the thoughts themselves, regardless of what the medications do or don't do.

 

[Banned]

They are not really negative thoughts..just thoughts about everything - work, home, dogs, pig (I'm getting a pet pig!), new business, old business, do I stay where I live or move to a different town, I'm like a not-very-intelligent-Google on a random search

I think I need to figure out how to just slow my thoughts down. I get all these ideas that I want to act on, some of them are not even practical...but the ideas always come to me at night. I think I also take the Imovane as a way to fall asleep before the thoughts start bombarding me.

 

[Daniel E.]

Still, how you relate to your thoughts is more important than the thoughts themselves. You seem attached to those thoughts, rather than able to focus on, say, your breathing, or some background music.

Generally, CBT and mindfulness approaches are more effective for insomnia than sleep medications in the long term.

 

[Banned]

Oh ya that's definitely true. They drive me and take over my entire being. It's like I get possessed mg:.

 

[AmZ]

Hi Turtle,

It seems like we are on the same medications, Cipralex and Imovane. (I'm also on Lithium).

I think I've had a few times where the Imovane didn't help me fall asleep and I was like a walking zombie because of it. It had totally zonked me out but I still didn't manage to sleep. In saying that, I've been on and off of the Imovane for the last several months and it has served me well. The only problem I find is that it helps me fall asleep but doesn't keep me asleep. i.e. I wake up early in the morning or wake up after a few hours of sleep. That's when they added Etomine (anti-psychotic sedative) to the mix which helped prolong my sleep.

On some occasions I have taken a double dosage of Imovane 7.5mg x 2, which my psychiatrist said that I can do. This increased the sleepiness and totally knocked me out for the count.

I'd like to be able to sleep without the Imovane but whenever I come off of it, I start having problems falling asleep. Even with several months of therapy to try to help with my sleep problems and I still need the Imovane.

 

[Daniel E.]

Are you trying to wake up the same time each day? Trying to fall asleep is overrated. If you can't fall asleep, just read a book or whatever. The important thing is to still wake up as scheduled.

BTW, a CBT workbook: Amazon.com: The Insomnia Workbook: A Comprehensive Guide to Getting the Sleep You Need (9781572246355): Stephanie Silberman, Charles Morin: Books

 

[Banned]

I do wake up at the same time every day (12:30pm)...but my shifts are changing to 5am starts next week so I'll have to start getting up at 3:45am. If that doesn't make me sleep I don't know what will!

---------- Post added at 12:22 AM ---------- Previous post was at 12:18 AM ----------

Hi AmZ,

Ya the Cipralex has been the best thing for my depression. I really liked Luvox for racing thoughts but it didn't seem to help my depression as much as Cipralex. Cipralex has pretty much given me a life I never could have imagined. I like the Imovane because it actually does keep me asleep, where-as when I tried other sleep aids they would put me to sleep but not keep me asleep.

I guess everyone is different, eh?

 

[AmZ]

I guess that everyone is different, yeah

Cipralex works very well for me too for the depression side of things. I took it for a couple of weeks and a big switch went off which still hasn't come back on at all.

I'm just struggling with anxiety right now. I thought that the Cipralex would/could help with that also... If it was helping with the depression then it could help with the anxiety also. But seems not. Anxiety is out of the roof.

Good luck with the Imovane

 

[Daniel E.]

The CBT workbook for insomnia mentions distraction as an alternative to racing thoughts, including racing thoughts during the day: Racing Thoughts (Another distraction technique listed on the next page is "increasing your sensory awareness. Involves focusing on your surroundings using all of your senses...")

Another book, Restful Insomnia, states that "evening rituals" that help you "relax into your body" and switch from "doing to being" can help regardless of the racing thoughts. Another tip from the book is writing down some of the "best solutions" during the mind racing (but I would think that may eventually reinforce the unwanted "doing" behavior):

When her mind started racing over work, she turned on the book light and wrote her best solutions in her journal. If thoughts of her daughter's boyfriend intruded--Can't change that tonight. Erica opened House and Garden magazine and visualized a remodeled kitchen. Her eyes grew tired. She switched the book light off...

Restful Insomnia: How to Get the ... - Google Books

And, of course:

People with insomnia often make the mistake of going to bed before they are sufficiently tired. ... Worthless lying in bed, while your thoughts are racing and you are anxious about not falling asleep, not only stresses you out but also causes you to associate the bed and bedroom with sleeplessness.

Coping with Your Insomnia - Google Books

Moreover:

The “racing mind” that you may experience is sometimes the result of lying awake, not the cause; and blaming insomnia on being unable to “turn off my mind,” which is routine among insomniacs and which escalates feelings of loss of control, is not always accurate.

Say Good Night to Insomnia - Google Books

Another point from that book is that people with insomnia tend to exercise less during the day than they used to because of feelings of fatigue, but that lessening of physical activity makes one less tired for the next night.

---------- Post added at 12:05 PM ---------- Previous post was at 11:21 AM ----------

I'm under a ridiculous, ridiculous amount of stress right now so I'm thinking that's why I need them

Generally speaking, dealing with your daytime stress/anxiety would likely be more effective. Pretty much anything seems more effective in the long term than sleep medications, which seems like a temporary solution. Based on your old posts, it seems you have been on this same sleep medication on-and-off since at least 2009.

As the books state, people with insomnia tend to feel they are out of control when it comes to their sleep habits (which can only increase their perceived need for sleeping pills). But insomnia relates to a number of daytime behaviors that one has control over, such as exercising more, abstaining from napping, doing relaxation techniques, decreasing rumination, abstaining from caffeine (which can increase anxiety), etc.

 

[Banned]

Thanks, Daniel.

I did go see my therapist today. I told her everything that's going on, and she told me I'm doing well but now I feel worse than I was before I went.

I haven't had a real depression in about nine months, but I feel like one is setting in. To give you an idea of what I'm dealing with in JUST the next two to three weeks:

- getting rid of my old business (retail store)
- opening a new home-based business
- getting my IUD out
- going for surgery
- going out of town to judge a dog show
- dealing with stressful, stressful, stupid head office
- applied on a promotion at my part-time job, interview is at the end of the month

I've spent time in the bathroom throwing up I'm so stressed. I'm not eating. I'm flaky and absent-minded, and I'm starting to get really depressed and over-whelmed.

I think I use sleep to try and quell the stress, and the pills just speed up the fall asleep process. Oh and then yes, there's the racing-non stop thoughts that are sometimes quite disturbing. My psychiatrist says I'm in great shape...my therapist says I'm doing great. But I feel anything but great. I feel finished.

I didn't take a pill last night but I also didn't go to bed til 4am. I don't understand how when I explain everything I'm dealing with people can say how great I'm doing. For the first time in almost a year, I truly feel ****.

 

[Daniel E.]

Personally, I am a "fan" of the psychologist Neil Fiore and the way he presents information, e.g.

http://forum.psychlinks.ca/anxiety-and-stress/27429-relax-and-center-with-dr-neil-fiore.html
http://forum.psychlinks.ca/resource...readings/8436-shift-from-worry-to-wonder.html
http://forum.psychlinks.ca/resource...4-tips-for-awakening-your-strongest-self.html
http://forum.psychlinks.ca/psycholo...3290-a-psychologist-s-view-of-the-secret.html

 

[Banned]

Thanks Daniel. I'll check out those links. There's so much information out there nowadays it's crazy...every little bit can only help!

And yes...been on Imovane since Oct 2009 - more on than off. I've only been off it a total of two months out of two years - last September and this past August/September. When I went on it I thought it would be a really short term gig just to regulate my sleep...I'm not adverse to taking "necessary" medications, but I think with some work this could become unnecessary. It's just that my work never seems to last more than a few weeks.

 

[Daniel E.]

There's so much information out there nowadays it's crazy...

Yes, there is. There is an article about that, too

http://forum.psychlinks.ca/coping-strategies/24864-the-only-3-pieces-of-advice-you-need.html

 

[Banned]

Haha. You are a walking encyclopedia of information! Thank you!

---------- Post added at 07:03 PM ---------- Previous post was at 06:58 PM ----------

PS --> I'm going to order a CBT workbook for insomnia. I have honestly found CBT to be the single most helpful thing for me...so I will put it to more use!

And I've just decided that when this month is over I'm going to the Carribean for a few days to relax and sleep and dive and relax and dive and dive and relax!

 

[Daniel E.]

The most counterintuitive part of CBT for insomnia involves sleep restriction:

Sleep Restriction
Another strictly behavioral approach is sleep restriction. In this approach, patients completed questionnaires to determine the amount of sleep that they report obtaining per night on a regular basis. They are then restricted to this amount of sleep and asked to stay up to a late bedtime hour in order to obtain this amount of sleep in a single consolidated period of sleep. For example, a patient who reports sleeping only 5 hours per night may be asked to stay up until 2:15 AM, and then allowed to sleep until 7:15 AM. If the patient has demonstrated success at obtaining these 5 hours of sleep per night on a regular basis, the amount of time that they are allowed to spend in bed is increased. Patients must first agree to a model of treatment that may not conform to their perception of how sleeplessness affects them, ie, that no matter how little sleep they obtain on a given night, they will not sleep the next night. If their sleep deprivation does cause them to feel sleepy, they must still restrict their sleep to their allowed nighttime hours. They are not allowed to take naps in the daytime, or to “sleep in.”

http://forum.psychlinks.ca/sleep-dr...-therapies-for-the-treatment-of-insomnia.html

Today I’d respond a bit differently: when someone says ‘Oh but I just can’t do this’ I’d spend more time exploring how long the sleep problem had been going, and discuss the short term vs long term gains. If the problem with sleep has been going on for a long time, the difficulty from sleep restriction over a fortnight or so in order to improve sleep over the long term might be worth it. It’s worth using something like a decisional balance chart, or ‘pro’s and con’s’ chart that draws up the good and not so good of each habit that influences sleep. Habits like going to bed early after a few nights of poor sleep might help the immediate fatigue – but the probability of waking during the night is increased, which in turn maintains the poor sleep pattern. Forgoing the sleep program because of irritability or fatigue might keep the peace at home in the short term – but maintains the erratic sleep pattern that can interfere with good relationships in the long term.

http://forum.psychlinks.ca/sleep-dr...with-thoughts-habits-take-time-to-change.html

Sleep restriction is probably the most controversial step of CBT-I, since (true to its name) it initially involves the restriction of sleep. Although it is counterintuitive, it is a crucial and very effective component of CBT-I. It involves controlling time in bed (TIB) based upon the person's sleep efficiency in order to restore the homeostatic drive to sleep. Sleep Efficiency (SE) is the measure of reported Total Sleep Time (TST), the actual amount of time the patient is usually able to sleep, compared with his or her TIB. Sleep Efficiency = (Total Sleep Time / Time In Bed) x 100

• First, Time In Bed is restricted to the Total Sleep Time
• Increase or decrease TIB weekly by only 20-30 min
• Increase TIB if SE >90%
• Decrease TIB if SE <80%

This process may take several weeks or months to complete, depending on the person's initial Sleep Efficiency and how effective the treatment is for them individually. Daytime sleepiness is a side-effect during the first week or two of treatment, so those who operate heavy machinery or otherwise cannot safely be sleep deprived should not undergo this process.

Cognitive behavioral therapy for insomnia - Wikipedia, the free encyclopedia

 

[Banned]

The last one looks complicated, and involves math. Hmmm.

But - no pill again last night, and I HAD to get up this morning to get to work. I have a long day, so I need to stay awake. And going to the Olive Garden tonight for my b-day. Yay pasta haha!

I've identified several things - I sleep any time I have nothing else to do, which has to stop. And I need to limit my time in bed, which is hard, because in addition to how much I love sleep, I also love my bed. It's so warm and comfy and the cat curls up with me and it's just bliss...but I need to contain that bliss to six or seven hours a night.

I also need to try and stay on morning shifts. When I work afternoons and evenings, I stay in bed until 75 minutes before work. So...if I have a 5pm start, I get up at 3;45pm. Not good.

With the amount of immediate stress I'm under and everything I have going on, it almost sounds crazy, but I feel like I need more to do to keep me from sleeping when I have nothing to do.