Lack of Sleep

  • Posted by a hidden member.
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    Jul 10, 2008 2:53 PM GMT
    I hate complaining, but I have been plagued with insomnia now for over three years that is now starting to get me really down. My doctor believes it is caused by two of my HIV medications. Whatever the cause, I find that I rarely sleep more than two to three hours in a row at night, and I start waking up around 3 AM. On a good night I get 5 1/2 hours of broken sleep and on a bad night it is 2 to 3 hours. As a result my mood is getting darker, I am crankier with my partner, and I have trouble getting pleasure out of most activities. The only positive side effect is that my voice gets deeper and huskier when I am tired!

    Do any RJ members have any pearls of wisdom that would help me get more sleep? I am not expecting 8-9 hours a night, I would be happy with 7 hours with few interruptions.

    Just to let you know, I am taking 30 mgs. of an anti-depressant called Cipralex that my Doctor prescribed to help me sleep better and to cope with depression. At first it worked pretty well, but now it seems to be losing its' effectiveness. My doctor has given me the option of going on a stronger medication but he says it will cause drowsiness!

    I am on 9 different drugs for HIV, cholesterol, tryglicerides, herpes, blood pressure and depression so I have been leery about taking on herbal medicines due to a fear of interactions. But I am getting to the point where I am open to anything.

    Thanks
    Jonathan
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    Jul 10, 2008 3:14 PM GMT
    The chief neural chemical in the brain for sleeping is gamma-aminobutyric acid (GABA) which you may have seen me mention on the threads before. You can google gaba and sleep and read to your heart's content all the citations you will get.

    You can try that. You can get it at any vitamin, health food, or organic food store.

    This may seem odd to you now, but the natural state for the brain is asleep. The brain actually has to produce chemicals to override its GABA in order to wake up.


    gaba.jpg

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    Jul 10, 2008 4:02 PM GMT
    I don't know anything about the meds but since I started Yoga I've been sleeping WAY better!!!
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    Jul 10, 2008 4:07 PM GMT
    I was going to say yoga too. Since I took up yoga in 1996, I sleep with ease and a lot. I was never a light or troubled sleeper, but since bringing yoga into my life I've only had trouble sleeping if there's some specific cause, such as a cold/flu type scenario.

    My first yoga teacher taught us this GREAT 'white wall, black wall' yoga relaxation technique. It never fails me. Many of the older ladies in that class would fall asleep. Charlotte - the yogi - would have to wake them up.
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    Jul 10, 2008 4:07 PM GMT
    Calson is right on with GABA. The one shown is even the one I take. When I take it it makes me drowsy within 30 minutes, and then I sleep really well. You can also take it with melatonin. My roommate who is an alcoholic cannot sleep when he stops drinking. He would take over the counter sleep-aids which only marginally help. When he took the GABA and melatonin combo he was amazed at how well he would sleep! Anyway, that is my testimonial icon_smile.gif
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    Jul 10, 2008 6:08 PM GMT
    I know you said you were feeling leery about taking on herbal medication, but I fount that melatonin(sp?) really helped me. Now, it didn't help me fall asleep any faster, but it did help me stay asleep. I've also taken prescription medication. If you don't want to go with the pills, try some warm milk before bed.. after a hot shower. If that fails.. just pop 2 or 3 benedryl, it will knock you out,lol.
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    Jul 10, 2008 6:11 PM GMT
    Have you tried meditation? I've been doing just ten minutes of meditation/breathing exercises on most days and it is very calming and good at stopping a racing mind (assuming that's part of your experience).

    I found good meditation techniques after a quick search via Google.
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    Jul 10, 2008 6:27 PM GMT
    Thanks guys for the suggestions, keep the coming please.

    The only reason I mentioned I was concerned about herbal medicines was the potential for bad interactions with my HIV meds. I know that I can't take St. John's Worts for example. But I will take the ones mentioned and do more research before asking my Doctors in August.

    I am starting to get worn out, one doesn't realize how important sleep is until one has a sleep shortfall of 15-20 hours per week, every week of the year. I just hope I don't "zone out" while driving at 80 mph!
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    Jul 10, 2008 6:37 PM GMT
    I'm not a doctor by any means and not on any other medication than my prescribed sleep meds, so I have no idea.

    I was diagnosed with chronic persistent insomnia, so I can feel for you - it's hell not getting any sleep.

    Maybe a dump question, but have you asked your doctor if a prescription sleep aid would negatively interact with your current meds?
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    Jul 10, 2008 6:43 PM GMT
    Ah man, insomnia sucks; sorry you've had to endure it for 3+ years. Just some thoughts (from a psych student icon_smile.gif ) :

    It looks like a side effect of Cipralex is insomnia.

    I wonder if your doctor might consult w/ a psychiatrist just to balance out and inform the options?

    I'd be curious if anything corresponded to the increase in insomnia that started 3 years ago..? Did you start new meds then? Other transitions in life that might have some relation or resulted in increased anxiety or depression?

    Do you wake up thinking/worried about things (anxiety)? If so, there are other SSRIs that could work for you very idiosyncratically. The med field still doesn't quite know how SSRIs work and why some work better for one individual over another w/ the same symptoms. Some SSRIs work well for both depression and anxiety, moreso than others.

    Sedatives (alcohol, anti-anxiety meds) create short sleep cycles. Even though booze can make us sleepy, it prevents deep sleep and results in short periods of sleep.

    My ex had a Rx for Trazadone, another anti-depressant, that he took at night to help him sleep, while taking Welbutrin during the day.

    Although it might all be med-related, a lot of people benefit from talking to a counselor, too.

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    Jul 10, 2008 6:54 PM GMT
    Thanks, I did not realize that Cipralex could worsen the insomnia. Sustiva (one of the HIV meds.) causes insomnia and/or depression. My doctor put me on the cipralex because I was depressed (not suicidal just depressed). I had lost my father, a friend and I was only sleeping 0-4 hours a night. Cipralex improved my mood and allowed me to fall asleep. But now I am having more trouble falling asleep (used to be 5 minutes now 20 minutes) and I start waking up as early as 1:30 AM.. I did add another HIV drug recently as part of a study. Of course one of the side effects is insomnia!

    I try to limit any alcohol to 1 drink every second or third night. I also stop drinking caffeine by 12 noon. I work out in the morning not at night. I don't think I am anxious about anything, if I am it is buried deep. When I am desperate I take a gravol to knock me out. But the next day I feel groggy which I hate.

    If things don't improve with less intrusive methods such as thoughs mentioned above, I may ask my doctor to prescribe a more powerful tranquilizer and try and cope with the drowsiness. I just can't see me coping effectively with life forever with this kind of problem (I am assuming the HIV meds are forever).

    I may seek out counselling if I start getting really depressed, but hopefully it won't come to that. I just don't want to put a strain on my relationsip with my partner.
  • ChrisRo

    Posts: 5

    Jul 10, 2008 6:55 PM GMT
    I am also an insominiac and eventually went to a Sleep study. I found out that during the night I would stop breathing and that is what was waking me up.

    I now have a CPAP machine (Constant Positive Airway Pressure) that assists in getting that deep sleep I need. I don't use it everynight, but when I start feeling tired, irritable and dark I use it.

    Meditation also is very helpful for me to get back to sleep.

    Thanks for the suggestions about GABA. I will try that.

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    Jul 10, 2008 7:32 PM GMT
    ChrisRo saidI am also an insominiac and eventually went to a Sleep study. I found out that during the night I would stop breathing and that is what was waking me up.

    I now have a CPAP machine (Constant Positive Airway Pressure) that assists in getting that deep sleep I need. I don't use it everynight, but when I start feeling tired, irritable and dark I use it.

    Meditation also is very helpful for me to get back to sleep.

    Thanks for the suggestions about GABA. I will try that.


    If you have a known problem for your sleeping problem, I am not sure I would recommend taking GABA. Your body is waking you up for a reason. You arent breathing. Knocking your brain out so it doesnt respond to the problem doesnt sound like a good idea. You could end up like Heath Ledger. Ask your doctor about it first.
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    Jul 10, 2008 8:07 PM GMT
    I'm awake at 4AM at the moment. LOL. But I get enough sleep so I'm not worried.

    Anyway, hope you get better sleep soon, JBE60. icon_sad.gif
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    Jul 10, 2008 8:11 PM GMT
    Agree with Caslon, your body talks to you. Sleep studies can answer a lot of questions. If you're getting to sleep, but waking up throughout the night, your body isn't allowing yourself to get into RIM. (Sleep Apnea could be the cause.) I didn't have this problem, as I could never "get to" sleep. However, once I did, I was fine - it took two weeks in a sleep center to figure this out - but it worked.

    I'm not an expert with HIV medication so I hesitate with saying, take this or try this. I would definitely check out a sleep center. And sometimes they even have equipment/tests you can take in your own home.
  • NYCguy74

    Posts: 311

    Jul 10, 2008 10:00 PM GMT
    jaydub saidyour body isn't allowing yourself to get into RIM.


    I think you meant REM (Rapid Eye Movement),
    RIM is something completly different, but as long as they've made an effort to clean up before hand (I think zim recommend toothpaste) it's not too bad.
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    Jul 10, 2008 10:17 PM GMT
    A couple of thoughts:
    1) You could ask your doctor about a medication such as Ambien CR or Lunesta to take 2-3 times per week so that you will get some sleep although they are not recommended to take every night.
    2) Rozerem which is a relatively newer drug that has shown some promise of alleviating insomnia although make sure your doc cross references it with your antiretrovirals as it does have some interactions
    3) Sleep Apnea is a good thought to discuss with your doctor as well
    4) It could be that your antidepressant is not working as insomnia is a huge symptom of depression and you may need to try another drug
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    Jul 10, 2008 11:11 PM GMT
    Thanks northcarolina, it has crossed my mind that the depression is the underlying cause still. Depression runs in my family big time but I know the meds I am taking can have that side effect (especially Sustiva). I may check out the sleep clinic just in case I have sleep apnea. Although I don't snore anymore which is often a sign of it.

    I just woke up from a nap on the couch so I feel a bit better. Boy was I sleepy.
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    Jul 10, 2008 11:14 PM GMT
    ChrisRo saidI am also an insominiac and eventually went to a Sleep study. I found out that during the night I would stop breathing and that is what was waking me up.

    I now have a CPAP machine (Constant Positive Airway Pressure) that assists in getting that deep sleep I need. I don't use it everynight, but when I start feeling tired, irritable and dark I use it.

    Meditation also is very helpful for me to get back to sleep.

    Thanks for the suggestions about GABA. I will try that.



    Are you sure you do not have sleep apnea?
  • MSUBioNerd

    Posts: 1813

    Jul 11, 2008 2:05 AM GMT
    Establish a routine. Don't use your bed for anything other than sleep...or, well, one other things that should be done in a bed...but the point is don't read in bed, don't watch TV in bed, etc. Actually, if possible, do those things in another room entirely.

    Listen to your body. If after half an hour to 45 minutes of lying there you're unable to fall asleep, get up and do something else for a while before trying again. You want to break the habit of lying in bed trying to fall asleep.

    In the half hour before you go to bed, don't subject yourself to bright lights. That means no television, no computer screen, and when possible, task lights on dimmer switches. If you're not able to avoid bright lights due to others being around, put on a pair of sunglasses.

    If you're a napper, you may need to break yourself of that. Insomniacs who take frequent naps have a harder time getting uninterrupted night time sleep than do those who avoid naps.

    Finally, accept that 8 hours of sleep is not a universal requirement. I wake up after 6.5 hours without an alarm clock, even when I have no intention of being up early. I have a friend who basically can't function with less than 10 hours of sleep. There's a fairly broad range out there, and you may fall on the low end of the sleep spectrum.
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    Jul 11, 2008 2:37 AM GMT
    one thing to try is making ur bedroom a place to only sleep. if u have a tv in there, remove it, if you work in there stop working in ur bedroom. if u read in the bedroom, stop reading there. besides sex, the only thing u should use that room for is to sleep. by making it a place to just rest, you might find that when u hit the pillow it will be easier to fall asleep and stay asleep.
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    Jul 11, 2008 3:12 AM GMT
    exercise-unto-physical-exhaustion, or a glass of wine or some warm milk and honey always help me... that sux that u have been wrestling with insomnia though- i feel like living death if i have merely one night of fitful sleep- my heart goes out to you... good luck..
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    Jul 11, 2008 3:12 AM GMT
    exercise-unto-physical-exhaustion, or a glass of wine or some warm milk and honey always help me... that sux that u have been wrestling with insomnia though- i feel like living death if i have merely one night of fitful sleep- my heart goes out to you... good luck..
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    Jul 11, 2008 1:25 PM GMT
    Thanks guys once again for all the helpful advice. I forgot about not using the bed for reading or watching TV right before sleeping. I don't watch TV, but I do read right before I sleep. Maybe I will try and read in the living room until I am ready to sleep. I also will try warm milk, and maybe cutting my coffee down from 2 to 1 per day.

    I have always been a fussy sleeper (at 6 months of age I spent the first night in our new house screaming because of the noise of the trains 1/2 a mile away). I must wear ear plugs, can't fall asleep if I am being held by my partner,I can't sleep while travelling, etc..

    As long as I get 6 hours I am fine, but once it gets into 3-4 hours I am not functioning the way I should. I just want to avoid more drugs in my life, I hate the feeling of drowsiness I get the next day from tranquilizers or gravol.

    Thanks for all you advice and support. icon_smile.gif
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    Oct 20, 2008 3:24 AM GMT
    Warm milk (OK, hot chocolate) worked for me when I had sleep issues from medication I was taking.

    Eventually, they added Ambien, after which I woke up refreshed, but I would be afraid of getting hooked on it.

    Good luck, Surreal life!