Which sleep aid gives you the best sleep?

[JBlue]

I am having serious sleep issues and I need to find a good sleep aid between now and Step 1 (June 9). The insomnia only pops up around exams but I am sure I will have problems on the night before Step. I have tried several sleep agents and here are the results:

1)ambian: didn't work: had kind of hallucinations/dreams all night and woke up feeling awful and kind of freaked out
2)melantonin: works o.k. but start to have some depression by day 4 on it
3)tylenol PM: slept solidly but felt groggy when I woke
4)yoga/visualization: works ok but not when I am really stressed. I did it TWICE last night and still couldn't sleep

The thing is that it I have read how sleep agents really don't give you the good sleep that you need and that they negativly impact your memory. I need all the memory I have but not sleeping is really wrecking me. I had a shelf exam today, and woke up at 2:00 am and could not go back to sleep. It has totally ruined my studying today for Wed.'s shelf, not to mention I felt completely undone during today's test. So, the question is what sleep aids have people tried that worked well, seemed to leave their memory intact and have few side effects? I think I will only need to take it occasionally during the next 6 weeks and probably the night before step. I would be willing to try another prescription one if anyone had some good recommendations. Thanks!

---

Members don't see this ad.

 

[mshheaddoc]

Being someone who has the same issues, have you tried heavy exercising? I fall into patterns as well and have tried quite a few sleep aides with no avail. I found the best things that actually helped was changing my diets, not trying to read anything about 30 mins before bed and really just relaxing, clearing my mind of any worries I have, and snuggling with my teddy bear

Most of the sleep aids I tried (prescription - all sorts of ambien, ambien CR, lunesta, etc) really made me groggy the next day and I really had issues with trying to function. Memory was shot, majorly. I had the same problem as you with the ambien CR giving me MAJORLY whacked out vivid dreams. Really started to freak me out. But honestly, if the meds don't work for you I would really suggest looking at your diet and exercise. Just a suggestion from someone who's been dealing with this sleep issue for about a year now. And I'm finally getting well needed rest (although its still not without waking up a few times but at least now I can fall back asleep and feel semi-rested)

Good luck.

 

[SoCuteMD]

Exercise .

Yoga won't necessarily work the first time, but after you develop a practice it will definitely help.

 

[JBlue]

Exercise .

I actually do excercise a fair amount. Yesterday I ran 3 miles and I usually do weights/cardiovascular for about 30 min. 4-5x a week. However, perhaps this isn't enough. I could up it to an hour or so and run 5 miles vs. 3. How much excercise do you need to feel like it helps you sleep at night? I also only drink green tea with some occasional black tea and try to stop with the caffiene around 12:00 pm (usually 2 cups/day). I could/perhaps should cut the caffiene out all together but sometimes studying is so boring/draining that I feel like I need something to keep me going. I also really think it is the stress of exams etc. that is keeping me up not the caffiene.

 

[Arctic Char]

good thread

i've been an insomniac all my life. i've never used a traditional sleep aide, but i had a prescription for loratadine last fall and man, it knocked me out cold. however, i woke up so groggy i felt like milk was pouring through my eyes. but i have also had scripts for beta-blockers at times, and i had the best sleep of my life every night. but this was a side effect to what it was intended to do.

so, since it is off and on, like you guys said - i've decided to embrace my endless nights and just take on more tasks . . . doesn't everyone wish there were more hours in the day? i guess we should consider ourselves lucky

good luck though, i hope you can get some quality sleep

 

[sga814]

400-600mg cap. Valerian root extract 1qd, 0.5-2hr b/f sleep

 

[ElanaMD]

I definitely have suffered from insomnia my entire life and have tried everything out there. Have you tried sonata? It works just like ambien but for me without the crazy hallucination effects. Supposedly ambien is the newer/better version of sonata, but I've used both for a while and I find sonata relaxes me in the same way ambien does without the weird side effects.

Also have you heard of remeron? It's brand new and works as a melatonin agonist (but more effective than actual melatonin). I didn't like it as much as sonata, but it's worth trying if other things haven't worked for you. I'm lucky because my dad's a psychiatrist so he's always bringing home samples. From what he's said, if you have trouble falling asleep (because of stress or anxiety or something like that) but don't want to feel groggy in the morning, you're not going to get anything shorter-acting than ambien or sonata (but not the CR kind). Other drugs (including lunesta) are usually better if you have trouble staying asleep during the night. Anyway hope this helps!

 

[n3ur05ur930n]

I am having serious sleep issues and I need to find a good sleep aid between now and Step 1 (June 9). The insomnia only pops up around exams but I am sure I will have problems on the night before Step. I have tried several sleep agents and here are the results:

1)ambian: didn't work: had kind of hallucinations/dreams all night and woke up feeling awful and kind of freaked out
2)melantonin: works o.k. but start to have some depression by day 4 on it
3)tylenol PM: slept solidly but felt groggy when I woke
4)yoga/visualization: works ok but not when I am really stressed. I did it TWICE last night and still couldn't sleep

The thing is that it I have read how sleep agents really don't give you the good sleep that you need and that they negativly impact your memory. I need all the memory I have but not sleeping is really wrecking me. I had a shelf exam today, and woke up at 2:00 am and could not go back to sleep. It has totally ruined my studying today for Wed.'s shelf, not to mention I felt completely undone during today's test. So, the question is what sleep aids have people tried that worked well, seemed to leave their memory intact and have few side effects? I think I will only need to take it occasionally during the next 6 weeks and probably the night before step. I would be willing to try another prescription one if anyone had some good recommendations. Thanks!

Have you tried Nyquil? I have taken it on occasion when I need a good night's sleep or need to sleep at an unusual time and have always found that I get a deep well-rested night of sleep. I have not found that it makes me groggy in the morning. Of course, I am a 6-10 hr/night sleeper. I can't vouch for how you would feel after less sleep than that having taken it.

 

[anon-y-mouse]

I am interested in this as well...

has anyone tried restoril / temazepam?

There was a thread earlier where some of this stuff came up... someone used a muscle relaxant to great success, I think cyclobenzaprine.

Sonata vs Ambien is interesting. I heard that one of them facilitates *falling* asleep and the other facilitates *staying* asleep, perhaps someone else knows more.

 

[DNM503]

Have you tried Nyquil? I have taken it on occasion when I need a good night's sleep or need to sleep at an unusual time and have always found that I get a deep well-rested night of sleep. I have not found that it makes me groggy in the morning. Of course, I am a 6-10 hr/night sleeper. I can't vouch for how you would feel after less sleep than that having taken it.

DON'T TAKE NYQUIL. Seriously, I took Nyquil the night before the MCAT because of insomnia, etc. etc. Oh god, that was a bad day. I had trouble even seeing the words on the page for the first few hours. Please, don't take Nyquil!!!!!!!!!!!!!!!! (I will mention I took it at like 3 or 4 AM, though)

 

[Tristy]

The only sleeping med (well, it's an antidepressant but you use the side effect---->extreme sleepiness) that has worked for me is Trazodone, knocks me out, I sleep all through the night and wake up fine.

 

[nibrocli]

The only sleeping med (well, it's an antidepressant but you use the side effect---->extreme sleepiness) that has worked for me is Trazodone, knocks me out, I sleep all through the night and wake up fine.

yes, trazodone here too. i was wondering if someone would suggest it!

 

[samenewme]

yes, trazodone here too. i was wondering if someone would suggest it!

Trazodone did squat for me. Tryptophan is pretty good. (Oh, go ahead and bring up the eosinophilia. I don't mind.)

 

[Learfan]

Try to get your doctor to write a prescription for clonazepam 0.5 mg. Take it about 90 minutes before you want to go to sleep. Works like a charm with no adverse memory effects. The worst problem you might experience is some mild morning tiredness which is easily overcome with a cup of coffee. This medication is also great for test anxiety. Take one the night before for sleep, have a cup of coffee in the morning and you go into the test awake and alert with great recall and a pleasant calm feeling that allows you to really focus on the test. This has worked for me multiple times with very good results meaning high grades. The only problem with clonazepam is that you will need more for the same effect if you use it frequently. I never take it for more than two consecutive nights.

Good luck on the exam.

 

[omgwtfbbq?]

I don't know.... I've been an insomniac since I was a kid and I can suggest AGAINST tricyclic antidepressants. I was prescribed one for insomnia and a problem with elevated levels of some sort of pain chemical (i don't remember what it was called) after a car accident.
it was a lower dose then they give peoeple who are depressed and its primary job is to make you tired. It doesnt.

oh! but it DOES make you irritable, get rid of your dreams, make you feel... pretty much no different. except now you're in a bad mood. I'd avoid even low doses of antidepressants even though a lot of docs prescribe them because they supposedly help give you good sleep. i don't know how , but its supposed to be something besides the anti-anxiety effect

 

[MossPoh]

I like a good ol' shot of southern comfort the "one drink" thing seems to make me more tired than any other form of medication....but I'm weird and general and haven't been able to sleep more than 6 hours in a row most of my life.......I go to sleep by 11:30 and wake up at 5:30 to 6 usually..just lay there semi-concious till my alarm goes off.......

 

[Katya00]

I don't sleep well either, actually I barely slept last night thinking about moving and wedding plans and money and everything else last night! I've used different things...for awhile I was taking Trazadone, and it was working fine, but when my mom got cancer I felt much more stressed, and my doctor switched me to Sonata. The Sonata works about 90 percent of the time for me, but last night I was just stressing too much to fall asleep (my fiancee's family is putting a lot of pressure on us about different aspects of our wedding).

The best way to use sleep medication I've found is to set up a fairly set schedule, where you wake up and go to bed around the same times, in addition to taking the medicine. I haven't found exercising or diet to help me either way, but I'm sure some people have luck with adding that too. And take the medicine at least an hour before you to go to bed...no matter what they say! If I take it and go to bed in 15 mins, I can't sleep. I have to wait until I feel really groggy, and then I'm out like a light.

 

[Tiki]

I'm surprised at how many of you take some kind of drug to help you go to sleep.

When I can't sleep, I use relaxation techniques. I tense each muscle group for ten seconds at a time and then relax it. It destresses me quickly and I usually fall alseep right after I'm done.

 

[Arctic Char]

I'm surprised at how many of you take some kind of drug to help you go to sleep.

When I can't sleep, I use relaxation techniques. I tense each muscle group for ten seconds at a time and then relax it. It destresses me quickly and I usually fall alseep right after I'm done.

you may be underestimating the frustration of true insomnia. keep in mind that most people who turn to meds - $$ - do this as a last resort. most of us have tried virtually everything. over a lifetime of insomnia, and asking for suggestions, we've heard it all . . . tried it all . . . and some techniques just don't work for particular people.

 

[njbmd]

I am having serious sleep issues and I need to find a good sleep aid between now and Step 1 (June 9). The insomnia only pops up around exams but I am sure I will have problems on the night before Step. I have tried several sleep agents and here are the results:

1)ambian: didn't work: had kind of hallucinations/dreams all night and woke up feeling awful and kind of freaked out
2)melantonin: works o.k. but start to have some depression by day 4 on it
3)tylenol PM: slept solidly but felt groggy when I woke
4)yoga/visualization: works ok but not when I am really stressed. I did it TWICE last night and still couldn't sleep

The thing is that it I have read how sleep agents really don't give you the good sleep that you need and that they negativly impact your memory. I need all the memory I have but not sleeping is really wrecking me. I had a shelf exam today, and woke up at 2:00 am and could not go back to sleep. It has totally ruined my studying today for Wed.'s shelf, not to mention I felt completely undone during today's test. So, the question is what sleep aids have people tried that worked well, seemed to leave their memory intact and have few side effects? I think I will only need to take it occasionally during the next 6 weeks and probably the night before step. I would be willing to try another prescription one if anyone had some good recommendations. Thanks!

Hi there,
Of the group you have posted, only melatonin will give you what you want. The trick to melatonin is to realize that less is more. In other words, do not increase the dose thinking that it will work better. A 1-mg tablet 30 minutes before retiring is a good start. If the 1mg does not work, then cut back to 1/2 mg. The ideal dose should give you vivid dreams and not leave you with a headache in the AM.

Too much exercise too late at night is not good either. While doing something aerobic is good for stress relief, overdoing it can leave you drained of energy and overtired.

Melatonin gets you into REM sleep faster and makes your sleep of better quality as opposed to quantity. That's why it works well with jet lagged folks. I take it on all of my overseas flights to Europe and my cross country flights to the west coast if they are late at night.

Also, do remember that during this time of stress (USMLE time), it's not good to do much experimenting with prescipts that affect your sleep. It's far better to have insomnia than to be drug groggy and trying to take Step I. You get one shot to do well and doing it without drugs is the best.

Good luck!
njbmd

 

[JBlue]

I took melatonin last night and it did seem to work pretty well. I tried 1 mg. and I was tired enough to go to sleep. Has anyone tried the new melatonin receptor agonist (someone mentioned it on this board but the name is Remelton, not remeron, or at least the one used specifically for sleep is)? What would the benifits be of taking the agonist vs. the real thing?

 

[Beau Geste]

I am interested in this as well...

has anyone tried restoril / temazepam?

There was a thread earlier where some of this stuff came up... someone used a muscle relaxant to great success, I think cyclobenzaprine.

Sonata vs Ambien is interesting. I heard that one of them facilitates *falling* asleep and the other facilitates *staying* asleep, perhaps someone else knows more.

I am a chronic insomniac - whether from stress or inheritance (my dad is an insomniac as well).

I have tried many different sleep aids:

1. Tylenol PM/Benadryl: I use it as a last resort - puts me to sleep but gives me the hangover feel in the AM (same for NyQuil)

2. restoril: works well in putting me out fast and staying asleep, but mild hangover effects. I only use this when I vist my folks and forget my own medication (it's in their medicine cabinet).

3. Melatonin: I use this pretty much every night. Jewel-Osco sells it in the mint wafer-form that dissolves under my tongue in 3mg doses. I take it 30-60 mins before bedtime and am able to doze off well. If I give myself 8-9 hours to sleep I don't have the hangover effect, and I have pretty vivid dreams and can usually remember them all.

4. Ambien/Sonata: I have tried these for several long flights to New Zealand and they didn't work at all for me. In fact, they worked the opposite way they should have - I was wide awake even after taking 2 Ambien!

5. Lunesta: Works the best for me, but really knocks me out. I use this when I am at that stage where I'm so tired from lack of sleep that I can't sleep, and when I can sleep at least 10 hours, otherwise I'm useless the morning after. I took it the night after my wedding without wearing earplugs in bed with my husband and I slept soundly throughout the night, when I usually wake up many times a night because of his snoring. It's just expensive and I only get so many samples from my mom.

My sleep schedule is not very regular so it throws me off a lot on falling asleep, and I'm a VERY light sleeper, so I wake up a lot at night as well. I usually combine melatonin with earplugs to get rest, and I end up with usually 8 hours every night (otherwise I have a hard time functioning).

 

[Beau Geste]

Oh yeah - meant to add in my other post a story about temazepam.

A few years back i was visiting my parents and couldn't sleep. Around 2am I went to the kitchen, where they keep their medicine cabinet, and saw my dad's temazepam bottle and took 2. What I didn't realize was that I saw the temazepam but grabbed the bottle of furosemide that was next to it and took two of those instead.

Basically I spent the rest of the night peeing every 15 minutes instead of sleeping!

 

[anon-y-mouse]

when I am at that stage where I'm so tired from lack of sleep that I can't sleep

I thought I was the only one who experienced this... my parents (and everyone else): "but you're so sleep deprived, shouldn't you be able to sleep right now??"

Thanks for the temazepam experiences.

I think I shall try melatonin- it seems cost effective.

 

[Beau Geste]

I think I shall try melatonin- it seems cost effective.

I think it's the best thing if you need something more long-term.

 

[stoic]

There was a thread earlier where some of this stuff came up... someone used a muscle relaxant to great success, I think cyclobenzaprine.

that'd be me. but insomnia isn't a chronic problem for me; we're talking maybe once or twice a month. a flexeril knocks me out everytime and i've never had any problems with weird dreams or being groggy.

DON'T TAKE NYQUIL. Seriously, I took Nyquil the night before the MCAT because of insomnia, etc. etc. Oh god, that was a bad day. I had trouble even seeing the words on the page for the first few hours. Please, don't take Nyquil!!!!!!!!!!!!!!!! (I will mention I took it at like 3 or 4 AM, though)

benadryl. the sleepy part of nyquil. it makes most people very sleepy (it's also in tylenol PM), but a small portion of the population becomes hyper instead of sleepy when they take it.

people, please read the label, ok? if nyquil works getting you to sleep, great. but there's no reason to take the nyquil unless you need the other products in it (APAP, pseduophedrine, etc). you can buy straight benadryl (diphenhydramine) for much less than nyquil (either packaged as a sleep aid or as an allergy med). 25-50mg is the standard dose.

 

[BobBarker]

A couple of beers or a shot usually make me pretty sleepy. Otherwise, 1 Tylenol PM makes me sleepy without feeling hungover. I have a bad knee so sometimes I'll take 1 Tylenol PM and a couple of ibuprofen and I'll have a nice painfree sleep.

 

[Dov]

Ambien takes some getting used to. It always knocks me out. I am usually a little out of it if I am woken up or don't give myself 8 hours. I know what you mean about the dreams but they stop.

 

[JBlue]

A few years back i was visiting my parents and couldn't sleep. Around 2am I went to the kitchen, where they keep their medicine cabinet, and saw my dad's temazepam bottle and took 2. What I didn't realize was that I saw the temazepam but grabbed the bottle of furosemide that was next to it and took two of those instead.

Basically I spent the rest of the night peeing every 15 minutes instead of sleeping!

That is very funny! First laugh I have had today. I took melatonin last night but woke up at 2:30 and have been up ever since. I had my pharm shelf exam today so I am sure it is just the stress that is keeping me up. Has anyone taken melatonin and then had to wake up 4 hrs. later (for example what if I took it in the middle of then night when I can't go back to sleep?)?

 

[SLUser11]

I understand that many of you sleep subjectively poor, but lets not jump straight to the Benzos to cure your disease. So far, I've read of at least five people in this thread with "insomnia," which when you take a closer look is often just poor sleep hygiene.

I have slept poorly for several years, but it's mostly because I was used to staying up late, and always having the option of sleeping in if I was too tired for school. This is a luxury you lose during third year because skipping clinical obligations is not an option the way skipping class is. Also, like many other med students, I have a problem shutting my mind off at bedtime.

Most of the drugs being discussed in this forum are DEA controlled substances, schedule IV and higher (ambien, sonata, lunesta). Before you mess with benzos (lorazepam, temazepam), antidepressants (remeron, imipramine, trazodone), and antipsychotics (seroquel, etc), you should start with behavior modification and over-the-counter remedies.

Here are my suggestions:

1. Practice good sleep hygiene. if you want details on that, google it or something, but the bed is only for sleep/not for reading or watching tv, etc.

2. Limit or eliminate afternoon and evening caffeine drinks. this is often overlooked.

3. Try over-the-counter sleep aids. Benadryl/diphenhydramine is cheap and easy. DO NOT use tylenol PM or similar products unless you have an actual need for the acetaminophen...especially if you're also drinking alcohol....you'd be surprised how few tylenol PMs it takes to cause liver toxicity when you mix it with booze.

My new love affair is with doxylamine succinate (unisom)....similar antihistamine to benadryl, but works better for some people....and is the sleepy ingredient in lots of cold remedies like ny-quil.

Both of these medications have anticholinergic effects, and can affect memory if overused.

Also, melatonin as mentioned before is good at RESETTING your circadian rhythm, and there are some good studies out there supporting its effectiveness (for instance, with residents adjusting to night float). Of course, it may also cause man-boobs, and nobody likes those.

If you fail all of these methods, then MAYBE controlled substances are the solution, but none of them are designed for long term use, and in my opinion, anything that can put you to sleep easily is potentially addictive.

 

[noonday]

as an actual insomniac (not someone with "poor sleep hygiene") i've tried lots of things...

i'm only posting about ambien, because it (for me) is the devil. sure, i thought it was great a first. i would sleep 7.5 hours out cold, wake up all fresh as a daisy and rested. and then...i took it one night when i only had 6.5 hours between when it would kick in and when i had to be up. so i just set two alarms, popped the ambien, and went to bed. 7.5 hours later, i'm showered, dressed, and sitting at my desk at work. my car is in the parking lot. i have no memory of ever getting up, ready, driving to or starting at work.

completely freaked me out. the amnesia is a bitch.

 

[sacrament]

I've had life-long sleeping issues, and Ambien, Sonata, melatonin, Tylenol PM, etc. never did anything for me. The only thing that really does the trick is promethazine. It's predominantly used, of course, as an antiemetic, but man... it knocks me the f**k out.

 

[Sammich81]

JBlue I feel your pain. I have always been a night owl, against all my best efforts, but it became intolerable second year. I would study til my eyes burned and I literally fell into bed after talking to my boyfriend for 15 min. So here is what worked for me:

1. You have to knock off studying maybe 45 min before bed, put the books aside, and do something else. Try to do the same thing every night, whether it's playing a CD or doing a little yoga, so you start to associate that with getting ready for sleep. Me, I liked to occasionally have a glass of wine. Yeah it's bad sleep hygiene but it was a ritual that worked for me.

2. Sonata. It usually didn't make me feel knocked out unless I took it on an empty stomach. And I slept 6-7 hours on it and never suffered any amnesia, but I never tried to drive, either...just walked to school.

3. This sounds silly, but lavender is a relaxing scent. I sprayed my sheets with lavender linen spray every night right before bed. I started to get sleepy the minute I smelled it.

4. Bedtime yoga: a few months ago Fitness magazine had a series of yoga poses that can all be done in bed. Takes about ten minutes, and I felt like I was floating by the end of it.

Good luck with Step 1. I have never been happier in med school than when I kicked the crap out of that test, at least to the best of my abilities! You sound like you're working hard, so you'll be fine

 

[Beau Geste]

My body's hormones are always out of whack (I think due to the synthetic thyroid I take). My sleep hygeine could be better, but it's not horrible.

I still stand by earplugs and melatonin.

 

[sacrament]

Sonata vs Ambien is interesting. I heard that one of them facilitates *falling* asleep and the other facilitates *staying* asleep, perhaps someone else knows more.

Sonata has a shorter half-life, so theoretically you shouldn't still be feeling the effect when you wake up in the morning, which is good. The downside is that it may clear from your system rather quickly so if you wake up in the middle of the night, you might not be able to fall back asleep.

 

[jameslynton]

During my divorce sleep was just a dream. Tried ambien with poor results. Later have found if I am really wired Benadryl worked wonders and is over the counter also.
Later found an uncle who was a practical country Doctor had been using it for years. My sister use to call his routine Bean up, bennie down. Worked well on his allergies also.

Some time sleep does not need to be so high tech.

 

[Surg Path]

I am interested in this as well...

has anyone tried restoril / temazepam?

There was a thread earlier where some of this stuff came up... someone used a muscle relaxant to great success, I think cyclobenzaprine.

Sonata vs Ambien is interesting. I heard that one of them facilitates *falling* asleep and the other facilitates *staying* asleep, perhaps someone else knows more.

Obviously there's all kinds of meds. Exercise works for me, and before a big exam, ambien.

My opinion:
Be careful with temazepam, or any benzodiazepenes (valium, xanax, ect), especially the short acting ones like tamazepam, as they can be habit forming very quickly.
Sedating antidepressents (Remeron is a new one) have been around forever (eg Doxepin). Safer but generally not used prn (as needed).
Nyquil, and other stuff with sedating antihistamines make a lot of people groggy. That said, some use benadryl without the groggy problem.
If ambien doesn't work, sonata or another selective GABA agonist might work (the most recent one escapes my memory).

Finally, insomnia is a classic sign of mood and anxiety disorders. See someone who has some clinical experience with these meds (eg psychiatrist).

As the saying goes, 'the doctor who treats himself is a fool for a patient'

 

[marimiyaz]

Sonata has a shorter half-life, so theoretically you shouldn't still be feeling the effect when you wake up in the morning, which is good. The downside is that it may clear from your system rather quickly so if you wake up in the middle of the night, you might not be able to fall back asleep.

yeah, i read this in the nytimes the other day. I really need to switch from ambien to sonata.

Anyways I'm happy i found this thread because it is good to know i am not the only night crawler out there.

I've had chronic insomnia, basically started in college. My primary problem is that i have a really really difficult time getting tired at night and actually *Falling asleep*. However, once i'm asleep, i'm out-i can sleep for up to 12 hours sometimes (this was not always the case-used to be able to get up after like 8 hrs). Nowadays no matter what i feel sooo tired in the mornings, whether i've gotten 4 hrs or 8 hrs or even 10 hrs. my body seems to have no rhythm anymore.

Even when i deprive myself of sleep (ie: 3-4 hrs of sleep) by trying to force myself to get up early (ie: 8am)-the next day, i will feel tired and groggy all day, but not be able to fall asleep at a normal hour the following nights even though i'd only gotten 3-4 hrs of sleep.

Some days, i get ridiculously tired like at 4pm or 5pm, just when i really don't want to be tired, and have to nap. I can never seem to get really tired enough to fall asleep at a normal bed time, like 11pm. it's like my body likes being nocturnal, and has an opposite reaction to light than normal (i realize this sounds silly, but after 4 years of this....) I've tried relaxation, exercise, melatonin, ambien, etc. Melatonin worked for me for a while. Then it stopped working. same story with ambien. For the last month or so i've been trying going without any meds....my schedule is soo out of whack. yesterday i fell asleep at 9am (having been up all night), slept until like 3:00pm (because i had to, not by choice). It's now 5am the next day and i'm still up.

anyways i think i'm going to try sonata. will report back on how it is.

 

[Arctic Char]

I understand that many of you sleep subjectively poor, but lets not jump straight to the Benzos to cure your disease. So far, I've read of at least five people in this thread with "insomnia," which when you take a closer look is often just poor sleep hygiene.

I have slept poorly for several years, but it's mostly because I was used to staying up late, and always having the option of sleeping in if I was too tired for school. This is a luxury you lose during third year because skipping clinical obligations is not an option the way skipping class is. Also, like many other med students, I have a problem shutting my mind off at bedtime.

Most of the drugs being discussed in this forum are DEA controlled substances, schedule IV and higher (ambien, sonata, lunesta). Before you mess with benzos (lorazepam, temazepam), antidepressants (remeron, imipramine, trazodone), and antipsychotics (seroquel, etc), you should start with behavior modification and over-the-counter remedies.

Here are my suggestions:

1. Practice good sleep hygiene. if you want details on that, google it or something, but the bed is only for sleep/not for reading or watching tv, etc.

2. Limit or eliminate afternoon and evening caffeine drinks. this is often overlooked.

3. Try over-the-counter sleep aids. Benadryl/diphenhydramine is cheap and easy. DO NOT use tylenol PM or similar products unless you have an actual need for the acetaminophen...especially if you're also drinking alcohol....you'd be surprised how few tylenol PMs it takes to cause liver toxicity when you mix it with booze.

My new love affair is with doxylamine succinate (unisom)....similar antihistamine to benadryl, but works better for some people....and is the sleepy ingredient in lots of cold remedies like ny-quil.

Both of these medications have anticholinergic effects, and can affect memory if overused.

Also, melatonin as mentioned before is good at RESETTING your circadian rhythm, and there are some good studies out there supporting its effectiveness (for instance, with residents adjusting to night float). Of course, it may also cause man-boobs, and nobody likes those.

If you fail all of these methods, then MAYBE controlled substances are the solution, but none of them are designed for long term use, and in my opinion, anything that can put you to sleep easily is potentially addictive.

didn't i already post saying that many of us have tried virtually everything? your post here reminds me of the kind of naivte that regards alcoholics just not having any will power. it perfectly highlights your ignorance of the condition. and don't drop articles unless you post the astract or link.

 

[devonshire]

I didn't read thru the whole thread, but here's some of the things that helped me a lot. Sorry if they've already been mentioned.

1) I noticed a big difference in my sleeping after getting a white noise machine. I just can't stand silence, and the low hum of one of these things is really calming. Kindof like how some mothers will put their babies on top of a dryer to get them to sleep. My machine has specific sounds, not generic white noise: rainfall, beach, creek, etc.

Here's a common white noise machine. Mine was a little more expensive.
http://www.acousticalsurfaces.com/white_noise/white_noise.htm

2) I cut caffeine out of my diet for a totally unrelated reason, but I noticed it improved my sleeping a lot. And when I say cut out caffeine, I mean i really cut it out: you'd be surprised how many products have caffeine in them. Including chocolate.

3) I saw somebody mention Yoga before. I think this is really good as it involves deep breathing techniques. Once you learn how to do it well it can really lower your heart-rate, and calm you down.

4) Another thing I don't think people have mentioned is to create a good sleeping environment. By this, I mean having a room that isn't scattered with your papers and books, and all the stuff that worries you. I know it can be hard to keep school material out of your room (I can't), but if you're lucky enough to have an extra room in your apartment (or whatever) you should keep study and sleep separate.

 

[SLUser11]

didn't i already post saying that many of us have tried virtually everything? your post here reminds me of the kind of naivte that regards alcoholics just not having any will power. it perfectly highlights your ignorance of the condition. and don't drop articles unless you post the astract or link.

Quote from you earlier in the thread: "i've been an insomniac all my life. i've never used a traditional sleep aide...."

....so you haven't tried everything.

Since I'm finishing med school and you seem to be getting started, I doubt you can school me on most medical conditions, even as ignorant as I seem to you, unless you just read about it in Robbins the night before......sleep disturbances included.

There are many uninformed posts in this thread, usually starting with "I read about that in the New York times" or "I take Tylenol PM and then five beers later, I'm sleepy." My post was aimed at them to help them work forwards instead of backwards when addressing their problems falling asleep. If you felt offended by this, and.....:::tears::::......you felt I didn't understand your true suffering .......I don't care.

Most people self-diagnose themselves with insomnia, and then self-treat. In the process, they don't address some of the major factors contributing to their sleep problems.....so kindly f@#k off.


Some review articles for those sleepless nights:

Nir, Isaac. Melatonin for the treatment of disorders in circadian rhythm and sleep: could it form a basis for medication? Receptors & Channels. 9(6):379-85, 2003.

Leppamaki, Sami. Partonen, Timo, et al. Effect of controlled-release melatonin on sleep quality, mood, and quality of life in subjects with seasonal or weather-associated changes in mood and behaviour. European Neuropsychopharmacology. 13(3):137-45, 2003 May.

Cajochen, C. Krauchi, K. Wirz-Justice, A. Role of melatonin in the regulation of human circadian rhythms and sleep. Journal of Neuroendocrinology. 15(4):432-7, 2003 Apr.


Sleep Hygiene info:

http://en.wikipedia.org/wiki/Sleep_hygiene -As much as I hate Wikipedia, this sums it up well.

 

[moranwoods]

My fiancee uses Unisom or a generic of the same. Works well for her.

 

[Callogician]

I have had a long history of minor insomnia, but ten months ago, I purchased a Sleep Shade from Sharper Image (tm), and I have slept much better than in the past. The one I got is Velvet and costs about $25. It would have been worth it for $125 no contest. If you are very sensitive to light when trying to sleep (like me), you might want to look into a high end sleep shade.

 

[Arctic Char]

Quote from you earlier in the thread: "i've been an insomniac all my life. i've never used a traditional sleep aide...."

....so you haven't tried everything.

Since I'm finishing med school and you seem to be getting started, I doubt you can school me on most medical conditions, even as ignorant as I seem to you, unless you just read about it in Robbins the night before......sleep disturbances included.

There are many uninformed posts in this thread, usually starting with "I read about that in the New York times" or "I take Tylenol PM and then five beers later, I'm sleepy." My post was aimed at them to help them work forwards instead of backwards when addressing their problems falling asleep. If you felt offended by this, and.....:::tears::::......you felt I didn't understand your true suffering .......I don't care.

Most people self-diagnose themselves with insomnia, and then self-treat. In the process, they don't address some of the major factors contributing to their sleep problems.....so kindly f@#k off.


Some review articles for those sleepless nights:

Nir, Isaac. Melatonin for the treatment of disorders in circadian rhythm and sleep: could it form a basis for medication? Receptors & Channels. 9(6):379-85, 2003.

Leppamaki, Sami. Partonen, Timo, et al. Effect of controlled-release melatonin on sleep quality, mood, and quality of life in subjects with seasonal or weather-associated changes in mood and behaviour. European Neuropsychopharmacology. 13(3):137-45, 2003 May.

Cajochen, C. Krauchi, K. Wirz-Justice, A. Role of melatonin in the regulation of human circadian rhythms and sleep. Journal of Neuroendocrinology. 15(4):432-7, 2003 Apr.


Sleep Hygiene info:

http://en.wikipedia.org/wiki/Sleep_hygiene -As much as I hate Wikipedia, this sums it up well.

i know i know, i'm totally sorry about that post. i'm in jordan right now, and i got hasty with my reply. i started writing before 1) thinking, and 2) reading your entire post; then my time ran out on the "pay per minute" machine and i couldn't get around to editting my stupidity before anyone saw it.

forgive me

 

[alpenglow]

I suggest you try the Valerian suggestion on the first page. As a "make-your-own" herbalist, I have been able to knock out the worst insomniac. You have to adjust the dose to find what works for you, but I assure you, it works. Too much will leave you groggy, so cut back a bit if this happens.

 

[drmota]

i'm surprised that not many people have mentioned TURNING OFF YOUR LIGHTS. when i used to stay up too late i realized that it was because i would leave all my lights on and just keep going on with my night as if i need no sleep. keep your room very dark when it needs to be and you should be cool.
-mota

 

[Surg Path]

i'm surprised that not many people have mentioned TURNING OFF YOUR LIGHTS. when i used to stay up too late i realized that it was because i would leave all my lights on and just keep going on with my night as if i need no sleep. keep your room very dark when it needs to be and you should be cool.
-mota

I wish it were that easy for everyone.

 

[orangecatmd]

I had trouble sleeping also. But I was told something by the Kaplan people that really helped me sleep better. For the longest time I was very concerned the night before a big exam that I will not be able to get the sleep I need. And the thought was making me even more stressed and kept me up longer. But I was told the the most important thing is to get the right amount of sleep not the night before, but two nights before. So if the exam is on Wednesday, the important thing is to get sleep on Monday night. After observing myself I can say that there is something to it. Unless I am unlike most people.

 

[MissMuffet]

I have had a long history of minor insomnia, but ten months ago, I purchased a Sleep Shade from Sharper Image (tm), and I have slept much better than in the past. The one I got is Velvet and costs about $25. It would have been worth it for $125 no contest. If you are very sensitive to light when trying to sleep (like me), you might want to look into a high end sleep shade.

A sleep shade, white noise, cool room, half a benadryl, 2 ibuprofen... and I sleep like a baby.

 

[stoic]

A sleep shade, white noise, cool room, half a benadryl, 2 ibuprofen... and I sleep like a baby.

what's the ibuprofen for?