Hello, I M Facing A Problem With Falling Asleep. I

Posted on Wed, 15 Apr 2020

Wed, 15 Apr 2020 Answered on

Last reviewed on

Question : Hello, I'm facing a problem with falling asleep. I have been facing stress-related issues in the recent past due to personal problems. My stress became worse and I reached a stage where sometimes I fail to sleep the whole night. Even if I sleep, I will have a disturbed sleep with weird dreams. Please help.

Answered by Dr. Sudhir Kumar (25 minutes later)

Brief Answer:
Your problem seems to be insomnia related to stress.

Detailed Answer:
Thank you for posting your query.

I am Dr Sudhir Kumar, Neurologist, and I would try my best to help you.

I have noted your clinical details. Based on this, your problem seems to be insomnia related to stress and anxiety.

We need to identify the factors causing stress (persona;/family/job-related/financial, etc) and try to resolve them if possible.

Then, regular diet and exercises are useful.

In some cases, we need to give medicines to reduce stress such as escitalopram or clonazepam. If needed, medicines for sleep such as zolpidem may also be needed.

I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.

Wishing you good health,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Answered by Dr. Sudhir Kumar (16 minutes later)

Brief Answer:
You need additional medicine for sleep.

Detailed Answer:
Thank you for getting back with detailed information.

I know divorce can be stressful, however, over time, you will overcome the stress due to that.

Esclo forte, I think is a combination of escitalopram (anti-depressant) and clonazepam (anti-anxiety), which should be continued.

In addition, you will require a medicine for sleep purpose. The best would be zolpidem for this purpose.

Dr Sudhir Kumar MD DM

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (2 minutes later)

Thanks for the reply doctor. Just to brief my problem and history - I am divorced recently and that is causing me stress. I am able to do my daily activities without any issues. The moment I go to bed, my thoughts and stress become uncontrollable. And the dreams become very disturbing sometimes.
I consulted a Neurologist before, Dr. XXXXXXX XXXXXXX He suggested Esclo Forte(clonazepam) during bed-time. It was helpful in the beginning, but it doesn't help me fall asleep. The other day I was awake the whole night in spite of having that tablet.
My habits - I am a vegetarian, don't smoke and don't drink. I walk every day for an hour in the evening. I generally have a cool shower after my walk and go to bed with music of my taste. Apparently, these days I'm afraid that I'm not able to come out of it and my sleeplessness is increasing day by day. And, the day when I do not sleep properly in night, the next day becomes horrible and I feel too sleepy. When I sleep during the day, some kind of dreams chases me down, making me have a dissatisfied sleep.

Please help.

Answered by Dr. Sudhir Kumar (7 minutes later)

Brief Answer:
These medicines will help you.

Detailed Answer:
Thank you for getting back.

1. The combination of escitalopram and clonazepam is available. For my patients, I prescribe Nexito Forte at a dose of 10 mg once daily at night

2. Zolpidem is available as Zolfresh. For my patients, I prescribe 10 mg, as and when needed for sleep.

Both these are needed for one month, and then a review is needed.

Dr Sudhir Kumar MD DM

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (0 minute later)

Thanks for the help. Please let me know how long should I continue the medicines and the dosage in detail.

Follow up: Dr. Sudhir Kumar (3 minutes later)

And will these medicines help me get rid of the dreams that I am getting?

Answered by Dr. Sudhir Kumar (5 minutes later)

Brief Answer:
Thanks and best wishes.

Detailed Answer:
Best wishes,

Dr Sudhir Kumar MD DM

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (3 minutes later)

Thanks doctor.