Brief Answer: Explained below.. Detailed Answer: hello and welcome to HCM! I have read your question carefully and can see that you have prostate cancer, and sleep apnoea. you have been using clonopin for past 19 yrs or so and now it does t work any more. Ther are sleeping problems and only Advil PM helps in getting some sleep. Firstly, ibuprofen is component in Advil PM which is a pain killer, it is not the one which makes you sleep. it has another drug which helps you get some sleep. I don't think you need ibuprofen for any pain symptoms, it has not been mentioned in query, so I suppose that you are just taking it for sleep. Secondly, you are rights that clonopin dosent work with you now as it used to do so before,as tolerance has developed to its action and also due to continuous use, the body has become addicted to taking sleeping pills. When I have such patients in my clinic, I usually go with some sleeping measures and zolpidem tablets, may be in 5- 10 mg, and it usually works. it has lesser addiction potential and safe. You should discuss about this with your treating doctor, he would know about it. Plus try these measures:: -avoid sleeping in day time, - reduce tea and coffee after late afternoon hours - take less liquids after evening, this will reduce urine formation and so, you will not be disturbed at night by that - milk helps in sleeping, so you may take it - try out deep relaxed breathing while you try to sleep ... Hope the reply is useful Wish you good health ! feel free to ask more questions for clarification; if you are satisfied, please rate the answer. Dr. Manisha Gopal

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Brief Answer: Please read below Detailed Answer: hello, As I mentioned earlier, I would have started you on zolpidem, may be in a dose of 5-10 mg. It has worked great in my patients with similar problems. If necessary, I may combine it with clonopin for few days until you back to normal sleep. In rare instance, if that doesn't work, then there is quetiapine, I have never been disappointed with this drug in case of sleeping problems. Your doctor would know of them easily. Discuss with them and ask for a prescription. It's good that you do not take any stimulating drink like tea, etc. Lorazepam will not work as it is a close molecule to clonopin,and the dosage of clonopin was already high when it stopped working in you. Along with these:: 1. you should take care of not taking rest during day time, like, continue doing one thing or ether and keep yourself somewhat busy 2. if possible, try to go for some walk in evening hours 3. schedule your sleeping and waking times, if you can't get sleep for 15-20 min of going to bed, start doing something else 4. do not keep a clock in your room, this is most disturbing, one continue to see the time and think that it's too late and he can't sleep....so, take away the time piece.. 5. if you can't sleep, you may read a book( a boring one , preferably) , as this might put your buttons off and you can sleep 6. avoid watching TV or playing on mobile when unable to sleep, they stimulate brain and make sleeping more difficult. I can very well understand the pain of not being able to sleep, but it happens to many people who have been on a sleeping pill for long time. But it is manageable.... please try the above medicines....I hope that both medicines and these sleep hygiene tips, get you a good deserved sleep! Please feel free to ask more queries for clarifications If you feel satisfied, then kindly rate the answer. Dr. Manisha Gopal MD Psychiatry

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