Suggest Treatment For Insomnia

Posted on Wed, 22 Jun 2016

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Wed, 22 Jun 2016 Answered on

Thu, 14 Jul 2016 Last reviewed on

Question : Sir/Mam,

I have sleep disorder issue/ Even if I am enough tired and get to bed - I feel asleep in 10-15 min but the sleep does not last more than 3 hrs. I struggle to get the extended sleep for next 2 hours and finally get another 2 hours of disturbed sleep.

I had posted this problem on 1st week of Jun and the doctor asked to get the blood tests done. I had done a complete master check up. Unfortunately I dont remember the Doctor's name and also my previously asked "Health question" is NOT appearing in this page

Would like to talk to a Doctor on this at the earliest.
Thanks
XXXXX

Answered by Dr. Dr. Chintan Solanki (1 hour later)

Brief Answer:
please update your blood reports and provide more details

Detailed Answer:
Hello Mr XXXXXXX

Thanks for writing to us.

You have sleep disorder. I want to clarify about the same and want more information from you to help you further.

Insomnia (sleep disturbance) is of two types:

Primary: There is problem of only sleep disturbance and no other physical or psychological problem is there. In this case treatment for sleep problem is needed.

Secondary: There is some underlying physical or psychological problem which is responsible for sleep disturbance. In this, main treatment is done for underlying problem.

One should follow some measures called 'sleep hygiene' which would help in sleep. You can find the same in below link.

sleepfoundation.org/ask-the-expert/sleep-hygiene

Drinking a cup of warm milk before going to bed helps in 30-40 of patients and they do not need medicines as per my clinical experience.

Above all, medicines are there for sleep disorders. I would like to guide you further about the same after you provide some more details.

Let me know,

- Since when are you suffering from sleep disturbance?

- What was the schedule (timing) and duration of sleep before the problem started? How much reduction in sleep from previous?

- Does he have any stress in life (it can be social, economical, relationship, study/work or emotional)?

- Does he have any physical psychological illness?

- Which treatment/medicines have been tried until now and in what dose?

- Please upload your blood reports.

I will be happy to help further after your response.
Regards,
Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Dr. Chintan Solanki (1 hour later)

Thanks a Lot Doctor, for the detailed info. I will upload the REPORT soon and also provide the all Historical data
Apologies- I assumed we are going to have call , hence did not provide the details. Will do that soon

Answered by Dr. Dr. Chintan Solanki (1 hour later)

Brief Answer:
you need to write/attach reports

Detailed Answer:
Hi,

Thanks for follow up.

No need to apologies. It is ok. You have selected communication through questions and answers. Please write/upload your reports and your data.

I will wait for your information.

Take care.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Dr. Chintan Solanki (25 hours later)

Sir,

PL. find the other details as required. Any other details required, pl. let me know
Also the Blood report is attached which i did on 2nd-Jun-2016 as part of MAster health checkup

Details
=====

- I have been having this Sleep disorder almost for last 4 years
     Initially - it was problem about getting initial sleep. was not able to sleep till 3 am
     Somehow that got solved
     now I can get sleep in 15 min after going to bed (usually around 11.30 pm) but awake at around 3 / 3:30 am almost everydaya
     I feel slightly sweaty when this sleep interrupt happens
     After that wont get sleep till 5 am or even 6 am.
     somehow again get sleep for next 3 hours

- now my sleep is INterruped ie 3 hours then next 2 hours no sleep. again sleep for next 3 hours
- I have some stress but even when I feel normal, still same problem
- I even go for some Yoga on weekends and do meditation ( 5 to 10 min) before sleep
- Have a glass of milk before sleep
- I tried Nervijan, nitcalm etc for 1 week each as prescribed by doctor. But stopped it becos was getting a Sleep hangover next morning
-

Thanks a lot.
Any help in resolving this would be a great help to me - Dr.

Answered by Dr. Dr. Chintan Solanki (11 hours later)

Brief Answer:
Lorazepam or clonazepam is good option

Detailed Answer:
Hello,

Thanks for reports and sorry for delayed response.

Your reports are almost normal. Fasting glucose is slightly higher. You can repeat that report with report of Hb1ac to rule out problem of diabetes.
Cholesterol is also high. In that case you can start drug from satin group. However I strongly recommend doing regular exercise, modifying diet (low fat, more protein, avoid junk food and using garlic in food) and avoiding sedentary lifestyle.
Nervigen is multivitamin. It is not for sleep.
Nitcalm is nitrazepam and it is potent drug and likely to cause hangover. I never use it for primary insomnia.
I recommend starting low dose lorazepam or clonazepam to sleep continuously for 6-8 hours without next day hangover. Continue sleep hygiene with that.
You need to get prescription for this.

I think you will be able to sleep well with this. Even if you cannot after this approach I recommend doing sleep study for exact diagnosis and rule out sleep apnea.

Take care.

Note: For further guidance on mental health, Click here.

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