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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Sleeplessness?

Hi Doc
I am having sleeplessness from about an year now . Diagnosis was a form of depression and anxiety attack . Honestly, I DO NOT have any reason for any sort of anxiety . Whatever from last fortnight i was taking tab Minnite 15 mg, Qutan 25 mg and Lonazep 0.25 all once . The sleeping did not improve and now from last 5 days , Doc added tab Paxidep CR 25 mg and increased Qutan to 200 mg .From the same night , I am having severe hot blast in my entire body - heat eminating from inside the body and ear . The sleep disturbance has NOT shown in improvement . It takes long time to fall asleep and sometimes, even with Ambien , I keep wide awake throughout the night . And it drains out my energy and health .
ADVICE PLEASE
Rita Bose
posted on Fri, 14 Mar 2014
Twitter Thu, 17 Jul 2014 Answered on
Twitter Thu, 17 Jul 2014 Last reviewed on
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Psychiatrist,  's  Response
Hello Rita, thanks for your query; there are many reasons for lack of non fulfilling sleep quality (insomnia) including anxiety, depression, poor lifestyle, poor sleeping patterns etc. Considering you are on multiple medications at present including T. Mirnite (mirtazapine), T. Paxidep (paroxetine), T. Quetan (Quetiapine) & T. LONAZEP (Clonazepam); I would like to know your exact set of symptoms & sequence of addition of these medications. For your ongoing sleep problems, lets start from basic measures; 1. Try to sleep & get up at fixed times 2. If you dont feel sleepy within 20 minutes of going to bed, get out of bed & pace around, read a book, soothing music till you feel sleepy again & then go back to bed 3. Use bed only for sleeping & sleeping only!! 4. Avoid tea/coffee after 6pm 5. Avoid daytime naps 6. Do 30 minutes daily physical exercise including cardio, resistance training, yoga & pranayama. If problem is only sleep; consult your Psychiatrist about medications like Agomelatine (agoprex), Ramelteon (rametax), Trazodone (Trazonil) or optimising T. Mirtazapine (Mirnite) alone & tapering off all other medications. You can get back to me for any further assistance. Good Luck
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What Causes Sleeplessness?

Hello Rita, thanks for your query; there are many reasons for lack of non fulfilling sleep quality (insomnia) including anxiety, depression, poor lifestyle, poor sleeping patterns etc. Considering you are on multiple medications at present including T. Mirnite (mirtazapine), T. Paxidep (paroxetine), T. Quetan (Quetiapine) & T. LONAZEP (Clonazepam); I would like to know your exact set of symptoms & sequence of addition of these medications. For your ongoing sleep problems, lets start from basic measures; 1. Try to sleep & get up at fixed times 2. If you dont feel sleepy within 20 minutes of going to bed, get out of bed & pace around, read a book, soothing music till you feel sleepy again & then go back to bed 3. Use bed only for sleeping & sleeping only!! 4. Avoid tea/coffee after 6pm 5. Avoid daytime naps 6. Do 30 minutes daily physical exercise including cardio, resistance training, yoga & pranayama. If problem is only sleep; consult your Psychiatrist about medications like Agomelatine (agoprex), Ramelteon (rametax), Trazodone (Trazonil) or optimising T. Mirtazapine (Mirnite) alone & tapering off all other medications. You can get back to me for any further assistance. Good Luck