My insomnia comes and goes and mostly it's a problem of falling asleep and do fine if I ever drift off. The major causes seem to be pain and stress but I also have a tremor which is barely perceptible but keeps me awake. This is controlled pretty well by tizanidine but if I use the tens too much then the drug might not be enough.

I'm trying to get off the ~30mg of seroquel I've been using since this has started causing me to bite my mouth and I can't stop it. The seroquel will be hard to cut since it helps with the sleep so much. It also causes halucinations so I really shouldn't be taking it anyway probably. These are all I take regularly for sleep but I take the other medications around my sleep schedule. For instance I try to have the gabapentin at a very low level when I go to bed since it tends to keep me awake.

For typical pain I'll take tylenol 3 and the codeine will knock me out. For Localized RSD pain I take tramadol with acetomeniphen. (of course you can't take this with tylenol 3)(talk to your doctor). I take extra seroquel for minor stress and valium for more "specific" stress.

Keeping to a regular schedule helps. I don't eat within 3 1/2 hours of bedtime and no coffee within 8 hours. I avoid water within 2 hours. I try not to oversleep but when you have insomnia this can be extremely difficult as you need more in the morning. Snoring has been a problem recently but tongue exercises actually help as does propping up the head of the bed a little bit.

It helps to start really winding down an hour or even two before bedtime. Try to get things wrapped up for the day as much as possible so you aren't going over things when you lie down. Surprisingly it seems to help to have some odd question to sleep on; just some conundrum that might not even have a definitive answer.