[SpaceCadet]

I've been having a horrible time falling asleep and staying asleep. I'm up at least 2-5 times throughout the night and its starting to take its toll on me. I usually wake up and start the whole going to sleep process over again; having a snack, reading and then falling back asleep. But, I'm back up again within an hour or two.

My psychiatrist prescribed me Trazodone, which I probably won't ever take again. It knocked me out, but I couldn't get my brain to wake up all day today. It brought back old symptoms from earlier in my recovery, and some new ones. I was having symptoms of delirium today and every time I stood up, I felt like I was going to black out.

I take Gabapentin before bed - that helps me fall asleep, but its not keeping me asleep throughout the night.

Has anyone tried Melatonin?

What other options do I have? I'd prefer not taking another sleep aid like Trazodone.

Thanks everyone,

Nick

[Shewarrior]

I have problems staying asleep when my pain level is high melatonin is cheap online and perfecty safe. For me, trazadone is what I need to stay sleep. Maybe your doc can give you a lesser dose of trazadone. It sounds like you're sensitive to meds so I'd give melatonin a try. I bought mine on puritan*edit*they have buy one get two free I think.
Hope this helps. Good luck to you.

Originally Posted by SpaceCadet

I've been having a horrible time falling asleep and staying asleep. I'm up at least 2-5 times throughout the night and its starting to take its toll on me. I usually wake up and start the whole going to sleep process over again; having a snack, reading and then falling back asleep. But, I'm back up again within an hour or two.

My psychiatrist prescribed me Trazodone, which I probably won't ever take again. It knocked me out, but I couldn't get my brain to wake up all day today. It brought back old symptoms from earlier in my recovery, and some new ones. I was having symptoms of delirium today and every time I stood up, I felt like I was going to black out.

I take Gabapentin before bed - that helps me fall asleep, but its not keeping me asleep throughout the night.

Has anyone tried Melatonin?

What other options do I have? I'd prefer not taking another sleep aid like Trazodone.

Thanks everyone,

Nick

[Mark in Idaho]

Melatonin is easy to find. You do not have to go online to get it. Many find it does not last. They get to sleep but do not stay asleep.

Do you have any sensations when you wake up?

Do you feel uncomfortable in any way?

[SpaceCadet]

Originally Posted by Mark in Idaho

Melatonin is easy to find. You do not have to go online to get it. Many find it does not last. They get to sleep but do not stay asleep.

Do you have any sensations when you wake up?

Do you feel uncomfortable in any way?

No, I just can't stay asleep. I have to go to sleep 10-12 hours before I need to wake up to make sure that I get a full 8 hours. I used to have mini-panic attacks while trying to fall asleep, but that's not the case anymore. I'm very comfortable in my bed, the house is so quiet you could hear a pin drop. I don't get it???

I'm usually very tired at the end of the day, too.

I took double the amount of Gabapentin that I normally take tonight. We'll see how that goes, I guess? I'm tired of not getting any sleep!!!

Nick

[HeadStrong]

Hi Nick,
Same boat here. Since the injury, it's like my brain has forgotten how to sleep. I can fall asleeep and alsdo wake up several time throughout the night.

I have been on nortriptyline , also tried Nyquil, herbal teas, and currently trying melatonin. So far it helps me fall asleep faster, but doesn't help me stay asleep. Even the Beta-Blocker I am on for Migraines, makes me very drowsy....but I can't seem to stay asleep.

I am not a caffeine person so that is not an issue, I have cut out Tv before bed, and still can't seem to sleep well. The doc is aware, but doesn't seemed overly concerned....so I can relate!

Someone mentioned hyper-arousal sleep disorder after injury? Check out this page in the tbi guide: http://www.tbiguide.com/sleepdisorders.html

Let us know if you find something that works for you.

[Klaus]

When I am stressed about something I tend to wake up far too early and struggle to get back to sleep, even if I'm not actively thinking about whatever is stressing me, it's like my general subconscious levels of stress are the problem. I wasn't very functional on little sleep even before my injury.

Things which reduce my stress also seem to help my sleep. A Mindfulness course I have been on has been the most help in that respect.

I also no longer drink any liquid after 8pm. That way when I wake up hopefully I can drift off again without needing to wake up properly to use the toilet, after which all is generally lost!

[Eowyn]

Here's the sleep info we got from Nedley:

- Eat plenty of tryptophan. Your brain needs it to convert to melatonin. Top sources of bio-available tryptophan are tofu, flax seeds (ground), roasted pumpkin seeds, gluten flour, sesame seeds, almonds, black walnuts, and blackeyed cowpeas.
- Have your blood levels of vitamin D and calcium checked. These must be present in order for the brain to convert tryptophan into melatonin.
- Get sunlight through the skin (for vitamin D) and through the eyes (for melatonin).
- To help regulate circadian rhythm, get a light box. There are different times for different colors and lux capacities. We got the Philips GoLight Blu, which you can use for shorter amounts of time. With this light, use for 20-40 minutes between 5-7 AM if you have trouble falling asleep. If you have trouble with early waking, use again for 20-40 minutes between 2-4 PM.
- Get up between 5-7 AM. Go to bed between 8-10 PM. Sleep that occurs before midnight is more restful.
- Eliminate all caffeine.
- Avoid eating after 3 PM, or if you do eat make it a very light meal (soup, fruit, crackers or toast). This enhances melatonin production.
- Exercise a minmum of 60 minutes sometime during the day.
- Expose yourself to daylight in the daytime (open blinds, sit by windows, go outside). In the evening, close the blinds, turn off lights, make things dark. When you are sleeping, make it very dark. Use room-darkening shades or an eye mask if needed. Melatonin production in the brain is related to receptors in the eyes, so exposing yourself to the correct levels of light and dark at the correct times of day can affect your circadian rhythm.
- For really really optimal circadian rhythm regulation, avoid lighted screens in the evening (TV, computer, phone, etc.).
- If you wake up in the night, stay in bed, stay still, and keep your eyes closed as much as possible. Even if you do not subjectively feel that you are asleep, you may in fact be in stage one sleep and then be able to drift off to higher levels if you stay still. If you move around or get up, you definitely are not sleeping at all.
- Try to replace anxious or upsetting self-talk such as "I can't sleep AGAIN, I'm never going to get rested, I'm going to be a mess again tomorrow." with more calm or realistic self-talk. NOTE: If somebody figures out some good self-talk for this, please let me know, because I still get myself worked up when I wake up in the middle of the night.

ALL THAT SAID: I did sleep somewhat better while I was actually at the retreat but I never did actually get to sleeping all the way through the night. Since I have come home I have still really been struggling with it.

ALSO PLEASE NOTE: This info is primarily geared toward depression, not PCS. So, while it is brain-friendly, it may or may not specifically address all the needs of the brain-injured brain.

["Starr"]

Originally Posted by Eowyn

- Try to replace anxious or upsetting self-talk such as "I can't sleep AGAIN, I'm never going to get rested, I'm going to be a mess again tomorrow." with more calm or realistic self-talk. NOTE: If somebody figures out some good self-talk for this, please let me know, because I still get myself worked up when I wake up in the middle of the night.

I've always been a poor sleeper my whole life and have tried many different things. The anxious self talk is very destructive to sleep habits as you've said but is so "natural".

Over the years, I've developed different ways of coping with it. When I notice I'm heading down that path of "If I don't fall asleep now, tomorrow will be horrible" etc, I replace it with things like:

"It doesn't matter if I sleep right now, its only one night and I will do ok with a bit less sleep."

Then I start to really think about my individual body parts and how they feel.

"My feet are nice and warm and feel so comfy resting on the mattress" and really feel my feet.

"My knees and thighs sink deeply into the soft bedding, that feels so nice".

"My back is so supported and relaxed"

And if I come to a body part that isn't in its most comfy spot, I think about that too and think maybe if I shift a tiny bit this way it will be nicer. Or if I tuck this pillow like that.

I think really focusing on each part and its comfort and how the sheets feel and the softness makes me really relax, calm down and fall asleep quickly.

By the same token, if something is really uncomfortable (like the dog accidentally got upstairs and ate a cookie in the bed leaving crumbs!) I get up immediately, change the sheets and try again. Otherwise, all I can think about is how prickly things are

Not sure if that will help you, but that has improved my ability to ward off the negative stressed out "must sleep now" thoughts that don't allow for any sleep.

Starr

[EsthersDoll]

Hi Nick,

The troubles I have falling asleep have gotten much better over the last year. A year ago, I had a lot of trouble falling asleep and staying asleep and would wake up several times each night - it was awful!

Now, I generally fall asleep within a half an hour to two hours after going to bed.

Aside from time, and just getting better cognitively, which has reduced my anxiety levels a great deal, I think the number one thing that has helped me to fall asleep each night is to wake up at the same time consistently every morning.

I tried taking 5-HTP, which my acupuncturist told me is tryptophan, but it didn't seem to help at all. But I do think it's worth trying because I'm pretty sure it's helped a lot of people.

Nowadays, when I have trouble going to sleep, I usually try to meditate to relax. I've also used the trick Starr uses to relax each part of my body, starting with my toes and moving through each part until I get up to my head. Or I eat a light snack, like a yogurt cup, or some cheese or beef jerky. (Sometimes, I'm hungry and I don't realize it and then putting something in my tummy makes me sleepy.) When none of that works, I get out of bed and read a little bit of something light in another room and that usually does the trick.

I know there are other sleep aid medications out there. Tell your physiatrist about the trouble you had with the newest one you tried and see if they can give you something else.

[Kenjhee]

I now have good luck with Ambien, but it didn't start that way. Regular Ambien would get me to sleep, but I would awake a couple hours later. We switched to ER, but then I stayed groggy during daylight hours.

For some reason my body got used to non-extended release Ambien, and I now get a full night's sleep with it. I have no idea why, but I'm not looking a gift horse in the mouth. I'm not happy about being dependent on another prescription, but am very happy that the sleep problem is not a problem for the time being (I certainly have enough of those).