[Todd]

Hi all,

I'm curious what you all take to help you sleep. Currently, I fall asleep fine, but around 4 AM I'm up and then toss and turn the rest of the night. The next day I'm wrecked because of the lack of sleep.

They gave me Klonopin but it only helps until around 4 AM, then I'm pretty much wide awake. Now they want to add Trazodone but I read the side effects (online) and found it a bit scary. Any ideas, tips, suggestions? I miss my sleep!

[K.Ibsen]

I take 1mg klonopin and 150mg trazodone. I've been taking klonopin for quite a while. I started the trazodone last week.

I continue to have trouble sleeping with the above mix of drugs. Sleeping is my biggest problem. The impact of problems such as my rigidity and bradykinesia make life more challenging, but poor sleep can make life miserable.

I've tried higher doses of klonopin, but I had problems remembering things--especially short-term memory. Of all the sleep aids I've tried, I think the klonopin has worked the best. It relieves the myoclonus through sedation. Unfortunately, it is addictive, but then again, addiction isn't so bad when monitored by a doctor. I had to battle the addiction to klonopin when the doctor lowered my dose a few months back.

So far, the only side-effects I've had from the trazodone are headaches, tinnitus, dry-mouth, and mild bruxism. I usually have these and a few other symptoms when I take antidepressants.

I also sometimes try diphenhydramine hydrochloride, which is found in Tylenol PM and related generics, and is also an antihistamine. There's an all herbal product called "Calms Forte" that is useful as a sleep aid and is also good for stress relief.

I guess I should also mention that I have sleep apnea and use a device called a CPAP machine to force air into my lungs and keep me breathing. It can be annoying, but it keeps me breathing.

[ol'cs]

..... so, you wanna sleep, eh? Best way I know of (no kidding) is a shot of Cognac. But alcohol is as addicting as any sleep medication and after awhile, either the dose must be ramped up, or you have to go sleepless for a few nights to get the same effect.
Now, if we were healthy, we could go on a long walk out in the fresh air, but many of us can't do that now. Reading. Pick up as boring a book as you possibly can find. Don't pick a riveting one , or I can guarantee you, you'll be up all night trying to finish it. I'm a scientist, so i have probably the most choice of boring books that one can imagine. !) minutes of anything with eqautions in it is guaranteed to put me in LALA land. However, it is often only temporary, that i think is the real problem that we are talking about here. NOw i've been on Klonopin for over 10 years so i can't use it every night or it just isn't effective, but it always works (2mg) to at least calm me enough (especially restless legs) to allow me to sleep. Trazodone does put one to sleep (i used too work for the guy who invented it, so i know a lot about it), but it can give one a bit of a fuzzy head well into the next day, as it's metabolite, a "phenylpiperazine" is quite long lived before it's all excreted.
There are two sides to the coin, falling asleep and staying asleep. It really helps to have a very dark room (even low light levels from bedside clocks are subconsciously "annoying") with an adequate (but indirect) flow of air that isn't too dry or too humid. A constant low humming sound as from a fan , helps to set a constant "background noise", so intermitant "bumps in the night" don't jump start the brainstem into consciousness. NO caffeine, and an empty bladder are imperative to keep on sleeping. "Antihistamines" that cause drowsiness do work to help you sleep (benadryl, etc), and the "non-benzodiazepine" sleeping agents (Ambien, Sonata, Lunesta) all are in a controlled release form now, but they are just as addicting as anything. The best thing with drugs is that you can get a bunch of different ones and rotate to avoid dependancy on any one, but lets face it, unnatural sleep aids eventually just don't work every night.
Like everybody who wants to sleep on time in a "natural" cycle; the best thing is to keep yourself from dozing off during the day, and try to expend at least some energy, or you just won't sleep on a regular basis. I've stopped trying, even though it buggers up my life. cs

[GregD]

Hi Todd,
I've had problems sleeping for a couple of years now. At first I was started on a low dosage of klonopin and Remeron just before bed. This combination worked well until the insurance company thought they knew more than the doctor treating me (two antidepressants). From there we went with Lunesta. Again this worked great until the insurance company wouldn't pay for the Lunesta. As luck would have it, they just started with a generic for lunesta about that time, Zolpidem Tartrate. It seems to work as well as the Lunesta.
As Cs mentioned these drugs are addicting. I only take it when I absolutely can not sleep.
Be careful and talk with your doctor about any sleep aid you take. Fully understand what you are taking.

GregD

[chasmo]

50/200 CR. A CR taken before retiring, usually helps most get 2-4 more hours of quality sleep.

Charlie

[BEMM]

Calcium is supposed to mellow you out and help you sleep, and Calcium's companion, Magnesium does the same. Take both, or one or the other at bedtime with a little milk ( too much milk and you will need to get up and pee).
Like cs, I read at night, and a boring book will put me to sleep in no time. I prefer introductions, they're very boring.
When I wake up during the night I make sure to change position, which takes a bit of work, and then I think about what I'm going to wear the next day. For some reason that is the most sleep inducing thought, and I usually fall asleep before I've made any decision. It is also so inane and so neutral a line of thought that it doesn't give me bad dreams.
A comfortable bed that is not used for daytime napping is a big help.
This subject is really not one into which I have deep insight, so my advice is not worth anything to those with real sleep problems. I sleep well. I don't often sleep more that 5 - 6 hours at night, but for a PWPD that is a good, long night's sleep. I don't take sleeping pills, I hope I never need to, but I can understand the desperation that makes one give in after long periods of sleeplessness.

[Evon]

Sleep. Without it I am almost guaranteed a bad day. I give in to taking meds to sleep but not every night if I can help it. .5 mg of lorazepam helps to calm me down and get at least 3 to 4 hours of sleep and then I am usually up again. My MDS prescribed a small amount of Seroquel which helped also but left me very groggy the next day. I will only use it when I am really feeling sleep deprived. Sometimes I just go with the flow and try not to think about it as a problem. It seems to be common for PWP so when you are up in the night you know you are not alone, a lot of us are going through the same thing.

[indigogo]

hey Todd - just wondering what other meds you are taking - in case one of them might be the culprit.

[chasmo]

trazadone goes, I had no observable side-effects from it. You just have to try it and see how it suits you.

Like I said earlier a 50/200 CR works best for the majority of us though......

Charlie

[Todd]

indigogo - I'm on Sinemet 25/100 3x day, Parcopa 25/100 first thing in the AM, Propranolol 80mg mostly for migraine reduction, and Klonopin 1mg at night for sleep.

Chasmo - I've read and heard from many about taking CR at night but my docs want to try and keep my Sinemet dosage low for fear of motor fluctuations. So that's why they gave me Trazodone, but when I read the side effects and found a website where patients reported their issues with it, it scared me, so I was looking for other options.

Everyone else - thanks for the tips and advice. I know that sleep issues typically come with the territory but I'm trying to get a handle on it somehow so that I'm not completely wrecked the following day after not sleeping. If I can get a handle on this, then I'll be doing pretty well.

Thanks to all!