Sleep advice?
 

Since my head injury I've had problems getting to sleep and staying asleep, even when I was prescribed tamazepam the week after my injury I only slept for 4 hours. Before my injury it sometimes used to take me a little while to get off but once asleep I would sleep soundly until morning. Now I just wake up for no reason after a couple of hours and can't settle back to sleep again, I've lost that relaxed sleepy feeling, I must be getting only 3 hours and it's getting frustrating and debilitating, I was hoping it was just a phase but it's not. Having tinnitus since my injury doesn't help.

A while back I was prescribed amitryptaline, an anti depressant, in a low dose (10mg) to aid sleep, I didn't take them because I'd never taken anti depressants so was a bit wary. Now I'm beginning to think I may need something as I'm feeling increasingly down. Another doctor I saw more recently suggested I try a more modern AD -an SSRI like citalopram or mirtazapine but I've read stories about how hard it can be to get off them and how long it takes for them to work. Anyway, I'm thinking of trying the amitryptaline, I figure 10mg is a low dose. Can't get to see a doctor until next week.

Full disclosure: I did my research and decided that SSRIs absolutely were not for me.

As for the Amitriptyline, when using it as a sleep aid, people sometimes find that they have to keep increasing the dosage. I know TBI patients who claim to have had better results with a newer tetracyclic antidepressant called Remeron (Mirtazapine). Like I said, I can offer no firsthand experience.

When you sleep, do you dream? Do you wake with any sense of refreshment?

SE,

Amitriptyline at 10 mgs is a common prescription for insomnia. That dose is very low. It is worth a try.

I need to eat a complex carb before going to bed so my body has sleep energy. I also need to be very comfortable, with soft sheets and pajamas so I have no odd sensations to stimulate my senses.

Sometimes I remember dreaming, I think I might even wake during dreaming. No, I don't feel refreshed when I wake, I don't feel anxious as such but a bit wired. It's as if an alarm goes off at 5am, it's uncanny. It's like I've got into some sort of bad sleep habit.

Basically I don't understand how I can wake up tired, yawn during the day but fail to fall asleep at night, it's bizarre! Maybe I'm getting too much brain stimulation during the day because pre injury I'd be zombied on 3 hours sleep but I'm not now. When I see the PCS neurologist I'll ask for some hormone tests to see what my cortisol and melatonin levels are, I wonder if they might be awry. I'm open to suggestions though.

I tried mirtazapine once, a friend who is on them for depression said they made him sleep so gave me one to try. It certainly made me feel sleepy and relaxed especially when I woke up it was like the old days of waking on a Sunday morning, but it made me constipated and lowered my blood pressure, pretty powerful stuff. I hear coming off them can give you insomnia :-(

EDIT

One other thing lately I feel queasy when I wake up...anyone else have this?

You might not be entering restorative REM sleep. This can happen with TBI/stroke patients. Sometimes it passes as the brain heals.

I'm on amitriptylan 50mgs a night (I also have anxiety issues) and I do very well on it. Don't be afraid to try it if you need it. A good night's sleep is one of the most important aspects of recovery.

A sleep study could help.

My sleep seems to be okay and then I go through phases of unrest.

My sleep study results showed I did not have sleep apnea but I do have interrupted sleep. That night the temp in the room was cool when I went to sleep but shot up hot as the night went on.

I notice I am MUCH more sensitive to well my senses. I need a cotton shirt, soft cotton sheets, a light source (no light at all and I get vertigo easily) a cotton quilt, down pillow on the flatter side to sleep on and a heavier down pillow to put on my head both with cotton cases. I need the temp cool and a fan running (fan must not make variations in sound tones or it's fired) to block out my tinnitus.

Without these things I do not rest well.

I see my sleep neurologist in a few weeks to discuss test results and how to have a more regular sleep pattern. The more of a normal schedule of sleep the better I function all around.

Jace

Well, I've been trying the amitryptaline, it seems to get me to sleep quicker but I still wake up a couple of times and in the morning I feel depressed and rough for a few hours. Seeing the doc today and ask if I can try some mirtazapine. Last night I slept from 12:30 to 1:30 then from 2 to just past 4 then kind of snoozed from then on. One day I'll sleep a full 6 hours! I was expecting some progress on this but I hear it can take a year before sleep gets better.

Vitamin B helps me sleep. No clue why. It also makes me have super vivid dreams.

Sometimes I can sleep pretty well and then at other times, such as right now, I don't, waking up all the time or being 1/2 asleep the whole time and feeling weird (?)

I have a ritual I have to do or get upset (?) like Living_Dazed, have to have a fan on but it has to be the same noise all the time, certain sheets and pillow case, complete darkness.

If the fan is not on I feel like going berserk, don't know why.

My concussion was over a year ago, hope you get some good sleep soon :)

Ha, yes bedtime rituals, I know what you mean mine is chamomile tea and toast. I also have the half sleep half awake thing going off usually after I wake at 4am I never know whether I've slept or not, it's like dreaming awake. Did you injure the front of your head, mine was just above the hairline. I'm always interested to know to see if there are similarities in symptoms - I should start a new thread on this if there hasn't already been one. Sleep is a complex thing I'm told and involves many parts of the brain. The brain itself never sleeps it's always active. I must say I miss that sleepy relaxed feeling I used to get zonking out after a days work.

I don't sleep well either, I have a very hard time falling asleep but do ok once I am asleep. I will sleep 4-6 hours. I have had strange and very real dreams since my accident, and have often woken myself up talking. I have found that I feel more closterfobic and do my best sleeping in the morning after my husband has gone to work.

I have tried, melatonin up 5mg then 10 and it will work, but not unless I only use it once in a while. I have taken Ambien, that made the dreams very strange and quit working after about 3 weeks. Now the doc said to try moving my magnesium vitamins to bedtime that it might help some. Can't hurt to try.

Ironically as I recover I seem to find it harder to get off to sleep, in the early stages of my PCS I'd be totally worn out in the evening.

Over here we can't get hold of melatonin without a doctors prescription on the advice of a specialist otherwise I'd definitely try some. I take a magnesium vit and 50mg of 5-htp at bedtime and 50mg Nytol for when I wake up, not sure they are working any more. I'm beginning to wonder whether it has to do with how much brain stimulation I get in the day, I might try a day without the computer and see if it helps plus I'll try moving my vit B supplement to the evening too as MomWriterStudent does. I've stopped taking the amiltrytaline as it was making me feel crummy.

I used that medication for a short while years ago for a long term headache cycle. It gave me restless legs and that was the end of taking it. Good luck, I have not yet found my own sleep secret. Mostly I sleep from 4am to? 7-10am no naps during the day just rest.