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 :)