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Sleep aids

happyHBmomhhappyHBmom Posts: 2,070
edited 06/11/2012 - 8:48 AM in Pain Medications
Today I told my psych that the Ambien is just not working that well for me anymore. He did not seem surprised, as tolerance exists there too. He gave me samples of two new sleep aids and said "try both and pick one."

One is Lunesta which seems to be similar to Ambien but maybe a little stronger? The side effect profile seems more severe.

The other is Silenor, which is a brand new one. I am intrigued by this one, it's an old tricyclic re-marketed in very low doses as a sleep aid. But I don't know whether it will work because it mostly maintains sleep, and I need both.

Anybody out there take either? Thoughts? The silenor has a very favorable side effect profile and also is not a CNS depressant (although of course it has some CNS effects, they are due to histamine inhibition).


  • I tried Lunesta a while back instead of Ambien. It gave me the worst taste in my mouth! Otherwise, I couldn't tell much difference from the Ambien and ultimately went back to it. Lunesta definitely has the best commercials. That Luna Moth floating around makes me feel sleepy just watching it.
    Good luck!
  • Last night I tried Lunesta and didn't sleep at all! I guess that answers that question!
  • Have you ever heard of Trazadone? I have been on it for almost 5 years now. It is very safe that it does not make you depended on it. You should look it up..

  • Happy HB, and I'm lucky to get 4 hours of sleep out of it! My PM asked if I wanted to try something else..... and honestly I am afraid to. I have heard of all the wicked effects like sleep walking, driving, eating and what have you, with so many of these sleep aids. He told me the amount of oxy I am taking contributes to my lack of sleep. I am afraid to hurt myself unknowingly while asleep.

    I will be interested to hear which one you decide to go with and how it works for you.

    Let me know. Good luck with the trial!

    Bags under eyes.... Virginia
  • Virginia, I have never ever had such a thing happen. You know, they have to write the most horrifying things on there just in case. I could look up the incidence in the trials for you if you'd like.

    The worst thing that has ever happened is that I've taken it while I was still doing things and then forgotten things I did the night before. But none of the things have ever been out of character.

    I can't tell you how much SLEEPING makes a difference in my life! Now that ambien isn't always working well, sometimes I don't sleep well again and ugh!

    Ambien is the first thing to try though. It works so well!

  • I take Zopiclone (brand name Imovane). It's not distr in the US, but Lunesta is very close to it. I like it, the only side effect is dry mouth for me. It doesn't make me groggy in the mornings, I wake up feeling well rested. The only problem is that it lets me sleep so well, I usually don't move and am that much more stiff and sore in the morning! But if you're looking for a good sleep, than I guess you have to weigh the pros and cons. I only use it when I absolutely need to, it does have addictive qualities, and if you use it every night, you might run the risk of tolerance, like with any med. However, there was a point when I did us it every night, and it didn't affect me in that way.
    APROUD CANADIANveteranButNOTa doctor, my thoughts are my own
  • I use meds every night because by the time I realize I am not going to sleep at night, it's too late to take something. I just get into such terrible cycles.

    I keep thinking I should try trazodone.
  • I haven't learned yet HappyHBmom, I'm the same way, but keep hoping that the sandman will find me...
    APROUD CANADIANveteranButNOTa doctor, my thoughts are my own
  • HB, can you comment on what happened when you took the other sleep aid your doc gave you to try? Did it work? I'm with you and feel ambien works best, but one 10mg hardly does the trick anymore...I wonder if it has anything to do with our narcotic receptors at all????? I don't know, but one ambien and I would be out cold, now one doesn't work anymore, it's almost like taking candy. I've also tried lunesta and it did nothing. I've tried trazadone, but was on 50mg and "heard" that 100mg is the "magic" dose...so maybe I could re-visit that one. Right now, I'm trying restoril and it's simply "ok"...not like ambien, but better than nothing. I do best if I have a little cocktail of meds (I know I may get some bashers here), but an ativan with a soma and a restoril or ambien...something like that. I really need to address this with my doctor next week when I go. I know as much narcotics I'm on is scary to add other things, but nothing phases me...not saying I'm immune to any problems ever occuring or anything...but I just want good sleep and to forget the pain for 6 hours...please!!!

    So, I was wondering the outcome of the other med your doc gave you a sample of...I had never heard of it before.

  • I gave up and went back to Ambien after 2 nights. I have been doing Ambien and Melatonin, which works pretty well. I don't want to try a cocktail because I really do worry that the respiration rate issue will bite me in the ass (and my psych, who prescribes my sleep aids, concurs).

    I am going to look for a link to send you to a deep relaxation tape. I think a huge part of it is just that we aren't trained to go to sleep without the "extra," which is a habit. I think I forgot how to go to sleep because Ambien was so effective, and now that it's not as effective anymore, I'm up a creek. But then I remember that I didn't go to sleep before that either.

    The silenor did no better than the lunesta but it says it might take a while for full effectiveness. Not sure why! I just need to try it for a few days, but my husband went out of town this week so I needed to sleep.

    With both of them, I went to sleep, with a little more trouble, but I didn't stay asleep at all. I woke up like 100 times. With Ambien I'm staying asleep, but having trouble going to sleep.
  • thanks. and i truely believe a lot is in my head...like you said...we forgot "how" to go to sleep. I will try the guided imagery. Thanks!
  • One of the websites has a bunch of stuff about "sleep hygeine" or something. Cleaning your mind. Yeah, that's it!
  • This med is not a sleep med per say. It is used for many things. However I no longer need it for the migraines, but it is also used for nerve pain and insomnia which I still suffer from.

    Amitriptylin. I have 25 mg but often times cut it in 1/2. A full pill gives me 12 hrs of sleep - something I don't like lol I do not feel "drugged" or anything bad the next day.

    L1 - S2 "gone" useless in 1 way or another. DDD. RA. Bone Spurs. Tons of nerve damage/issues. Stenosis. Both knees replaced. 50 yrs old. I had a great fall (hence my user name) at age 41 and it has been a domino effect every since.
  • Yeah, the reason Ambien really worked for me is that it works for exactly 8 hours, then *poof* it's gone. I wake up feeling like I slept great and am ready to go.

    Even benadryl makes me feel like a slug the next day, LOL!

    Sigh, they need to figure out what the deal is with ambien and pain meds. Although my psych said most of his patients do develop tolerance, so I guess it's not just us, THG. I miss just being able to go to sleep without worrying! Not being able to sleep is just the worst. It was the most awesome feeling knowing that was one thing I never had to be concerned about.

  • HB, have you tried Zanaflex (tizanidine)? It's a muscle relaxant with some pain-relieving properties, and I find it helps me sleep also. It gave me a terrible dry mouth to start with, but I find it much more effective than Ambien or any of the other 'Z' hypnotics (zolpidem, zopiclone, zaleplone). My doctor prescribes me Rohypnol on an occasional basis for really bad insomnia, but I find I even stay awake on that sometimes! Sleeping pills seem to have a paradoxical effect on some people. Good luck!
  • I've taken both amitriptyline and nortriptyline, and neither of them ever did anything for me, I might as well have been taking sugar pills. They do say though, that the combination of amitriptyline and gabapentin is good for nerve pain for a lot of people.

    But the zopiclone, maybe because I don't take it all the time, does the trick for me when I need it. Even though I only get my best sleep after 4 am, I'm used to getting only about 3 hrs. But if I have something going on the next day that I need a good solid sleep for, I take the zopiclone so I can get to sleep early.

    So funny how we all have different effects from the same meds.

    And it's so true that we need to retrain ourselves for sleep. They say not being on the computer for at least an hour before bedtime, always go to bed at the same time, keeping the same bed time routine every night, reading for a bit, not having a tv in the bedroom all helps. But funny, I do need noise, like the tv on along with a fan going, to get to sleep. If it's dead silent, there's no chance.
    APROUD CANADIANveteranButNOTa doctor, my thoughts are my own
  • Rohypnol is Schedule IV in the US- illegal for all purposes!

    I would love to try a muscle relaxer but I've not wanted to approach my PM about it. Can you take it with the hypnotics, or would I have to give it up?

    I do also, by the way, have an "as needed" prescription of Xanax. I just use it very seldom now because I worry about interaction, and I wouldn't want to take the xanax and zolpidem together while also on long-acting narcotics. Even if the chance of a negative incident is only 1 in 10,000, I wouldn't take that chance- my kids need me.

    But I do admit that I was having a panic attack over being overtired while the kids were in school the other day and I took 2 xanax and plopped myself down for a little assisted napping. That was helpful!

    I've tried to look up the risks of even taking melatonin along with the zolpidem. I haven't found many resources.

    Funny thing, a vicodin used to put me right to sleep. HAHAHAHAHA.

  • I have been prescribed various different sleep aids over the years and the two that my PM doc prefers are Benadryl and Phenergan. Both allow me to get about 5-6 hours of sleep.

  • I, too, have tried many sleep aids.

    What is working best for me, at the present time, is Trazadone and Melatonin.

  • Benadryl no longer helps at all for me, but still makes me groggy the next day.

    Wow, this intractable insomnia seems like a not uncommon thing! You know, the desparation over not being able to sleep is what killed Heath Ledger and Michael Jackson, among others. It is so bizarre to be CRAZY tired and just completely unable to sleep.

    I slept well last night, so that's good :) I was even able to grab an extra half hour after my son woke me up and then left again!

    The one I will probably ask for next is Trazodone if I can't get it worked out with these.
  • Sleep deprivation among us spiney's, seems to be a common complaint.

    You sometimes get to the point where just 3 hours of solid, uninterrupted sleep, is a blessing.

    When I first started the Trazadone, I think I got 5 hours of uninterrupted sleep. I couldn't believe it. Sometimes, I would even get close to 6 hours! When I added Melatonin, it has helped to slowly let me drift off into a nice sleep. It really just depends on my pain levels during the night with me. Sometimes the Trazadone can't take over the stabbing ice pick pains in both hips, but at least I can generally count on 3 hours of sleep.

    The good thing with Trazadone is you can titrate up, if need be. I haven't done that since being on it. I prefer to work with my night pain via Lidoderm patches, heating wraps with ace bandages securing them around my knees and having my TENS unit going on my thoracic area. When I am jolted awake, it is generally due to nerve pain, so I take a dose of Neurontin. Just depends on what pain wakes me up during the night.

    If you are prescribed Trazadone, I wanted to let you know that you should have your hubby right next to you during the first couple of nights. If you need to get up to tinkle, you will need his assistance. At least, I did. It made me very weak in my knees and very wobbly when I tried to walk the first couple of nights.

  • It hasn't always been an issue for me- depending on what meds I'm on, there have been times that waking up has been my problem. This was when I figured out that I could not be on 200 mg of Topamax + a long acting opiate. I went days where I wasn't awake for more than a few hours!

    So I guess I have to count my blessings that my pain is fairly controlled now (as long as I don't DO anything) and yet I'm able to be awake all day.

    I am one of those people who is a mess without sleep. I just can't handle it. You who say you get 6 hours a night- I could never function. We all have our weaknesses (ha ha), and sleep has always been mine- if I go more than a few nights without a full night's sleep, I will end up as sick as a dog. As it is, my immune system is sub-optimal (I have low IgG 1&2, low IgM, and low IgA) and sleep is where that shows the most. Everything changed for the better when I started taking Ambien!
  • happyHBmom said:
    I would love to try a muscle relaxer but I've not wanted to approach my PM about it. Can you take it with the hypnotics, or would I have to give it up?
    My doctor prescribes me both. I was taking baclofen 3/day, but stopped while I was off work as my neck/shoulder spasms loosened up a bit. I used to take Flexiril, but it lost it's effectiveness after a while. At first, the flexiril would put me to sleep, but the baclofen never made me tired.
    APROUD CANADIANveteranButNOTa doctor, my thoughts are my own
  • HB, I was concerned at first when my doctors prescribed muscle relaxants and a sleeping pill, because they are both CNS depressants (not to mention the opioid medication, which also falls into that category!). However, my doctor explained that it is common to prescribe various depressants together, as long as it's done carefully it should be okay. It can actually have a beneficial additive effect, again, as long as the doctor knows which drugs are safe together and in what doses.

    My 'family doctor' used to give me clonazepam (Klonopin, Rivotril) to take in mid-evening/early night, and Ambien to take a couple of hours later to help me get to sleep. The clonazepam helped relax me but the Ambien often would merely wake me up and make me hyperactive! I've always had sleeping problems, as far back as I remember. I find that unless I'm really, really tired, I just can't sleep, sleeping pills or no sleeping pills.

    The psychiatrist my family doctor referred me to prescribed Rohypnol for 'refractory insomnia', so I take that sometimes (it's Schedule III here). However, I've found the best thing for sleep is to be as active as possible during the day (difficult when you have chronic pain) and try as hard as possible not to sleep or take naps during those hours. Lately I have found tizanidine (Zanaflex) very helpful for sleep - I'm only on 2mg, so I don't know how long the effect will last, but it's certainly helping more than the hypnotics at the moment!

    I don't take a sleeping pill with the Zanaflex, because it is quite sedating (to me, at any rate). I take it with my small nightly dose of Temgesic (my main opioid for pain relief) and it's really helping so far. I hope you are able to get some relief soon.
  • Magic pill, here its almost 3:00 am and I am wide awake AGAIN & in pain. Took my restoril 1 hour ago and my soma 2 hrs ago and now due for 30 mg oxy. Last night I slept at 5:00 am. I am Soooo tired!
    Want some zzzzzzzzzzzz's!

    I've been taking my valium but I think I need to revisit my xanax, guess I need to speak with my pain doc Monday!

    Wishing all a peaceful & restful night (or at least a few hours) SLEEP!


  • A strange world when everone is sleeping and your NOT! It's a place I don't like to be. Like bizarreo land. Tick tock!
  • Absolutely- a doctor generally knows exactly what type of cocktail will be a safe one. My doctor hasn't told me to stop taking Ambien because of the Fentanyl, or even the xanax. But I wouldn't take them all together without a talk with him (actually, I just wouldn't, it's way too close too the Heath Ledger mix, even if it is missing a few I'd be too freaked out).

    My psych is a med expert, so I am pretty trusting. My xanax, by the way, are .25s, they are like baby xanax (which is why I'm allowed to take 1-2 every 6 hours as needed- well that and the fact that "as needed" often means "once every several months")

    I am going to give the silenor a try for a few days and see what happens. I like that it isn't a hypnotic. I can't tolerate the icky taste from the lunesta.

  • I have found sonata somewhat helpful. Was in the same situation where ambien wasn't working as well and although sonata doesn't necessarily help get a full 8 hours, it's pretty mild and has a short half-life that if you wake up at 2 am, you can take another.

    I know it's not ideal, but it something.

    Other things to try if you travel at all:benzodiazepines like nitrazepam and Erimin.

    No question, at least for me, that narcotics do sonething to the GABA receptors, making benzos marginally less effective.
  • This is the first time I've seen someone mention Erimin (nimetazepam) on this forum! Are you in Asia, Clem96?
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