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Asked by stojcev (Male; 33; 78794; No allergies, major illnesses or surgeries or any history of major illnesses. ; Relevant drugs:Mirtazapine -
15 mg a day, before bedtime. ) on Mon 21, Jun 2010 04:48pm for $19.00:
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For a few years now, I have had a difficult time sleeping. Sometimes, I simply
cannot fall asleep due to "over thinking." However, I got to the point where I
kept waking up in the middle of the night and couldn't fall back asleep. As soon
as I would wake up in the middle of the night, the thought that I wouldn't fall
asleep would enter, and sure enough I couldn't fall asleep. When I wake up in
the middle of the night, it is usually because I have to go to the bathroom,
despite the fact that I go to the bathroom before I go to sleep. I cannot fall
asleep all night and I am lucky to get 5 hours of sleep. On average, I would say
that I spend about 30 minutes a day thinking about my poor sleeping.
For the past 2.5 years, I have been taking 15 mg of Mirtazapine before bedtime
that was prescribed by my doctor. It seems to work 95% of the time and I stay
asleep for the duration of the night, which is usually about 6 hours. I do sleep
better while taking Mirtazapine. In addition, falling asleep during the day is
rare as well. Before that, at the age of 28, I began taking Mirtazapine for well
over a year. When I slowly tapered off taking the pills, I began having extreme
difficulty sleeping and could barely sleep 4 hours, which put me in such poor
shape. I began to fall asleep during the day and became moody as well.
I am 33 years of age who keeps in fair physical condition - lift weights 3 to 4
days a week for the past 13 years. I have never been overweight and I also jog 1
to 2 times per month and play sports on occasion. I do not smoke or drink
alcohol. I do have a green tea every single day for the past 6 years however as
well as having an occasional soda - caffeinated. I tried to stop drinking green
tea for a month but it had no effect.
Please help, I do not know how to improve my sleep in an organic fashion and
without the means of taking pills. When I slowly taper off the pills again this
summer, I am afraid that I will have the sleeping problems again and I do not
want to take pills for the rest of my life. Please help me sleep without the use of medications.
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Answer by Dr.Kokil Mathur (doctor) on Mon 21, Jun 2010 06:56pm:
Hi! Thanks for the question on the forum. You could be suffering from insomnia. This can be due to physical or
emotional stress, depression (this you probably have as you are taking Mitrazipine), allergies, asthma, high
blood pressure, heart disease, arthritis, hyperthyroidism, and sleep apnea. You should ideally consult an
internal medicine specialist and a sleep specialist for this. If no cause is found then some counseling and
review for depression may help. Meanwhile you can try out simple things like yoga, a brisk walk before
bedtime, a glass of warm milk at bedtime or even listening to soothing music in dimmed light. While all these
steps can help, it is important that you consult a sleep specialist to rule out any sleep disorder. Sleep
studies should be carried out and you should also be assessed for other medical conditions causing this.
Please feel free to ask anything else you may want to know. Take care! |
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Follow up:
Request for Clarification by Dr.Kokil Mathur on Wed 23, Jun 2010 07:21am:
Hi! Yes, you can drink green tea or any form of herbal tea in the morning. Only do not take it late night.
Regarding tapering of Mitrazipine, only your treating doctor can tell you how to go about it. Generally dose
is reduced step wise depending on the response to reduction, which you cannot do yourself. Also on net since
you cannot be examined, it is difficult to give a correct dose reduction plan. Do discuss this with your
treating physician. Take care!
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Comments:
Comment by Dr Ajit Singh on Mon 21, Jun 2010 09:05pm:
Hello stoicev, welcome to ask medical doctor.com. Your post has been fairly justified by Dr.Kokil Mathur. You
are suffering from chronic nocturnal awakenings. I would like to brief out certain other things which might
help you to reach the diagnosis and certainly the treatment. All these years you were using antidepressants,
which has created this physical dependence and manifest during its withdrawal, if not tapered carefully. Apart
from physical dependence these drugs also cause psychological dependence. Usually insomnia is often confused
with Delayed sleep phase syndrome, which has to be ruled out in your case too. This can be done with the help
of a specialist in sleep medicine. The other causes apart from what Dr. Mathur has explained are restless leg
syndrome, bipolar disorder, schizophrenia, brain lesions, or any history of traumatic brain injury. Sleep
studies using polysomnography and studies of the brain metabolism using positron emission tomography {PET}
scans will help reach diagnosis. Simultaneously have a Psychologist counseling to treat psychological
dependence. Stop drinking caffeinated soda. Have a hot water bath and a glass of hot milk before going to bed.
Make sure that the lighting of your bedroom is enough dark and noise free to have better sleep. Exercise on
daily basis along with yoga and meditations. Do not have nap, this will again cause insomnia. Hope this
additional information helps you. Any doubts, kindly keep posting. Regards Should I stop drinking green tea in the morning?
In addition, how do you suggest I taper off of Mirtazapine? |
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