
I Had One Day Normal Sleep, But The Next Day

prescribed me 15 mg Temazepam on XXXXXXX 20, however it still one day works well, and the next day not as well or not working . the pattern seems continuing . I am a 74 years old retiree with no other medical issue and no previous sleep disorder. I would like to ask doctor why I sleep every other day and could not get daily sleep even with medicine.
Zolpidem and melatonin would suit you better.
Detailed Answer:
Hi,
Thank you for posting your query.
I have noted your clinical details and the problem seems to be primary insomnia, without any other significant disease.
The medicines you have tried so far (lorazepam and temazepam) belong to benzodiazepine group of drugs. These drugs are known to cause sedation, drowsiness, imbalance and other side effects especially in older people.
Trazodone is more of anti-depressant and it has only mild effects on sleep.
The best drug combination for you would be melatonin with zolpidem.
Melatonin is the natural sleep inducing hormone.
Zolpidem induces sleep but does not alter the natural sleep architecture. Moreover, it does not have any hangover (which is commonly seen with benzodiazepine group of drugs).
Best wishes,
Dr Sudhir Kumar MD DM
Consultant Neurologist


Is it something wrong in my nerve system to cause me sleep one day normally and the following days just not sleep at all, the medication help me ,but still one day better than other day even I took same dose. This is the reason I would like to get a specialist to help.
I have used 6mg melatonin lately alone, and it did not make me sleep, but my stomach feel uncomfortable.
I will be very glad if you can recommend the specific combination of zolpidem and melatonin .I will ask my doctor to presctibe zolpidem which he did not want me use because worrying about sleeping walking or sleeping driving.
Thanks again
ZOLSOMA is available in XXXXXXX
Detailed Answer:
Thank you for getting back.
For my patients, I prefer melatonin 3 mg and Zolpidem 10 mg combination. In XXXXXXX a fixed dose combination by name Zolsoma is available. If you are unable to get the fixed dose combination, you can take both separately too.
I regularly use Zolpidem and I have not seen sleep walking and sleep driving, so the risk of that seems to be low.
Dr Sudhir Kumar MD DM


Very glad to talk with a doctor who also is a patient. I will be very glad to learn little history that you deal with sleep problem if it is possible to share.
Thanks again!
Zolpidem should be taken about 30 minutes prior to time of sleep.
Detailed Answer:
Just to clarify, I use Zolpidem for my patients (and not on self).
Zolpidem acts quick and should be taken about 30 minutes prior to the time, you normally go to bed. So, it should be taken at home, and not outside. One should not drive after taking it, as it impairs the concentration and attention, within 10-15 minutes of taking it. The best part is it works only for for a few hours and so, you wake up fresh and there is no hangover.
Melatonin can be taken about 60 minutes before sleep time, if it is taken separately.
Dr Sudhir Kumar MD DM


Temazepam is my current medicine. Is temazepam can also be used with melatonin? How many minutes should temazepam be taken before going to bed? Since I do not get same sleep everynight ,some day with quickly deep sleep, and other day taken much longer time to get little or no sleep even I take exact same dose.Do I need up(only 30mg available ) my current dose or I can take second dose if I can not return to sleep after wake up at middle of the night. Please advise.
Temazepam can be taken an hour before going to bed.
Detailed Answer:
Temazepam takes 1 to 1.5 hours to show the peak effect, so, it can be taken about an hour before going to bed.
30 mg is the usual advised upper limit of Temazepam, so, an extra tablet is not recommended.
Melatonin may potentiate the effect of temazepam, so, it can have a synergistic effect on sleep.
Dr Sudhir Kumar MD DM

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