Suggest Treatment For Disturbed Sleep

Posted on Sat, 17 May 2014

Question: I never gets a sound and proper sleep,please suggest.sm time i used to take chlonotril .25 mg to get away from anxiety. I a m a high bp patient 36 year old.thnx

Answered by Dr. Sunil Gupta (26 minutes later)

Brief Answer:
More information required

Detailed Answer:
Hi Mr. XXXXXXX

I am a psychiatrist and I think I might be able to help you. You have mentioned about inadequacy of sleep, being a hypertensive and taking clonazepam (clonotril) for anxiety. It would be helpful if I could also get the following information regarding your condition:
- How long are you suffering from anxiety and sleep disturbance?
- If possible, can you please elaborate on what exactly happens when you feel anxious (like palpitations, tremors, sweating, worrying)?
- Are you on any anti-hypertensives currently?

Currently, from the information you have provided, it seems you might be suffering from some subtype of anxiety disorder which is leading to you symptoms. In that case, clonazepam will give you only immediate relief and not long term help. In fact, in long term, if taken without proper supervision, it can lead to dependence. You might benefit from selective serotonin reuptake inhibitors like sertraline or paroxetine together with proper treatment for hypertension. You should consider consulting a psychiatrist for the same. In addition, relaxation exercises like progressive muscular relaxation can also help you relax.

Hope I have answered your query. If you have any further questions I will be happy to help.

Best wishes,

Dr. Sunil Gupta

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Sunil Gupta (2 hours later)

Hi Sir,

- How long are you suffering from anxiety and sleep disturbance?-
Since last 4-5 years but not always this case but sometime when things are not well in office.
If possible, can you please elaborate on what exactly happens when you feel anxious (like palpitations, tremors, sweating, worrying)?- Are you on any anti-hypertensives currently?
Worrying and feels that I am about to get a heart attack and more cautious about my health.

Are you on any anti-hypertensives currently?
I am taking a telsartan 40 for high blood pressure daily.

Please let me what should I do this specific case and get rid of the anxiety. I worried about much un neccessary things and this leads to insomania. I having this problem since last 4-5 years.

Answered by Dr. Sunil Gupta (1 hour later)

Brief Answer:
You will need treatment for anxiety disorder

Detailed Answer:
Hi Mr. XXXXXXX

Thanks for the information. From the information that you have provided, you seem to be suffering from anxiety disorder. The good news is that your condition is amenable to treatment.

As I had mentioned earlier, you should visit a psychiatrist for your condition. You will need treatment with selective serotonin reuptake inhibitors which are safe as well as effective. Baseline investigations in form of complete blood counts and thyroid function tests will be required. You will have to remember that the medications will be slow to act and will need days to weeks to show its effect. Since, you are also diagnosed with hypertension, you will also have to continue the recommended anti-hypertensives.

In addition to the medications, you can also consider option of psycho-therapeutic treatment like cognitive behavior therapy in case some one trained in it is available in your area. It will constitute of 12-20 weekly sessions which will focus on learning relaxation and understanding your underlying worries, helping you rectify your thinking pattern. You can also start doing daily exercise and meditation as that will help you relax yourself.

Hope I have answered your query. If you do not have any clarifications, you can close the discussion and rate the answer. Wish you good health.

Dr. Sunil Gupta

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Prasad