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Suggest Treatment For Insomnia

Posted on Tue, 26 May 2015

Question: we're trying to address my insomnia after waking up around 3 vie trazodone lowest dosage, rather than taking 5mg ambient.
It worked for first few days, but now it is back to what it was before, except it moved to 4am.
Today I took 5mg ambient, knowing it was kind of late. Slept to 8. w/o any side effects.
we're leaving for overseas and I usually need ambient in small space ( hotel, cruise cabin) where there is no place to go, to make sure at least my wife gets a good sleep. We travel extensively and it works. Last was Safari tents.
Would like to hear your opinion
Thanks XXXXXXX

Answered by Dr. Dr. Muhammad Sareer Khalil (17 minutes later)

Brief Answer:
Dose adjustments, replacement if persistant insomnia

Detailed Answer:
Hello and Welcome

I appreciate your concern

The dose of trazodone can initially be increased. If the insomnia persists or worsens then it could be switched to Nortriptyline ,Doxepin or Mirtazapine in consult with your doctor.

Suvorexant, an orexin receptor antagonist is a new drug for regulating the sleep cycle. In recent trials patients receiving suvorexant had a quicker sleep induction and spent much less time being awake for the rest of the night compared with those that received a placebo drug. You may discuss this option with your doctor.

As a matter of clinical experience, I would also advise that you download sleep induction audio tapes by XXXXXXX Bridges and listen to them daily at your bed time. Many of my patients have reported significant improvement in both sleep timings and quality.

Wishing you best of health

Thanks

Please consult your doctor before deciding on any further course of action.

Dr. M.S. Khalil

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Dr. Muhammad Sareer Khalil (55 minutes later)

Dr. Khalil;
thanks very much, it is very helpful. XXXXXXX
ps. did you see a problem using ambient at times?

Answered by Dr. Dr. Muhammad Sareer Khalil (1 hour later)

Brief Answer:
Ambient C.R would be better

Detailed Answer:
Hello again,

If you were my patient I would have recommended ambient CR instead of an immediate release to counter the 3 a.m insomnia. Other then that zolpidem ( ambient ) is fine in your case and you can continue it till you discuss this option with your doctor.

Thanks.

Dr. M.S. Khalil

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

Above answer was peer-reviewed by : Dr. Raju A.T