Brief Answer:
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Detailed Answer:
Hello,

Thanks for writing to us.

You have insomnia and you have tried Ambien, Xanax, Advil pm.

Still you are not able to sleep well.

I want to clarify about insomnia.

Insomnia (sleep disturbance) is of two types:

Primary: There is problem of only sleep disturbance and no other physical or psychological problem is there. In this case treatment for sleep problem is needed.
     
Secondary: There is some underlying physical or psychological problem which is responsible for sleep disturbance. In this, main treatment is done for underlying problem.

First of all try to follow some measures called 'sleep hygiene' which would help in sleep. You can find the same in below link.

sleepfoundation.org/ask-the-expert/sleep-hygiene

Drinking a cup of warm milk before going to bed helps in 30-40 of patients and they do not need medicines as per my clinical experience.

As such drugs from benzodiazepine group and Z group sedatives are used in sleep disturbance. But all are prescription medicines and you need to consult doctor for prescription. Anti-histaminic and melatonin are also used sometime when sleep problem is not severe.

Let me know more so I can guide you further.

- Since when are you suffering from sleep disturbance?

- What is type of sleep disturbance there? Is there difficulty in sleep onset, fragmentation of sleep or early morning awakening?

- What was the schedule (timing) and duration of sleep before the problem started? How much reduction in sleep from previous?

-Do you have any type of stress (it can be social, economical, relationship, study/work or emotional)?

- Do you have any physical illness?

- How were the medicines effective you have taken and in which dose you have taken them?

I will be happy to help further after your response.
Regards,
Dr.Chintan Solanki.

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