Brief Answer:
Improved sleep hygiene and medicines will help in sleep.

Detailed Answer:
Hello thanks for asking from HCM for your health related queries

I can understand your concern. You have severe insomnia and panic symptoms when you go to the bed. The persistent insomnia results in increased anxiety which can complicate into panic disorder which further worsen the complaints of insomnia. So to come out of insomnia and panic symptoms you have to break that cycle of "insomnia-panic-insomnia".

You are already taking Mirtazapine and Clonazepam and in my opinion these are fine drugs for your symptoms. If you are not getting good sleep even with these medicines then doses of Clonazepam can be increased. Increased doses will not only reduce the symptoms of panic but will help in sleep also. I'd also advise you to improve sleep hygiene for proper sleep.

- Fix your time to go to sleep. Light relaxation exercise before going to bed also helps in sleep.

- Warm water bath before sleeping also improve the situation.

- Avoid taking tea, coffee or carbonated drinks in evening hours.

- Use your bed for sleeping only and avoid watching TV or reading from bed.

- If you fail to get good sleep with in 15 minutes of going to bed then get up and try to divert your attention.

- Don't try to sleep and don't think about sleeping again and again. Sleep is a spontaneous process and you will sleep when body will need it. Avoid day time napping.

Please try to follow these measures and you will see improvement over time. Also if you are not able to sleep even with medicines and improving sleep hygiene then medicines like Z-drugs as Zolpidem or Zopiclone etc can help. These medicines help in inducing good sleep and your symptoms will decrease. Please talk to your doctor for prescription of the drugs.

Thanks, I hope this helps you. Please feel free to ask again for more doubts.

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