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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How To Treat Severe Insomnia That Hasn't Improved Despite Pills?

I have a severe case of insomnia and nothing helps me sleep - even the strong sleeping pills. I have no slept in 6 weeks and am completely unable to sleep. No one in my family had Fatal Familial Insomnia. Could I still have this disease without it running in my family? I am only 34 and the symptoms are so bad I want to die. I am waiting on seeing a sleep disorder specialist, but it sounds like the main symptom - you wake up one day never to sleep again is what I have. Please help! I want to express that no pills work.
Tue, 2 Aug 2016
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Psychiatrist 's  Response
Dear HCM User

You are suffering from insomnia. This could be primary (independent) or secondary to other medical and psychiatric conditions. As this is recent onset you need to undergo a few routine tests like CBC, LFT, RFT, TSH to rule out nutritional deficiency or hormonal imbalance particularly hyperthyroidism. Also if along with sleep disturbance you have other symptoms like mood disturbances, thought disturbances like pessimism or racing of thoughts, increase or decrease in energy levels, anxiety you may be having a mood disorder that is treatable with medications. It doesn't seem to be Fatal Familial Insomnia. Before trying sleeping pills please follow the following steps of simple hygiene.Establish this routine and it will benefit you.
Avoid napping during the day. Avoid stimulants such as caffeine, nicotine, and alcohol after late afternoon. Exercise regularly in morning or late afternoon. Associate your bed with sleep by using it just for that and not for watching TV, laptop, mobile. Avoid stimulating activities in evening. Establish a regular relaxing bedtime routine like reading, calm music, yoga. Do not bring your problems and worries to bed.Sleep and wake-up at fixed timings.
Hope your concerns are addressed.
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How To Treat Severe Insomnia That Hasn't Improved Despite Pills?

Dear HCM User You are suffering from insomnia. This could be primary (independent) or secondary to other medical and psychiatric conditions. As this is recent onset you need to undergo a few routine tests like CBC, LFT, RFT, TSH to rule out nutritional deficiency or hormonal imbalance particularly hyperthyroidism. Also if along with sleep disturbance you have other symptoms like mood disturbances, thought disturbances like pessimism or racing of thoughts, increase or decrease in energy levels, anxiety you may be having a mood disorder that is treatable with medications. It doesn t seem to be Fatal Familial Insomnia. Before trying sleeping pills please follow the following steps of simple hygiene.Establish this routine and it will benefit you. Avoid napping during the day. Avoid stimulants such as caffeine, nicotine, and alcohol after late afternoon. Exercise regularly in morning or late afternoon. Associate your bed with sleep by using it just for that and not for watching TV, laptop, mobile. Avoid stimulating activities in evening. Establish a regular relaxing bedtime routine like reading, calm music, yoga. Do not bring your problems and worries to bed.Sleep and wake-up at fixed timings. Hope your concerns are addressed.