Sleep pattern and sleeping pills

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fh2000

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I have always had trouble with my sleep. On average, I sleep about 5, 6 hours and wake up almost every 2 hours in between. This has happened to me for many years, even after 5 years of retirement.

Our life is now relatively calm and routine. Kids are all in other states with their own lives. There is no work issue for me and no other health issue, but I just can not sleep thru the night.

I am now traveling back in my home country for 2 months where universal health care covers everyone. To see a doctor at the hospital requires just $7 co pay. Everything else is free (visits, medications, Xray, CT, etc).

So, I went to a family medicine doctor at a hospital about my sleep issue. He prescribed 7 day Rivotril 0.5 mg for me to see how it affects me. After I took it few days, I can sleep the full 8 hours each night.

I am scheduled to see him again next week. I am thinking of asking for a longer timeframe, say 3 months supply prescription so I can continue to use it after I return to US.

What do you all know about this prescription and if there is a long term impact to the body?
 
Looking at drugs.com this (clonazepam) appears to be a pretty powerful drug.

But Wikipedia says it was the 44th most commonly prescribed medication in the US in 2020, so it's certainly popular. Seems not to be mainly prescribed as a sleep aid, but rather for management of epilepsy, however it does have that sedative side effect. The only issue I see is that it can lead to dependence in those who take it for longer than four weeks.
 
It's a benzo, not good for long-term use. I had sleep issues for most of my life. They went away after I retired. I'd try something like Trazadone or nortriptyline for longer-term use for pharmaceutical products or melatonin, cbd, or cannibis for a natural solution.
 
I don't know anything about prescribed meds, but try tart cherry juice concentrate. (It usually comes in a bottle.) I tried it, and it definitely does not agree with me, as I get so sleepy and drowsy that it even affects me in the morning (I should take less and see but I haven't tried yet.) This is just fruit juice, folks. Amazing stuff. It is supposed to help with gout pain as well as muscle pain. I took it for muscle pain, but it didn't work for that. The Amazon reviews showed tons of people mentioning it helped them sleep.
 
Even more natural is good sleep hygiene - regular bed/wake time, no distractions, cold and quiet and dark bedroom, don't watch TV or be on the computer or cell phone before bed, exercise every day, don't eat before bed, stay well hydrated, pay attention to sleep side effects of any medicine or OTC or supplement you take, etc.

If I'm good with all of those, I can sleep really well. It also can take a week or two to notice improved sleep after improving one's sleep habits. If I don't follow those habits, I can have great difficulty sleeping, including as bad or worse than the pattern described in the OP.

ETA: Hydration is the weird one. If I'm dehydrated, I'll wake up every two hours or so for no apparent reason. If I drink a full glass of ice water maybe an hour before bed, then I sleep well and don't have the every two hours issue. In middle age with sleep problems, especially men, can worry that drinking that much before bed might mean getting up every few hours to use the bathroom. There's definitely a middle ground.
 
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Had a relative who took tart cherry juice for pain. Turned out it has trace amounts of aspirin in it. Cheaper and more convenient to take the pill.
 
I’ve had sleep problems for years, largely related to my pain issues. I’ve tried the regular bedtime with quiet time before, not eating too soon before bedtime, and everything my doctors have suggested. I tried Ambien which I strongly suggest everyone avoid. Melatonin doesn’t work for me even trying from one mg up to ten.
The only thing that works for me about 80% of the time is a glass of scotch, a muscle relaxer and an over the counter sleep aid Unisom. Unisom is similar to other sleep aides but a higher dose than most. My doctor gives me a funny look, but agrees I need to sleep.
 
MRG said:
It's a benzo, not good for long-term use. I had sleep issues for most of my life. They went away after I retired. I'd try something like Trazadone or nortriptyline for longer-term use for pharmaceutical products or melatonin, cbd, or cannibis for a natural solution.
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It's Trazodone, but it's pretty weak. I've taken both Trazodone and Nortriptyline, and Trazodone helped very little (and you build tolerance), and Nortriptynol never helped in the slightest with sleep, it just gave me side effects. Tricyclic (TCA) ADs like Nortriptynol that actually are more likely to help with sleep include Amitriptyline and Doxepin.

Avoiding benzos is best. There are also plenty of horror stories from people trying to taper off benzos like Xanax, Ativan, and Clonazepam.

I use Ambien (Zolpidem) low dose sublingual overnight. It is benzo "like" and can build tolerance and dependency as well. But a low dose ~1.5 mg overnight can get me back to sleep for a while. And I don't take it every night.

Melatonin and various supplements such as L-Theanine, GABA, 5-HTP, Lithium Orotate, Valerian Root, Inositol, Taurine, NAG, Magnesium Glycinate, and Glycine have proven worthless for me, same thing with CBD, CBN, CBG, THC (cannabis sourced), and THC Delta 8. Hydroxyzine, Benadryl, and Unisom have had limited effect, like Trazodone, and I rarely take them.

A more effective AD than Trazodone for more difficult cases of insomnia is Mirtazapine, but it tends to make people put on weight, will usually leave you more groggy, may cause optical issues like floaters or visual snow, will become less effective over time, and it can be difficult to wean off of.

There's a newer class of sleeping medications that work differently rather than sedating and should be less habit-forming. I haven't been too impressed by the review feedback. Side effects include night paralysis and daytime grogginess. There are no generics, so they can be more costly.

Dual orexin receptor antagonists (DORAs):
Oldest: Belsomra (suvorexant) - 12hr half life
Second: Dayvigo (lemborexant) - 17 (5mg) -19hr (10mg) half life
Newest: Quviviq (daridorexant) - 6-8hr half life

Some of the tips from others here might help some people, but they are all old news to me along with many others and don't work, but I have bad tinnitus screaming all night, so there is no such thing as "quiet".
 
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Some people have problems with benzo's and others don't. It could depend on a combination of dosage and continuous use?

I've taken low dose (like 0.5mg) benzo's for about 10 years to help with muscle spasms and sleep. But I only have taken when I've had a few nights in a row with limited sleep, and/or a rough day with muscle spasms.
I haven't had a problem with side affects. But of course, individuals vary.

After I retired I didn't have sleep issues anymore, so I no longer take them.

Maybe take only when you feel you really need to catch up on sleep if you're nervous of side affects.
 
I have a pretty strong opinion when it comes to pills that induce sleep. I've personally known people that have developed a dependency on them and it's not pretty.



Cut out caffeine, exercise more, meditate, turn off all electronics 2 hours before hitting the pillow, hot bath at night, read before bed are a few of the habits to form before taking these meds.



I know it's probably hard to form new habits but pills are a big no no in my book. Good luck!
 
FREE866 said:
I have a pretty strong opinion when it comes to pills that induce sleep. I've personally known people that have developed a dependency on them and it's not pretty.
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Well it's easy to have that opinion when you don't need them.

Cut out caffeine, exercise more, meditate, turn off all electronics 2 hours before hitting the pillow, hot bath at night, read before bed are a few of the habits to form before taking these meds.
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I have a long Word document with all those tips and far more, but they're aren't helpful to a lot of people, especially if you have the equivalent of 2 smoke alarms going off in your ears due to terrible unmaskable tinnitus.

I know it's probably hard to form new habits but pills are a big no no in my book. Good luck!
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Habits often have nothing to do with it. Medication is absolutely necessary sometimes for some people. Don't assume everyone has a more typical case of insomnia.
 
Magnesium often helps people relax and sleep. Plus many of us are magnesium deficient. (Briefly, many soils are lacking magnesium after decades of farming, and the plants grown there no longer provide the nutrients they once did.)

There are many types of magnesium and they are relatively inexpensive. There are oral dosages, magnesium skin lotions, and some folks soak in Epsom Salt baths.

Many folks swear by Mag Glycinate for sleep, but it has the exact opposite reaction in some people, including me.

I take Mag Malate and Mag Taurate with my other daily supplements and, along with good sleep hygiene, sleep very well.

Poor sleep is awful. Best of luck with finding a good, healthy solution.

omni
 
I never had a sleep problem until 2 years ago. Now I fall asleep quickly but wake up every 2 hours. If I can’t go back to sleep after a hour I get up and read for awhile. My mom had this problem around my age and eventually couldn’t sleep more than 6 hours a night. My 2 older siblings are like my mom. In my family it’s just a byproduct of aging. I wouldn’t take a medication for this.
 
I didn't put a quote from my article above for fear of offending someone who thinks they are terrific meds but it did indicate increased risk of motor vehicle accidents and hip fractures. . . https://www.aafp.org/pubs/afp/issues...0815/p224.html

Is it still worth it? It might be. It is personal choice between you and your doctors.
 
I try to keep the noise down and stay comfy (not too hot or cold) at bedtime. If I need to settle down, then I get on youtube and play a song or two that I like. Then, I figure that if I need the sleep, I'll sleep.

I have never taken any sort of medicine for a sleep aid and don't want to. If I don't sleep then I either play some more music or do whatever seems appealing to do on the internet and try again later.

Maybe this just means I don't have a sleep problem? I have no idea. Anyway some nights I sleep 9 hours, other nights I'm lucky to get 4-5 hours, but I don't scold myself over it either way. I figure if I need the sleep I'll sleep. If I feel like it, I take a long nap in the afternoon.

One of the nice things about being a single retired person is that I have plenty of opportunity to sleep as much (or as little) as I want, day or night. My natural sleep patterns seem to vary from night to night, sleeping more one night and less the next, and so on. That's just the way I am and I can accept that. Works for me. :)
 
If you have not already tried: No caffeine after 12pm. No alcohol at all. Engage in active / physical sport for at least 4 hours a day. On nights that you still cannot fall asleep despite doing what I have listed here, take 3mg Melatonin.

Caffeine and alcohol disturb sleep. Physical sports tires your body and mind.

Rivotril is a dangerous drug. I would not want to be on it for any sort of duration.

I have had difficulty in falling asleep and staying asleep for the past 30 years, until I started golfing 4 to 5 days a week in retirement and cut out all caffeine after about noon. I don't normally drink alcohol, but on the very rare occasions which I drink, my sleep for the night goes really bad. Melatonin is my last resort drug when I still cannot sleep despite being physically and mentally exhausted.
 
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omni550 said:
Magnesium often helps people relax and sleep. Plus many of us are magnesium deficient. (Briefly, many soils are lacking magnesium after decades of farming, and the plants grown there no longer provide the nutrients they once did.)

There are many types of magnesium and they are relatively inexpensive. There are oral dosages, magnesium skin lotions, and some folks soak in Epsom Salt baths.

Many folks swear by Mag Glycinate for sleep, but it has the exact opposite reaction in some people, including me.

I take Mag Malate and Mag Taurate with my other daily supplements and, along with good sleep hygiene, sleep very well.

Poor sleep is awful. Best of luck with finding a good, healthy solution.

omni
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I get morning leg cramps if I don’t take magnesium before bed.
 
OP--you don't mention if you have ever been to the dr prior for insomnia or any things you may have tried in the past.
I agree with the recommendation of getting a sleep study.

Some people just don't need "8 hours of sleep". How do you feel in the morning and during the day?

Your prescription is a benzodiazepine, not recommended long term and also not recommended for older folks.

When you get back home, I would ask your PCP for a referral to a sleep medicine doctor. They are specialist for any sleep disorders/issues, and will hopefully work with you to help resolve your problem via tests, etc.
 
pacergal said:
OP--you don't mention if you have ever been to the dr prior for insomnia or any things you may have tried in the past.
I agree with the recommendation of getting a sleep study.

Some people just don't need "8 hours of sleep". How do you feel in the morning and during the day?

Your prescription is a benzodiazepine, not recommended long term and also not recommended for older folks.

When you get back home, I would ask your PCP for a referral to a sleep medicine doctor. They are specialist for any sleep disorders/issues, and will hopefully work with you to help resolve your problem via tests, etc.
Click to expand...

Thank you all for your responses. I have not done a sleep study. During my working years, I was on call many years being an IT professional and sometimes had to answer calls from India in the middle of the night. A female coworker once made fun of me for sleeping with my pager (remember those?) and it would "vibrate" when I was paged.

It was so disruptive that I had to sleep in a different room from my DW whom I love dearly. I am a very light sleeper so any slight sound or light would wake me up. My issue with sleep seemed to originate from those days.

I tried Melatonin and it has no effect on me. I tried with many non medication methods such as white noise or listen to boring podcast with little or no success.

I do have an appointment with my PCP for annual wellness check later this year. My PCP of 20 years did my wellness check just like the prior annual physical so I will for sure finally bring it up with him and see what he says.
 
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