I can't sleep dammit.

December 5, 2011 12:05 AM

Klonopin (clonazepam) withdrawal and insomnia. How do I get to sleep?

I had been taking klonopin for about a year (.5mg twice a day). A few weeks ago, my psychiatrist and I decided to get me off of this stuff with a tapering schedule lasting about three weeks. Everything is completely fine now that I've been completely done with it for two weeks except I cannot sleep. I am in college and right about now is when everything is due. Last week was hell and I feel like this week I have substantially more stuff due, that I need to be kinda well-rested to feel like I can do competently.

So, sleep strategies? I've tried relaxing and breathing and usually I get distracted unless I'm right on the brink of actually falling asleep. It's taking me 2+ hours to fall asleep and usually if I'm not asleep by then I'll go on the internet or read or something. Yesterday I got three hours of sleep and tonight isn't looking much better, but I still have the rest of the week to recoup my losses, so any advice would be helpful.

posted by tweedle to health & fitness (17 answers total)

My boyfriend, who takes vacations from his klonopin prescription as much as possible, swears by Dream Water.
posted by devymetal at 12:31 AM on December 5, 2011

Try reading a good book in bed until you can't read it anymore.
posted by rmmcclay at 12:47 AM on December 5, 2011 [1 favorite]

Why not call your psychiatrist and see if you can discuss this issue? He/she may be able to help with sleep hygiene strategies and/or pharmaceuticals (ranging from over-the-counter to strong sedatives depending on what's appropriate) to at least help you get through this crunch time in your studies.

Now put the internet away and get yourself into bed! Read a book (and I mean one for pleasure, not studying) if sleep is just not going to happen, but browsing websites is a horrible way to try to sleep, at least in my unfortunate experience.
posted by zachlipton at 12:48 AM on December 5, 2011 [2 favorites]

I have no idea where I picked up this theory, but I've been telling my kids for years "if you can't sleep, lying still with your eyes closed in a dark room is almost as good for your body and brain as sleeping".

In the last year or so I've been following my own advice, and it works for me. If I'm still awake at 2am and have to be up at 6am, I lie still with my eyes closed and just let my thoughts flow. Sometimes I'll do relaxation stuff (tighten toes, hold for a count of 10, relax them, tighten feet, hold for a count of 10, relax them, etc, up to my scalp). I definitely feel better the next day, much better than if I spend the night tossing and turning, reading, net-surfing, etc.

YMMV, but it's worth a try.
posted by malibustacey9999 at 1:15 AM on December 5, 2011 [3 favorites]

My daughter's prescription accidentally ran out and we had three days of insommnia and hysteria before we could get the new prescription so we are now planning a proper tapering off after being frightened by how bad the sudden withdrawal was. Her doctor is looking at months of tapering, not weeks. She's been on a fairly minimal dose for about a year now. Maybe you should talk to your doctor about making the tapering period longer?

She's struggled with insomnia and hypervigilence for years. Exercise seems to help, either right before sleep, or during the middle of the night (treadmill or just going for long walks). Warm showers, lavender oils, milk haven't.

Are you definitely not sleeping, or are you getting crappy sleep? She will say she hasn't slept at all, when I know from checking on her during the night that she was asleep for periods, but the sleep is not satisfying and she can't remember it or feel rested in the morning. Backrubs and a heavy blanket over her have helped with crappy sleep as opposed to insomnia.

I count back from 100, without moving, restarting from 100 again if I move a muscle. It's rare that I get to zero completely still and awake, and when that dones, I give up and get out of bed.

Good luck - clonazepam is very helpful, but so hard to quit.
posted by viggorlijah at 1:23 AM on December 5, 2011 [1 favorite]

As a longtime insomniac, longtime zolpedim tartrate (Ambien) user, over the past few months I have found a remarkable way to fall asleep: a sleep mask and a sound machine. Keep expecting it not to work but so far, its working. Need a comfy mask and sounds that you like. For me, in the northwest, that sound is ...rain. Almost too simple but it's working. Consider it.
posted by lois1950 at 1:32 AM on December 5, 2011

Oh man, the withdrawal from that sucks ass. (My pdoc didn't taper me and I dropped from 1mg at night to nothing. But I was withdrawing from Seroquel at the same time.)

Making my bed as awesome as possible, sprinkling with some lavender essential oil, listening to movies very quietly (so if you are fidgety, you can't hear it), reading, and keeping lights turned low a while before bed.

And time. It took me a while before I felt I could sleep semi-normally again. (I have issues with sleeping and I actually had to get on a different med to help with it.)
posted by sperose at 4:32 AM on December 5, 2011

Long time insomnia sufferer here. I've recently discovered that a 30 minute bedtime routine works wonders - shower, turn off lights, light some candles, a few minutes of yoga and meditation, then read in bed for a few minutes. It helps an amazing amount.

Crucial: no computer or tv in the hour before bed. The light wakes your brain up.

I also second the sleep mask and sound machine suggestion made upthread. Keeping the room cold is also essential for me.
posted by yarly at 5:04 AM on December 5, 2011

I think your situation is maybe a little beyond this, but one way I deal with insomnia is to tell each of my body parts to go to sleep, starting at the bottom, and to regulate my breathing. Make sure when you get into bed it's warm and comfortable and you've eaten comfort food. Then:

(Breathe in) Toes.

(Breathe out) Sleep

(Breathe in) Ankles

(Breathe out) Sleep

(Breathe in) Calves

(Breathe out) sleep

(Breathe in) shins

(Breathe out) sleep

. . . and on, slowly, up to your hair, breathing deeply each time.
posted by goofyfoot at 5:04 AM on December 5, 2011

I find 2 melatonin works really well. Or now that I have a cold, 1 chlor-trimeton and 2 melatonin. (4mg of Chlorpheniramine Maleate and 6 mg of melatonin.) It works for me and without it I do not sleep. Even if I get a ton of exercise, even if I'm pregnant. It doesn't make me groggy in the morning like Benadryl.
posted by artychoke at 5:36 AM on December 5, 2011

Benadryl or diphenhydramine is recommended (by Dr. Drew) for patients with dependency issues. It makes you sleepy without risk of dependence. IANAD. I find it helpful.
posted by reverend cuttle at 6:52 AM on December 5, 2011 [1 favorite]

Try reading a good book in bed until you can't read it anymore.

This is what I do, but I've also been told that I shouldn't do anything BUT sleep in bed. Reading, talking, working creates non-sleeping associations with the bed environment, and can stimulate your brain.
posted by reverend cuttle at 6:54 AM on December 5, 2011

Great advice here from fellow insomniacs.

I wonder why your tapering schedule was only 3about weeks. Klonopin is a pretty strong drug, and your body has been accustomed to having it as a signal for your body to sleep. I would think a taper would be longer, think a couple months.

I would see if your doctor would script you something different to help. Perhaps ambien or a shorter acting benzo like xanax. In the mean time, try melatonin. If you are not cannabis adverse, I would have a little bit before bed. It can be tremendously helpful in inducing sleep and staying asleep.
posted by handbanana at 7:30 AM on December 5, 2011

I was having insomnia so severe it was affecting my health, and my doctor wrote me a scrip for trazodone. BOOM, done. It's not habit-forming, it doesn't knock me out -- it's like it doesn't make me sleep, it just makes me GO to sleep. More importantly, it makes me go BACK to sleep; I wake up non-groggy even if I have interrupted sleep (I have a baby so this is common). If sleep-hygiene stuff isn't working, it might be something to talk to your doctor about.
posted by KathrynT at 9:45 AM on December 5, 2011

melatonin and relaxation/meditation will help. and patience (hard, i know). it will take time for your body to re-set. be careful with benedryl if you have issues with depression or other mood disorders - too much of it or taking it too often can have a seriously negative effect on your mood.
posted by unlucky.lisp at 7:01 PM on December 5, 2011

KathrynT: " it doesn't knock me out "

Speaking for yourself. I used to say "I'm going to get Trazostoned" before I took one because it would knock me out for 14 hours. If I got up any sooner, I couldn't stay awake.

When I can't sleep I often listen to a (relatively quiet) podcast like the ones from HowStuffWorks.com. I listen to the episodes where the subjects are something I'm not really interested in when sleepy, and the conversation kind of eventually fades into the background and I doze off during them. Paradoxically, if I listen to music it has to be instrumental because my brain will try to hear and keep up with the lyrics and it keeps me awake.
posted by IndigoRain at 8:00 PM on December 5, 2011

Got off Klonopin and Ambien. Now I take 50 mg of diphenhydramine (2 benadryl caplets) about an hour before I want to sleep. Avoid the Tylenol/Advil/whatever PM. They are just diphenhydramine (benadryl) plus a painkiller. Many OTC sleep remedies are just diphenhydramine marketed under a trade name.
posted by kamikazegopher at 9:28 PM on December 5, 2011