I need to sleep
March 30, 2013 7:25 PM   Subscribe

I keep good sleep hygiene. I have herbal tea and a warm bath/shower an hour before bed. I take 50-75 mg of Benedryl (or equivalent) every night. I'm still only sleeping 3-4 hours a night. I can't take Ambien because it makes me sleepwalk. Ideas?
posted by kamikazegopher to Health & Fitness (35 answers total) 11 users marked this as a favorite
What happens when you don't take the benadryl? Do you sleep more, less, or the same?

I also think regular exercise could be helpful.
posted by mai at 7:28 PM on March 30, 2013

How much caffeine do you consume during the day?
posted by k8t at 7:29 PM on March 30, 2013

Do you go to bed at the same time each night and get out of bed at the same time each morning? Do you exercise (and if so, what time during the day)? Have you had a sleep study done? You don't really provide us with enough details to answer your question.
posted by MaryDellamorte at 7:31 PM on March 30, 2013 [1 favorite]

Do you spend that hour before bed in a dim room and not in front of screens?
posted by Andrhia at 7:33 PM on March 30, 2013 [1 favorite]

Seconding all the above questions, plus how's your diet? Do you have trouble falling asleep or staying asleep?

Do you maybe wear too much clothing or use too heavy a blanket? Being too warm could be a problem.
posted by mchorn at 7:34 PM on March 30, 2013

I really do not think you have provided sufficient information for other than very general replies--age, general health, specific health problems, exercise habits, issues with weight, use of stimulants, medications you are taking, external/internal stress, changes in sleep habits, is thus a problem and are you fatigued during the day, naps, changes in daily schedule etc. I am not suggesting these all have to be addressed or considered on Ask MeFi but they are important in assessing sleep problems.
posted by rmhsinc at 7:36 PM on March 30, 2013 [1 favorite]

Melatonin is worth a shot. It's cheap, pretty harmless, and works well for some people.
posted by miyabo at 7:39 PM on March 30, 2013

Response by poster: If i don't take Benedryl i don't sleep at all. I drink coffee in the morning, but cut out caffeine after noon. I take a 3 mile walk during my lunch hour. I try to sleep at the same time every day. Possibly related: I work on the east coast but live on the west coast. I go home every other weekend, so there may be an element of jet lag in my sleep.

And on preview, I'm 36 and in good health. I've been struggling with PTSD of late and nightmares make me not want to sleep. I'm not on medications other than Benadryl for sleep. I don't take naps and I don't have apnea.
posted by kamikazegopher at 7:40 PM on March 30, 2013

Have you talked to your doctor about trazodone, just a thought.
posted by treehorn+bunny at 7:45 PM on March 30, 2013 [2 favorites]

FWIW, caffeine at any time of day can make it incredibly difficult for me to fall asleep (and give me panic attacks, too.) You might consider cutting it out entirely.

You also might consider judicious use of melatonin for your constant time changes. It can be amazing.
posted by Andrhia at 7:46 PM on March 30, 2013

Melatonin is a natural sleep herb that seems pretty harmless
posted by Jacen at 7:50 PM on March 30, 2013 [1 favorite]

Tolerance to the sedating effects of Benedryl develops very quickly. It's possible that it may not be working for you anymore.
posted by el chupa nibre at 7:50 PM on March 30, 2013 [1 favorite]

Trazodone. DO IT.
posted by joan_holloway at 7:57 PM on March 30, 2013

I get better sleep when I cut out caffeine altogether. Taking calcium and magnesium before bed also helps. Blackout curtains can be helpful, too.

Are you having trouble falling asleep or are you waking up in the middle of the night?
posted by needs more cowbell at 8:01 PM on March 30, 2013 [1 favorite]

Co-q-10 in the morning, about 12 to 14 hours before bedtime, melatonin 30 minutes before bedtime, journal and therapy for the ptsd. Co-q-10 is the co-enzyme for melatonin. I used it for a few years to get my brain's chemical waking and sleeping cycle straightened out after lots of medication and severe insomnia. I usually sleep pretty well these days.
posted by Michele in California at 8:05 PM on March 30, 2013 [2 favorites]

I'd recommend a sleep study and getting to the bottom of the PTSD nightmares. You've pretty much told us the cause of the lack of sleep.

Everyone is so terribly different in what they need. In order to sleep properly, I have to take a small dose of an amphetamine compound. Otherwise, my brain is awake at 4:45 am, and wants to go out and play. It works for me, but makes every pharmacist double-take.
posted by A Friend of Dug [sock] at 8:08 PM on March 30, 2013 [1 favorite]

Completely get off of caffeine. If I have caffeine at any point during the day, it ruins my ability to sleep no matter what else I've done.
posted by These Birds of a Feather at 8:08 PM on March 30, 2013 [1 favorite]

I know some people who only sleep that much per night. As rmhsinc asked, is this causing you problems? (I assume so since you've asked for advice, but I also know some people who have worried about their perfectly fine for them sleep habits because they thought they should be sleeping in some other, more socially-approved way.)

I know some people who are extra sensitive to caffeine. I find for myself that it kind of builds up in my system, so that five days in a row of having a cup of coffee in the morning disrupts my sleep more than the individual effect of a cup of coffee on a single isolated day.

Benadryl tends to wake me up rather than put me to sleep. From what you've indicated, this is not likely the case for you however.

Diet? Quality of light in the hour before bed? Other factors known to affect sleep that have been mentioned upthread? There's lots of research into sleep (both healthy and disturbed) from the last decade or two - have you done a thorough search online and at your local library?

But there's kind of this elephant in the room that you mentioned when providing additional info. My layperson's impression is that sleep disruptions are a pretty common PTSD symptom. Are you seeking professional help to treat the PTSD? If so, have you mentioned your sleep concerns to doctor/therapist-type person? If not, if your health insurance situation allows, my non-medical advice would be to start treatment for the PTSD and nightmares asap (which may include helpful medications as others have mentioned, but probably also helpful therapy).
posted by eviemath at 8:13 PM on March 30, 2013 [2 favorites]

Do you go to sleep and sleep a solid amount of time or does it take forever to fall asleep or do you wake multiple times?

I wake multiple times and th only way to get myself back to sleep is to listen to a (boring) podcast.
posted by dawkins_7 at 8:40 PM on March 30, 2013

Copying & pasting part of an answer I gave to a previous question:
You might try the "isolation chamber" approach: NO sound, NO light. Install blackout curtains (I have this kind), and remove / cover any source of light in your room - clock faces, power strip lights, laptop charger LEDs, etc. Get it as close to complete blackness as you can. And then put in earplugs even if you don't have a noise problem, so the only sound you're hearing as you lay there is your own breathing. I've found that removing all light & sound stimuli from the bedroom gives my stay-awake-brain nothing to latch on to, so it gives up most of the time and lets me sleep.
posted by D.Billy at 8:46 PM on March 30, 2013

Are you actually tired? I have known a few people that have lived their whole lives only sleeping four hours a night. Maybe that's all you need if you wake up feeling refreshed.

If not, then what everyone else said.
posted by greta simone at 8:53 PM on March 30, 2013

If you can't get yourself to sleep more than 3 hours a night, maybe try having naps during the day as well. At least that way you'll get more sleep in total. Look into "polyphasic" sleep for some ideas of how to structure it.
posted by lollusc at 8:55 PM on March 30, 2013 [2 favorites]

If you are sleep deprived, you are dream deprived. Sleeping more will lead to dreaming more. The initial dreams will be vivid. Even without trauma, most people interpret these vivid dreams as nightmares. I have spent part of my life afraid to sleep because the nightmares were so bad. So I suggest you try to ramp up the solution slowly. If you find something that works, try to ease into it. Otherwise you may feel really burned and unwilling to try it again. I have heard plenty of people say "X drug or supplement caused me such severe nightmares I will never take it again" when the real issue was it made them finally sleep deeply and that is why they experienced nightmares.

I initially took co-q-10 alone and added melatonin later. That helped me gradually start sleeping better. Melatonin alone made me feel like I could not wake up. I have heard magnesium is a component of co-q-10, so the suggestion to take calcium and magnesium may be another means to ramp up slowly. It took me a few years to resolve my severe sleep issues. I suggest you expect this to take a while and plan accordingly.
posted by Michele in California at 9:18 PM on March 30, 2013 [3 favorites]

Nthing trazodone and/or klonopin and/or whatever else you and a qualified physician find works for you. Especially if you have PTSD, life is hard enough without eschewing the available tools to deal with it.
posted by walla at 9:56 PM on March 30, 2013

If I take more than 25 mg of benedryl I get a little jittery. Maybe try cutting back to 25?
posted by Sassyfras at 10:05 PM on March 30, 2013


posted by sebastienbailard at 10:24 PM on March 30, 2013 [1 favorite]

If you cannot afford a sleep study for some reason, you might at least see if you can set up camera to record your sleeping for a few nights. It would be the best if you could have a very sensitive microphone so that you can hear your breathing patterns.

I don't know what the source of your PTSD is, but some people with sleep apnea wake up due to their inability to breathe regularly. Your brain could be interpreting that as an attack.

Lack of sleep can lead to major health problems and also make it harder to recover from mental health issues, so I highly recommend that you check with a physician if that is an option.

When I did my sleep study, the person doing it told me that they have had at least one person that they had to wake them up and could not, ethically, let them go back to sleep without putting them on a machine. His breathing was so dangerous that he could have died any night.
posted by slavlin at 10:48 PM on March 30, 2013

Nthing Trazodone. 50-150mg is the typical sleep dosage. IANAD.
posted by professor plum with a rope at 2:06 AM on March 31, 2013

I also came in to suggest looking into polyphasic sleep.
posted by kmennie at 6:49 AM on March 31, 2013

Taking a modest (<RDA) magnesium supplement at bedtime has dramatically improved the quality of my sleep & frequency of dreams. It's pretty widely held that most people are mildly deficient.
posted by sudama at 7:05 AM on March 31, 2013

Trazadone, again. Michelle in California is correct: you may have some vivid dreams when you begin sleeping deeply again, and this is an anecdotal side effect that many people report while taking the drug. But you've got to get your body and brain the sleep they need to function properly and put you in the best shape possible to cope with and overcome the PTSD issues you're struggling with.
posted by foxy_hedgehog at 8:07 AM on March 31, 2013

Magnesium really does help me and a lot of other people. You have to take it with food, unfortunately, so I take a tablet with dinner or an evening snack.

I have terrible insomnia and I begged my doctor for a sleep study and am waiting on the results. If you continue to have sleep issues that are not easily taken care of then I suggest getting a sleep study done.

And yes, Trazodone gave me the worst nightmares ever, as well as a zombified feeling the next day. I've sworn off Trazodone for those reasons. Reading Michele's post, perhaps I was dream-deprived and the Trazodone was causing rebound dream sleep and, looking back, I might have powered through that if I had known at the time. But the Traz left me feeling hung over for the better part of the next day after taking it. No way could I power through that or wait that out patiently. YMMV on sleeping meds. Trazodone is a godsend for many but it didn't work at all for me.
posted by Rosie M. Banks at 8:39 AM on March 31, 2013

Trazodone never worked for me, either. My problem is falling asleep (delayed sleep phase disorder), which Trazodone didn't help with, and the hangover the next day sucked. And FWIW, Benadryl-type drugs make me jittery and sleepy at the same time; I'll fall asleep, but then I wake up in starts several times throughout the night, which isn't something I usually have a problem with.

What has worked for me is melatonin. I tried it as a total last ditch effort, thoroughly skeptical, but it actually makes me sleepy within a half hour of taking it, so as long as I then actually go to bed, I'm golden. I also use a white noise app on my phone (apparently I can't fall asleep without the sound of rain falling). There is some ritual involved in both of those, which also helps, and might work nicely with your tea and bath routine. Some people do experience nightmares with melatonin, and I did at first (I have also had struggles with PTSD) but they didn't last long and they weren't awful so much as weird.

If you are seeing a therapist, they might be able to offer some suggestions. Mine suggested sleeping with a light on (which doesn't work for me because it keeps me up, but might work if nightmares are your primary concern). On the occasions when I do wake from nightmares, however, I have a few techniques she taught me to calm myself down. One is the butterfly hug protocol and it works reasonably well (even though I am way too cool and cringe every time I hear the words the butterfly hug). Although, again, my situation might be different because the problem I have is falling back asleep into the nightmare too quickly, so I need a way to process it before going back to sleep.
posted by looli at 12:22 PM on March 31, 2013

Response by poster: I am getting professional help for my PTSD issues. Sorry for those who felt like I was burying the lede. I am already working on that part and am looking for something to benefit me in the meantime while I am working this out. I was kind of hoping for a magic med that has eliminated sleep problems for fellow Mefites.

I've tried Trazodone before without success. I will give the Ca/Mg and melatonin a shot as well as the butterfly hug (which I am also way too cool for). I have problems both falling asleep and staying asleep. I'm absolutely exhausted. I don't think I can handle more intense dreams right now.

Thank you all for your perspectives on this.
posted by kamikazegopher at 12:40 PM on March 31, 2013

"I've been struggling with PTSD of late and nightmares make me not want to sleep. "

I used to suffer horribly from PTSD-induced nightmares. My therapists never really helped and I didn't want to take medicine that would make me groggy during the day. My neurologist is actually the one that helped me. He treated a lot of veterans, so he understood PTSD. He prescribed alpha blockers for me - specifically, Prazosin. It was one of the best things I ever did for myself, and it changed my life. I literally suffered with nightmares and no sleep for 6 years of my life until I started taking Prazosin.

Here is some info if you want to discuss with your doctor.

Two other things that really helped me were learning to sleep with a sleep mask on, and turning on a loud humidifier each night at bed time. The humidifier both provides white noise to mask other sounds as well as humidity so I don't potentially wake up all thirsty and dried out feeling.

Good luck. Feel free to PM anytime to discuss PTSD nightmares or anything else sleep-related.
posted by corn_bread at 5:36 PM on March 31, 2013

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