Thanks for the additional information,
Well to asnwer your question, yes you can take xanax in the morning and ativan at night but the thing is that it will increase your chances of becoming dependent on these drugs. Plus the fact that youre already on opoids for pain relief as well can increase the chances of respiratory depression of occuring. But since you dont take the pain meds regularly that shouldnt be a problem yet.
Now the sleep problem that you have can be due to several causes, the first thing to consider is that because of your snoring you might have sleep apnea and this can cause the insomnia and snoring both. If left untreated this cna lead to heart and lung
problems and high blood pressure as well. So the first thing to do would be to get a sleep study done which would show any problems like sleep apnea. If thats teh case wearing a mask while sleeping can help with the problem.
Now the anxiety that you have can be secondary to a medical problem like pheochromocytoma
. This can be the case if you have high blood pressure during the attacks. This is a disease in which there is increased released of catecholamines which leads to the symptoms of a panic attack and high blood pressure as well. this can be determined by checking your BP first of all and if its raised then going for test like 24 hr urinary catecholamines, urinary VMA levels etc. This is then treated with drugs like aplha and beta blockers
plus surgery if needed.
Also the causes of insomnia can be several apart from these two and the space here is limited to list them all so ill give you a useful link where you can learn more about this and do try the conservative measures written in this link, they have helped numerous patients plus it also contains some alternative medicines which are available OTC to help you sleep,Insomnia
Now for now i think you can try the ativan and that can help with the sleep or if you dont want to become addicted or tolerant to benzodiazepines, you can ask your doctor to prescribe you ambien which is a drug which contains zolpidem
which works well in inducing sleep and the best thing about it that you wont get addicted to it. In addition a benzo which helps in inducing sleep better than the other drugs is midazolam (dormicum). this is one drug whcih you can sk your doctor about. But the main issue here is that of anxiety, treating that should treat your sleep issues as well. You are already seeing a doctor so ask him about biofeedback techniques as well in addition to the medication as that can help you overcome your anxiety issues and also abort panic attacks, psychotheraoy works wonders as well.
i hope this answers your question
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Edited by Dr. Muneeb Ali on 1/20/2010 at 10:01 PM EST