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Dr. Vikas
Dr. Vikas, Doctor
Category: Medical
Satisfied Customers: 2207
Experience:  MBBS; MD
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I have been prescribed Imovane (zopiclone) to assist with sleep.

Customer Question

I have been prescribed Imovane (zopiclone) to assist with sleep. I should mention I was diagnosed with ADHD in August at age 36 and starting a dexamphetamine regime (5mg x 2 am, 5mg x 2 noon) did not cause any sleep problems.

I may be stressed about work, as my contract finishes next week and I haven't sorted a new job yet although my prospects are good. I turned down a job offer a few weeks ago and since then I've had problems falling/staying asleep. I can now stay asleep, but still have trouble falling asleep at night.

Even if I manage to get a good amount of sleep (without imovane), I'm still extremely sleepy during the day and although I resist the urge to nap in the day, I am very alert at night. It's almost like I have jetlag.

I was prescribed Imovane but it left me zombie like the next day. Even taking just half a tablet at 9:30pm left me unable to drive until 11am-ish the next day. Is this normal? It seems like an extreme reaction to me. As I teach gym classes at 6am and evenings and I work full time, being unable to drive or think straight is a major issue. I've had to stop taking the meds but now I am back at being sleepy during the day and hyper alert at night. Help!!
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. Vikas replied 2 years ago.

Hello,

What you are currently experiencing could be transient Insomnia and it may be stress related.

A very few patients who take Zopiclone (Imovane) complain of excessive sleepiness and carry over sedation over the next day and I must say it is rare but still some patients report it.

I am suggesting you an alternative medicine which we usually prescribe to our patients who have noticed excessive sedation with Zopiclone. Most of the patients who were switched over to Zolpidem found it very useful.

So you can discuss with your doctor about trying Zolpidem inseted of Zopiclone.
Zolpidem also has rapid onset of action and is preferred in patients having difficulty in falling asleep, it also has shorter duration of action in comparison to Zopiclone and therefor the chances of carry over sedation to the next day are very much reduced.

Best wishes,

Vikas


Please feel free to ask if you need clarification/more information. Kindly click the GREEN ACCEPT BUTTON if you are satisfied with the answer. POSITIVE FEEDBACK and BONUS are warmly appreciated
Customer: replied 2 years ago.
Is this insomnia if I'm sleepy during the day but not at night? I thought insomnia meant one couldn't sleep at all. My problem is my body's sleep pattern is out by about 10 hours. I can sleep during the day just fine, although I'm avoiding this habit now the problem is so consistent.
Expert:  Dr. Vikas replied 2 years ago.

Well, if you are not able to sleep at night this is very natural to feel sleepy during the day time.

You have mentioned that you are able to sleep during the day time. Are you able to sleep for 6 -8 hours during the day time and feel fresh after this sleep?
Customer: replied 2 years ago.
Yes I've got in about 6 hrs & woke up ready to go. Problem is, that's midday & I have a very busy life. Speaking of, it's 11pm here & I have to be up before 5am to teach cycle. So while I'm not tired I have to try to sleep.
Expert:  Dr. Vikas replied 2 years ago.
Are you still taking Dexamphetamine?
Customer: replied 2 years ago.
Yes. x2 in morning, usually 5:30 or 7:30am; x2 around 11-12; x1 @ 2pm. The last dose is new, my ADHD support group suggested an early/mid afternoon dose can assist sleep. I have been falling asleep earlier since introducing this - at midnight/1/2 am as opposed to 3,4 or 5am before.
I started dexamphetamine on 9 August but no sleep probs until 19 Sept.
I'll need to go off line now as per my sleep hygiene recommendations. Please excuse me for not replying nutil tomorrow.
Expert:  Dr. Vikas replied 2 years ago.
Thanks. In your case, there can be a possibility of sleep wake schedule disturbance.

Sleep wake schedule disturbance involves the displacement of sleep from its normal routine. Patients cannot sleep when they wish to sleep, although they are able to sleep at other times. Also, they cannot be fully awake when they want to be fully awake, but they are able to be awake at other times. It is considered to be a misalignment between sleep and wake behavior.

Circadian rhythm sleep disorder

Just let me know, what do you think about this being the possible cause behind your symptoms.
Customer: replied 2 years ago.

I believe the cause may be work-related and financial concerns.

 

When it first appeared, I put the sleep issues down to stress about these two things:

1) I was preparing a safety training presentation for executives and directors at one of our clients. 2) This required me to fly, in the past few years I have experienced anxiety during take off and landing. I'm fine once the plane is cruising as long as there's no turbulance. During this trip I wasn't anxious and I wonder if this is because my ADHD medication is working well. The training also went extremely well.

 

After the training and flight my sleep pattern was still bad. In fact, it got drastically worse. From falling asleep around 2am and getting 2 hour blocks, I was now falling asleep around 4am for less than 1 hour blocks.

 

The first night it appeared I had rejected a job offer earlier that day. I'm still confident I made the correct decision. While I can secure employment easily, I'm at a point in my career where I need to be discerning. Due to poor financial management when I was unmedicated, I don't have the savings I should to carry me for a month or so and this worries me.

 

That is a long answer, but hopefully enough detail. I have put a lot of thought and analysis in trying to find the cause myself in hopes of addressing whatever it is. As a contractor, I only get paid when I work and lack of sleep is prohibiting me from working full time. It's also leaving me physically incapable of teaching gym classes which loses me casual pay. This just adds to my financial concerns.

Expert:  Dr. Vikas replied 2 years ago.

Thanks for the detailed information and please accept my apology for the delay in reply.

To summarize, if you are able to sleep for 6-8 hours day during day time to compensate for your inability to sleep at night, it could be Sleep-wake schedule disturbance, otherwise, I would rather call it transient Insomnia which is stress related.

I personally feel that once you are able to get a proper 6-8 hour sleep during night, this should help you in regularizing your sleep schedule.

What you can do is that, just try to avoid any day time napping and after discussing with your doctor, take Zolpidem instead of Zopiclone just 15 minutes before going to bed.
Since Zolpidem is short acting and the sedative effect is usually up to 4-6 hours, there should not be any carry over sedation to the next day.


Best wishes,

Vikas

Please feel free to ask if you need clarification/more information. Kindly click the GREEN ACCEPT BUTTON if you are satisfied with the answer. POSITIVE FEEDBACK and BONUS are warmly appreciated
Dr. Vikas, Doctor
Category: Medical
Satisfied Customers: 2207
Experience: MBBS; MD
Dr. Vikas and 7 other Medical Specialists are ready to help you
Customer: replied 2 years ago.

Thank you Dr Vikas

 

I have in recent days experienced some improvement in symptoms and I think this may be due to the 2pm dose of dexamphetamine.

 

I will keep the alternative medication in mind if the problem appears again.

 

I am now sleeping from midnight usually without waking before I need to be up. Last night I fell asleep around 11. Although I woke twice and on the second occasion struggled to get back to sleep, I was disturbed by a housemate so I think I may be on the mend.

Expert:  Dr. Vikas replied 2 years ago.
You are most welcome. I wish you a very early and speedy recovery.

Thanks for coming to JA.

Best wishes,

Vikas

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