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Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4486
Experience:  MD Psychiatry
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Female 44 yrs old. Sleep disorder. Prior to first child at

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Female 44 yrs old. Sleep disorder. Prior to first child at 19 yrs old had no sleep disorder. After first child and since problems sleeping. On meds now to sleep, but any noise movement she will wake up. Also, when she cant sleep, mind racing. Thinks way too much, cant stop, thinks about everything.

Hi there ,


Welcome to Just answer !


Well, the sleep disorder that she is having is called as Insomnia and it is coupled with Generalized anxiety disorder ( GAD ) , in her case as the features such as mind racing , thinking too much about things , etc are characterstic of GAD , and it is possible that her GAD is causing the insomnia or vice versa .


As far as the treatment is concerned ,she has been placed on the right meds , but since thay have not been of any much help so below i am mentioning the treatment regime whch you discuss with her doctor and get her started on it , and i am quite sure that her insomnia as well as GAD both will be taken care of in a 2-3 months duration.


The treatment regime is as follows -


1) 1 Anti depressant such as Effexor XR , usually started at 75 mg / day single morning dose , but it is upto your doctor's discretion to decide the dose of it . This effexor XR is to be taken only in the morning .


2) 1 Anti anxiety drug such as either Buspar ( buspirone ) or Klonopin ( clonazepam ) , any one of these to be chosen , and given twice aday , after meals , that is after breakfast and dinner , and accordingly let the doctor decide the dosage .


3) Ambien CR ( ZOLPIDEM ) , WHICH IS LONG ACTING , and is different from ambien ( plain ) , as it works throught night , and gives you sound sleep. Ambien CR is to be given at night only , half hour before sleep . The preferred dose is either 6.25 mg or 12.5 mg , single night dose , some start at 6.25 mg while others on 12.5 mg , but i would recommend that initially she starts on 6.25 mg night dose , and discuss this with her doctor .


4) Sleep hygeine -- which consists of the following measures .


a) proper sleep environment --- which includes quite , and dark room and familiar environment .


b) encourage -- bedtie routines, going to bed when tired only, regular exercise , if not asleep within 20 minutes of rendering to sleep then sit up and indulge in relaxation exercises.


c) Avoid -- Late evening exercises , late night meals and heavy meals at night ,excessive alcohol , smoking , caffeine intake ,excessive daytime sleeping .


I am mentioning below a link which will throw more light on Sleep hygeine .


I suggest that you discuss this regime with her and her doctor and get her started on it , i am quite sure that with this combination of drug therapy and sleep hygeine she will come over her anxiety disorder as well as her insomnia .


I wish her all the best and rapid recovery .


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Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4486
Experience: MD Psychiatry
Dr. Kaushik and other Mental Health Specialists are ready to help you

It is not uncommon for sleep patterns to change w. age and also be influenced by hormones and the level of stress one is under. There are other non medications options that help w/ improving sleep such as : melatonin (natural hormone), lemon balm (herb), the use of blue LED (some times used by people who have seasonal affect disorder S.A.D) but also very useful in those with insomnia or disrupted sleep, use of self hypnotic tapes/CD, taking tryptophan (an amino acid) Other suggestions: limit heavy meals prior bed time, TV watching right before bed, strenuous exercise, consumption of caffeine. *The information on supplements is for information purposes only and not intended to diagnose or treat any condition. Please always consult with your PCP on any supplementations even w/ natural products.