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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