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mindhealer, Therapist
Category: Mental Health
Satisfied Customers: 693
Experience:  Licensed in MD and am also a Board Certified Diplomate (Advanced Practioner) I have over 10 years experience
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I started having insomnia problems about 5 weeks ago when I

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I started having insomnia problems about 5 weeks ago when I moved from Los Angeles to San Diego for medical school. The first night, I slept fine, but the following nights I frequently woke up in the middle of the night. That weekend, I returned to LA to help my wife with her move, and my insomnia worsened. I had one night of no sleep and then went to the doctor and was prescribed Ambien. The Ambien put me to sleep for the next two nights but only for 4 hours the first night and 3 hours the next. I then stopped the Ambien and had another night with no sleep. My doctor then prescribed trazodone (1.5 mg at night) and ativan (1 mg at night). I have been taking these meds with the Ambien, and on good nights, I fall asleep but wake up 3-5 times at night - usually starting only an hour after I fall asleep). On bad nights, I can't fall asleep until 4 AM or so and then I continue to wake up every hour. My question is should I discontinue the meds and hope that sleep will eventualy just renormalize? I'm also concerned about sporadic fatal insomnia - though I know it's a rare disorder. Do you think there is any cause for concernwith SFI? Thanks!
Good afternoon and thank you for the opportunity to help in answering your question. First let me say that I'm sincerely XXXXX XXXXX hear of the difficulty you're experiencing. Based on the detailed information you've kindly provided I wouldn't worry too much about SFI as has a genetic basis so if there's no family history you should be fine in that regard.

As for the sleep issue it sounds as though the onset is directly correlated with you moving to a new area away from family and friends as well as starting medical school...both of which can be significant stressors and each could contribute to the insomnia, if not cause it. Please correct me if I'm wrong but my impression is such that you may be experiencing difficulty with adjusting to your new life and the demands and responsibilities that come with it.

My suggestion would be to stay on the medication for now and use as an adjunct dome relaxation techniques such as progressive muscle relaxation (YouTube search will demonstrate how to do this) and guided imagery could also be helpful. I would suggest trying these for a week and if you do not notice any improvement it may be beneficial to speak with a therapist to help you manage better the adjustment you're experiencing. This is by no means uncommon and I've seen it and treated it often in my practice. It's rather easy for stress to have such an impact on us and not even realize it.

I hope that I've been helpful in answering your question and that you found my suggestions to be of benefit to you.

Please let me know if you have any further questions as I want to ensure your question is completely and thoroughly answered.

If you feel I've answered your question to your satisfaction I would sincerely XXXXX XXXXX clicking the ACCEPT button thereby giving me credit for the answer. I hope this finds you well and look forward to your response.
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