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Linda D.
Linda D., Psychotherapist, LMSW, CASAC
Category: Mental Health
Satisfied Customers: 498
Experience:  LMSW, CASAC
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Looking besides klonopin and Seroquel. I have previously

Customer Question

Looking for alternatives for sleep besides klonopin and Seroquel. I have previously been on trazodone ambien. No longer work. Seroquel and klonopin work most of the time and then just suddenly stop working. I take 100 mg Seroquel and .5 mg klonopin. Thxx
Submitted: 8 months ago.
Category: Mental Health
Expert:  Linda D. replied 8 months ago.

Hello, my name is ***** ***** I am a licensed psychotherapist in private practice in NYS. Thank you for using Just Answer. I know it can be very distressing and anxiety provoking to stay awake all night unable to sleep. Here in Rochester, New York we have a sleep study center that has diagnosed numerous causes in my clients for insomnia. they take a holistic approach, evaluating lifestyle, hormones, brain activity, untreated mental health issues such as depression and anxiety. I have found this to be the best alternative for individuals who have been medication resistant and have had prolonged insomnia when they start to see me. Have you considered this for yourself?

Expert:  Linda D. replied 8 months ago.

If a sleep study clinic is not available in your community the following are some other therapies that have been successful in treating insomnia:

Biofeedback — Biofeedback uses sensors placed on your skin to track muscle tension or brain rhythms. You can see a display of your tension level or activity, allowing you to gauge your level of tension and develop strategies to reduce this tension. As an example, you may slow your breathing, progressively relax muscles, or practice deep breathing to reduce tension.

Stimulus control — Stimulus control therapy is based on the idea that some people with insomnia have learned to associate the bedroom with staying awake rather than sleeping.

●You should spend no more than 20 minutes lying in bed trying to fall asleep.

●If you cannot fall asleep within 20 minutes, get up, go to another room and read or find another relaxing activity until you feel sleepy again. Activities such as eating, balancing your checkbook, doing housework, watching TV, or studying for a test, which "reward" you for staying awake, should be avoided.

●When you start to feel sleepy, you can return to bed. If you cannot fall asleep in another 20 minutes, repeat the process.

●Set an alarm clock and get up at the same time every day, including weekends.

●Do not take a nap during the day.

You may not sleep much on the first night. However, sleep is more likely on succeeding nights because sleepiness is increased and naps are not allowed.

Sleep restriction — Some people with insomnia have long awakenings during the night and some try to deal with their poor sleep by staying in bed longer in the morning to "make up" some of their lost sleep. This additional sleep later in the morning may make it more difficult to fall asleep that night, resulting in the need to stay in bed even longer the following morning. Sleep restriction consolidates sleep and breaks this cycle.

●The first step in sleep restriction therapy is to estimate the average number of hours per night that you sleep. Decrease the total time allowed in bed per night to that average sleep time, as long as it is not less than four hours.

●A rigid bedtime and awakening time are recommended and naps are not permitted. This causes partial sleep deprivation, which increases your ability to sleep the next night.

●Once sleep has improved, you may slowly increase your time in bed to find your needed hours of sleep.

During the first few days to weeks, you may feel sleepy during the day and may have difficulty being alert. You can deal with this by increasing activity levels when sleepy, avoiding sedentary activities, and discussing the sleep restriction therapy with your therapist, who may need to fine tune sleep times. It is best to try sleep restriction therapy with a therapist because reducing sleep too much can produce sleepiness that can result in accidents.

Cognitive therapy — People who are awake at night commonly become concerned that they will perform poorly the next day if they do not sleep enough. Such thoughts can initiate a cycle where being awake at night increases your anxiety, which then makes it more difficult to sleep. You may begin to blame all negative events in your life on poor sleep.

During cognitive therapy, you work with a therapist to deal with your anxiety and negative thinking. The therapist will help you to realize that poor sleep alone cannot be the cause of all of your problems.

Phototherapy — Phototherapy, also called light therapy, is an effective therapy for people whose insomnia is due to a problem called delayed sleep phase syndrome. People with this disorder have a problem with their body's "sleep clock" such that they have a difficult time falling asleep until much later in the evening or night than they wish (and therefore wake up later than they wish in the next morning).

Phototherapy involves sitting in front of a specially designed light box for 30 to 40 minutes. The timing of the light exposure is important. If done in the morning after awakening, it will cause you to fall asleep earlier in the evening. If the light box is used in the mid-afternoon or later, it will cause sleep to be delayed. In less severe cases, waking up consistently at a given time in the morning, followed by physical activity with exposure to bright light (eg, a walk outside), may be sufficient. Alternately, you may sit in an area with bright sunshine (eg, near a window or on a porch). The exposure to bright light at specific times helps to realign the body's sleep clock.

Chronotherapy — Chronotherapy is also used in people with circadian rhythm sleep disorders. It involves intentionally delaying going to sleep by two to three hours on successive days until you are able to fall asleep at the desired bedtime. This can be difficult to do at home and often involves taking some days off from work or school to accommodate the moving sleep period when it occurs during the day. After reaching the desired bedtime, you must strictly enforce the newly aligned sleep-wake schedule.

Also, I have a client who has used Belsomra very effectively to help her with chronic insomnia. It is a prescription medicine that was approved by the US Food and Drug Administration (FDA) in 2014 for insomnia. It works by blocking a brain chemical called orexin. Under normal conditions, orexin helps you to stay awake. The most common side effect of Belsorma is drowsiness the next day. People who take Belsomra should be cautious because drowsiness in the morning can affect driving safety, job performance, and decision-making. It should also be used with caution in people with obstructive sleep apnea, as it can cause problems with breathing during sleep.

Please do not give up hope that you will be able to manage your insomnia someday. There are new therapies and medications being discovered all the time to treat disorders. I wish you all the best, ***** ***** me know if there is anything else I can help you with. Sincerely, ***** ***** LMSW,CASAC

Expert:  Linda D. replied 8 months ago.

Hello, I am wondering if you have had the chance to review my suggestions to you regarding other alternatives to medicine that may help your chronic insomnia. I hope yu find them helpful. I would appreciate it if you would take a moment to rate my service to you. Thanks so much, Linda d. LMSW, CASAC

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