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Bill
Bill, LCSW, Consultant, Expert Witness
Category: Mental Health
Satisfied Customers: 3707
Experience:  35 years treating individuals, couples, families with mental health and substance abuse prob's
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I have insomnia. I take klonopin 1 mg plus ambien 10 mg and

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I have insomnia. I take klonopin 1 mg plus ambien 10 mg and wake up in 3 hours and can't get back to sleep. Taking klonopin .5 mg doesn't help. I am trying to find a sleep protocol that would give me 7 hrs sleep even if I have to take something when I wake up in 3 hours.
Bill :

Hello- Thank you for asking the question. I have over 30 years of experience working with individuals, couples and families & am happy to reply.

Bill :

I am sorry to hear about this problem.

Bill :

If you are available to chat - I have a question for you?

Customer:

Fire away with your questions Bill.

Bill :

Have you ever had a Sleep Study?

Customer:

Yes. In 2006 latency study diagnosed apnea and then went for titration study. Used CPAP for a few years, then lost 15 pounds due to intense exercise. Had 2 more latency studies in 2010 and 2011, both confirming no apnea or any other sleep disorder such as rls.

Bill :

Great-------Have you ever had any other therapies associated with the Chronic Insomnia- Behavioral or Psycho therapeutic?

Bill :

I am attaching a link for the Journal of Clinical Sleep Medicine- that outlines the complete protocol for management of Chronic Insomnia in Adults:

Customer:

I had met with a psychiatrist, mostly to regulate meds. He put me on remeron back in 2002 plus klonopin and zoloft 50 mg as I had my first major depressive episode, which went away over time. I recently went on zoloft 50 mg about 12 weeks ago. My primary care physician had me on temazapam for one month which worked well in the middle of the night. Also tried xanax, but too short a half life and rebound anxiety was bad. Currently seeing a psychologist but only had 2 preliminary discussions. Have not gotten to this insomnia issue yet. It's been with me for 20 years at least but I wasn't on any meds back then. I just woke up, read for an hour, then went back for broken sleep. That doesn't work any more. Long answer, wanted you to have all the info.

Bill :

I appreciate the information- As you will find in the link- Cognitive Behavioral therapy in addition to the correct Pharmacological agents have shown to be the most effective combination in addressing this issue.

Customer:

Bill, so I gather you don't have any other pharmacological advice at this time?

Bill :

I would review the link and address issues related to medications with your Doctor and Continue in therapy- Cognitive Behavioral Approaches have demonstrated to be the best psycho therapeutic approach. I think you also need to have 1 Doctor managing medications as relates to this and as is supported in the research.

Bill :

WHen you open the link- and scroll down to page 500 you will see what is the standard protocol that is recommended.

Customer:

Ok, thanks.

Bill :

These medications are what you should discuss with your Doc.

Bill :

I think you will find the information very helpful

Bill :

I wish you the very best.

Bill :

Kindest regards.

Bill and other Mental Health Specialists are ready to help you