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Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4635
Experience:  MD Psychiatry
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I have been a severe insomnict for 20 ys. I am not 43. And

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I have been a severe insomnict for 20 ys. I am not 43. And can't take it anymore. I am a paramedic and work crazy hours which I know doesn't help. I've taken ambien but it not working. Any suggestions would be greatly appreciated. Please!!

Hi there,

Welcome to Just answer !

I am sorry to learn about your problem and i empathize with you.

Well you see it is your unconventional work timings which compel you to remain awake at odd hours of a day which has disturbed your circadian sleep rhythm and insomnia is a repercussion of this disturbed sleep-wake cycle. The condition that you are suffering from is clinically termed as Shift - work sleep disorder ( SWD) and it is seen in those people having work timings which are not conventional ( 9 am- 6 pm) .

I am sending you a link below which you can go through to learn more about the condition and to become aware of some daily routines which a person with your condition should adhere to in order to get a satisfactory sleep during the day despite of the odd work hours.

Now other than this , since it seems like you have developed resistance / increased tolerance against ambien (zolpidem) which explains why you are not getting sleep after it's use like before , so i reckon you should try another sleep aid drug like --

1) Lunesta ( eszopiclone ) at dose of 2 mg before bedtime , if not getting enogh sleep on this dose , the dose shall be raised to 3 mg before bedtime.


2) Trazodone at dose of 50 mg before bedtime ( 1/2 - 1 hr before sleep) , it is an anti depressant drug but being used frequently and successfully for insomnia as well.


3) Valdoxan ( agomelatine ) at dose of 25 mg, 1/2 - 1 hr prior to bedtime, it is an anti depressant drug which is unique in resurrecting the disrupted sleep circadian rhythm / sleep -- wake cycle .

So all of these 3 very good options are there for you to try , and each of them unlike benzodiazepines are less susceptible to abuse and dependence and thus are much safer in comparison to a benzodiazepine.

Kindly discuss these with your prescribing doctor and get started on any one of them.

I hope this helps.

Wish you all the best.

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If there is any further assistance needed please feel free to ask using the reply button.


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