Can’t Sleep…

Reader’s Question

I am 28 years old. My problem began 3 weeks ago. I cannot sleep; I spend the whole night thinking. Sometimes I sleep 2 hours, but it is difficult to relax. I close my eyes to try to sleep, but I feel my eyeballs rolling over for all sides. I despair of not being able to sleep and that causes me many nerves. I went to the hospital, and they gave me pills to sleep (zolpidem 5 mg)…but it hasn’t helped… I went again to the hospital, and they gave me 4 pills for 4 days (lorazepam 1 mg). When I take it in the night I feel calm and relaxed and can sleep — but only for 3 or 4 hours. I feel desperate because it is difficult to go to work every morning without sleeping sufficiently. Can you help me???

Thank you, thank you, thank you!

Our Consulting Clinical Psychologist’s Reply

The key to your situation is the time frame. When you say, “My problem began three weeks ago”, that tells us the major factor is situational in nature. I’d first take a review of the past several months. There’s a good chance a lot of things have happened recently that have increased your stress level. Our sleep is always a good thermometer of our stress level. There are also several types of the can’t-get-to-sleep situations such as:

1. We’re “wired” and too excited to sleep,
2. We fall asleep but wake up frequently,
3. We finally get to sleep but wake up at about 4:00 am, and
4. We can’t get to sleep because our brain won’t stop thinking.

The last two versions are typically found in depression for example.

Emergency rooms are often band-aid facilities — providing a short-term solution. The medications you received, Lorazepam for example, are antianxiety meds that last only 3-4 hours. You may want to consider consultation with a family physician or psychiatrist. In clinical practice we have good success with long-acting low-dose antidepressant medications such as Elavil or Remeron when used for sleep. A psychiatrist would be the best professional to evaluate the combination of stress issues and sleep problems for you.