Q: insomnia- needing something immediate help.

[Guest guest]

Help with difficult insomnia case:

Just recently started working with a man with history of insomnia for greater

than 20 years. He has done sleep studies – no sleep apnea and they determined

that it was just anxiety. He recently tried SSRI's with no effect. He will

take 12mg of benadrly sometimes and that helps with falling back to sleep and

also 3mg melatonin. He will take ambien as needed and tries to not take it

often. He also says he has used xanax and tries to not use it often, but thinks

of using more daily now. So he is getting desparate because nothing is helping

him and he is needing to use ambient more often. Of late, nothing is working

for him consistently (benadryl, melatonin). The insomnia started with anxiety

of not getting a good night sleep and when he doesn't he is extremely tired and

foggy headed. This then becomes a vicious cycle. He has tried acupuncture. He

did a neuroscience test a year ago with mild adrenal subfunction and slightly

elevated taurine, histamine, and dopamine. His acupuncturist gave him travacor

and kavinace and travacor (contains 5htp, b vitamins, and other herbs) made him

feel great for 1 week and than too energized and manic afterwards. He has a

history of not reacting well to B vitamins with horrible headaches.

I talked to him about creating healthy sleeping habits- turning off T.V at

night, doing castor oil packs, listening to meditation tape, which he finds

helpful during the daytime to help him relax, but having tried changing his

night time habit of watching TV to unwind, he finds it torture. The TV just

helps calm down his mind. His mind is active all the time.

I started him with magneleuvers 1 packet bid, passiflora plex 10 drops tid, unda

9, 30, 1001 (5gtts tid), tilia tomentosa ½ tsp tid and he's been on it a week

and every night he has sleep difficulties, and NOW he has trouble falling

asleep. One day of poor sleep leaves him foggy headed. He even tried taking

250mg of valerian and reported none of that helping until he took an ambient.

In the past he found he could only tolerate 25mg of valerian; 50 would make him

drowsy. I am trying to help him sort things out- he is taking medications and

herbs, so hard to say what makes him drowsy, but he knows the medications at

least helps him fall and stay asleep. He tried increasing melatonin to 6mg and

felt drowsy. Thought about using 5htp, but given the past reaction with

Kavinace, not sure. He seems to be sensitive to herbs and nutrients and having

opposite effect. I also suggested he eat some protein in evening just in case

he's waking up due to blood sugar issues. I feel like I'm covering everything,

but he's in need of something that has an immediate effect and I'm not sure what

to expect of the undas?

Any treatment suggestions? Do I have the right undas and suggestions? I told

him if he gets no response we need to do evening cortisol, melatonin and

neurotransmitter profile.

I know we need to give treatment time, but this man doesn't see effect of

treatment and reaches for his ambien when he can't sleep because he feels so

dysfunctional without sleep.

Thanks for reading and any help soon would be appreciated.