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Re: Sleep Medication

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> A month or two ago there was some post about a sleeping pill that had

> a bad reputation. The one that was ban in most European countries.

> What is the name of the sleep medication. I think maybe Ellen was on

> it and got off.

Jack, I think you are talking about Ativan.

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Does anyone else have a problem with sleeping. I only average 1 to 2 hours if

sleep a night. I am scared to try sleep aids. Anyone have this problem, if so

what do you do?

AFIBsupport wrote:

> A month or two ago there was some post about a sleeping pill that had

a bad reputation. The one that was ban in most European countries.

What is the name of the sleep medication. I think maybe Ellen was on

it and got off.

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Hi Sheila, are you only sleeping 1-2 hours a night because you are in AF?

or worried about going in? I developed a " phobia " about sleeping, because

of my afib episodes occuring when I was just about to fall asleep. I no

longer " slept " in the same bed with my husband, and rested during the night

propped up on about four pillows, because I thought being in a prone

position brought on the af. When I described this anxiety to my doctor, she

prescribed Ativan, an anti-anxiety drug. I take 1/2 mg each evening, and

now sleep through the night. I have ignored the warnings about it, because

it's so wonderful to sleep again, and to be alert and productive at my job.

(I had previously had other sleep medication prescribed, but never took it

because paliptations were listed as a common side effect, and I didn't need

any more of those.)

Sandy

Re: Sleep Medication

>

> Does anyone else have a problem with sleeping. I only average 1 to 2

hours if sleep a night. I am scared to try sleep aids. Anyone have this

problem, if so what do you do?

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Ativan is the sleep medication that I was inquiring about.

I had heard some bad stories about it and had forgotten the name. A

friend of mine is on it and I found out the name. If he misses

taking it, he has nightmares at night, and hallucinates during the

day, but refuses to come off of it. Thanks to everyone who answered

my post.

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> Ativan is the sleep medication that I was inquiring about.

> I had heard some bad stories about it and had forgotten the name.

A

> friend of mine is on it and I found out the name. If he misses

> taking it, he has nightmares at night, and hallucinates during the

> day, but refuses to come off of it. Thanks to everyone who answered

> my post.

Jack, I have posted about Ativan. I completed a taper off

it about a month ago. According to my psychologist (I'm doing

cognative behavioral therapy) and accupuncturist (an MD) both of

which I'm seeing for anxiety, which is why my former internist

prescribed ativan, it can take months after discontinuing it

for the body to get totally back to normal.

The withdrawal process is bad, supposedly the worst for any

medication including because you have to taper off it so slowly.

It took me 7 weeks to taper off 1 mg a day, and I had tremoring,

freezing,

hot flashes, flu-like symptoms, dizzy spells that lasted a half

hour or more, nightmares, waking up every two hours at night, panic

attacks to the sky, very hampering shortness of breath, agorophobia,

depression, small seizures. Tachycardia is a very common withdrawal

effect, as are extra beats. A small number of people, like me, seem

to have afib as an effect, although this is not medically accepted.

My first afib problem coincided with a doc taking me off all

medication five days before a medical procedure. I didn't know at

the time I has addicted to the ativan, as I didn't crave it, etc.

I am hoping that as I get further away from it, my afib may get

better (I wish :-) I am lucky that I have a new internist and new

cardiologist who have been very supportive thru this whole mess.

Ativan is a benzodiazepine(sp?) and its addictive effects are similar

to other benzos, like Xanax, etc. I believe the current thinking is

that it should not be prescribed for more than 2-4 weeks, although

some doctors are still very ignorant of its dangers.

One thing to note is that the body develops a tolerance for it, so

someone can start developing withdrawal effects even without

decreasing their dose.

I am trying to walk for an hour a day and find that that helps a lot

with sleeping.

A nice med, huh.

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At 06:30 PM 4/5/01 -0400, you wrote:

>Does anyone else have a problem with sleeping. I only average

>1 to 2 hours if sleep a night. I am scared to try sleep aids.

>Anyone have this problem, if so what do you do?

I had a sleep study and they found that I had central (not

obstructive) sleep apnea. Central sleep apnea happens when

the brain sends signals to stop breathing. The sleep study

people also indicated that this was often seen in " heart

patients. "

Sleep apnea causes hypoxia (low blood oxygen) which causes the

brain to swell. Could the swelling brain cause problems in the

hypothalamus messing up the hormonal breathing/heart rate

controls?

I have not yet figured out what to do about the sleep apnea

but if we can figure out how all these things are related, we

might discover a single solution to the whole mechanism. At

least that is my game plan.

-Dale from Arizona

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> After reading Trudy's message and your message, Ellen, I am getting

freaked

> out about taking Ativan (I especially didn't like hearing

the " dumbing down "

> part -- and as much as I hate to admit it, I think it's true).

It's nice to

> sleep, but...

>

> How much were you taking, Ellen? Over what period of time did you

wean

> yourself off? What was the strength of your very last dose, 1/4mg?

or

> smaller?

Sandy, yahoo's " benzo " group, for people doing withdrawal from this

type of med, has a lot of info. In their Files section, two useful

things are the faq and the brochure from Hoffman LaRoche. The

brochure says cut by about 10% of the original dose each time, and

stay at the new level for one week to one month, depending on how you

feel in terms of withdrawal effects. There is a general belief in

that group that if you go too fast, the effects are not only worse

but withdrawal is prolonged. However, I went somewhat faster (7

weeks from 1 mg) because I felt that I could, except once I had to go

back up a level and just stay there for another week, as I was having

a lot of heart effects.

A few tips I learned. Ativan seems to have two sort of time frames

associated with it. It drops sharply 6-8 hours after a dose, so it

was a big win for me to spread out the dose and take part of it every

8 hours vs. once or twice a day, as the former avoids an increase in

physical symptoms. Also, the blood level of it drops in such a way

that the withdrawal effects peak on days 5-7 after a cut in dosage,

so knowing that helped me get thru that part.

Also, there are things you can do to mitigate the withdrawal effects -

wrap up warmly if you are freezing, get a quieter alarm clock to

avoid some of the hypersensitivity to noise, etc.

That said, you may not be dependent on ativan yet. The Hoffman

LaRoche brochure says of people who take it for a year, 50% become

dependent. Some people get dependent in just a few weeks, though.

It can be difficult to cut the dosage in those approximate amounts as

the pills are small. However pills as small as 0.5 mg are available,

and some generic 0.5 mg pills are larger than others, making cutting

them easier.

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Let me put in another plug for walking as an exercise to help with

sleep and a general improvement in how I feel both physically and

emotionally. I started at 20-30 minutes a day and am at an hour now,

which I think is about the max I will go to. It is a very relaxing

thing, burns off adrenaline, is good for the heart, you will look

more in shape physically, great for the complexion, etc. It also

gets me out of the house, so there is less time to mope in terms of

worrying about the heart, etc. Instead I get to admire the new spring

flowers and chat with the neighbors I meet.

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