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#1 of 5 Old 02-05-2010, 11:43 AM - Thread Starter
 
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Hi, everyone. Haven't been on here for awhile b/c I was doing so much better. Insomnia was my main issue & I took Zoloft, which cured the problem, and Remeron to help me sleep until Zoloft kicked in. After 6 months on my therapeutic dose of Zoloft (late June to early Jan.), my pdoc and I agreed that I could wean. My reason was the sexual side effects. As far as sleep goes, I had only taken Remeron a few times since October, all on nights with a clearly identifiable trigger, so overall I was doing really, really well.

I tapered off Zoloft for 3 weeks and have been off completely for 4 weeks. During these 7 weeks I didn't take Remeron even once. I slept great pretty much every night, even when my daughter (15 mos.) woke multiple times. I felt like I was completely back to normal.

This week my daughter's sleep has been disrupted. She was waking often--sometimes 5-6 times a night. I was usually able to fall right back asleep after nursing her for 5-10 min., so it was annoying but not that big of a deal as far as losing sleep goes. Well, Wednesday night she was up off and on from about 2 am to 3:45 and I don't think I slept at all after 2am. I could feel my anxiety rising b/c I was so frustrated that I didn't know what to do to help her--she didn't want to nurse, didn't want to be put down or held, she would fall asleep only to awaken 10-15 min. later, just as I was beginning to doze, you get the picture.

So I figured this was just a one-night blip. Despite not feeling anxious, I could not fall asleep last night. Didn't do anything differently as far as routines go; I just couldn't fall asleep. I ended up having to take TWICE the usual Remeron dosage to fall asleep and even then it took me 2 hours! Even during the worst of the insomnia I think I only took more than the typical dosage (7.5 mg) maybe 2 or 3 times. So it's an indicator to me of how keyed up I was.

I have a call in to my pdoc to see what he recommends. He just called me back and recommended that I go ahead and take Remeron from the outset tonight and maybe the next few nights so that I'll get some sleep and rebuild my confidence in my ability to sleep. So I guess I'm just looking for some encouragement, more than anything. I know now that I CAN sleep normally, both with and without Zoloft. But it frightened me that my trusty sleep med--the med that got me through hell when I couldn't sleep and when Ambien didn't work--barely worked for me last night.

And it bothers me that something as little as my daughter keeping us up for a couple hours was enough to raise my anxiety to the point that I couldn't sleep. My husband just seems to roll with the punches and doesn't get stressed out about such things, whereas I got so frustrated and upset that I couldn't sleep. I just feel silly for letting a temporary problem (dd's disrupted sleep) send me off into a spiral. Last night she slept from 7:30 to 6:15, so her previous problems were obviously fleeting.

Part of me feels like if I were just a more relaxed person and didn't have such a strong (over?)reaction to temporary problems I wouldn't be in this situation. I never had this problem b/f dd was born; as high-strung as I was, stress rarely affected my sleep. At one level I know I'm being too harsh on myself, but on another level I feel like I should have a better handle on how I respond to stressful situations.

Anyway, just wanted to update you on my situation and ask for any advice or encouragement you may have.
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#2 of 5 Old 02-07-2010, 04:50 AM
 
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I had insomnia with my postpartum anxiety and it was really hard, so I feel your pain.

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Originally Posted by estercita View Post
And it bothers me that something as little as my daughter keeping us up for a couple hours was enough to raise my anxiety to the point that I couldn't sleep. My husband just seems to roll with the punches and doesn't get stressed out about such things, whereas I got so frustrated and upset that I couldn't sleep. I just feel silly for letting a temporary problem (dd's disrupted sleep) send me off into a spiral. Last night she slept from 7:30 to 6:15, so her previous problems were obviously fleeting.
Be kinder to yourself. When you're exhausted, your body (and then your mind) goes back to those same feelings you had when you were exhausted from insomnia and anxiety. Those are scary feelings. For me, it's like having a tiny bit of PTSD - not being able to sleep raises all kinds of irrational feeling in me.

Think of it this way -- the first time around, you were washed down in a horrendous flood of emotions (and hormones). When you can't sleep, it's like feeling the water rise again. The fear of being swept away in the flood is real.

Have you ever done any work to help teach yourself relaxation? By your own description, you were high strung before you dd was born. For me, I stayed on my meds for a lot longer than I had originally planned. It's only now that my kids are much older (5 and 8) and I have time to exercise and attend to some of my needs that I've been able to wean down.

Exercise is crucial for me. If I get enough exercise, I sleep better. The thing that works best for me is a combination of aerobic stuff and yoga. Yoga is very centering. My therapist also taught me to meditate. I'd highly recommend it. I don't do it nearly enough, but when I do it regularly, I can get my body and mind under control more easily.

I also take melatonin on days when I'm a bit anxious but not so anxious that I think I need sleep meds. (I've only taken sleep meds 1-2 times in the last year.) So, when you go off the Remeron, you might want to think about adding some melatonin for a few days to transition.

Finally, please keep an eye on your moods. I'm glad you called your pdoc and I think the plan to take some preventative sleep meds for a few days is a good one. If you still don't feel better, please get back in touch with your doctor. I had to go back on meds after weaning off. I wasn't happy about it, but in retrospect, I'm glad I did.

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#3 of 5 Old 02-07-2010, 06:13 PM - Thread Starter
 
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Thanks for your helpful response and for sharing your experiences. The metaphor of feeling the water rising again is very apt. It's like, "Oh crap! I was safely back on the shore after months of trying to reach it. What am I doing out here in the water again?!" I have half-jokingly described to friends the dark days of insomnia in terms of PTSD, so it's interesting that you bring that up. During the thick of the insomnia I felt so despairing of ever getting better, so the thought of even taking a step back toward that state is very scary, as you said.

I did work on relaxation a lot while I was going through insomnia, but when it became clear that Zoloft treated the underlying problem, I pretty much set the behavioral stuff aside (although I've always practiced good sleep hygiene like regular sleep/wake times, caffeine avoidance, no work 1 hour b/f bed, etc.). But it would probably do me good to practice some relaxation for those moments when I can feel the anxiety rising.

Thanks again--it's great to know that others understand.
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#4 of 5 Old 02-08-2010, 02:47 PM
 
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I just want to commiserate and offer my sympathy.

I have sleep issues from time to time. It's never been so bad that I've had to use sleep medication, but I'm on my 4-5th day now and just feeling exhausted.

LO is getting molars, so that's not very helpful, but he wakes a lot anyway. At about 2-3 I'll wake up and wonder what time it is and then from there I get nervous/anxious about falling back asleep and from there it escalates until I get out of bed totally pissed.

I've been running a lot, hoping that gets rid of my anxiety. I'm also going to get some good sleepy tea at the store and hope that helps.

As someone who has recurring insomnia, I have to keep telling myself "it's cool. don't worry about the sleep. the sleep will come, it always does." Sometimes it takes a while, but if I do what I know I need to to take care of myself (exercise, etc), eventually I sleep and feel better.
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#5 of 5 Old 02-08-2010, 03:24 PM - Thread Starter
 
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Thanks for your empathy. I appreciate it!

I talked to my pdoc this morning & he recommended that I take double the dose of Remeron (15mg, which is more sedating than the 7.5mg I had been taking as needed) for a couple of weeks to get back into a rhythm, then cut back to 7.5 for about a week & then try sleeping on my own again. I think by taking it 1 hour before bedtime instead of waiting to see if I fall asleep or not will work better right now because it will ease my anxiety about falling asleep.

It's amazing how in just a couple nights I went from feeling completely confident in my ability to sleep (wow--my daughter woke up X times and I got right back to sleep every time!) to wondering how it was possible to feel so confident!

I'm a lifelong runner & eat well, so none of that has changed, but I know it's important to maintain those practices.
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