[estercita]

Hi. I'm new to this group. I'm hoping for some suggestions & support. I've been dealing with terrible insomnia since mid-Feb. & am desperate to see some improvement. I have a 5 month-old breastfed baby who's sleeping through the night. I think the insomnia triggered mild depression--on days I get 5+ hours I feel pretty much like myself & days that I don't, I feel like I'm never going to get over the insomnia, that I'll be stuck here forever.

I started Ambien 12.5mg in early March & have weaned down to 5mg. The Ambien was losing its effectiveness (e.g., night before last I slept only 4 hours) so I figured I was better off just getting off. I started Zoloft 2 weeks ago but haven't noticed any effects yet.

I've also been following sleep restriction therapy & 2 weeks ago I started seeing wonderful results: I was sleeping about 6+ hours a night & sleeping soundly until the alarm went off. I was so hopeful. Then this last week I started waking up every morning before the alarm, after just 5 or 6 hours of sleep. The last 2 nights I awoke after only 4 hours. This hadn't happened to me for several weeks. Usually after a bad night (<5 hours) I sleep better the next night because I'm so tired. That just didn't happen last night. I got another hour or so of sleep b/c I took an extra 2.5mg Ambien.

I feel like I'm reaching the end of my options here. My doctor doesn't even want me taking the Ambien even though it's widely considered safer than other options, & the other meds he & his wife (also a doctor) prescribed didn't work (trazodone, vistaril). He hasn't suggested any others. Based on the discussion boards I've read here & elsewhere, it sounds like most mothers with insomnia problems somehow found meds that helped & that they eventually got better & were able to sleep on their own. I haven't even found a med that helps me sleep consistently, and I'm despairing that I'll ever get better.

My options are more limited because of breastfeeding. Did any of you who took benzos also breastfeed? What about the side effects and addictive potential of benzos?

My husband thinks that the hormonal changes related to breastfeeding are contributing to the insomnia. I haven't seen any research that supports this, but I suppose it could play a role. Do any of you know about this? He suggested weaning our baby at 6 months. I hate to do this, especially if it's not the cause of the insomnia.

I'm taking the Zoloft in the morning, which my therapist assured me would minimize any side effects of insomnia. I slept well last week, so it doesn't make sense that Zoloft would affect my sleep this week but not last week. The idea was to take Zoloft to minimize anxiety that might be contributing to insomnia. I suppose it could still kick in to help me since it's been just 2 weeks. For those of you who took Zoloft, did it help you sleep better & be able to fall back asleep after waking up in the middle of the night?

I'd appreciate your suggestions and support. I'm terrified that I'll never sleep normally again & that I won't find my way out of this.

 

[demottm]

Hi Mama, I'm sorry things are rough for you right now. They will get better though. It sounds like you are doing all you can to stay on top of things. I am going to suggest getting some exercise everyday. I have found that while caring for an infant is mentally exausting sometimes my body doesn't get as worn out as it needs to. So maybe a couple hours walking with the baby or an hour of aerobics couls do the trick. Best of luck to you.

 

[lisasaurus]

i have been where you are. hang in there, it WILL get better. my doctor had me on ativan to help with sleep. i took a very small dose before bed for a couple of months and then found that i didn't need it anymore. I also take zoloft, and i think that helps too.

recently i had trouble sleeping again and found a WONDERFUL CD at the library that has helped me to sleep better than i have in a looong time. Its a guided imagery CD called: Healthful sleep

http://www.healthjourneys.com/Produc...?catid=4&id=13

I can't recommend it enough.

No matter what you try and no matter what ends up helping, the point is that you are trying. That is great, thats a huge step towards healing. Insomnia is so common in PPD, but it GETS BETTER. I promise it does.

Edited to add: My doctors were more comfortable with my taking Ativan than they were Ambien while breastfeeding. I think because Ativan has been around a lot longer. It is potentially addictive over a long period of time, so be sure to work closely with a knowledgeable provider while using (if you choose that route).

 

[ShwarmaQueen]

To some extent, I think insomnia in new moms IS related to breastfeeding and your primal sense of protecting your young baby. I wouldn't ween at 6 months, some sleep problems will fix themselves as the baby gets older. Hang in there momma.

 

[readytobedone]

Quote:

Originally Posted by estercita I'm terrified that I'll never sleep normally again & that I won't find my way out of this.

gosh, mama, i have soooo been there and could have written that.

i started having some mild insomnia when DD was a newborn, then it progressed to severe insomnia (we're talking nights i didn't sleep at all, then slept only 2 hours the next night, rinse repeat for weeks on end)...

in my case, zoloft did eventually help a ton. in the meantime, benzos (ativan) were a lifesaver. ambien made me feel weird and hallucinate, but it didn't really help me sleep very much

benzos (in small doses, taken sparingly) are fine for breastfeeding. and if your LO is STTN, then you can be assured they aren't going to get much exposure at all to what you take before bed, kwim?

try to find a doc who is supportive of your having the drugs you need. in your situation, i wouldn't hesitate to try benzos.

also, did you by chance have a traumatic birth? i ended up diagnosed with PTSD, which was the underlying cause of my insomnia. after having that properly treated, i started sleeping normally again.

 

[estercita]

Thanks for the support. Lisasaurus, a friend actually gave me a copy of the CD you mentioned. I do find it very relaxing, but unfortunately it hasn't helped put me back to sleep in the middle of the night. The relaxation track did put me to sleep for a nap once. Maybe I need to listen to it every day for a few weeks. Did you find that was necessary?

readytobedone, how often did you use benzos & for how long? Did you have any trouble weaning? How long did it take for the Zoloft to help with your sleep? I have no side effects from Ambien, which is why I prefer it over, for example, trazodone, which gave me horrible side effects the 2 nights I tried it. But the Ambien's not really working anymore, so I'm sort of at a loss. Generally at least 6 hours pass between the time I take a sleeping pill & nurse my baby, since my husband has agreed not to bring her to me until a certain time of the morning. (She still refuses a bottle so pumped milk is not an option.) So that helps alleviate some concern about meds. I don't think my doctor's open to benzos, but maybe I should ask.

I ended up with an unexpected C-section 36 hours after my water broke, including 9 hours of regular labor & 9+ hours of Pitocin labor. After all that I was <4cm dilated.

Although I wanted & prepared for a natural birth, I was not traumatized by my experience because my husband & I exhausted all of our options before agreeing to interventions & made informed decisions rather than feeling coerced. I do think, though, that a bunch of underlying stressors related to motherhood, work, etc. converged to trigger the insomnia.

 

[lisasaurus]

are you seeing a counselor? what type of doctor is managing your meds? I really think seeing someone who specifically treats PPD could be a huge help for you. I've seen two different psychiatrists who specialize in postpartum mood disorders, and both were completely comfortable with prescribing ativan for sleep. Let me know if you need help finding providers in your neck of the woods.

i think it wouldn't hurt to try the CD for a few more nights and see if it helps.

another couple of things that I do as part of my "sleep routine":

* chamomile lavender tea (1 or 2 cups a decent amount of time before bed)
* Hops pillow- sewed a little sachet pillow filled with calming herbs like chamomile, lavender, hops and mugwart. I stuff this little pillow in my bigger pillow's case. i would love to make one for you if you're interested. Just PM me your address.
*epsom salt baths!!!- 3-4 cups of epsom salt in warm bath before bed.
*magnesium supplement before bed. the powder that you dissolve in water.

 

[estercita]

Update: I had another really bad night. This time I woke up after just 3 hours, took 2.5 mg Ambien extra & it didn't put me to sleep, so I tried again an hour later & nothing. Met with my doctor this morning. He definitely does not want to prescribe Ativan or other benzos b/c of the addictive potential & concerns with breastfeeding. I am extremely hesitant to take something I could become addicted to, but it seems that many of you were able to take a benzo as prescribed & not have trouble coming off of it. A psychiatric nurse suggested 25mg Seroquel for sleep, but I've read some bad things about side effects. Has anyone had experience with Seroquel?

 

[lisasaurus]

i don't have experience with Seroquel, but I would definitely trust a psychiatric nurse more than random information found on the internet. the internet can be a really bad source of information for those of us suffering from anxiety. maybe try to stay away from surfing around about side effects and whatnot.

again i strongly suggest you get in touch with a specialist who has experience working with breastfeeding mothers and knows the up to date info on these medications. i hope you can find someone you trust soon, you deserve to feel better and get a full nights sleep, mama!

 

[lisasaurus]

and about the benzos... do you have a history of addiction problems? that would probably be the only reason not to try that route. the way you would be using the drug would probably be for a limited amount of time... a month or two (or less!) until your sleep gets regulated (and the zoloft maybe kicks in) and you don't need pharmaceutical help with sleep anymore. once your sleep gets better, you'll probably start feeling a whole lot better. it has such a huge effect on our moods.

hang in there!

 

[estercita]

I have no addiction history. I'm such a prude that I've never even been drunk, smoked a cigarette, or had more than 3 drinks at one time. The idea with the Ambien was to get my sleep regulated, but it never happened. So part of me is skeptical that taking a benzo would solve the problem. Isn't there still an underlying cause of insomnia? Supposedly that's what the Zoloft will help, but it hasn't happened yet...

 

[readytobedone]

Quote:

Originally Posted by estercita I have no addiction history. I'm such a prude that I've never even been drunk, smoked a cigarette, or had more than 3 drinks at one time. The idea with the Ambien was to get my sleep regulated, but it never happened. So part of me is skeptical that taking a benzo would solve the problem. Isn't there still an underlying cause of insomnia? Supposedly that's what the Zoloft will help, but it hasn't happened yet...

i think your doctor is being a prude about the benzos

i don't know if anxiety is a factor in your sleep problems, but if it is, then there is every reason to think ativan, etc. would help more than ambien. i may just be projecting my story onto you, but i had similar lack of results with ambien and side effects with trazodone, and finally settled on ativan.

i took it most nights for the better part of 6 months. then after i got my PTSD treated, i weaned off, no problems. i do take it occasionally (like if i'm under LOTS of stress, i'll take it before bed). i filled a script last june and am still nursing that same bottle...

it isn't some scary addictive horrible drug. if it were me, i would find a new doc.

 

[lisasaurus]

i agree with the last post- if your insomnia is more or less related to anxiety, the benzos would be more helpful than ambien and the like. for me, i was given ambien by a family physician initially, and while it helped some, i felt like it just knocked me out. i never felt rested, and i never felt like i was making progress because i wasn't going to sleep "on my own." with the ativan (which again was prescribed by a psychiatric nurse with a special interest in PPD), it allowed my mind to stop spinning which then made it much easier to sleep and to return to sleep if i woke up to take care of the baby in the middle of the night. i felt like although i was taking medication to help, i was mostly getting to sleep on my own. when i was ready i was able to wean down my already small dose and then stop using it completely. and like the poster above, i still use it occasionally if needed, because i know it is a much better next day if i get sleep.

 

[azgirl]

I am so sorry you are going through this! I wanted to add my experience. A couple of months post-partum I started suffering from extreme insomnia. My baby was in the NICU, but I was getting up to pump. I would pump in the middle of the night and then not get back to sleep. Benzos didn't really help...I would fall asleep okay but I would still wake up at 3 or 4 in the morning and not be able to go back to sleep. Zoloft took a few weeks to kick in...but did finally "cure" my insomnia. I am currently trying to wean off the zoloft and my insomnia is creeping back. So, I would give the Zoloft more time to work and possibly increase the dose rather than going with other meds. Just my two cents. I really hope you get relief soon!

 

[estercita]

Thanks for sharing your experience, azgirl. After talking to my doctor I increased the Zoloft dosage to 100mg yesterday. I also slept for 5 solid hours last night, which is still not great but an improvement over the previous 2 nights of 3-4 hours. After feeling incredibly down yesterday morning--probably the worst I've felt since the insomnia started--my mood improved throughout the day & I decided to stick with my plan to wean off of Ambien & continue with sleep restriction therapy to regulate my sleep, while waiting for the Zoloft to kick in. It's very encouraging to hear that it helped with your insomnia. It gives me hope that I will not be stuck here forever.

 

[lisasaurus]

thats great that things are improving for you!

 

[estercita]

Quote:

Originally Posted by readytobedone i started having some mild insomnia when DD was a newborn, then it progressed to severe insomnia (we're talking nights i didn't sleep at all, then slept only 2 hours the next night, rinse repeat for weeks on end)...

readytobedone, how did you keep going during those days after such awful insomnia? I've averaged 4 hours/night for the last week & I feel like I'm just at my wits' end. I don't know that I've ever felt so low in my entire life. I just don't know what to do.

 

[dianakaye]

I don't know if my insomnia ever was that bad, but I for sure have been there. I actually went into a manic episode once over insomnia and had to be hospitalized for 2 weeks (TTMI, I know).

I have a breastfeeding 5-month-old as well, and I still get insomnia every time I have a menstrual cycle (again with the TTMI), and here's what helps me:

- A good jog
- Melatonin sometimes helps
- Chamomile tea helps sooo much
- Making sure I have relations with my DH to help relax (seriously enough with the TTMI already)

One of the main problems with insomnia is that you sleep less because you're worried about not sleeping.

My brother who also suffers from bi-polar disorder has taken saraquil (sp?) for years now and it's pretty heavy duty stuff and addicting. He's had to up his dosage several times. I would exhaust every other option before trying it.

 

[estercita]

I wanted to give you all an update. I met with a psychiatrist yesterday & he wants me to stay on 100mg Zoloft for another 2 weeks (I've only been on this dosage for <1 week, was on 50mg for 2 weeks before that) & then check back with him to see if there's improvement. In the meantime, I'll stay on Ambien & continue weaning off, since it's not working anyway. If my sleep still hasn't improved, he wants to prescribe Remeron. Do any of you have experience with Remeron for sleep?

I'm finding it increasingly difficult to maintain my spirits, esp. since I've only been getting 4.5 hours of sleep on average for the last week. I simply can't fall back asleep after I wake up in the night. I bounce back on days that I get 5-6 hours & then I feel like I sink lower & lower after the 4-hour nights. Positive self-talk only goes so far. Not sure how I'm going to make it through the next 2 weeks...

The worst part is I start thinking things like, if I hadn't had my daughter, I wouldn't be in this situation. I feel like I'll be stuck here forever. I know that many of you overcame your insomnia & that gives me hope. I just hope that I'll be able to say the same.

 

[readytobedone]

Quote:

Originally Posted by estercita readytobedone, how did you keep going during those days after such awful insomnia? I've averaged 4 hours/night for the last week & I feel like I'm just at my wits' end. I don't know that I've ever felt so low in my entire life. I just don't know what to do.

i felt just like you feel. i don't know how i got through it, to be honest. i told everyone who asked me that it was the worst thing that ever happened to me in my whole life, and it was.

i guess the good news is, once i started sleeping again, life went back to normal. that will happen for you, too--i'm sure of it. you just have to muddle through and remember this has happened to other people. you don't die from it; you just feel like dying!

and i read your update and still think your doctor should let you try benzos. it can't hurt to try something new. what happened with me was the insomnia led to anxiety, which fed my insomnia, which made me more anxious...you get the picture. ativan helped a lot.

if they're worried about breastfeeding, you could just agree to pump and dump for 12 hours after taking the drug. and then not do it if you don't want to