What do I have to do?

[hallowedink]

Seriously, I am at a loss here. I go to my doctor every week and tell him the same thing: "I'm not sleeping. It's making my mood much, much worse, leaving me oversensitive to every little thing people say, making me much more prone to migraines, and generally making life a lot harder to cope with. If I could just get one or two good nights of sleep a week then I think things might start to improve."

Every week, I get the same response: "You're on enough medication already." (it's not helping with all or my symptoms, the only one covered is psychosis in fact) and "You seem to be doing fine." (yeah, that suicidal ideation that's going on? don't worry, I'm faking it), followed up with "You're just going to have hang on. Upping your dose of Lamictal might help" (actually, it's activating for me) "and as your mood improves your sleep will get better." (no, it won't)

Firstly, my mood is not improving. Secondly, I CAN'T SLEEP. At all. I get maximum four, maybe five hours a night. I'm tired all the time, but I can't fall asleep. Nothing he has prescribed me so far has helped. His sage advice is "split the Nitrazepam in half" ... with the result that I can't get out of bed the next morning because I'm so groggy, but sleep? Nope.

What do I have to do to get him to take me seriously? End up in hospital again? That's what it took last time. I'm close to ending up in A&E again. Believe me, I'm getting very, very desperate. First the eating now the sleeping, it seems that he's systematically letting me down on all of my major problems. What do I have to do to get him to listen to me? WHAT?

[dedoubt]

Are you taking care of your sleep hygiene (eg. going to bed early enough, without distractions; no screens in the hour or two before bed; no caffeine at all, ever; comfortable sleeping area; etc.)?

If you are doing everything you can with your behavior/environment and still not getting more sleep than that, it does seem to be something pdoc should address with meds. Of course, I'm not your doctor, or a doctor at all-- I'm just speaking from my experience. Personally, I have three different meds that I am given for sleep, if I want to use one. I generally end up with circumstances making it hard to take any sleep med (I have to get up super early with my kids & need to be wide awake), but I do have them as an option for when I am desperate.

I did stop complaining to my pdoc about my lack of sleep. I tend to sleep between 4-6 hours, with occasionally less or more, and that has been standard for about 1 1/2 years. However, I am very bad at making sure I do everything I can to get more sleep. I use my computer until I am about to sleep, I drink coffee (sometimes LOTS of coffee) and other things that are making sleep difficult. I kind of don't bother trying anymore, because I always have this feeling that I'm not going to fall asleep anyway, so why try? <-- stupid thinking. Until I change my ways, I need to expect that I won't sleep enough, and my moods are going to take longer to stabilize...

[hallowedink]

@ dedoubt: Yeah, I've been making sure that my sleep hygeine is good. I go to sleep at the same time every night (11:30-12 ish) and get up and the same time every morning (9:00). I don't work before I go to bed. I excercise in the mornings, I sleep in quite a dark room. Unfortunately, I can't do anything about the horrible bed, because I'm in residence at university, but it doesn't really seem to make a difference - I sleep just as badly at home. I don't drink tea or coffee (only very occasionally)... I really don't know. I think I've got everything covered, but still I just can't sleep.

Ideally, I need to get a sleep study done, but that's not going to be happening any time soon. My doctor's reluctant to refer me, I can't pay for it privately, and I'm already waiting on the CMHT to refer me re eating, so I'll speak to them about sleep probably only in a few weeks time.

I'm just getting really frustrated. I've explained to my doctor a million times that my sleeping is out of my control. Nothing I do seems to make me sleep better or worse. I know sleeping tablets aren't a long term solution, but they could tide me over for the next few months until I can get a sleep study.

I just want some relief.

Thank you both for your comments and insights.

[Calypte]

Have you ever tried (or read about) sleep restriction as a therapy for insomnia? It's supposed to be a quite effective non-medication approach to insomnia. Basically, it means that if you only sleep four or five hours a night, you start spending only four or five hours a night in bed. Once your body adjusts and you sleep for most (say, 80 or 90%) of the time you spend in bed, you add 15 minutes to your time in bed. And so forth until you sleep a normal amount of time. It might be worth looking into, although I can certainly understand wanting to sleep better RIGHT NOW. Not sleeping is really awful.

[y58]

hallowed, is it possible your doc is afraid if he gives you sleeping pills you will OD?

[hallowedink]

hallowed, is it possible your doc is afraid if he gives you sleeping pills you will OD?

I don't look after my medication anymore, which he is aware of. Whilst I am in such a bad way, I've given all of my prescription meds to my boyfriend, so I never have more than a few days' supply on me.

Also, I don't think he's aware of the thoughts I have about overdosing, or the fact that I've done recently, because I didn't go to hospital that time.

@ Calypte: I've not heard of that before, but it sounds interesting. I'll certainly look into it as a possiblity.