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TL;DR: New to Vraylar.  Going to sleep, but once I wake up, I can't get back to sleep, so only getting 2-3 hours of sleep a night.

 

I started taking 1.5mg Vraylar 2 weeks ago.  The first two nights I took it PM, and it gave me stark insomnia, so I switched to AM dose.  Now I'm getting an average of 2-3 hours of sleep a night.  I'm getting naps in during the day so I'm functioning, but if anyone has had similar experience I'd appreciate advice on how to address it.

Other meds are Lithium and Lamictal (9 years).  I'm trying an atypical antipsychotic to try and address chronic mild depression without going manic the way antidepressants would put me.  I'm extremely sensitive to stimulants and antidepressants; they push me toward manic. 

There are no other indications of mania (which is a danger; before Vraylar I tried Latuda and 2 days at 40mg put me over the moon).  I can get to sleep normally in the usual bedtime range of 10-12 PM, but I'll wake up between 1 and 3 and not be able to get back to sleep.  I routinely wake up during the night and go back to sleep, but for the last week "go back to sleep" isn't happening any more.

I am tracking sleep with Fitbit HR so I have confirmation that sleep is short and that deep/REM stages are being deeply reduced.

I do routinely listen to soft music to go to sleep, and have tried doing that after my middle-night wakeup, to no avail.

 

Anybody else experience this kind of pattern?  Any suggestions?  

 

 

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When I was on vraylar I went almost a whole week with getting little to no sleep...I think it is a very activating medication...some people feel calm from it but to me it turned me into a dysphoric state from little to no sleep, so I had to get off of it.

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7 minutes ago, Fruitful.Entropy said:

Any suggestions?  

I have no experience with Vraylar, but have you told your pdoc about your sleep issues?

Do you think your doc would be open to letting you try a sleep medication?......There are quite a few options to choose from.

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7 minutes ago, CrazyRedhead said:

I have no experience with Vraylar, but have you told your pdoc about your sleep issues?

Do you think your doc would be open to letting you try a sleep medication?......There are quite a few options to choose from.

or maybe Klonopin? I have no experience with Vraylar, but Klonopin has helped me in the past when I've had episodes of not staying asleep during mood things.

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Quote

I have no experience with Vraylar, but have you told your pdoc about your sleep issues?

Oh, absolutely.  I'm calling my PDoc with updates as warranted; I've called her 3 times in these 2 weeks with either routine updates or requests for change (e.g., after two days of insomnia, I called and said "I want to switch to morning dose to try and address the insomnia.")  Her advice on this more recent sleep issue was to nap less, but it's really really hard to not nap when  you only had 2-3 the night before.

Quote

Do you think your doc would be open to letting you try a sleep medication?......There are quite a few options to choose from.

She would.  We left it that we'd give it some time to see if I got acclimated to the med and the sleep fixed itself, so that's probably the next step.  I just figured I'd do some open source research first :)

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3 minutes ago, Fruitful.Entropy said:

Oh, absolutely.  I'm calling my PDoc with updates as warranted; I've called her 3 times in these 2 weeks with either routine updates or requests for change (e.g., after two days of insomnia, I called and said "I want to switch to morning dose to try and address the insomnia.")  Her advice on this more recent sleep issue was to nap less, but it's really really hard to not nap when  you only had 2-3 the night before.

She would.  We left it that we'd give it some time to see if I got acclimated to the med and the sleep fixed itself, so that's probably the next step.  I just figured I'd do some open source research first :)

Same happened to me and it never improved, which is why I’m no longer on it. ?

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Quick update - 

  • Spoke to PDoc about how to improve my sleep - 
    • She half-heartedly asked about Trazadone and I said I'd prefer not to
    • She recommended 3-6 mg of Melatonin
  • 3-6 mg Melatonin at bedtime or at middle-of-night-wake-up-time didn't do anything
  • Tried 9 mg at bedtime and got a better night's sleep
  • Per discussion with PDoc, experimenting with 9 and 12 mg doses

Sleep has improved to ~5 hours sleep (compared to 2-3 early on), which is better, but still short of what it should be.  Fitbit measures of deep and REM sleep seem lower than average (for whatever that's worth).  Still napping if I feel exhausted midday.

Continuing to stick with it because otherwise the Vraylar seems to be just what I need in terms of improving mood without inducing mania.

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Posted (edited)
On 5/6/2019 at 8:45 PM, Fruitful.Entropy said:

Quick update - 

  • Spoke to PDoc about how to improve my sleep - 
    • She half-heartedly asked about Trazadone and I said I'd prefer not to.

 

On 5/20/2019 at 2:06 PM, Mazzei said:

Just out of curiosity, why did you say no to Trazadone?

I'm curious too, why you said no to trazodone?

Edited by CrazyRedhead

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On 5/20/2019 at 2:06 PM, Mazzei said:

Just out of curiosity, why did you say no to Trazadone?

On 5/22/2019 at 9:20 AM, CrazyRedhead said:

 

I'm curious too, why you said no to trazodone?

Sorry, just seeing these now.

My previous experience with Trazadone was during hospitalization 10 years ago.  What I recall about it is that it would linger after waking, leaving me feeling groggy and very slow of thought for 2-3 hours.  I'm concerned that, for example, my morning meetings at work will suffer if my brain is full of sludge due to Trazadone.

That said, I'm considering asking my PDoc for a PRN so I can try that on weekends.  My average sleep is now ranging from 5.5 - 6.5 hours (measured by Fitbit, so, add an hour of "awake" but in bed to get traditional "hours of sleep"), but I still feel tired and need naps regularly.  And I still have 3.5 - 4.5 hour outlier sleep days.  And if Fitbit is to be believed, deep and REM sleep are lower than average.  So I'm wondering if a good, deep Trazadone-induced sleep on weekends when it's okay to be slow in the morning might help my mind and body.

It's still worth hanging in there at this point.  The Vraylar strongly inhibits the sharp depressive dips and alcohol cravings; it's a measurable improvement to my well-being.  But I'd like to keep nipping away at the sleep problem.

 

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