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Sudden Complete Insomnia

insomnia sudden insomnia cant fall asleep ambien lunesta

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35 replies to this topic

#31 crazepharmacist

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Posted 26 June 2014 - 10:52 AM

You're dosing your testosterone all wrong and is likely the main culprit of your insomnia issues. No one does bi-weekly injections. Thebleast you can get away with is once per week injections. Ideally you want twice weekly, spread evenly to keep your levels as even as possible. With once every two week injections you must have massive hormonal swings and is likely the reason your estrogen is high. If you're on 400mg bi-weekly cut your dose into two 100mg injections per week. same dose just more frequency If your estrogen levela do not go down then you will either need to reduce your dose or go on an aromotase inhibitor. also, make sure your doc is writing you for the proper estrogen test. There is a female one and a male test. many doctors doctors do not know the difference . Every lab is different but you want something akin to estradiol ultra sensitive test.

Edited by crazepharmacist, 26 June 2014 - 11:14 AM.

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#32 wolfram9999

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Posted 26 June 2014 - 02:20 PM

To expand on trazadone, its actually an SARI (Serotonin antagonist and re-uptake inhibitor). This means it is both an SRI (works the same way as SSRI's) and also an antagonist to certain serotonin receptors. However like most drugs it has other mechanisms of action that aren't directly related (or believed to be, to its antidepressant effect) and this is where most of its sedation comes from. It doesn't become much more sedating at higher doses and most of this sedation comes from 5ht2a, h1 antagonism (very weak and possibily insignifcant) and alpha1 anatagonism. Its not as potent a sedative as Mirtazapine, hence why I suggested mirtazapine over trazadone. Additionally in a small % of the popultion trazadone can actually be activating.
 
It does take the heart about an half an our after any exercise to return to normal. However this could be a physiological sign of anxiety. You have clearly stated you have been subject to a fair bit of stress in the last few months. It follows the evidence and my prediction...this is the most likely cause of your insomnia.
 
I would recommend against discontinuing the T. Changing to many meds at a time makes it very hard to know what is working and what is making it worse.


While I definitely experienced stressors over the last two months, I honestly don't feel those are the largest contributing factors to my insomnia. As to the breakup, it hit me hard for a few days and then I was off talking with other people... I think on it from time to time but barely at all. It's certainly not in the forefront of my thoughts. The work stress came right before the insomnia started but the driver for the work issue was resolved before the first week of insomnia was over.
Physically, I still feel generally amped up. Sometimes, it's energizing and sometimes it's anxiety-causing, but lately I'm physically always "on" even if mentally I'm not thinning of much of anything. And then I have these spells where my heart will start racing out of the blue, even if I'm just chilling on the couch. It seems, honestly, that any severe mental anxiety I have had in the last few weeks is preceded by a physical sensation as opposed to the other way around.

As for eliminating the T, that's the only drug I've taken out of the equation. None others.
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#33 rwac

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Posted 26 June 2014 - 04:12 PM

Are you low carbing?
Have you tried eating some ice cream at night?
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#34 Tom_

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Posted 26 June 2014 - 04:17 PM

As per ususal this thread is degrading in to psudoscience (not all of you, although it tends that people mention some evidence based approaches while also mixing in psudoscience).

 

2mg of Mirtazapine will hardly be abosrbed. 6mg of Quetiapine is also not an effective dose. Your response can only reasonably be put down to a placebo effect (since you didn't expience any hightened side effects a pharmacodyanmic explanation is highly unlikely).

 

The prescription of hormone supplementation is the only evidence based approach to treating primary male hypogonadism. Taking dodgy supplements is an awful idea.

 

The person who said they knew they weren't having microsleeps...the whole point of microsleeps is that you don't notice them. People (without sleep pathology) even occationally have them in the day without noticing if they are suffering from even acute moderate sleep depervation. People suffering from severe insomnia almost universally get signifcantly more sleep than they think they are getting, in some cases they aren't even suffering insomnia and only have sleep state misinterpation (not something I'm suggesting is likely here or in your case). Sleep state misinterpation is to be expected in cases of insomnia, whether its a mild moderate or severe descrepancy. I do conced in amount 10% of cases it doesn't play any part.

 

In insomnia after the first few days adrenal function is actually supressed not increased. There is no vicious biological cycle, the 'excess' activity is psycho-somaticly induced worrying about lack of sleep. However cortisol production is increased, which has both stimulatory and depressive effects on a range of systems.

 

Yes anti noradrenergic drugs may help you sleep but that will only happen due to there depressant effect. Not because they are correcting some adrenagicly driven pathophysiology.

 

Just because you are experiencing physical symptoms of anxiety does not preclude an anxiety, depressive or stress based disorder being the driving force behind the insomnia. It's just as likely if you were experiencing acute dysphoria or psychic agitation. However that certainly does not mean these 'physical' attacks should be written off as anxiety. You should mention them to your doctor and discuss whether or not to have an ECG/EKG. When these attacks happen it might be useful to measure your heart rate (having taken a base rate over two days (three times each day, morning, afternoon and evening). If there is no increase then its almost certainly benign psychogenic palpatations. If its increased its more than likely panic but should still be examined.

 

Depending on when you last had bloods done its worth mentioning to the doctor having them re-done (basic metabolic pannel, thyroid function tests, liver function tests, fasting glucose or Hba1c and a full/complete blood count).


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#35 wolfram9999

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Posted 20 June 2018 - 02:17 PM

I never logged back in to give the solution, but basically it was the testosterone therapy. Once I was off T and my levels went back to normal, I started sleeping just fine.
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#36 John250

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Posted 20 June 2018 - 04:42 PM

Hey folks. Newbie here (well, former lurker) with newfound, sudden onset of insomnia.
Male, 32.
Started with feeling increasingly amped up over the course of a week with varying sleep quality. Stopped caffiene. Then, on the night of Sunday 6/1, stopped sleeping entirely. Started feeling myself jump awake (mentally, not physically) when sleep began to come.
Didn't sleep for four days and then got an Ambien prescription, 10 mg. Took it on and off for two weeks...
When it worked, I got 6 hours at max (only twice), or as low as none.
Would not sleep more than an hour at most (sometimes not at all) on the days I didn't take it.
Toward end of second week, stopped working entirely.
This is the third week with no sleep. Saw the doc again on Wednesday and got a new prescription for lunesta, 3mg. First night, worked great. Felt myself falling asleep (unlike ambien which just blacked me out eventually). Felt a little drugged the day after but it was workable. Last night, took 3/4 of the lunesta. Could clearly feel it working but never fell asleep. Mind kept running and wouldn't shut up, same issue as I've had the last three weeks...
History: high blood pressure, taking lisinopril, last 8 months or so.
Testosterone replacement therapy, taking t cypionate, biweekly injections for last 2.5 mounts or so.
Current high or abnormal tests:
T levels now in mid-500s
Estradiol high at 106.
Hematocrit and hemoglobin levels just over normal.
Norepinephrine elevated at 414 (highest end of normal is 444 I think).
Any thoughts or help are appreciated. Going a bit Looney Tunes given I'm working on an average of 1 hr sleep per night these days.

Xposted from introductions thread. Thanks everyone... Appreciate your help!!

Bi weekly Cypionate is a terrible method. Your testosterone and estrogen will spike very high during the first week and significantly drop the following week. You want to do 1 shot/wk minimum(100-150mg/cypionate) to maintain steady blood levels. Preferably 3shots in smaller doses of 30-50mg/wk)per week(MWF). This will not only increase free testosterone more but it will lower estrogen as your estrogen is way too high. Get bloodwork done 2-3 days after your last shot. You want total and free testosterone LC/MS and “ultrasensative Estradiol.” If estrogen is still high you want to incorporate an anti estrogen like arimidex at small doses 3x/wk. start with .25mg MWF and evaluate from there.

Your estrogen is high because you are aromatizing too much from the spike and dip in testosterone. Donate blood once every 4months to lower hemo levels but keep an eye on iron,ferritin and TIBC. If blood pressure is still too high on Lisinopril then you can try adding a low dose of 12.5mg hctz as they work synergistically. Or the new 3rd generation beta blocker Nebivolol is pretty beneficial.

Edited by John250, 20 June 2018 - 04:51 PM.






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