Are there any doctors who work with sleeping pills other than psychiatrists?

overtheedge

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I've been working with an ENT for a while now who has been prescribing sleep medications to help fix my insomnia. I've tested the four or so sleep meds he's Rx'd with partial success but after telling him this last med didn't work he says he's out of his depth and the only doctor he can recommend who deal with more than just the basic prescription sleep drugs is a psychiatrists.

I'd rather not deal with a psychiatrist unless I absolutely have to, they are so skeptical of CFS and it would be a hassle to dodge around something that plays such a big part in my life, also, the majority of the psychiatrists I've met I'd call incompetent

What should I do? I'd really like to find a doc who knows the sleep meds they use inside and out and have quite a range of sleep meds to prescribe. Should I seek out another ENT? Should i call a sleep center and ask to be put in contact with one of their doctors? Should I look into finding a sleep specialist?

Of course if you folks have worked with any specific doctor who has fixed up your sleep I'd be interested
 

lenora

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Hello overtheedge........I'd say that in the U.S. at the moment, a psychiatrist is probably the way to go. We recently had a witch hunt re: Fentanyl and even the sleep specialist(direct outgrowth of the fentanyl fiasco) are requesting that we see a psychiatrist first. Also, please bear this in mind. Today's psychiatrists are generally used for twos thing and two things only: First: Figuring out which med(s) to put you on and Second: Figuring out which patients will be true to their drug schedule and those who won't. This isn't the worst thing that could have happened to us...we've been needing someone to weed out the good/bad for quite sometime now. I'm sorry that we have to go to two more specialists, but that's out of our hands...or at least that's the way I see it.

I don't know if you'll be given sleep studies (where you spend a night or two with them in a lab like setting) and also try to figure out our drugs and see if anything is causing problems with something else, etc. It may or may not work out. You'll probably be given the same prescription for sleep that doesn't work for the rest of us BUT chances are great that you'll be cleared to try whatever it is that your Dr. wants. Also, there is the possibility that you do have something wrong with your breathing & they'll catch it. That's what they were initially set up for.

You may even be able to have your interview with the psychiatrist by something like Zoom. You slowly get used to these things....medicine has changed so much. For counseling you're sent off to a psychologist or counselor. Don't be afraid if you haven't done it, most are very well trained and can really help you get to the heart of a problem. Many a relationship has been saved, changed and saved. I only wish we had started going to one when I first became ill.

We've been using one for about 35 yrs. now, and we're all very fond of one another & even my husband has taken to her in a good way. She has helped immensely over the years. If money is a problem, mention it upfront and either they'll do it or will send you to someone who works on a sliding scale fee. Sometimes they're organizations and you may have to wait longer than you want... I used to have quite a few friends who were psychiatrists and it's amazing how many will do it for nothing...with the right patient, of course. They're wives are often psychologist and counselors so I really do know a lot of what goes on....and that doesn't extend to talk about the patients. They're often very good people and after going to one and knowing them, I have a lot of respect for them. You're always going to find some bad people in any profession and that includes our everyday doctors. Not all people are created equal....sadly.

You'll have to put in your time and effort...no, it isn't much fun, but it would you feel safe in going to a Dr. who pretends to know what he doesn't? No, your doctor is doing you a favor. Yours, Lenora.
 
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geraldt52

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I can't imagine that most GPs wouldn't prescribe any of the available sleep meds, but they may also want you to see a sleep specialist for a sleep study. I seriously doubt a psychiatrist would be of any greater help. Your ENT has probably already prescribed what is available...there aren't a huge number of choices. I would caution you, because most doctors probably won't, that sleep meds are not intended to be taken long term, and you could set yourself up for rough times if you try to use them that way. Be very, very careful going down that road. You may think you're already having rough times, but if you become habituated to sleep meds you'll find out how bad rough times can be.
 

lenora

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Hello overtheedge & Gerald52......I know from personal experience that there are far more than 4 types of meds that can be used as sleeping pills. The fact with us seems to be this: We have a sleep disorder....what it is no one knows, at least at this point. I know from not my case but others, that sleeping pills work for a total of 2 days and that's it. We're then up for a few nights. Personally, after talking to my Dr. and making up my mind (in the reverse order) I decided years ago to stay off the things. Gerald's right, they do have a higher rate of addiction. Why add one problem to another? Natural products have never done anything for me, and as of probably 6 yrs. or more ago, I've been on my own. One could say I've given up hope, but it has been a very, very long time. I've noticed that anesthetics cause it to worsen for a few days, as well as the fun-loving steroids. However, there are times when we have to use these things and I'm not saying we shouldn't. Just tighten you seatbelt....of course it may not happen to you.
 
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Speak with your dr as there a few other meds which are used for other things. amitryptralin and trazadone can help with sleep but used as an antidepressant and/or pain
 

Abrin

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I've been working with an ENT for a while now who has been prescribing sleep medications to help fix my insomnia. I've tested the four or so sleep meds he's Rx'd with partial success but after telling him this last med didn't work he says he's out of his depth and the only doctor he can recommend who deal with more than just the basic prescription sleep drugs is a psychiatrists.

I'd rather not deal with a psychiatrist unless I absolutely have to, they are so skeptical of CFS and it would be a hassle to dodge around something that plays such a big part in my life, also, the majority of the psychiatrists I've met I'd call incompetent

What should I do? I'd really like to find a doc who knows the sleep meds they use inside and out and have quite a range of sleep meds to prescribe. Should I seek out another ENT? Should i call a sleep center and ask to be put in contact with one of their doctors? Should I look into finding a sleep specialist?

Of course if you folks have worked with any specific doctor who has fixed up your sleep I'd be interested
Since we are talking about insomnia I would personally try to get a referral to a sleep specialist since they are used to dealing with those types of issues.

That being said, I do feel that I should give you the heads up that it is possible that there is no sleeping pill out there that will end up being able to help you.

In my own personal case, after running through all the families of sleeping pills without success my sleep specialist eventually gave up on trying to get me to sleep properly and prescribed me modafinil in hopes of making my waking hours more productive instead.
 

Learner1

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Of course if you folks have worked with any specific doctor who has fixed up your sleep I'd be interested
I have worked with naturopathic doctors who practice functional medicine (there are MDs, DIs, and DCs who do too), which looks at the body as a system of systems and how nutrition and lifestyle factors affect health. Though they can prescribe pharmaceuticals, they also prescribe nutrients, botanicals and other natural substances that can solve health problems.

All drugs that "help" sleep come with a cost. They can be addictive, affect cognitive function, promote dementia, affect daytime function, and deplete nutrients. And, they can be counterproductive for ME/CFS patients.

Many of us have been helped by some combination of:
  • Magnesium glycinate
  • Melatonin
  • Theanine
  • GABA
  • Taurine
  • Glycine
  • Progesterone
  • Sauna
  • and others
 

lenora

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Speak with your dr as there a few other meds which are used for other things. amitryptralin and trazadone can help with sleep but used as an antidepressant and/or pain
Speak with your dr as there a few other meds which are used for other things. amitryptralin and trazadone can help with sleep but used as an antidepressant and/or pain
Hi Wendi......Many doctors have the knowledge to help with sleeping meds. The problem is that we have problems beyond what they're used to dealing with. I've been on both amitriptyline & trazadone (which everyone from a sleep study seems to be put on) and neither of them worked for long in the least.) Now Elavil was the first drug ever used for an off-label purpose....that is it was used to for pain in patients with ME. It never worked for me...or didn't work long if that's the case, and trazodone is given to almost everyone with a sleep disorder. It simply doesn't do it for us and we're on our own. Something will eventually be discovered...and wouldn't that be heavenly? Funny, I've lived through all these matters and am still hopeful that something will be found. Thanks for helping out...we need it. Yours Lenora.
Since we are talking about insomnia I would personally try to get a referral to a sleep specialist since they are used to dealing with those types of issues.

That being said, I do feel that I should give you the heads up that it is possible that there is no sleeping pill out there that will end up being able to help you.

In my own personal case, after running through all the families of sleeping pills without success my sleep specialist eventually gave up on trying to get me to sleep properly and prescribed me modafinil in hopes of making my waking hours more productive instead
Since we are talking about insomnia I would personally try to get a referral to a sleep specialist since they are used to dealing with those types of issues.

That being said, I do feel that I should give you the heads up that it is possible that there is no sleeping pill out there that will end up being able to help you.

In my own personal case, after running through all the families of sleeping pills without success my sleep specialist eventually gave up on trying to get me to sleep properly and prescribed me modafinil in hopes of making my waking hours more productive instead.
Hi Abrin.....First of all, it would be helpful to know where you live. If you're in the U.S. you may not be able to avoid seeing a psychiatrist today. Why? Check with the people who helped abuse Fentanyl and are now being treated like precious children, while the rest of us are left to picking up the pieces (once again) from their abuse of a system that was working just fine. Our doctors are having trouble getting insurance, a new specialty has arisen to care for people needing opioids....Pain Specialists and as part of their requirements (courtesy of the govt.) we now have to see a psychiatrist. Don't assume they're all against us, b/c that simply isn't the case. They're used to spot those who are using a medication when it's not necessary and, are driving up the cost of such b/c they're selling it on the streets. I, for one, refuse to be on fentanyl any longer and nothing will entire me back to it. I am staying with the Pain Specialist because first of all, they're hard to find and second, I like him. We get along just fine and I feel that he trusts me and I trust him.

I know it's all extra of top of having an illness to begin with, but aIso feel that eventually your visits will go to Telemedicine and you'll deal with him/her via your computer. This has changed and there will be no going back. Doctors are afraid of losing their licenses today, so I don't think you'll see a return of the old days.

You may have to see the psychiatrist one time, so don't be too upset about any of it. Why should the Dr. be afraid of losing his license b/c he missed one or two drug abusers? If you look at it that way, it makes sense.

I recently went through this in the hospital. The Dr. was actually in CA and I spoke to him twice. It was surprising how much information we exchanged and he wasn't against people with ME/CFS/FM in the least. Telemedicine has been used in certain parts of the country, but here in Dallas, it's something new. Not any longer, though....it came and is here to stay. I can remember my brother using it in a rural area about 8 yrs. ago. It was necessary b/c of a shortage of doctors and was a good replacement. Yours, Lenora.
 

lenora

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It was a neurologist who prescribed sleep medicine for my insomnia (my insomnia was caused by a concussion though). Perhaps a neurologist can be of help?
Yes, a neurolgist would be a good "go to" Dr. for help with sleeping problem. From my experience, though, they can only do so much without sending you off for tests. You're quite right a concussion would be quite a different matter. I hope you're doing better. I doubt that a sleep specialist would give medication without you seeing a psychiatrist TODAY. It was even different as short a time as 18 mos. ago, a lot of them don't even carry insurance for opioids today. My Internist will prescribe certain meds for me that no one else will...
 
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lenora

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Abrin....That makes a big difference and, depending upon which province, an even greater one still. I don't know what the laws are there....let me ask if you're planning to come to to the U.S. to see a sleep expert here? See, this changes the entire situation, as you know. Do you have the name of an expert in this country? How about Toronto, have you tried there? I would imagine that city would be at the top of its form in Canada. We lived there for about 10 or so years probably 42 years ago. OHIP had just started and life was so simple si(Another thought...a pharmacy would know. Also, it would know if you need a prescription monthly or if you could have a 30 day supply of the drug) Do you think our equipment may be better? It may be & may not dependending upon what they have in Toroonto.

I'll tell you that a good many of us have lived without decent sleep for 35 yrs. or more. Yes we may fall asleep while watching TV, not even a deep sleep, and then be awake all night long. It's not a great way to live, but after awhile you realize that it isn't going to change. In my case, 3 sleep clinics were unable to make any difference. I may often be awake for 3-4 days at a time. I've ruined 3 laptops by spilling hot tea when I've suddleny fallen asleep....and then I'll be awake for the next 10 hrs.

I wish I knew how the Canadian system is handled, but I'm afraid that I can't be of more help than I have been. I would call some sleep clinics in your area, find out the latest testing and then compare it to what you're seeing in the U.S.A. If it's a stranger, ask them what they would do if they had your problem. You'd be surprised at the good answers you get from people. How about MRI's (with & without contrast). A good head shot will probably be required by whoever you see. It's posible it's best left now until you actually make the appt. & you can find out what's needed, etc. Here the staff will generally make the arrangements. I don't know about Canada. Good luck, Abrin. Yours, Lenora.
 
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Learner1

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I'll tell you that a good many of us have lived without decent sleep for 35 yrs. or more. Yes we may fall asleep while watching TV, not even a deep sleep, and then be awake all night long. It's not a great way to live, but after awhile you realize that it isn't going to change. In my case, 3 sleep clinics were unable to make any difference. I may often be awake for 3-4 days at a time. I've ruined 3 laptops by spilling hot tea when I've suddleny fallen asleep....and then I'll be awake for the next 10 hrs.
Something will eventually be discovered...and wouldn't that be heavenly?
Have you tried any of the natural substances I listed above??? Perhaps one or a combo may work. They don't have the side effects of many of the drugs you mentioned.
There are naturopathic doctors in Canada that could help you with alternatives to drugs which can cause you further problems
 

Abrin

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I wish I knew how the Canadian system is handled, but I'm afraid that I can't be of more help than I have been. I would call some sleep clinics in your area, find out the latest testing and then compare it to what you're seeing in the U.S.A. If it's a stranger, ask them what they would do if they had your problem. You'd be surprised at the good answers you get from people. How about MRI's (with & without contrast). A good head shot will probably be required by whoever you see. It's posible it's best left now until you actually make the appt. & you can find out what's needed, etc. Here the staff will generally make the arrangements. I don't know about Canada. Good luck, Abrin. Yours, Lenora.
Hey Lenora,

I think we might have gotten our wires crossed. I actually wasn't asking for help. I saw that you had quoted my original answer to the OP in your post and then tried to answer the question that I saw that you had posted under the quote because I then mistakenly assumed that it was directed towards me. :)
 

lenora

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Have you tried any of the natural substances I listed above??? Perhaps one or a combo may work. They don't have the side effects of many of the drugs you mentioned.

There are naturopathic doctors in Canada that could help you with alternatives to drugs which can cause you further problems
Thanks, Learner 1 but, no, I haven't tried any of the supplements yet. I have to get this eletrolyte problem straightened out first (blood tests every 2 wks. for 6 mos) so you can see it won't be for awhile. Which ones worked best for you? I also know I won't be give progesterone....just too many things wrong with me. Again, if you tell me which ones you used & how you reacted, I'd give them a try. Thanks for being concerned. Yours Lenora
 

Learner1

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They all have helped.

Magnesium is an electrolyte, but over 70% of adults are short of it, so it's usually a good guess. Your electrolyte measuring doctors should be able to test it.

Melatonin is an antioxidant and works in the mitochondria. It is good for helping one get to sleep.

GABA is a calming neurotransmitter. Taurine is an antioxidant and has a similar effect to GABA.

Theanine is calming, helps improve sleep quality, increases mental focus, can promote weight loss, etc.

Progesterone is typically low in women over 40, promoting estrogen dominance and increasing cancer risk. Waking up in the middle of the night is a symptom of low progesterone.

There are other natural substances that promote healthy sleep as well, without the unwelcome side effects of pharmaceutical sleep aids. Especially if one is a patient with a lot of other problems, it might be wise to not make them worse by piling on mire pharmaceuticals.

The one for NE)CFS patients to stay away from is 5-HTP which could trigger the metabolic trap found by Robert Phair.
 

overtheedge

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I can't imagine that most GPs wouldn't prescribe any of the available sleep meds, but they may also want you to see a sleep specialist for a sleep study. I seriously doubt a psychiatrist would be of any greater help. Your ENT has probably already prescribed what is available...there aren't a huge number of choices. I would caution you, because most doctors probably won't, that sleep meds are not intended to be taken long term, and you could set yourself up for rough times if you try to use them that way. Be very, very careful going down that road. You may think you're already having rough times, but if you become habituated to sleep meds you'll find out how bad rough times can be.

I've had a sleep study done, the in home one, they want me to do a lab study before they will provide any treatment for the apnea, thing is I have this weird symptom where even slight pressure if constant becomes painful to the point that i cant even wear a necklace as I'll start feeling the area it's resting on like its a much heavier weight than it is and have to constantly shift it around.

Due to that symptom the at home sleep study where i had to try and sleep with a pulse ox pressing on my finger and a box pressing into my chest was one of the most painful things that has happened to me in the last 6 years or so, felt like death the day after that, it set me back a month or two as I could barely do anything during that time my health was so weak. the study detected some things that made the doctor want me to do the in lab study but I haven't had many points since that at home study where my health has been better than it was back before that study, not that the study is responsible for that, but I can't risk another health crash that bad while things are already so bad.

That whole pressure causing pain thing is weird
For me it's worse when my health is worse, on days where im feeling bad i can feel bottom of my feet hurting from just standing on the ground and when im in bed I have to constantly shift around from the pain of contact with the bed even though it's a memory foam mattress.
Does anyone else have this symptom or know what to do about it?

which drugs specifically are you wary of? Benzos and Z-drugs are the main ones i hear about as being addictive, are there any others you're leery of?
 

Learner1

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which drugs specifically are you wary of? Benzos and Z-drugs are the main ones i hear about as being addictive, are there any others you're leery of?
https://www.addictioncenter.com/sleeping-pills/symptoms-signs/

A lot of the symptoms/side effects can make ME/CFS symptoms worse.

Not being able to sleep is not a deficiency of some drug. I say this, not to be judgemental, but because I've had enough sleep problems of my own that have been addressed without a drug and with nutritional supplements.

The sorts of symptoms you describe could very well be symptomatic of nutrient deficiencies. Have you seen a functional medicine doctor or had comprehensive nutrient testing, like a Genova Diagnostics NutrEval done?
 

geraldt52

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...which drugs specifically are you wary of? Benzos and Z-drugs are the main ones i hear about as being addictive, are there any others you're leery of?
All of them, when used for anything other than a short term measure, including the antidepressants being used for sleep. And I'm not much more of a fan of any of the supplements, in terms of side effects, although they seem to carry relatively less risk for habituation. Sleep can be a hellish problem, but don't think for a minute that you can't make your situation worse with drugs and supplements.
 

overtheedge

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@Learner1

They say you can often identify the condition you have by its most unusual symptom, the sensitivity to pressure just seems so weird, but i have no idea what to call that symptom. I mean I definitely experience PEM and other things typical of CFS but I'm still holding out some hope i can find some alternate cause of my illness instead of having to wait till whenever it is the cure for CFS is found. But your definitely right, the nature of the symptoms can make the overall condition much harder to manage.

I've worked with functional medicine doctors for years and have had the nutreval done as well as having a GDX labs amino acid test and organic acid test done before i had the nutreval. The nutreval was done at a weird time, I was on the SCD diet, and the results of the nutreval weren't focused on as thoroughly as they could have been but most of the stuff the nutreval recommends I've taken at one time or another, really many of those those things have been taken all at once at different points in time, the vitamins, probiotics, antioxidants, EFAs, etc. have been used consistently for a while when working with functional medicine doctors. I tried all the amino acids the tests recommended without any noticeable change, at least on the first one, the profile of the second amino acid test, the one that was part of the nutreval, had results that were very different than the first one.
 
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