Benzos Extended Use of Benzodiazepines For Insomnia

[Jktm]

So I've had issues with insomnia my entire life, but in the past few months it has become a complete nightmare (or lack thereof I guess you could say). Nothing seems to work on my insomnia for any extended period of time, but I haven't had the chance to use benzodiazepines for sedation for an extended period of time, so hope is still in that boat for me.

I've tried Diphenhydramine HCL and Doxylamine Succinate up to 450 and 150mg respectively and can't seem to get to sleep on these anymore. I've tried Zolpidem in the past up to 60mg and don't even feel the slightest bit sedated on it. Clonazepam doesn't do a damn thing for me anymore even for anxiety in anywhere near clinically therapeutic dosage ranges. And while it will work at ever increasing doses, Seroquel just doesn't seem safe to keep going with considering how quickly I've been having to up the dose, and I really hate how it makes me feel (not to mention my quality of sleep is fucked on it and I wake up tired as fuck (not because of the actual drug; it's not a hangover-y feeling)). I refuse to take Zyprexa as my BMI is already around 38, and that shit causes weight gain and diabetes worse than Seroquel does.

The only thing (and I've only gotten to use it twice and the uses had a month of separation between them) that seems to help me sleep is 2mg (which is odd, because a therapeutic dose of alprazolam for me is around 4mg for anxiety) of Estazolam (ProSom), but it not only helps me get to sleep; I actually wake up rested alert and the only times this has ever happened in my entire life has been on this drug.

My question is, is this actually sustainable as a long-term treatment, or will I have to quickly start upping the dose like I had to do with the Seroquel? I'm just tired of not being able to sleep at all anymore, and I refuse to look to Seroquel as long-term treatment as I've already reached 300mg (and I believe FDA-approved max dose of this in schizophrenia is around 800mg), and I just fucking hate the shit. I swear, I almost wish I had access to propofol and insulin syringes.

Any constructive feedback would be greatly appreciated.

 

[Captain.Heroin]

So I've had issues with insomnia my entire life, but in the past few months it has become a complete nightmare (or lack thereof I guess you could say). Nothing seems to work on my insomnia for any extended period of time, but I haven't had the chance to use benzodiazepines for sedation for an extended period of time, so hope is still in that boat for me.

I've tried Diphenhydramine HCL and Doxylamine Succinate up to 450 and 150mg respectively and can't seem to get to sleep on these anymore. I've tried Zolpidem in the past up to 60mg and don't even feel the slightest bit sedated on it. Clonazepam doesn't do a damn thing for me anymore even for anxiety in anywhere near clinically therapeutic dosage ranges. And while it will work at ever increasing doses, Seroquel just doesn't seem safe to keep going with considering how quickly I've been having to up the dose, and I really hate how it makes me feel (not to mention my quality of sleep is fucked on it and I wake up tired as fuck (not because of the actual drug; it's not a hangover-y feeling)). I refuse to take Zyprexa as my BMI is already around 38, and that shit causes weight gain and diabetes worse than Seroquel does.

The only thing (and I've only gotten to use it twice and the uses had a month of separation between them) that seems to help me sleep is 2mg (which is odd, because a therapeutic dose of alprazolam for me is around 4mg for anxiety) of Estazolam (ProSom), but it not only helps me get to sleep; I actually wake up rested alert and the only times this has ever happened in my entire life has been on this drug.

My question is, is this actually sustainable as a long-term treatment, or will I have to quickly start upping the dose like I had to do with the Seroquel? I'm just tired of not being able to sleep at all anymore, and I refuse to look to Seroquel as long-term treatment as I've already reached 300mg (and I believe FDA-approved max dose of this in schizophrenia is around 800mg), and I just fucking hate the shit. I swear, I almost wish I had access to propofol and insulin syringes.

Any constructive feedback would be greatly appreciated.

Tolerance is likely to occur with time.

If you only use it a few days a week when you feel you most need it, keeping in mind to have days without sleep meds regularly, it's possible that you won't need to up the dosage.

 

[brutus]

Your doses of drugs that you have been posting are completely reckless and your comment about wanting to find some propofol makes me wonder if you have a death wish.

Tolerance to benzos does not build in regards to anxiolytic effects unless you abuse benzos.

 

[macd610]

I am just going to address the question in the title. I've been taking 1mg Alprazolam for sleep for a couple of years. It definitely does the trick ...when I have it. THAT is the issue for me. If I don't have it due to running out a few days early, or being unable to get an appt w my psychiatrist in time, I feel badly all the way around. I've definitely become dependent upon it.
At my last appointment, my psych. told me that there have been studies done recently (on Alprazolam) and there is much evidence suggesting that long term use of this drug actually WORSTENS sleep issues.
He is encouraging me to lower my dose, and I am a bit nervous. Again, the studies he told me about were on xanax alone. I don't think this is a decision to be taken lightly at all. Be careful.

 

[Jktm]

I'm sure you'd have a death wish too if you had a third of the medical problems in the book at the age of 20, and couldn't even get to sleep to take a break from life. I've got no fucking job (and not for wanting to not work; I used to work overtime as a shift manager in high school and still managed to graduate 15 months early), I couldn't go to school this semester because of medical problems, and I spend most of my time in the recliner because of how shitty I feel.

And I said "almost wish I had access." It was really an exaggeration.

Also, 4mg is a clinically therapeutic dose of alprazolam. And I don't just dive into drugs first thing at the doses I've posted. The night I took 44mg of clonazepam was a one time thing, and it wasn't in one dose, it was spread out over a 16 hour period. If it's so reckless, then why do I still have moderate-severe anxiety, and pain levels averaging a 6 even when I take these large doses? I was in the BHC receiving 1mg of xanax QID and was still having panic attacks.

Thanks for talking down to me though, appreciate it.

 

[Gyrospeck]

IME, benzo tolerance develops fairly quickly to the sleep properties (at a stable and low dose). This is true of the pain relieving/muscle relaxing properties as well. IME, it takes less than a year (sometimes only a few months) for the drug to lose these properties. Again, this was a low (under 3mg/day) stable dose without much abuse.

Tolerance to the anxiolytic properties grows much more slowly, however.

Based on my experiences, I would not recommend seeking a benzo for long-term insomnia. They will work wonders if taken occasionally, but habitual use does lead to tolerance. Btw, I cannot help but notice that you have already tried several different benzos/z-drugs. You reported a tolerance and/or lack of effect with these drugs in your first post; what will make Estazolam so different?

 

[Jktm]

IDK, I've used Xanax for sleep before, but it had me waking up tired like I always do. I've only had estazolam a couple times at the BHC, and it was literally the only thing that made me wake up rested. I think that's why I like it. I can take it, go to sleep (not pass out) within an hour or two (and at a dose of 6x less agonism than the amount of xanax needed to give me anxiolytic effects), and wake up 6 hours later rested. I can also wake up when I need to. My entire life it's been nigh impossible to be awoken by anything, and when I do finally regain consciousness, I'm tired as fuck. Sleep obviously isn't happening with other treatments, and I'm not sure if Amobarbitol/Senobarbitol would be a good idea/if anyone would be willing to Rx them. Most lay people in the area I live in don't even know what barbiturates are......

Thank god it's after noon; now I won't feel like an alcoholic for chugging this four loco...I feel like shit...

 

[Jktm]

Other than that one, the only other benzo that allowed me to sleep easily was triazolam...not sure if it was .25mg or .5mg; it was at the dentist for conscious sedation, and it only worked with my tramadol, flexeril, lyrica, ~60mg of MS that I copped (it was a 100, but I busted it in two as I knew I was going to be taking the Halcion), and N20.

 

[tricomb]

Benzodiazepines lower the quality of sleep that you get, so long-term daily use of benzodiazepines for insomnia is really reckless and irresponsible if you ask me. As a long-term user, I've accepted that you can't rely on these drugs everyday without consequences, and in my opinion, the risks of daily use far outweigh any potential benefits.

Triazolam is a great hypnotic, I often use it when I need help falling asleep, but not staying asleep. To stay asleep, I prefer to use temazepam.

 

[Jktm]

So then what do I do when nothing else works? lol

I'm at a loss...

 

[tricomb]

^Everyone's different man, but it's real easy for me to just say to myself "nothing else works, I need benzodiazepines for this" but I think we both know how that ends up.

You just can't rely on benzodiazepines every day man, and you can't resign yourself to believing that it's the only choice you have. That's just justification.

Work on your sleep hygiene, diet, and exercising as much as possible pain permitting. Tire yourself out so that you're actually sleepy.

 

[Jktm]

I'm eating a bit better since I got out the BHC when I checked myself in for suicidal ideation, anxiety, and anorexia, but still not eating much...you'd think that my low-intake would tire me out...

Also, it's been said many times (and I have read elsewhere) that benzodiazepines lower one's quality of sleep, but why do I wake up easier and rested when I take it? If I don't, I'm headed straight for the kuerig when I wake up...Could it be my untreated panic disorder (and tylenol/ibuprofen treated pain) causing a lot of my problems? What's weird is that when I was on a sympathomimetic amine, I seemed to sleep better as well...

 

[Gyrospeck]

^ When I first started using Xanax for sleep, I also felt that I got more restful sleep. I have a history of night-time panic attacks, so I truly felt that Xanax was a lifesaver. IME, the hypnotic properties do not last if you use them everyday while the anxiolytic properties do. It took less than a year for me to notice that taking LESS Xanax gives me better sleep. Benzos (and all hynotics) change how you sleep (such as less or more REM sleep) and this will have effects after extended use. My main concern with benzos is that lack of stage 4 sleep can be associated with less secretion of growth hormone and other restorative processes such as maintaining the immune system.

I want to make it clear that benzos have great hypnotic properties IF used sparingly and short-term. This is a big if since these drugs are habit forming. I don't know you or your situation very well, but I would advise being careful with benzo hypnotics.

I also second tricomb's advice regarding diet, exercise, and sleep hygiene. These will help sleep length & quality far more than any drugs will.

 

[Captain.Heroin]

You could always have a sleep study done, but I'm not sure if that would even help or not.

Do you get enough exercise throughout the day? Without enough physical activity - it's going to be hard to get a good night's rest.

 

[Jktm]

I honestly would exercise if I could...and I'm supposed to be seeing a sleep specialist in 2 weeks (I'm going to try to get in earlier if possible though)...my PCP wouldn't order they study...said she'd let the sleep doctor do it...then she started saying that I try to get medications from too many places (when I've seen her for everything (except the phentermine I got from a diet doctor and the very few times I've had to seek urgent care/emergency care)) and then refers me out to 4 different doctors...fucking idiot lol...

 

[teological]

Your doses of drugs that you have been posting are completely reckless and your comment about wanting to find some propofol makes me wonder if you have a death wish.

Tolerance to benzos does not build in regards to anxiolytic effects unless you abuse benzos.

Considering that the OP has specifically stated in his post that his insomnia has been going on for umm… his ENTIRE LIFE, what makes you so sure that he was abusing them to get to those dosages? Have you not heard of tolerance increasing over long term USE?

His comment about the Propofol was clearly a colloquial statement. Maybe English is your second language and you do not understand slang or sarcasm, if so, then GET OFF and stop taking every little thing as literal information, consider the context.

Your one bit good advice about the benzos, still seems to attack the OP in an indirect way. Again what makes you think he was not USING his benzos…the OP seems to be having a hard time in life and does not need people as careless and clueless as you to come here and have a go in the name of “harm reduction”, thinking you are all high and mighty.

 

[RobotRipping]

Your doses of drugs that you have been posting are completely reckless and your comment about wanting to find some propofol makes me wonder if you have a death wish.

Tolerance to benzos does not build in regards to anxiolytic effects unless you abuse benzos.

any sources to back this up? if i could be really sure about this i'd go back to daily therapeutic benzo use rather than struggling to get through constant panic attacks.

for OP: have you tried taking 50-75mg of diphenhydramine (higher doses will keep you awake and restless) and a lower dose of a hypnotic? I do 50mg-75mg of dph along with 3.75 mg of zopiclone and if i'm not too high or caffeinated i can usually get to sleep and stay there. I've had insomnia my whole life as well and it has kind of defined my existence so i know what it's like. Without the zopiclone i will have a massive panic attack every single night when i go to sleep and it is shit to live like that. It just relaxes me and takes away bedtime anxiety so i can fall asleep, doesn't really sedate me.

Sleep hygiene is also very important as is adjusting your daily schedule so that is more in line with your natural cycle.

 

[Jktm]

I finally got about 5 hours this morning. I don't know if I just wore myself out, but last night I was having the strongest urge to end things, and started hyperventilating and rocking/shaking like I normally do when I go into a panic attack, but I never actually crossed the line to go into panic. It was the weirdest thing. It's like I had enough adrenalin surging through my body to keep it from happening. As if it knew that going into full-blown panic would probably push things over the edge. No "actual" panic attack, but hyperventilated to the point of extremities going numb, and head getting really light. After a couple hours of the near-panic attack, I eventually started to calm down. And when I did, I went into sleep paralysis for about an hour. Couldn't move like I was passed out, but was still awake. After about another hour of being wide-awake. I tossed and turned for another hour in the recliner, but eventually, sleep came. Normally when I do sleep, I have to fall asleep on my side, but will wake up on my back. I have hyperkyphosis, so when I wake up on my back on a flat surface, it's god-awfully painful. I guess I was too tired last night, because I didn't roll onto my back in my sleep like normal, and goddamn do I feel like shit for it lol...Exhausted as fuck too...Yet my mind is at peace a bit more...

Trust me, I know the bit about sleep hygiene...And I've tried taking lower doses of benadryl, yes. The closest thing to a hypnotic I have at my disposal is Seroquel, and it's hit or miss...Only seems to work when I'm already sleep deprived. Normally what I'll have to do is keep using the benadryl until the dose gets so high it starts to have the early effects of the deliriant it is, then back off of it for a few weeks. That hasn't been working recently. Dropping back down has no effect at all, and the high doses don't do it either. Thanks for the posts, though.

 

[brutus]

Considering that the OP has specifically stated in his post that his insomnia has been going on for umm… his ENTIRE LIFE, what makes you so sure that he was abusing them to get to those dosages? Have you not heard of tolerance increasing over long term USE?

His comment about the Propofol was clearly a colloquial statement. Maybe English is your second language and you do not understand slang or sarcasm, if so, then GET OFF and stop taking every little thing as literal information, consider the context.

Your one bit good advice about the benzos, still seems to attack the OP in an indirect way. Again what makes you think he was not USING his benzos…the OP seems to be having a hard time in life and does not need people as careless and clueless as you to come here and have a go in the name of “harm reduction”, thinking you are all high and mighty.

I take Klonopin and Unisom daily along with having insomnia and GAD my entire life. No one needs to take 450mg of Unisom or 44mg of Klonopin ever. Those doses are ridiculous and dangerous. I stand behind my original post completely.

Despite decades of basic and clinical research, our understanding of how benzodiazepines tend to lose their efficacy over time (tolerance) is at least incomplete. In appears that tolerance develops relatively quickly for the sedative and anticonvulsant actions of benzodiazepines, whereas tolerance to anxiolytic and amnesic effects probably does not develop at all.

Source

 

[tricomb]

Bringing yourself to sexual climax prior to bedtime should also be tried.

I've been taking benzodiazepines for insomnia long-term for many years now, and I make it a point never to exceed 30mg temazepam (60 in extreme cases), or 0.5mg triazolam. Taking ever-increasing doses will backfire, Wiggi is right, you do not want to be taking 44mg klonopin and relying on it for therapeutic effects.

edit:

Considering that the OP has specifically stated in his post that his insomnia has been going on for umm… his ENTIRE LIFE, what makes you so sure that he was abusing them to get to those dosages? Have you not heard of tolerance increasing over long term USE?

Tolerance may increase but that doesn't mean it's appropriate to be forever increasing the dose you need. I went down that road with alprazolam and it doesn't turn out well. Take my word for it.

His comment about the Propofol was clearly a colloquial statement. Maybe English is your second language and you do not understand slang or sarcasm, if so, then GET OFF and stop taking every little thing as literal information, consider the context.

Seeing as he runs North and South American Social and Drug Discussion, I'm going to guess he's fluent in English.
I think that Wiggi, like myself, was alarmed when reading the propofol comment due to the risks involved. It may seem clear to you that it's sarcasm, but Wiggi was not the only one who needed reassurance on this subject. I assure you that there are many cases when the OP says something seriously that people interpret as sarcasm and the right thing to do to reduce harm is to seek clarification.

I cannot comment on any personal feelings that posters may have, obviously, they are personal feelings, but I don't think Wiggi's comments were totally unfounded. The OP is definitely at a much higher risk for death and has a history of self-destructive tendencies, I worry about you Doug. That's why I want to make sure that you don't even attempt to rely on benzodiazepines daily long-term, and I am definitely not being high and mighty under the guise of harm reduction.