[Guest]

I have had chronic sleep maintenance insomnia quite some time. I have had a sleep study normal results. I have used Ambien several years try restrict use. I take 300 mg of Serzone nightly to help manage a chronic pain problem. I am generally in bed at 9:30 - 10:00pm. I wake several times a night around 3:00am I wake am unable to return to sleep. can I do to get back to sleep how can I solve problem long term?

[Guest]

I am terribly sorry for the late response, a mild glitch in my email system, now corrected. There are two main methods of treating insomnia, pharmaceutical such as ambien or behavioral. Behavioral therapy includes relaxation therapy, sleep restriction and stimulus control. Stimulus control is when a person does not go to bed if not tired, usually best for sleep onset insomnia. Sleep restriction is where one restricts there amount of sleep to guarantee that 90% of the time they are in bed they are a sleep. What is really important is to determine why you have insomnia. Depression and anxiety disorders are a common cause and maximum therapy of those is important. Other causes include chronic pain syndromes, which should be treated maximally. Medications are a main cause of insomnia and reviewing these may be of benefit, nefazadone does not commonly cause insomnia. Other medical problems such as gastroesophageal reflux can cause sleep maintenance insomnia as well. In summary insomnia can be due to many different causes. Discovering the underlying cause may be helpful. If not then the behavioral therapy above may be of benefit. Pharmacological therapy with ambien as described is often used as well.