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Insomnia shortly after knee surgery, haven't slept more than a few mins in almost a week

Commented on November 12, 2014
Created July 21, 2012 at 3:53 PM

I had a knee scope on 7/3. I eat paleo with dairy (cream + cheese) and per below some coffee and some alcohol (though not at all for past week for either). I only tend to eat 2 meals per day, and pretty low carb. Last night I added a bunch of sweet potato at both meals, thinking more carbs might help, but for most part I haven't been worrying about diet as much as the drugs.

I've never been a great sleeper, but was doing ok at the time, generally sleeping 1-2AM to 9-10AM. I often read for 30-60 mins before falling asleep. I try to avoid computers late at night but usually watch TV.

I was prescribed Vicodin and used it fairly sparingly for the first few days after surgery, taking maybe 4 the first 24hrs, then 3, and then just 1 when I went to bed for maybe two days. I was sleeping ok thru this period.

However the first night I didn't take it I just couldn't sleep. This would happen every so often (a few times per year) so it was unpleasant but didn't think that much of it. For the next few days I went back to taking 1 pill when going to bed and slept ok (probably a bad mistake). I also decided to completely drop caffeine. I had been drinking a fair bit of decaf coffee (never after early afternoon) but gave that up (I'm pretty sensitive to regular coffee and switched to mostly decay a while back). I also gave up all alcohol. I had been drinking 1-2 glasses of red wine per night prior to the surgery, didn't drink at all immediately after (while on the heavier Vicodin) but then went back to some wine during the failed transition (never with Vicodin though, I know the Tylenol + alcohol is terrible for liver).

About a week ago, I decided I really should stop taking Vicodin at night. The first night I didn't sleep at all again, and I pretty much haven't slept since. After 2 days I happened to have a followup with surgeon and asked for Ambien (5mg, the smaller dose).

My experience with the Ambien has been awful, the pills give me incredibly anxiety and don't seem to knock me out, or if they do I might sleep for 10-15 mins. When I take the Ambien I wakeup with my heart absolutely racing. I think I tried using Ambien on its own for 2 nights.

Last night I took 5mg time-release Melatonin and after a few hours I gave in and took 2 Vicodin's, figuring it'd at least knock me out, but it made me incredibly hyper. After six more hours, I took 1 Ambien and it didn't do much of anything. I'm absolutely desperate and I'm pretty sure I have clinical strength depression/anxiety right now. I'm having a hard time avoiding crying during the day and am absolutely miserable all night.

Finally, I have one of those blue-light-therapy boxes and I've been using it for 45mins around 6AM most days, figuring it wouldn't hurt and might help.

My blood pressure is actually normal, but my pulse is elevated and at night I feel like my heart's going to burst out of my chest. I'm so anxious about falling asleep that I can't seem to follow any sort of relaxation technique.

I fear I've completely broken all hormonal balance and have no idea what to do next. I'm going to try to make an appt at a sleep clinic.

Has anybody out there gotten things this broken and found a way to get back on track?

0b3df8bb8986a115a99d6a9fc8fac037

on November 12, 2014
at 12:11 AM

My husband had knee replacement 5 weeks ago and has had a terrible time sleeping.  He hasn't slept for the last 72 hours.  He too has tried everything.  Going to the Orthopedic doc tomorrow.  Maybe he will have some suggestions.  

085aae8ad22c92b7f6813ed994d2b40f

(5)

on July 27, 2012
at 02:10 PM

@Crowlover would you have concerns about taking 15mg of time-released melatonin every night for a prolonged period? If I do that, I'm sleeping 5-6 hours per night in a few chunks. That seems to be the only thing that helps me fall asleep (also trying 5HTP, GABA and Magnesium (Natural Calm) but haven't noticed much from any of them. I've tried taking less twice in the past week, and both times slept even more poorly. How I wish I could get a normal 8hrs on consecutive sleep like I used to! I'm also using the blue-blocking orange glasses at night but not sure they're doing much either.

4ef079c57d2140bba4dbf4e30240a645

(4413)

on July 22, 2012
at 12:11 AM

Good Joe. Yes, try a much higher dose like 15mg and if that doesn't work then go to 20mg. If you are still not sleeping and/or are still depressed and anxious try the others. Poor sleep can be such a vicious cycle. Use what you need to turn it around asap then see if you can get away with less. I take both 5htp and melatonin for mood and sleep issues and its been amazing. Good luck

085aae8ad22c92b7f6813ed994d2b40f

(5)

on July 21, 2012
at 09:02 PM

Thank you! I took 5mg extended release melatonin last night, and didn't really notice anything (hence stupidly taking 2 Vicodin after a few hours, which made everything far worse and probably wasted a week of withdrawal :( ). I definitely won't take the Vicodin or Ambien again, and I guess I'll try increasing the extended release melatonin. I also ordered some light-blocking glasses to wear at night to try to stimulate natural melatonin.

085aae8ad22c92b7f6813ed994d2b40f

(5)

on July 21, 2012
at 05:15 PM

Near Boston, MA, so not the best legal option, thanks

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2 Answers

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1
4ef079c57d2140bba4dbf4e30240a645

on July 21, 2012
at 07:58 PM

Sorry. This sounds very hard. Better times ahead so don't worry.

I agree with Matt. Get off the narcotics and Ambien. Narcotics are known to mess up sleep.

Get some 5htp ASAP and take it at night is my recommendation. It really helps. You may have vivid dreams for the first night or so, don't worry. Start with 100mg and work up as needed.

Also Thorne makes a Gaba that is very effective and crosses the blood brain barrier where other Gaba products do not. Its called PharmaGaba (phenibut) and it works. I know many people who take it for anxiety during the day. If its makes you tired then you have taken too much. Great product.
http://www.thorne.com/Products/Mood-Sleep-Support/prd~SP662.jsp

Additionally I suspect your cortisol level is high at night when it should be low.
You can test for this and its a very useful test anyway. Saliva is best - a four sample in a day test.

DiagnosTechs is probably the least expensive and they can handle this test it seems without messing it up like they do all others, in my vast experience with them over 20 years. I only recommend them for this test.
http://www.diagnostechs.com/Pages/AdrenalStressIndex.aspx

Also, how much melatonin are you taking (and Im glad to hear its the extended release form)? YOu might need a lot for a while to turn this around. 20mg of extended release.

Still, I bet you have too high cortisol in the evening. There are supps specifically for this. My daughter who is in grad school and has been very stressed takes them and they help. I can find the name and let you know if you want. Get the test is my recommendation and increase your melatonin.

085aae8ad22c92b7f6813ed994d2b40f

(5)

on July 21, 2012
at 09:02 PM

Thank you! I took 5mg extended release melatonin last night, and didn't really notice anything (hence stupidly taking 2 Vicodin after a few hours, which made everything far worse and probably wasted a week of withdrawal :( ). I definitely won't take the Vicodin or Ambien again, and I guess I'll try increasing the extended release melatonin. I also ordered some light-blocking glasses to wear at night to try to stimulate natural melatonin.

4ef079c57d2140bba4dbf4e30240a645

(4413)

on July 22, 2012
at 12:11 AM

Good Joe. Yes, try a much higher dose like 15mg and if that doesn't work then go to 20mg. If you are still not sleeping and/or are still depressed and anxious try the others. Poor sleep can be such a vicious cycle. Use what you need to turn it around asap then see if you can get away with less. I take both 5htp and melatonin for mood and sleep issues and its been amazing. Good luck

085aae8ad22c92b7f6813ed994d2b40f

(5)

on July 27, 2012
at 02:10 PM

@Crowlover would you have concerns about taking 15mg of time-released melatonin every night for a prolonged period? If I do that, I'm sleeping 5-6 hours per night in a few chunks. That seems to be the only thing that helps me fall asleep (also trying 5HTP, GABA and Magnesium (Natural Calm) but haven't noticed much from any of them. I've tried taking less twice in the past week, and both times slept even more poorly. How I wish I could get a normal 8hrs on consecutive sleep like I used to! I'm also using the blue-blocking orange glasses at night but not sure they're doing much either.

1
7f7069fc4d8d2456cec509d0f9e9bb34

(865)

on July 21, 2012
at 04:58 PM

Where are you? First of all, get of the drugs and use things like valerian an chammomile to settle down. If you are where it it legal/medicinal, oral marijuana is a great sleep aid. Have your wine as well.

085aae8ad22c92b7f6813ed994d2b40f

(5)

on July 21, 2012
at 05:15 PM

Near Boston, MA, so not the best legal option, thanks

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