Question
hello Dr. Karel.
i'm a 24 years old married girl. actually i used to have dysmenorhea. once i got married (8 months ago) i suffered dysparunia. i discovered that i have moderate endometriosis laparoscopically and they were removed. after that, i had to take subcutaneous GnRH agonist for 4 months (once per month) to continue my treatment. since i started these injections i had difficulties in sleeping that i can not sleep wothout Panadol Night or Adol PM to get into sleep.
you cann't imagine how i'm suffering doctor. sometimes i'm awake for 48 hrs continuousely also without ability getting to sleep. i've searched whether it is a side effect of the GnRH agonist but i didn't find such a side effect written at all. i have no strsses that make me not to sleep that way.
please give me your advise how i can get into sleep comfortablly and without the panadol night or adol PM..
THANK YOU,,,
Answer
First of all i am not a doctor. Im a respiratory therapist with a sleeping disorder but quite knowledgeable on sleep. I think the drugs you take at night are panadol pm and advil pm. Any sleep drug if you miss taking it will cause even worse insomnia and after awhile you constantly need more for the same effect. This is why these drugs should be used no more than 7 days. I first suggest you tell your md if the panadol and the advil are prescription as in the states here they are over the counter. What you must do first is gradually decrease the dose over time. For example for 7 days cut off 1/4 of the pill, stay on 3/4 of the pill, then the following week cut down to 1/2 stay another 7 days on 1/2 and then cut off another 1/2 and stay on just 1/4 of the pill for 7 days until you are completely off. As far as the other meds for your endeometriosis, its possible its a side affect, everyone reacts differently to drugs. But what I can tell you is that hormones play a great demand on sleep. For example I who suffer from narcolepsy, too much sleep since im in menopause now have insomnia at night. But I dont take anything for it. However you can try these tips see below. I would speak to my gyn doctor if this persist about the hormones and sleep, but first try the tips above and below. But any of these meds you should tell your doctor first that you are planning to wean off the sleep meds if he gave you them. Just off the sleep meds, any other meds you need for the endometrious that you must speak to the doctor as Im not familiar with them, but do know beyond a shadow of a doubt that anytime a woman has hormone trouble like yourself sleep is definitely affected. My guess is also that after the healing of your laparoscopicy and the endometriosis is under control so will the sleeplessness. Perhaps knowing that can ease your mind. Try the tips below. Good luck.
You must go to bed and awaken the same time each day regardless of little or much
sleep you got the night before. This starts to reset your sleep clock
3 hours before bedtime stay away from
tea, coffee, caffeine, caramel colored soda like, coke,pepsi, ginger ale,
or root beer, chocolate and exercise .All these make for restless sleep.Do the following religiously for 4-6 weeks although some have seen changes in as little as 2 weeks.
Make sure room is quiet and dark. When you go to bed if you start to
twist and turn or if you wake up in the middle of the night and cant
go back to sleep, twist and turn for only 20 minutes, then get up, go
into a different room and read a book or magazine only! No computer!
When you start to doze immediately go back into the bedroom.This retrains
the brain into thinking that the bedroom is for restful sleep only. Do
this as many times as you awaken thru the night, it will lesson.
30 minutes before bedtime take a hot bath and immerse hands under the
water.Latest research states that the palms of the hand when immersed
in hot water send signals to the brain to relax. 15 minutes before bedtime\
drink a glass of warm milk. Milk when heated contains tryptophan, a
natural amino acid sleep inducer. Go to sleepnet.com click on disorders
insomnia for more tips. Feel free to email again , Karel
