Post natal insomnia - help and support needed

[Force12]

I've been suffering from insomnia on and off since my daughter was born 10 months ago. My issue is early morning wakening, 5am on a good day, 2 or 3am on a bad day and I'm unable to go back to sleep. DD sleeps through the night now, fortunately. On the occasion when she does wake I struggle to fall back asleep.

I'm at the end of my tether having tried non medical approaches including sleep hygiene, cbt, acupuncture, hypnotherapy.

GP gave me a prescription for amitriptyline 50mg but the sedation affect wore off after a couple of weeks and even after trying a higher dose of 75mg last night I still woke about 3.30am.

Is this unusual? Everything I had read about amitriptyline suggested the affect wouldn't wear off... so I am feeling very disappointed about that as I had slept well on it for about a week.

I'm going back to the GP on Monday.

Does anyone have any advice about what I should be asking for? Any other medications that might help?

I'm feeling so low about this and at the end of my tether after months of insomnia (albeit on and off).

Thanks in advance

[Jemimapuddleduk]

So sorry to hear you are struggling. I had postnatal insomnia which triggered pnd. I took dosulepin which is a sedating antidepressant like amitryptaline. I did find that it took a few weeks to notice improvement in sleep and mood and that I needed to go from 25 to 50 to 75 then 100 mg over several months. I stayed on the 100mg dose for around 6 months and then started reducing again with minimal side effects. I started them in March 2015 and I am still on 25mg every other night as abit scared of coming off them totally! They feel like my security blanket and we have had a very tough year as a family. I also had CBT which really helped too.

[Flanderspigeonmurderer]

I was prescribed zopiclone when I had PND and had just about stopped sleeping. It was only for about two months, a month of that was weaning down to stop. It helped get me back in to a good sleep cycle.

[Force12]

Thank you both for replying. Jemima I have read your posts from last year which really resonated with me. I am glad that you are making a full recovery now. After my experience with the amitriptyline (which worked for 10 days and then stopped) I am a little reluctant to try something else as I'm scared it will happen again.

[LHReturns]

Force, I had exactly the same thing after my son was born in 2014.

I had post natal anxiety and insomnia which developed to PND. I recall having many a conversation with Jemima when she was going through this. I really identified with her experience.

For me, after months of fannying about with natural sleep therapies, and amitriptyline also didn't work for me - finally it was it was a proper SSRI that sorted me out (all of the issues that had festered by then!). My insomnia was definitely linked to anxiety and eventually depression, so that was what needed addressing. Happened to be prescribed escitalopram, but SSRIs are mostly the same. Early waking is closely linked to depression.

As Jemima says it takes some weeks to positively impact sleep, but once it did I slept normally and I never needed to take a sleeping tablet again. Having let it go on for 10 months (surviving on a few hours sleep each night, sometimes none) I would say it took a year for me to feel fully over chronic sleep deprivation. I would never go through it again, and continue to take my medication, even though I am pregnant again now.

Jemima, it is so nice to connect with you on a thread again. I have read many of your threads this year and I hope things are turning a corner for your lovely family. You will be able to face anything in life once this is behind you.

[LHReturns]

Just reread my post - OP I am not saying you are depressed at all. That was the root of my insomnia, probably not yours. Just be careful as Jemima and I both found it wasn't a long jump from long term insomnia to deeper mental health issues.

[Force12]

Thanks for your response LH.

It is a question which I keep asking myself.... am I depressed? Is this the cause of the not sleeping??

The thing is when I have a good night I feel great. But a low day inevitably follows a bad night. I guess it's a question of chicken and the egg.

I am planning to go back to have some hypnotherapy as that sorted me out after a particularly bad spell in may.

If that doesn't work I will go back to the Gp. I do worry about insomnia being a potential side effect of an ssri. How did you find it?

Thanks for your support

[LHReturns]

OP I totally understand.

I have always been told (and always experienced) that if insomnia is one of your symptoms of depression, then it will be cured (after early side effects wear off) by a SSRI. I originally took my SSRI to cure my insomnia (as that bothered me more the anxiety and depression) and it worked 100%.

Insomnia can be a problem for some people that didn't have insomnia to start with. Has always cured mine (I have had insomnia issues for many years - well before I had a child).

I don't want to drug push you as SSRIs are a fairly heavy way to address this. I just wanted you to know your 'big options' for if you decide the need arises down the road. I couldn't face one more minute lying awake at night all alone - so I hit it with a dump truck.

Good luck!

[couchtofivek]

I had terrible post natal insomnia.
It turned out my hormones had gone totally wacko. Oestrogen that's too low and/or fluctuating causes insomnia.
Are you using any hormonal contraception? Or breastfeeding?
Is there a cyclical pattern to it - around ovulation and premenstrually?
Unfortunately for me SSRIs made my insomnia much worse. It seems they either make you sleepy or wired.

[LifeBeginsNow]

I'm struggling too but mine is related to pain. I've been prescribed amiltriptaline because it's a pain suppressor but after giving it the recommended 6 weeks to work, I saw no benefit.

I had a last attempt and changed the time I take it. Instead of as I go to bed, I take it at 8pm. I can feel the effects as I get closer to bedtime and I'm usually falling asleep on the sofa. It might be worth a try to see if this small change helps.

[EmmaJane26]

Hi there, I so feel for you. I had exactly the same as LHReturns. I was prescribed Sertaline - which addressed the anxiety and subsequently the insomnia. It took about 3 months for me to stop worrying about sleep and once I stopped worrying my sleep came back. The scars took a little longer to heal but I can now say my sleep is totally back to normal - better than before in fact - as I could sleep forever now - and I also have the tools to deal with the odd bad night if I am worrying about something. It will be sorted with the right support - I just wish someone had told me that at the time as it felt like the end of the world when I was going through it xx

[EmmaJane26]

Ps I came off Sertaline after about 9 months and am still totally fine.....indeed happier than before. I should add I had never had any mental health issues before giving birth or since - crazy what having these gorgeous babies does to you! X

[Force12]

Thank you for sharing. Good food for thought x