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Insomnia and cfs
Suffering from chronic fatigue and insomnis since last 1 year. My doctor has given me zolpidem 5 mg and melatonin 3 mg for insomnia.
With this i can fall a sleep but staying a sleep is still very very difficult. Hardly get 3-4 hrs sleep.
So next day too much drowsiness and more fatigue.
Cant increse melatonin dose as it is causing me bodypain and leg pain.
What to do for staying a sleep.
I am already doing yoga and meditation and avoiding screen time.
Answers (5)
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It seems you are experiencing sleep-maintenance insomnia (difficulty staying asleep) despite medications. Zolpidem mainly helps with sleep initiation, but may not always maintain sleep for the whole night. Since melatonin is giving you side effects, increasing its dose is not advisable.
Some points to consider:
• Avoid alcohol, nicotine, and caffeine (especially after evening).
• Maintain a fixed sleep and wake time, even on weekends.
• Avoid lying in bed awake for long; if you wake up and can’t sleep within 20 minutes, get up, do something relaxing (dim light reading, relaxation exercise), and return to bed when sleepy.
• Ensure your bedroom is dark, cool, and quiet.
• Since you are already doing yoga, meditation, and screen restriction, you are on the right track.
Next Steps
Discuss with your psychiatrist/physician about other options which are more effective for sleep maintenance.
• A proper evaluation for causes of chronic fatigue and insomnia is important—thyroid function, vitamin B12, vitamin D, anemia, sleep apnea, or mood/anxiety disorders should be ruled out.
• Consider Cognitive Behavioral Therapy for Insomnia (CBT-I), which has strong long-term benefits and reduces reliance on medications.
Health Tips
Do not increase medication doses on your own without medical supervision.
• Long-term use of zolpidem carries a risk of dependence and next-day drowsiness, so it should be reviewed regularly.
• If you notice snoring, choking at night, or excessive daytime sleepiness, please get evaluated for sleep apnea.
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Dr. Seujee Goswami
Adolescent And Child Psychiatrist
13 yrs exp
Bangalore
You are able to fall asleep with zolpidem and melatonin, but waking up frequently and sleeping only 3–4 hours suggests sleep-maintenance insomnia. This is common and may need a different approach than just sleep-inducing medicines. Long-term reliance on sleeping tablets alone is often not effective.
Next Steps
• Discuss with your doctor about reviewing current treatment. Sometimes medicines targeting sleep maintenance (rather than just sleep initiation) are considered.
• Get evaluated for possible causes of poor sleep such as sleep apnea, thyroid imbalance, mood/anxiety disorders, vitamin deficiency, or restless legs syndrome.
• Keep a sleep diary for 1–2 weeks (time to bed, wake-ups, naps, energy, mood) to share with your doctor.
• Do not change or increase doses on your own—especially zolpidem, as it can cause dependence.
Health Tips
• Fix a regular sleep–wake schedule, even on weekends.
• Avoid alcohol, caffeine, and heavy meals close to bedtime.
• Keep your room dark and cool, use the bed only for sleep.
• Gentle exercise (morning walk, stretching) may improve nighttime sleep.
• If awake in bed >20 minutes, get up, do something calming, and return only when sleepy.
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