Fighting insomnia with melatonin

Well... I am surely a hard-headed rascal sometimes. I've been struggling with sleep issues for a while. Even before my diagnosis with breast cancer. However, I will definitely say that going through the treatment for my cancer has increased my anxiety and made my insomnia worse. Some months ago, my oncologist expressed displeasure that I was still taking the prescribed sleep aid ambien. (yes, he wrote me the prescription) I suppose that he was concerned that I was becoming dependent on them. I'm not sure that I would call it dependency... but I was thrilled to be able to sleep through the night and an added bonus was no nightmares!

Score! (by the way, PTSD is real -- my nightmares are attributed to post-traumatic stress disorder, sigh)

Anyway... after Dr. S basically told me that he didn't want to write me another prescription I felt that I would be okay with over the counter pills. (shrug) I'd used them in the past with very mixed results but I hoped that I could find a combination that worked for me this time.

Yikes! Let's just say that my body doesn't really care for the OTC sleep aids. Ambien was a god-send. Unisom (and others like it) felt like they came straight from the devil himself. The beauty of Ambien was that I could take it, fall asleep within 30 minutes and wake up feeling fine and refreshed. I would experience a restful night's sleep and that was the goal. OTC's on the other hand, yuck. None of the above. I would regularly over-sleep. It could take as long as 2 hours before the pills kicked in. And... when I did wake up, I would likely be groggy for hours. Really not a good look at all. But I was trying to figure things out... because I knew if I went back to Dr. S to ask for more Ambien, it was going to be a challenging conversation.

Sigh. I'll be honest, I tried a lot of things. Including taking Nyquil -- yep, the cold medicine -- just to get some sleep. Nyquil sleep isn't bad at all and didn't have the same grogginess problem that the generic pills had. However, I got creeped out by the notion of taking more medicine than I needed just to get some sleep.

I tried tea. I tried taking a warm bath. I didn't try warm milk but that's because milk upsets my stomach and that really would have interrupted my sleep. I tried a lot of things that people suggested. (laughs) I'm giggling now but for months I was struggling. And then I gave up on taking anything. Just said eff it ('scuse my language) and decided to just let my body do what it wanted to. It worked because my schedule was different and I could sleep late if I needed to. However, it wasn't a great plan because my body really was having difficulty calming down and getting good rest.

Well, one thing I didn't try that I had heard worked was melatonin. I didn't believe it would work honestly. I don't have a lot of faith in herbal supplements. Most of the time, they just don't do for me what they do for others. (shrug) But finally, a couple of weeks ago I remembered to pick up some melatonin while I was at the drugstore. And I crossed my fingers that I hadn't (once again) added more crap to my "breast cancer graveyard of useless stuff that I'll never use"...

It took a few tries to get to a dosage that worked for me. But, it WORKS. In fact, the melatonin got my body back to a normal sleep pattern and I don't have to take it every day, like I had to take my Ambien every day (though, I looked forward to my Ambien sleep in a major way). I take it every few days or so... when I realize that I'm off in my sleep pattern (like tonight) and then I'm right side up soon enough.

In fact, I'm so sleepy typing this post that I can't even believe that I haven't conked out yet. (laughs)

So, if you're experiencing sleep issues... try some melatonin. I'm a witness that this stuff is the truth. Now, I'm looking for something to help me with these night sweats...

Insomnia... still

My insomnia is back -- or maybe it never went away. I've been trying to go without my sleeping pills but its not working. I'm going to have to give in soon and refill my prescription (or get some over the counter pills) because I have been up consistently until the early morning hours for weeks now. I end up getting sleep thru cat naps during the day... but its difficult to function when I'm awake and the rest of the world is asleep.

I cannot blame chemotherapy or any other part of my breast cancer treatment. I am no longer in treatment and yet... my sleepless nights go on and on. Seems like there is no end in sight. As I keep forcing myself to focus on more holistic and natural ways to heal and move on with my life, this insomnia deal is really bugging me. Before breast cancer, I was struggling with over the counter sleeping aids... with pretty miserable results. Over-the-counter sleeping pills take forever to kick in and make me sleepy and then are super difficult to shake off when its time to get up in the morning.

Between me and you... Nyquil was a good help to get to sleep (ssshhhh!) but I worried that taking all of that medicine was just too much. All I wanted to do was sleep. So, when I mentioned to my oncologist that I was having difficulty sleeping while I was in treatment, he prescribed Ambien for me. MANNNNNN... that was the best sleep ever! Well, the second best sleep ever. The absolutely best sleep ever is whatever they give you in the hospital when you're having surgery. I have no idea what type of anesthesia that is but it is amazing.

At any rate... I've been taking Ambien for awhile now and the last time I saw my oncologist he seemed disturbed that I was still taking the Ambien. He wanted me to find other ways to get to sleep. So, now, months later... I'm trying to figure out ways to get to sleep without using some sort of pill to get me there. Needless to say... weeks of sleepless nights are showing me that I need to work harder. Or give up and just go back to over the counter pills.

Suggestions are welcome...

Insomnia and night sweats... oh my!

Sleep has not been my friend for a long time. Even before my cancer diagnosis, I didn't sleep that well... but I had no idea that it could actually get worse! Lawd... I want to sleep. I want to go to sleep like normal folks and not sweat all night (or cough all night thanks to my summer cold).

As it turns out (surprise, surprise) insomnia is a common side effect of breast cancer treatment and often continues well after treatment ends. I've been taking Ambien off and on since my diagnosis... but since I've been sucking down cold medicine for two weeks, I've been wary about taking Ambien on top of the Nyquil. Doesn't sound like a good recipe to me.

Nyquil doesn't make me sleepy.  But it contains my cough and clears my sinuses... so for that I'm thrilled. Basically, I've traded sleep for being able to breath easily and not cough all night. I can't seem to do much about the night sweats. (shrug) I just keep the fan blowing on me constantly and hope for the best.

I've tried tea, silence, soothing music... sigh. Nothing's working. So, I guess until this cold is gone, sleep will escape me. Here's a funny... "younger pre-menopausal women who are thrown into menopaus because of their breast cancer treatment are more likely to experience insomnia..."

Sigh. Is there ANYTHING associated with breast cancer that I'm not likely to experience thanks to my youth (relative though it may be). Geez... If you see me on the street (or more likely on-line) and I'm nonresponsive... ignore that. I'm just sleepy.

Have I mentioned lately that hot flashes are evil?

Well... I think they are evil. Every doggone night I look forward to interrupted sleep (assuming my eyes actually think about closing without a sleep aid)... waking up drenched in sweat is not my idea of sexy nor fun. But it is my night-time reality.

Last night I took two advil pm pills so that I could sleep. [I finished my prescription of ambien a couple of weeks ago and am now relying on over-the-counter sleep aids to get me through the night.] Two hours later, I was still wide awake and wanting to be asleep, so I popped two more.

Yeah.  I know what you're thinking. "She's really not too bright, huh?" (laughs)

So no... I wasn't too surprised when I had difficulty waking up Sunday morning. I woke up really late and was very groggy. But I knew that having that much sleep aid in my system would leave me groggy and since I really didn't have anything critical to do, I was okay with it. However, as the day ended and I began to mentally prepare for the work week, I realized that I couldn't (or shouldn't) take anymore sleep aids because I couldn't afford to oversleep and be late for work. .

I decided to take a chance that my body would relax appropriately and allow me to sleep at a decent hour. Of course, I did not add in the factor of the night sweats... and now I'm screwed.

Currently it is the middle of the night -- around 2:30 a.m. -- I have to wake up early (really really early) because I move slowly and it takes me forever to get ready for work now. Its too late to hope for sleep. What little rest I could have had has been interrupted several times with night sweats. I've changed my pajamas -- slipping out of the satin red pjs and into a ratty old cotton t-shirt -- and I wish I could turn back time so I could get some sleep.

I just had to let you know ... in case you forgot or weren't paying attention -- HOT FLASHES & NIGHT SWEATS have to be the devil's product. What's really crazy is that the heat isn't even consistent. You can be going along just fine, feeling comfortable and relaxed and then wooosh! Sweat is pooling on your back, your face is dripping and your hair is becoming saturated. Since I now keep a standing fan going in my bedroom all the time... I get up and adjust the fan's output and get back in the bed. A few moments later... I'm cold. I've got wet, cold clothes sticking to me... and the breeze from the fan is making me shiver.

At that point... I do the unthinkable.. and turn on my electric blanket. (laughs)  Ten minutes later... I'm yanking it off and turning my body so that the fan is hitting me dead center.

These stupid shenanigans happen all night long. (laughs)

If I take my sleeping pill at an appropriate time, I'm good. Unfortunately over-the-counter medication isn't as precise as prescriptions... and sometimes it takes hours before they kick in.

Every night is an adventure.

Did I pick the right time to take my pills? Is the fan up high enough? Is the blanket on low enough? And so on.

Tonight, I didn't make the right decision. Which means that tomorrow will be a very long day at work. I don't know if I will sleep at all tonight.

I see Starbucks in my future...

Mood swings as side effects... who woulda thunk it?

The other night I was up surfing the internet and I came across an article that connected mood swings and depression with Tamoxifen.  If you've been following the blog for awhile, you've probably noticed a lot of posts lately about my depression fears and my crying spells. It never occurred to me that any of this emotional stuff could be a side effect of my medication. I honestly thought that it was part of the baggage that comes with battling breast cancer. It is... but I think in my case, there's something more.

I've noticed that when I talk with other breast cancer patients and survivors... they seem to be more balanced than I am. Women who have battled cancer numerous times, have a smile on their face and a pep in their step that I simply do not have. That bothers me. Why aren't I more upbeat or at minimum more balanced about this ordeal? Why do I cry just about everytime someone says breast cancer out loud to me? In my head, I don't feel that I should cry...but for some reason, I do.


(more after the jump... click on the READ MORE link)


For example... yesterday I received an award for being a breast cancer "shero" and in all of my preparations for the acceptance speech, I didn't prepare for tears. Yet, when I got to the podium... I was a bucket of emotion and tears just kept streaming down my face. That wasn't my intention but (once again), it was what happened. Meanwhile, later in the day, several breast cancer survivors came up to me to talk and they all were so very composed, so very calm about their journey with breast cancer.

Why isn't that me? I had been told by many that time would make it better...but it doesn't seem to be working that way actually.

I've been telling myself (and others) that I'm just a cry-baby. But I will be calling my oncologist on Monday to discuss the possibilities of the Tamoxifen causing side effects that are playing with my emotions. When I think about all the ways that I'm not feeling quite myself... I see that there is a pattern that I have to address.

A few of the Tamoxifen side effects include:

• hot flashes
• low sex drive
• mood swings
• nausea
• headaches
• weight gain

Interestingly enough, a few days before I read the article linking depression and Tamoxifen, I read a few articles about the use of anti-depressants with Tamoxifen. To summarize... if I choose to take anti-depressants (assuming that I need them), I have to be quite careful which pills I take because some anti-depressants reduce the effectiveness of Tamoxifen. (geez!) Basically, I am dealing with occasional headaches, serious mood swings, weight gain, some nausea and hot flashes.

Compare those symptoms with some of the symptoms of depression:

• difficulty concentrating, remembering details, and making decisions
• fatigue and decreased energy
• feelings of guilt, worthlessness, and/or helplessness
• feelings of hopelessness and/or pessimism
• insomnia, early-morning wakefulness, or excessive sleeping
• irritability, restlessness
• loss of interest in activities or hobbies once pleasurable, including sex
• overeating or appetite loss
• persistent aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment
• persistent sad, anxious, or "empty" feelings
• thoughts of suicide, suicide attempts

I have quite a few of these symptoms as well... so, now I'm concerned. Calm, not scared... but definitely concerned. I hope to know something in the next few days...if nothing more than either there's something to be concerned about or there's nothing to be concerned about. I will keep you posted about what I learn. The way that I shift from laughing to crying... and vice versa has begun to concern me. I may have noticed it sooner if I didn't spend so much time alone. But, a talk with the doctor(s) is definitely in order.

My insomnia has gotten so bad that I have to double my ambien dose just to sleep more than 20 minutes. And without it, I do not sleep. Period. Its a little unsettling. And the other symptom that is beginning to really concern me is my eating habits. I have gotten to a point where I often forget to eat. Like today. Its almost midnight, I haven't eaten a thing all day. As soon as I finish this post, I'm going to eat. But for someone who likes food as much as I do... not eating for an entire day -- for no reason -- just isn't normal. (I feel scrambled eggs and maybe a bagel in my immediate future) This all just tells me that even when you're out of the phase of "active" treatment for breast cancer, you have to remain focused and diligent about taking care of your entire self. I've been so focused on my physical healing and scars that I was diminishing the possibility of having emotional scars that needed attention as well. I won't continue to make that mistake.