[Lev]

Dexamethasone-related sleep problems

by Lev on Fri Sep 26, 2014 11:55 am

A nice Friday to all of you ...

Usually I can sleep from I turn the light off till I want to wake up early in the morning, using my inner watch. Fine.

Tada! In comes dexamethasone.

From the first day, the nurses asked whether I want a sleeping aid, and I refused. I have never touched anything sedative, relaxing or anything like it (ok - good wine).

After 8 weeks of cyclophosphamide / Velcade / dexamethasone (CyBorD / VCD), I finally surrendered. I have a nice 5 meter (16 feet) high bedroom windows with a fine view of the Scandinavian sky ... but now I have counted most of the autumn stars.

I told the nurses and doctors:

- It has to be out of my body after 6 hours.
- I do not want to have any medical effect the day after.

They gave me 30 Imozop (zopiclone)

RESULT

1. Took 1, went to bed.
2. Slept from 22-6 (10 pm - 6 am), when my alarm sounded like something from another world trying to call me back (I usually wake 10 minutes before the alarm and never ever hear it).
3. It was good to sleep through the night.
4. But I could feel the drug for at least another 2-4 hours.

QUESTION

Does anyone know sleeping aid/pills that help you to sleep for lets say 5-6 hours and is out of the organism after at least 8 hours. It is OK if it's prescription-only. In Scandinavia, nearly everything has to be prescribed.

It is really important for me to have it out of the body after max 8 hours. If not, I will rather live with the sleeping problems.

Maybe sleeping aids are just not for me. Just now I'm considering trying a half tablet tonight (1/2 * 7.5 mg), or reading a good book or Netflix.

Best regards,

Lev

A little bit about Zimovane and Imovane

Drug abuse, dependence and withdrawal: Use of sedative/hypnotics agents like Imovane may lead to the development of physical and psychological dependence or abuse. Once physical dependence has developed, abrupt termination of treatment will be accompanied by withdrawal symptoms.

Just the medicine I want to start using: http://products.sanofi.ca/en/imovane.pdf

[Blackbird]

Re: Dexamethasone-related sleep problems

by Blackbird on Fri Sep 26, 2014 1:55 pm

Ambien (zolpidem) worked well for me. It is generally metabolized in about 4 hours, which was my experience. I would take the dex on Mondays and take a whole Ambien prior to going to bed and it worked well. On Tuesday and Wednesday, I would take a half of one, since the dex was starting to back off. By Thursday I didn't need anything to sleep.

I guess for some people Ambien can cause sleep walking with no recollection of it by the person taking it. I didn't experience this at all.

[Cheryl G]

Re: Dexamethasone-related sleep problems

by Cheryl G on Fri Sep 26, 2014 2:25 pm

Zopiclone is commonly used in Europe, I believe, because it's been available generically for quite a while, making it cheaper than branded drugs. However, it's half life is about 6 hours, and even longer in older people, so it's not surprising that you awake feeling groggy. I don't believe the drug was ever approved by the FDA for use in the U.S.

A related drug, Lunesta (eszopiclone), which has a similar half life to zopiclone, has been popular in the U.S. However, Ambien has been one of the most popular sleep aids in the U.S., not least because of its shorter (2-3 hour) half life.

If you really want a sleep aid that is in your system for just a short time, then a drug to consider is Sonata (zaleplon), with a half life of just 1-1.5 hours. It was popular in the U.S. a while back, but my impression is that it isn't all that popular any longer, perhaps because Ambien is fine for most people. I believe Sonata is available in many European countries, but probably under a different brand name.

[Multibilly]

Re: Dexamethasone-related sleep problems

by Multibilly on Fri Sep 26, 2014 2:41 pm

I am a big fan of Ambien. I use it to deal with jet lag issues when I travel overseas (which I do fairly often). I take it about 30 minutes before I want to go to bed and I wake up quite alert after 6 hours and feel perfectly normal.

[Chris M.]

Re: Dexamethasone-related sleep problems

by Chris M. on Fri Sep 26, 2014 9:33 pm

Hi,

My husband took Ambien on dex days, and it really helped! He originally used Benadryl (di­phen­hydramine), but that just wasn't strong enough to counteract the dex.

Best wishes,
Chris M.

[MattSchtick]

Re: Dexamethasone-related sleep problems

by MattSchtick on Fri Sep 26, 2014 10:57 pm

I took a rather different approach to dex-induced sleeplessness.

I was prescribed temazepam (Restoril, Normison) to combat the dex effect, but, like most people, I was very wary of developing a sleeping pill habit. So I never took them. I am in the fortunate position of being retired from work (and therefore the need to be fully alert the next day) so, rather than fight it, I just let the weekly dex cycle dictate my sleep patterns.

At the time I was playing through a brilliant but VERY long computer game called Mass Effect. So I would often just play long into the night until I felt tired enough to get a few hours sleep, and then would have an afternoon snooze the next day to make up for the hours lost the night before.

I was taking the dex at breakfast time as part of my CyBorD induction regime, but I was usually still buzzing at my normal bedtime, so quite often I just stayed up until 3 or 4 am. Strangely, the dex never interfered with my afternoon nap.

This solution is not going to work for everyone, but it certainly did for me, and after 12 weeks of induction I did not have to face up to quitting sleeping pills.

Andy

[Lev]

Re: Dexamethasone-related sleep problems

by Lev on Fri Sep 26, 2014 11:43 pm

Hi Andy, even though I go to work, a lot, I may end up following your path. It maybe make sure to sleep Friday and Saturday nights.

Dex Friday morning, sleeping pill Friday + Saturday. Dex Monday and maybe / maybe not one pill Monday night, going very early to bed.

Greetings

[Lev]

Re: Dexamethasone-related sleep problems

by Lev on Fri Sep 26, 2014 11:48 pm

Question: If I take dex, 40 mg, on the following cycle

Friday
Saturday
Monday
Tuesday

Friday
Saturday
Monday
Tuesday

will the level be high during the entire week, or should the sleep problems be expected to hit only on the day of intake?

And how is it when you end the cycle, no more rounds. How long time until the sleep-disturbance part of it can be expected to be over?

Greetings

[Castaway]

Re: Dexamethasone-related sleep problems

by Castaway on Sat Sep 27, 2014 10:04 am

Hi All, great discussion.

I was taking Revlimid / dex for my treatment plan. The Revlimid was 25 mg 21 days on with 7 days off. The dexamethasone is 40 mg once per week. I took the dex on Friday mornings with breakfast. I would usually not feel anything from the dex until after midnight for some reason. So I started taking it later in the morning and that helped. But could never get past around 3 am with sleep.

I have recently had my Revlimid taken away from my treatment plan due to a very bad rash and swelling issues. Just started Velcade with dexamethasone this week. Second Velcade subq injection this past Thursday. Don't know if it's the new mix of Velcade and dex, but I stayed up last night to watch some of the Ryder Cup which was around 10:30 p.m. or so. Figured I would fall off to sleep watching the TV, but didn't sleep at all. I did take a nap yesterday afternoon for about an hour, which is something I don't usually do.

I also try to stay away from sugar foods especially on dex day. i did have waffles with breakfast and used some regular syrup, which I thought was the sugar free stuff. I am having my next visit with my oncologist next Thursday. i am going to bring up the suggestions for Ambien.
I really don't want to add anymore drugs in my system, as some of you have pointed out, but I don't know what other options would be.

My wife and I used to drink "Sleepytime" tea. That worked very well when we wanted a good night's rest. The ingredients are spearmint, lemon grass, licorice, chamomile, and lemon. No green tea in the ingredients list. I will ask my doc about that also.

Thanks for all the good info.

Castaway

[Mike F]

Re: Dexamethasone-related sleep problems

by Mike F on Sat Sep 27, 2014 11:30 am

Medical cannabis is available here, and I found it to worked well for me.

I would take my dex right before going to bed on Tuesday night, which would allow me to get a pretty decent night's sleep before the effects kicked in.

On Wednesday night, I would smoke a small amount of marijuana, which would relax me and get me to fall asleep. I'd also have a small amount of an edible cannabis product - usually a couple of little pretzels or something like that - which would keep me asleep. That would get me 5 hours or so.

No need for anything to help me sleep by Thursday night.

While being rather fuzzy from the dex crash on Thursday and Friday, I didn't have too many problems working during that time.

Of course, this only works if you have a legal version available to you. It's also extremely important to understand the dosage information on the edibles and to start very conservatively. It's easy to take too much, and, while not dangerous to your health, it is an experience most people find very unpleasant.