Hypomania and sleep + medfail

[untonuggan]

Hi all! Just found this community tonight. I was wondering if anyone here has had experience with (1) hypomania and sleep; (2) migraine medication and sleep.

I have bipolar II (formerly known as manic-depressive syndrome), which means that when my mood fluctuates it's usually towards the "depressed" end of the spectrum. When I do have "mania", it's a slightly-less-high form known as hypomania. So if I were to go on a hypomanic spending spree, it would be more like $100 rather than a manic $1,000. I haven't had a hypomanic episode for years, but I'm getting the royal treatment now. Working with doctor on it, but of course it is that lovely vicious cycle: the more hypomanic you are, the harder it is to sleep; the less you sleep, the more hypomanic you get. So I get in bed and my mind starts going-going-going with a "flight of ideas." I normally use a mood light in the mornings, but I can't while hypomanic (as it can make the hypomania worse). Does anyone else have experience with hypomania/mania and sleep?

Second comes the lovely paradox of my migraine medication. The only thing I've had much luck with is Midrin, which is a compound of a variety of substances...including caffeine. (Caffeine causes your blood vessels to constrict, reducing headache pain.) Problem: if I get a migraine in the evening, then I will most likely be awake because of the Midrin. Of course, I could try to sleep off the headache, but I usually like to nip it in the bud...

Hap.

Comments

[revena]

My experience with hypomania and sleep is mostly that Ambien is kind of awesome. I've had some success with taking soothing baths and trying to set bedtime routines and stuff, but when I'm on the more manic end of my personal spectrum it's pretty much medicated sleep or no sleep, for me! :(

[untonuggan]

Yeah, I may end up talking to my doctor about Ambien...or just try taking melatonin supplements first.

[blueraccoon]

First note, slightly off topic, but how old is your supply of Midrin? I've had a scrip for it that my local pharmacy wasn't able to fill because the medication was discontinued? I don't know if that was one supplier or if it's in general.

On topic: I have anxiety and depression (I'm not bipolar exactly, but I go between anxious and depressed) and have tons of experience with being too keyed up to sleep. I've used a variety of options to keep me sleeping. The thing I have found that works best for me is alprazolam, aka Xanax, which is a benzodiazepene (tranq). Unfortunately, Xanax is massively addictive, if you use too much of it or use it too regularly, but it may be something you want to discuss with your pdoc or whoever's treating you. Any of the benzos will work really well to calm you down and send you off to lala-land. The trick with all of them is that a, they're all addicting to various degrees, and b, they don't give you very good quality sleep--they compress you REM cycle, but that's the trade-off you get.

Other sedating drgs include trazodone (puts most people to sleep like a log; I've never had luck, but I'm weird), seroquel (will make you sleep like the dead but is expensive as it's not a generic, so check with your insurance plan), and others I can't think of right now but if you give me some time, I might be able to come up with.

I also get chronic migraines, and at this point I'm taking narcotics for them. I don't know what you've tried for migraine medication, but your general options are triptans like Imitrex or Maxalt, or NSAIDs like Toradol (available as an injectible in most urgent care centers or ERs, but I've been told it comes in pill form), or narcotics like Dilaudid, Percocet, etc. I used to take Fioricet but I had the same problem as you; it made me wired, and the last time I asked for it I was told it was also being discontinued or no longer used, my guess is due to the barbituate in it, but I don't know.

The best luck I have these days is when I get a headache that looks like it'll turn into a migraine, I take oxycodone and lie down with a cold eye mask (I have one that's full of microbeads and I put in the freezer; it seriously works better than ibuprofen half the time) and attempt to coax it back into submission with about an hour of quiet time. I don't know if you've tried ice packs for migraine, or in combination with medication, but it's a pretty cheap remedy that does seem to at least help.

I think I've bored you enough, but if you've got any other questions or whatever, hit me up :)

[untonuggan]

I got the midrin because my pharmacy is wonderful! The manufacturer (and everyone else) has stopped making it, but my (local) pharmacy is also licensed to compound medications. (Think, making pills more friendly for small children...or changing doses.) So after a couple of months they found the ingredients and compounded midrin for me. After insurance (thank goodness for insurance!) it was about $20 for 30 pills.

Ahem, yes. Thanks for the info about various sleep medications. ^_^ Will perhaps read through it more when I can actually concentrate...

[rydra_wong]

Wow, you have a compounding pharmacy! *is jealous*

As a practical point, have you tried a version of the midrin without caffeine? Or is the caffeine essential for it to work for you?

[untonuggan]

Hm, that's a good point...since they *do* mix it specially for me anyway. I should ask my doctor/pharmacist about making a non-caffeinated version...

[sciarra]

Hi! I'm BP II as well, with a side of migraines. I use imitrex quite successfully, but for sleep, I've had to go with seroquel (when it's really bad) or ambien (when it's only moderate).

Seroquel will also help snap the manic cycle, although it really makes you sleepy. Like you've been hit by a ten-ton truck. But I take half a 25 mg and it will let me sleep like nobody's business and still wake up in the morning.

Hope this helps.