Who to ask about insomnia, psychologist, or doctor?

Post Reply New Topic

I'm an adult (18 years) and I have intermittent insomnia. Some nights I can sleep fine. Other nights I am up at 1.30am. I can generally tell within 20 minutes of going to bed whether or not I will fall asleep. And it doesn't change no matter how long I lay there. The best thing I can do for myself is get up and read or do something quietly for 30 minutes or so, and then go back to bed and try again. I have some over the counter pills. They help a bit, but not always.

I was on melatonin for a little while as a kid. I want to know is it also the go to medication for adults with autism related insomnia, or is it just the thing they give kids because they're too young for anything else? It isn't funded in my country, and I'm not sure if my doctor would even give it to me. Has anyone had melatonin as an adult? Has it worked? Who prescribed it?

In the U.S., I believe melatonin is available over-the-counter, that is, you can buy it and you don't need a prescription.

As to the question in your title, I think you could start with either doctor or psychologist. Insomnia can be quite a difficult and complex nut to crack. On the other hand, it could be that learning about "sleep hygiene" is all you really need. I do encourage you to work with either of these kinds of professionals because sometimes in trying to figure out things ourselves, we have trouble seeing our own blind spots, and other times, we give up before giving something a fair trial. Good luck.

We give melatonin at the hospital all of the time. The NP on call doesn't like giving sleeping pills because they are addictive and ambien doesn't work well in geriatric patients - they tend to go nuts. Melatonin is a natural hormone that the body makes for sleep and it does other things like regulating a woman's menstrual cycle. They probably gave it to you as a kid because it is safer than sleeping pills. Dosage of melatonin we give is 3-6 mg.

Imo, a psychiatrist would be best to talk to and for you probably one that is smart in Asperger. I went to a psychiatrist for sleep problems and I also had anxiety problems. He was able to try different things to see what worked best because sometimes a sleeping pill helps, sometimes anxiety meds help or even an antidepressant can be used for sleep purposes. I also tried an anti-seizure med which worked for me for a couple years just on its own. They prefer to find something that helps you that is non-addictive, of course. And I believe that it is easier to get an appointment with a psychiatrist so tweeking of meds can be done quicker. A psychiatrist will also know all the latest drugs for sleep, anxiety and depression. They may send you also to a medical doctor for a checkup and labs just to make sure everything else is in working order first. So, maybe the right answer to your question was both.

Look up CBT for insomnia including articles about bluelight and sleep hygiene for free.

I have no idea how your drug system works in New Zealand.

Chamomile, passion flower (i like tinctures), lavender essential oil, even sleepytime tea works for light insomnia.

Melatonin is a hormone which is found otc in North America. You can build tolerance to it if you relied on it every night and your body would eventually down regulate its own production as nearly all hormones in your body are regulated by a negative feedback system but you wont run into those problems if you just have occassional insomnia.

I know zopiclone is available as a prescription in New Zealand which will knock out cold within 10 minutes and last for about 8 hours. It is closely related to benzodiazepenes and suffers from problems like rebound insomnia, dependence, and withdrawal, though not as bad as benzos. It also has addictive potential.

Nearly all sedating drugs affect your sleep architecture to some degree, usually in a negative way.

Cardio exercise in the day can help you sleep better at night.

Avoid using your electronic devices for 1 hour before bedtime as the blue light spectrum emitted from the devices can affect your sleep/wake cycle. Gradually dim your interior lighting at night and avoid using the fridge late at night before bed as the bright light can have the same negative effect.

Keep a regular sleep wake cycle regardless of what you have to do the next day and regardless if you have anywhere to go.

Expose yourself to preferably bright sunlight during the first half of the day, preferably upon waking to help keep your sleep/wake cycle in check. Your body's sleep/wake cycle is regulated by your body's internal clock which needs consistency and is influenced by light.

Also keep your room cool which promotes sleep.

Make your bed every day.

Remove all electronic devices from your bedroom if possible, preferably only using your bed for sleep and sex, nothing else. That way if the moment you enter your bedroom at night, your body/mind automatically clue in that it is time to sleep.

Avoid naps during the day.

Use black out curtains.

Avoid stimulating video games before bed as well as avoid stimulating/scary movies directly before bed. Avoid watching anything that would get you upset directly before bed like politics on tv as anger only aggravates insomnia.

If you are lying in bed worrying about what you have to do tomorrow tell yourself "f**k it, there is nothing you can do about tomorrow while lying in bed at 3 am in the morning". Set reminders on your phone for anything you have to remember the next day and forget about it.

Cover up any clocks, staring at a clock when you cant sleep will only make your insomnia worse, as well as the light from the device will negatively affect your sleep if the display is anything but red LEDs.

Use a bluelight filter on your devices in the evening when the sun sets.

Try using a source of white noise while you sleep, either an airconditioner or just an audio clip of white noise you find on the Internet and have it play in a loop. White noise is effective to drown out annoying sounds in your environment which would otherwise make it difficult for you to sleep or wake you up. I find white noise is effective for drowning out obssessive thoughts from OCD or other anxiety disorders. An idle mind afterall is a playground for anxiety of any kind. White noise occupies this vacancy.

There you go, saved you the cost of how many psychologist appointments which would only have garnered you likely half of these tips at best.

It depends on the source of the insomnia. You would have to determine the cause first, and a GP would likely be the first to exclude any obvious causes or purely physical causes. They would also be needed to refer you to an appropriate therapist if it was a psychological cause.
Many autistics have sleep deviances. I've had it my whole life and am on two types of sleeping aides to try and control it but it doesn't work. I've been on melatonin too, but it's a high dosage so prescription, and I think it does make some difference (but as I said, doesn't control it). The other is a benzo which is obviously less than ideal.
So I'd say pin the cause first before you start applying proverbial shattershot with all these home remedies, and know what you're dealing with before you continue down the right path to address the causes of your problems.