Q: I am 63 years old, height is 5.8 and weight is 63 kg. I am a non-smoker and a vegetarian. I have systemic hypertension well under control 120/80 with Tenoric 25 mg and Repace AF. Under advice for hypertension and sleep disturbance, taking Larpose 2 mg for the last 20 years (started with 1 mg). Tried to switch over to alprozalom with out success and tried all tricks to discontinue the medication for sleep but with out success. I take a nap for 20 min after lunch. I go to bed around 10.30 pm and hear music or listen to news. I am able to sleep by around 11.30 PM without any problem but invariably wake up at 4 am inspite of the medication Larpose. On some days I could fall back to sleep and on other days keep awake relaxed till 6.30 am and sleep till 7.15 am but do not feel fresh in the morning. Is there any solution to this problem?

A:The problem which you have is largely sleep maintenance Insomnia. Since you do not have a significant anxiety component, I don't see why you should continue on Larpose. However, you have got addicted to it over the years. Try following steps:- 1. Stop Larpose. Instead take Zolfresh 10 mg at bed time daily to start with. Also take Tab. Eternex or Meloset (Melatinin 3 mg one tablet along with Zolfresh). Melatinin is like a vitamin and sold over the counter in US and now easily available here. The drugs should be tapered off over 4-6 weeks. 2. Observe sleep hygiene precautions i.e. no tea or coffee after 5:00 pm, regular walk in the evening daily. Avoid TV or loud music once you switch off the light at bedtime, don't apply your mind to planning or to the day's events etc. once you retire to bed. Same applies if you wake up in the middle of the night or early morning. You could also try switching your bed room for a few days to break the monotony.