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Inability to sleep at night

Q: I am 39 years old, working in a pharmaceutical company as manager for the past 5 years in the same position. My problem is I do not get sleep properly at night. When I lie awake for more than 1 hr, my heart beat increases and I feel like passing urine. This continues till I fall asleep. I tried Alprozolam 0.25 mg but stopped it because I may become addicted to it. Then I started taking Zolpidem 10 mg half tablet daily at night as per the doctors advise. In between I got sleep without the tablet also. The problem is after 15 days again I face similar situation. My question is 1. What is the permanent remedy for this? 2. Is there any harm in taking Zolpidem tablets for a long period?

A:You have symptoms of anxiety at night which are responding to drugs partially. I presume that you do not have any symptoms during the day,including your occupational and psychosocial functioning. For a permanent remedy, we will have to find out the cause of your problem. A preliminary work up of your physical condition as well as a detailed psychological assessment is required. This includes your personality, lifestyle, relationships - familial, sexual, personal and professional; work pressures, unfulfilled ambitions and desires, achievements and frustrations etc. Your treatment may then include counselling, behaviour therapy or psychotherapy as well as medicines for a short while. There is no harm in taking Zolpidem daily on a short term basis. However,a healthier and permanent solution is treating the cause. You should consult a psychiatrist.

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