I have severe Insomnia. I know that my sleep disorder is caused by several mitigating factors that come together. 1) I suffer from shift related sleep disorder, in that i work 12 hr Nightshifts (7p-7a) 3-4 nights/week. 2) I have severe Tinnitus, so when it becomes quiet and time for sleep, I am left with screaming high pitched sound bilaterally. 3) I suffer from severe sensorineural hearing loss. When i take my Hearing Aids off at bedtime, I am functionally Deaf. Not being able to hear anything (my hearing loss is fairly recent, like only 2 yrs) causes some anxiety since i know i will not hear anything like a storm, someone banging on my door, tornado sirens, or someone breaking into my home.

I have a wonderful Primary Care Doc... only see him every 6 mos or if I need anything in between. I used to take 50mg Trazadone, along with 3mg Lunesta for sleep. Then I needed to upgrade to 100mg Trazadone after about 8 mos of use, since the body gets used to things and doses. About 8 months ago, we d/c'd the Trazadone, and started 0.5mg Xanax. It was not quite enough, so now I take 1mg Xanax along with my 3mg Lunesta to go to sleep and it works fairly well. I dont seem to manage more than 6 hrs sleep though.

Wondering if it's time to re-examine the Lunesta? Ambien is NOT an option for me. And anything less than a hypnotic class med will probably not be sufficient.

Thanks in advance for any thoughts...