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 Post subject: sleep meds and insurance
PostPosted: Fri Sep 04, 2015 7:11 pm 
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I'm not sure if this is the right place for this post, but I want to put this question out there and maybe someone can help me understand. I've suffered with insomnia, before, during, and now after suboxone. Its been worse since I've stopped, but always pretty bad. So I saw my primary doc on mon, well his partner actually, and she asked how the 5 mg ambien I was prescribed was working. I said ok but only for a few hours. She immediately offered to up the dose to 10 mgs, but I told her I had read there was an extended release form and maybe that would help better because it would work longer? Now I'm not a doc just using logic. So she wrote me a script for ambien cr 6.25 mgs. I brought it to the pharm and they said I needed prior auth for it. The pharmacist said they may want you to try the reg ones first to see if they worked, I told her I had and they didn't. So they faxed the paperwork to my drs office and 3 days later I got a call from them. The ins company is refusing to pay for the ambien cr, and they called in a script for the 10 mgs, which still only work for a short while. Why won't the ins want to cover the cr? Its even a lower dose. Is it because its more expensive? I don't understand.


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PostPosted: Fri Sep 04, 2015 8:17 pm 
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Also, has anyone had any real success with any other sleep meds? I tried Trazadone and had a bad reaction, I tried Remeron and gained sooo much weight cause I wasn't sleeping, I was waking up every night and eating! I heard Lunesta is good but haven't tried it, wonder if my insurance would cover it anyway...


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PostPosted: Fri Sep 04, 2015 11:31 pm 
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It's probably because it's more expensive and maybe regular Ambien can now be found in a generic, but Ambien CR is still name brand only. It could be that they've dropped the price of regular Ambien because they came out with this new configuration even if neither has a generic yet. I'm not sure, but it's probably something along those lines.

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PostPosted: Sat Sep 05, 2015 5:32 pm 
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Yeah I know the manufacturer has sole copyright of a new med for like 7 yrs before anyone can sell a generic of it. I know the ambien I have is a generic or substitute. Maybe the cr came out more recently? I don't know.

What I do know is this !#$* is killing me! I had the wierdest dream last night. It started with a two headed black cat. Yes, it had two heads, two mouths, and in my dream I was sleeping and woke up because both heads were biting me.

I was in a strange family's house, a man, his wife, and a few kids. I told the man to get the shotgun and kill that creature! He said no, it would be too loud and would wake everyone up. I said ok, get a baseball bat then. He ended up trapping it in a cage and said he would take care of it in the morning.

The next morning, I guess it was in my dream, it was like "Dude Where's My Car". I couldn't find my car anywhere, had no idea where I was or how I got there. I just had my phone and tablet and I was searching through it for clues when I woke up.

I woke up around 3 am then never really got back to sleep for more than 5 mins. Got up at 6:30, went to work and literally ran and sweated my ass off all day. Now I'm home and I'm exhausted but I know I wouldn't be able to take a nap if I tried. I have stuff to do, grocery store etc, and I'm just trying to peel myself off my floor to get ready to go out. Yes I collapsed on my floor and haven't moved much for the past couple hours.

Sorry for my rant, this is just really bugging the hell out of me. I guess its true, no rest for the wicked.


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PostPosted: Sat Sep 05, 2015 6:08 pm 
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I think its a really good thing I have a taste for expensive liquor, cause I do try a couple drinks sometimes to help. I've even toyed with the idea of smoking some pot, I haven't in years and I don't know if I will, but I've thought about it. That's bad. I know. I just want to relax.


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PostPosted: Sat Sep 05, 2015 6:09 pm 
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Too bad even if I could get an rx for it, my insurance prob wouldn't pay for it anyway. Lol.


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PostPosted: Wed Sep 09, 2015 7:37 am 
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Good morning friends,

Just wanted to give an update about my frustrating sleeplessness situation. Yesterday while I was waiting in the dr office, I picked up a little publication about insomnia. I read that drinking can help you fall asleep faster and sleep deeper initially, but after a few hours it actually disrupts your quality of sleep. So last night I decided not to have anything to drink when I got home before I went to bed. Took my 10 mg ambien. I fell asleep pretty easily and only woke 3 or 4 times. I did end up waking up earlier than my alarm, but it was only about an hour before compared to the previous mornings where I woke up 3 or 4 hrs early. So I'm gonna keep abstaining from having a couple drinks before bed, and ill keep you all posted on how its working!

Have a great day!


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PostPosted: Fri Sep 11, 2015 3:13 pm 
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That's great to hear, Qom!

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PostPosted: Sat Sep 12, 2015 4:20 pm 
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A couple things... Yes, absolutely, the insurer doesn't want to cover Ambien CR because of the cost. I believe that both have gone generic; Ambien definitely did a few years ago (generic name is zolpidem) and I'm pretty sure the CR form did as well. But regular zolpidem is very cheap-- around 5-10 bucks per month. The controlled release form is about 10 times more expensive-- so insurance will do their best to avoid covering it. This is fairly routine for all meds... except for buprenorphine! Some insurers cover it, and save themselves tons of money... but some insurers continue to think that 'buprenorphine works exactly the same as heroin', and they insist on covering only a buprenorphine/naloxone product.

'Sleep hygiene' includes a number of measures that help a person sleep faster and deeper. Keep the room very dark, and a little on the cool side. Use a white noise generator to drown out little creaks and other noises that can wake you up. Avoid caffeine after 12 noon; it disrupts sleep MUCH longer than people realize. Realize that light turns off the brain pathways that make you sleepy-- especially the bluish wavelengths of light in computer and phone screens. That light stops the production of melatonin, so consider using 3 or 6 mg of melatonin at bedtime if you watch TV before sleep. Keep the brightness low at night-- and reduce the power of the bulbs in your bedroom. Avoid exercise in the last 4 hours of the day, as that often disrupts sleep. If you cannot sleep, get out of bed and do something mellow for 20 minutes, until you feel sleepy.. then try again. Most important-- DO NOT NAP. Adults fall asleep ONCE per 24 hours- and if you sleep in the daytime, you will struggle with sleep at night. And finally, bed is for sleep or sex. Otherwise, stay out of bed.

One last thing-- use at your own risk. There is a med called 'intermezzo' that is indicated to help a person get back to sleep if they wake in the middle of the night. It is taken sublingual, and absorbed in the mouth, just like Suboxone. It is expensive and rarely covered by insurance--- but it is only a small dose of zolpidem, the same drug as Ambien. Ambien or zolpidem is absorbed through mucous membranes and that route causes a higher blood level than if you take it orally... but it is cleared more quickly. I don't remember the exact instructions, but it is for people who have at least a few hours of sleep remaining, but who don't want to take a full sleeping pill.

If you take zolpidem in this way, realize that the dose of zolpidem in intermezzo is VERY SMALL-- about a quarter of what is in a regular Ambien tablet. Two mg sublingual is a FULL dose. The biggest danger/downside is that if a person takes zolpidem in this way, the person will become even MORE dependent on zolpidem to get to sleep. But is may be a helpful thing in rare situations.


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PostPosted: Sun Sep 13, 2015 3:04 pm 
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Anybody know anything about Belsomra? I know what it is and how it is supposed to work, I am just wondering if anyone has tried it. Does it cause more side effects than drugs like Ambien? I see the most common side effect is next day drowsiness, which I never experience with Ambien.


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