Posted 09 March 2019 - 08:14 AM
Posted 09 March 2019 - 08:46 AM
Cymbalta withdrawal does increase pain levels. It is called rebound pain. It will subside as your withdrawal lessens.
Posted 09 March 2019 - 09:04 AM
You might look this over and get some ideas to help your sleep. This is from the Section Medical Support and the thread Summary of Cymbalta Withdrawal.
How to Sleep Better
Tips for Getting a Good Night’s Sleep
Tip 1: Keep a regular sleep schedule
Getting back in sync with your body’s natural sleep–wake cycle—your circadian rhythm (daily rhythm)—is one of the most important strategies for achieving good sleep. If you keep a regular sleep schedule, going to bed and getting up at the same time each day, you will feel much more refreshed and energized than if you sleep the same number of hours at different times. This holds true even if you alter your sleep schedule by only an hour or two. Consistency is important.
⦁ Set a regular bedtime. Go to bed at the same time every night. Try not to break this routine on weekends when it may be tempting to stay up late. No more than 15 minutes earlier or later each day.
⦁ Wake up at the same time every day. If you’re getting enough sleep, you should wake up naturally without an alarm. If you need an alarm clock to wake up on time, you may need to set an earlier bedtime. As with your bedtime, try to maintain your regular wake–time even on weekends.
⦁ Nap to make up for lost sleep. If you need to make up for a few lost hours, use a daytime nap rather than sleeping late. DO NOT NAP MORE THAN 1 HOUR PER DAY as it may affect your evenings sleep. DO NOT NAP AFTER 5 PM. The best time to nap is early afternoon.
Fight after–dinner drowsiness. If you find yourself getting sleepy way before your bedtime, get off the couch and do something mildly stimulating to avoid falling asleep, such as washing the dishes, calling a friend, or getting clothes ready for the next day. If you give in to the drowsiness, you may will usually wake up later in the night and have trouble getting back to sleep.
⦁ Tip 2: Naturally regulate your sleep-wake cycle
Melatonin is your naturally produced hormone that regulates your sleep. Melatonin production is controlled by light exposure. Your brain will secrete more in the evening, as it becomes darker, Conversely, during the day your brain detects increasing light levels and begins producing serotonin, which causes one to wake and be alert.
Spending long days in an office away from natural light, for example, can impact your daytime wakefulness and make your brain sleepy. Then bright lights at night—especially from hours spent in front of the TV or computer screen—can suppress your body’s production of melatonin and make it harder to sleep. However, there are ways for you to naturally regulate your sleep-wake cycle, boost your body’s production of melatonin, and keep your brain on a healthy schedule.
Increase light exposure during the day
Remove your sunglasses in the morning and let light onto your face.
Spend more time outside during daylight. Try to take your work breaks outside in sunlight, exercise outside, or walk your dog during the day instead of at night.
Let as much light into your home/workspace as possible. Keep curtains and blinds open during the day.
Boost melatonin production at night
Turn off your television and computer. Many people use the television to fall asleep or relax at the end of the day. Not only does the light suppress melatonin production, but television can actually stimulate the mind, rather than relaxing it. Try listening to music or audio books instead, or practicing relaxation. If your favorite TV show is on late at night, record it for viewing earlier in the day.
Don’t read from a backlit device at night (such as an iPad). If you use a portable electronic device to read, use an eReader that is not backlit, i.e. one that requires an additional light source such as a bedside lamp.
Change your light bulbs. Avoid bright lights before bed, after 7 PM do not use a light greater than 25 watts. Reduce light exposure by significantly reducing the brightness on your TV or electronic device.
When it’s time to sleep, make sure the room is dark. The darker it is, the better you’ll sleep. Cover electrical displays, use heavy curtains or shades to block light from windows, or try an eye mask to cover your eyes. Most patients with chronic problems blacken their bedrooms entirely. Do not use nightlights if it can be done safely. Block all windows in the bedroom so light can not enter.
See... https://www.ncbi.nlm...n00057-0027.pdffor details
Tip 3: Create a relaxing bedtime routine
If you make a consistent effort to relax and unwind before bed, you will sleep easier and more deeply. A peaceful bedtime routine sends a powerful signal to your brain that it’s time to wind down and let go of the day’s stresses.
Keep noise down. If you can’t avoid or eliminate noise from barking dogs, loud neighbors, city traffic, or other people in your household, try masking it with a fan, recordings of soothing sounds, or white noise. You can buy a special sound machine or generate your own white noise by setting your radio between stations. Earplugs may also help. Sound machines can be purchased at local department stores.
Keep your room cool. The temperature of your bedroom also affects sleep. Most people sleep best in a slightly cool room. A bedroom that is too hot or too cold can interfere with quality sleep.
Make sure your bed is comfortable. You should have enough room to stretch and turn comfortably. If you often wake up with a sore back or an aching neck, you may need to invest in a new mattress or a try a different pillow. Experiment with different levels of mattress firmness, foam or egg crate toppers, and pillows that provide more support.
Relaxing bedtime rituals to try
⦁ Read a book or magazine by a soft light
⦁ Take a warm bath
⦁ Listen to soft music
⦁ Do some easy stretches
⦁ Wind down with a favorite hobby
⦁ Listen to books on tape
⦁ Make simple preparations for the next day
DO NOT exercise or do any significant physical activity after 6 PM. Anything considered work (laundry, dishes, etc) must be avoided after 6 PM.
Tip 4: Eat right and get regular exercise
Your daytime eating and exercise habits play a role in how well you sleep. It’s particularly important to watch what you put in your body in the hours leading up to your bedtime.
⦁ Stay away from big meals at night. Try to make dinnertime earlier in the evening, and avoid heavy, rich foods within two hours of bed. Fatty foods take a lot of work for your stomach to digest and may keep you up. Also be cautious when it comes to spicy or acidic foods in the evening, as they can cause stomach trouble and heartburn.
⦁ Avoid alcohol before bed. Many people think that a nightcap before bed will help them sleep. While it may make you fall asleep faster, alcohol reduces your sleep quality, waking you up later in the night. To avoid this effect, so stay away from alcohol in the hours before bed.
⦁ Eliminate caffeine. You might be surprised to know that caffeine can cause sleep problems up to ten to twelve hours after drinking it! No chocolate, most teas, coffee.
⦁ Avoid drinking too many liquids in the evening. Drinking lots of water, juice, tea, or other fluids may result in frequent bathroom trips throughout the night. Caffeinated drinks, which act as diuretics, only make things worse.
⦁ Quit smoking. Smoking causes sleep troubles in numerous ways. Nicotine is a stimulant, which disrupts sleep. Additionally, smokers actually experience nicotine withdrawal as the night progresses, making it hard to sleep.
⦁ Eliminate stimulants. No sugars, salty food or MSG. Sugar is a stimulant which can increase blood pressure and pulse. It can take significant time to process this material and slow down your metabolism. Salts like table salt and MSG provide sodium which is used by the body to help carry electrical system in our bodies. This can also increase heart rates and metabolism for several hours.
If you’re hungry at bedtime
For some people, a light snack before bed can help promote sleep. When you pair tryptophan–containing foods with carbohydrates, it may help calm the brain and allow you to sleep better. For others, eating before bed can lead to indigestion and make sleeping more difficult. Experiment with your food habits to determine your optimum evening meals and snacks. If you need a bedtime snack, try:
⦁ A small bowl of whole–grain, low–sugar cereal
⦁ Granola with low–fat milk or yogurt
⦁ A banana (not sugary fruits)
You’ll also sleep more deeply if you exercise regularly. As little as twenty to thirty minutes of daily activity helps. And you don’t need to do all thirty minutes in one session. You can break it up into five minutes here, ten minutes there, and still get the benefits. Try a brisk walk, a bicycle ride, or even gardening or housework. Serious exercise, even small amounts, must be done before 6 PM.
Some people prefer to schedule exercise in the morning or early afternoon as exercising too late in the day can stimulate the body, raising its temperature.
Tip 5: Get anxiety and stress in check
Do you find yourself unable to sleep or waking up night after night? Residual stress, worry, and anger from your day can make it very difficult to sleep well. When you wake up or can’t get to sleep, take note of what seems to be the recurring theme. That will help you figure out what you need to do to get your stress and anger under control during the day:
If you can’t stop yourself from worrying, especially about things outside your control, you need to learn how to manage your thoughts. When trying to go to sleep it is essential not to think about work, money, your family’s problems or other stressful subjects. These are very detrimental to sleep. Do not think about exciting subjects (a vacation, your favorite hobbies, etc.). Instead pick something mundane (boring). Pick a subject like weeding you garden, cleaning your car, etc. It will be difficult to stay focused on these boring subjects at first but it will become easier with time and practice.
If the stress of managing work, family, or school is keeping you awake, you need help with stress management. By learning how to manage your time effectively, handle stress in a productive way, and maintain a calm, positive outlook, you’ll be able to sleep better at night.
Relaxation techniques for better sleep
⦁ Deep breathing. Close your eyes—and try taking deep, slow breaths—making each breath even deeper than the last.
⦁ Progressive muscle relaxation. Starting at your toes, tense all the muscles as tightly as you can, then completely relax. Work your way up from your feet to the top of your head.
⦁ Visualizing a peaceful, restful place. Close your eyes and imagine a place or activity that is calming and peaceful for you. Concentrate on how relaxed this place or activity makes you feel.
Tip 6: Ways to get back to sleep
It’s normal to wake briefly during the night. In fact, a good sleeper won’t even remember it. But if you’re waking up during the night and having trouble falling back asleep, the following tips may help.
⦁ Stay out of your head. Hard as it may be, try not to stress over the fact that you’re awake or your inability to fall asleep again, because that very stress and anxiety encourages your body to stay awake.
⦁ Make relaxation your goal, not sleep. If you are finding it hard to fall back asleep, try a relaxation technique such as visualization (focus your eyes on something in the room), deep breathing, or meditation, which can be done without even getting out of bed. Remind yourself that although they’re not a replacement for sleep, rest and relaxation still help rejuvenate your body.
⦁ Stretching. If you wake during the night do NOT fight it or panic. If you can not go to sleep in 10 to 15 minutes, get up, wake 20 or 30 feet, stretch (touch your toes or stretch your arms), walk back to bed and lay back down again. Each time you stretch and lay down your body will produce a small amount of endorphins which help the body relax.
⦁ Postpone worrying and brainstorming. If you wake during the night feeling anxious about something, make a brief note of it on paper and postpone worrying about it until the next day when you are fresh and it will be easier to resolve. Similarly, if a brainstorm or great idea is keeping you awake, make a note of it on paper and fall back to sleep knowing you’ll be much more productive and creative after a good night’s rest.
FN - Sound machine/radio - I pick out which of the sounds (often I have high and low pitch, hissing, humming, and whirring all at the same time) I find most pleasing ... and somehow that helps me drift off to sleep ... It helps cover up outside noises.
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