I have GAD, panic disorder, trichotillomania and phobias. For the last sixteen years I've had nightmares all night, every night. *Constantly.* I wake up every 60-90 minutes usually in a cold sweat, shaking or crying, I've woken myself up by screaming, I've been convinced someone is in my room standing over me. They even reoccur throughout the night, when I wake up and calm down enough to go back to sleep, the dreams will often either reoccur or simply continue where they left off. I am so tired of it. I do not want to go to sleep. I just recently had my very first few good dreams in sixteen years and I suppose I can thank my Celexa for that (honestly a miracle), but before that I couldn't remember the last dream I had that wasn't a horribly disturbing nightmare. Therapy was useless for it. I found nothing to help.

Until now! Medications such as Prazosin and Topamirate are commonly prescribed to reduce uncontrollable nightmares. About a month ago I added Topamirate personally to my SSRI, I take 25 mg 2x/day. It started working on day three. It has reduced my nightmares *shockingly* well, by perhaps 80%...I probably dream like a regular person now!! I have long periods of dreamless sleep, I have normal, not completely disturbing dreams! I could cry. *Amazing.* This was an awful problem that plagued me for *sixteen* years and persisted through cognitive behavioral therapy, through my massively helpful SSRI which eradicated my anxiety, through *everything..*it seemed bulletproof. I'm so happy.

In general for sleep issues, these things may help if you haven't given them a shot already:

- Avoid alcohol and caffeine
- Melatonin is paradoxically most effective in *small* doses under 1 mg
- Make sure you're going to sleep and waking up on a consistent schedule, whether or not you have to go to work or have plans that day
- You may find yoga or exercise a few hours before bed helpful, or meditation just before bed
- Have a consistent bedtime routine
- Avoid bright light and screens before bed
- Try not to eat 2-3 hours before bed - when you're still digesting food in your sleep it can increase nightmares and sleep disturbances
- Try listening to audiobooks or podcasts on a 30-60 minute timer to prevent ruminating, racing thoughts and overthinking from keeping you awake
- Try a sleep medication such as hydroxyzine - I have insomnia and with hydroxyzine I've gone from waking 7-8 times a night to only 3-4