Please help. Severe pre-exam Anxiety/Insomnia.

[cyneuron]

Hello all,

I (a neurology residency aspirant) have my USMLE step 2 CK 1 week from now.

I had my USMLE step 1 screwed to a significant extent because I couldn't had slept for whole night (I still remember the clock hands at 05:30 a.m. last before i barely went to sleep and got up at 6:00 a.m.) and had done the mistake of not thinking enough to take a Sleeping pill before exam.

OK. I want help from you guys. There are posts on this question, but I didn't find better place than Neurology subsection to ask it (As I had posted before also regarding other issues, I know SDN Neurology members are the most helpful and responsive here; and who better than neurologists to take advice on insomnia).

I have decided to take sleeping pills for next 1 week. Because I am really sure that I won't be able to get over this insomnia problem (I have tried everything - activity pattern changes, diet (high carb and tryptophan in dinner, zero caffeine); my preparation level is good so its not the reason for anxiety). I am still awake at 2:00 a.m. despite studying for whole day and remaining awake with all above interventions.

And i surely don't want to screw my step 2 after studying so hard just because I may not be able to sleep because of my damn anxiety.

I don't mean to violate SDN terms of not asking/giving any specific medical advice. So I am just going to ask following -

I will greatly appreciate if people may share their personal experience of pre-exam anxiety/insomnia and whether they resorted to meds for short term in order to not hurt their exam ?

I will greatly appreciate your help at this important time.

Note - I am not asking for any medical advice/prescription. I am myself a licenced physician in my country. I just want to benefited from your experiences dealing with insomnia during exams and thus not repeat mistake. (Ask the people who have taken the road before you put your steps ahead....)

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[Yoyomama88]

tryptophan to serotonin leads us to melatonin!

Stay away from that other crap....

 

[danielmd06]

Note - I am not asking for any medical advice/prescription.

You may not be asking for a prescription, but you are soliciting medical advice and this is explicitly not allowed on SDN.

This insomnia is something that you should discuss with your own physician.

Good luck on your test.

 

[cyneuron]

You may not be asking for a prescription, but you are soliciting medical advice and this is explicitly not allowed on SDN.

This insomnia is something that you should discuss with your own physician.

Good luck on your test.

I didn't mean to violate SDN terms. I have modified my original question.

I will greatly appreciate if people may share their personal experience of pre-exam anxiety/insomnia and whether they resorted to meds for short term in order to not hurt their exam ?

 

[soulofmpatel]

I think that this is a legitimate question and does not truly violate the intended purpose of the SDN rules.

I would recommend that you get in the habit of going to sleep early and waking up early one week befor the test.

Just set your alarm for 5am for 1 week before the test and it will be easier to go to sleep the night before the big test because you'll be tired

quick advice for insomnia:

1) Do not do anything in your bed other than sleep. Specifically, don't read or watch television in your bed as it creates a state association (your mind learns to associate your bed with wakeful activities). "your bed is for sleeping and sex."

2) If you are trying to sleep and can't fall asleep after 20-30 minutes, don't stay in bed for hours. Get up to read or watch TV in a different room and try to fall asleep again in 30-60 minutes.

3) Tone down your activity level and dim the lights a few hours before you are planning to go to sleep

4) If you would like, you can take melatonin 3mg or 6mg which is a natural over the counter compound with a mild effect. It can be taken 20-30 minutes prior to going to sleep. Out of prescritpion sleep aids, Trazadone is probably the least habit forming. You generally should avoid sleep aids if you have sleep apnea.

5) keep a strict bedtime and wake up at the same time even on the weekend. set an alarm to wake up at the same time everyday. Don't take naps during the day

6) Don't worry or get anxious about not sleeping. Nothing bad will happen to you. You'll just be tired during the day and have a better chance to sleep well the following night.

7) The half life of caffeine is about 5 hours, so do not consume anything with caffeine within 10 hours of the time you plan to go to sleep.

 

[danielmd06]

Hello all,

I (a neurology residency aspirant) have my USMLE step 2 CK 1 week from now.

I had my USMLE step 1 screwed to a significant extent because I couldn't had slept for whole night (I still remember the clock hands at 05:30 a.m. last before i barely went to sleep and got up at 6:00 a.m.) and had done the mistake of not thinking enough to take a Sleeping pill before exam.

OK. I want help from you guys. There are posts on this question, but I didn't find better place than Neurology subsection to ask it (As I had posted before also regarding other issues, I know SDN Neurology members are the most helpful and responsive here; and who better than neurologists to take advice on insomnia).

I have decided to take sleeping pills for next 1 week. Because I am really sure that I won't be able to get over this insomnia problem (I have tried everything - activity pattern changes, diet (high carb and tryptophan in dinner, zero caffeine); my preparation level is good so its not the reason for anxiety). I am still awake at 2:00 a.m. despite studying for whole day and remaining awake with all above interventions.

And i surely don't want to screw my step 2 after studying so hard just because I may not be able to sleep because of my damn anxiety.

I don't mean to violate SDN terms of not asking/giving any specific medical advice. So I am just going to ask following -

I will greatly appreciate if people may share their personal experience of pre-exam anxiety/insomnia and whether they resorted to meds for short term in order to not hurt their exam ? I will greatly appreciate your help at this important time.

Note - I am not asking for any medical advice/prescription. I am myself a licenced physician in my country. I just want to benefited from your experiences dealing with insomnia during exams and thus not repeat mistake. (Ask the people who have taken the road before you put your steps ahead....)

Again, I understand and my original advice still stands...harmless though your question may seem at first blush. I don't doubt that you're just trying to learn ways to potentially aid your studies and boost your overall performance.

Acute adjustment insomnia is a recognized, legitimate medical diagnosis and you would benefit from discussing this issue with a physician.

Cognitive behavioral therapy is helpful in practically all cases of insomnia. You say you've tried certain tactics, but you need to discuss what you've tried and what else you could possibly try with a physician.

Pharmacotherapy is helpful in some. There are many potential short-term sleep aids that could possibly help you. But please discuss this with a physician.

As I said before, good luck on your test.