Question: verap. & sleep

OK, I’ve got a question here. As of this Monday night, I went from 120 mg verapamil to 180.

The last two nights, I’ve had what I’d call semi-insomnia. I go upstairs, lie down, and … basically spend anywhere from 45 minutes to a couple of hours staring at the inside of my eyelids. Every once in a while I’ll doze off enough to have a dream or two, and then I’m awake again, just lying there. “Lying in bed with your eyes closed” is not my idea of restful sleep…

When I can’t sleep, I’ll sometimes go down to the living room and lie on the couch there. Oddly, I can nod off there, every time.

Should I be worried about whether this is due to the verapamil increase?

Hi George,

I would say this is likely from the Verapamil increase. I have had vivid dreams and trouble sleeping most of my life. Verapamil exacerbated this when I was taking it. I say hang in there, try some techniques or supplements to help you sleep and hope it gets better, which it most likely will.

— Begin quote from “georgekoch”

When I can’t sleep, I’ll sometimes go down to the living room and lie on the couch there. Oddly, I can nod off there, every time.

— End quote

If this is odd, than I’m an oddball too! But, we already knew that right? :stuck_out_tongue: This is what I do when I’m having trouble sleeping. It almost always works.

Hang in there!


OK. I wonder if I should re-examine my own sleep habits, though, as I can’t find a single reason why I should sleep better on the couch than on my own bed. (I do have a tendency sometimes to doze off on the couch while watching a late show; maybe I’m getting too used to the couch?)

I actually rather like sleeping on the couch, but apparently no one else likes it, because someone always comes along and chides me for it, or tells me I should go upstairs (to bed).

I’m a little wary of taking pills in addition to the verap. because it already slows my heart rate and blood pressure; I don’t know which pills might cause a drop to unsafe levels. Maybe Tylenol PM would be innocuous enough. (I should call the pharmacy and ask these things, huh!)

I really hope I didn’t make the wrong move in sticking with verap. – and at a higher dosage to boot. If it works, great. But if I get to 8 weeks (3.5 weeks from now) and find it hasn’t worked, I agreed to go to Effexor at that point – and not only would I have wasted an extra month on the first pill, but I’ll then have to wait another month or so just to see if Effexor is the one!

Question of the day (well, OK, of the moment): If we have abortive medications for traditional migraine episodes, why can’t MAV be stopped so quickly?

Stupid question. Never mind.

When I started Verapamil and when I made increases I had slight difficulty sleeping because I was very aware of my heart beating. Perhaps when you are on the couch, you are not as focused on sleeping, so just fall asleep without any worries about whether you will fall asleep or not.
I also wonder why abortives do not work. perhaps different mechanisms of action are operating during MAV then during an episodic migraine.

Thanks Lisa.

Boy, whether with me or with the medicine itself, there’s always something. Jeez.

I don’t doubt that episodic migraine functions differently from continuous migraine (with vertigo/dizziness). It seems as though the longer it’s “allowed” to go on, the harder it is to interrupt the cycle.

Hey, wouldn’t that be an interesting theory (no) – if perhaps the length of time that MAV goes untreated is proportional to (or at least related to) the amount of time required to stop it.

Ever notice how, if you take an abortive medicine for a headache within the first little while, you’ll likely kill the headache fairly quickly, but if you wait for, like, 2-3 hours (or more) before taking medicine, the medicine won’t work as quickly?

I think just about EVERY problem in the WORLD becomes more resistant to treatment – or takes longer to resolve, at least – the longer it’s left untreated. Things really settle into a fixed pattern, or habit.

George - I wonder about that as well. When I first got ill, my symptoms actually came and went a few times. However, after a few months of having this, my symptoms never disappeared again. I’ve been sick for almost 2 years, and at this point I surely need meds to cure me. maybe you have a point.

I would love to know about the abortive medication too. Maybe another one we should have stuck on the list to ask Doctors Hain and Rauch.

I did ask a neurologist once if they would work and he said they were generally ineffective in MAV.

I do know that they say you have to take an abortive as soon as the warning signs of a regular migraine come on. So I am presuming regular migraineurs would, for example, take it at the aura stage. As we just seem to be ill all the time, we don’t move through any of the conventional phases of a migraine - prodrome, migraine, postdrome etc… it’s impossible to find that point.


I have a sneaking suspicion that once you hit vertiginous or dizzying migraine, the traditional rules go out the window. I doubt there’s any way to abruptly stop MAV. The question is, what’s the difference between episodic and continuous? I can’t even find 100% agreement on which of those is more characteristic of MAV.

Having continuous MAV feels like having a seizure that never ends. Or at least what I imagine that might be like. I feel like someone’s “gotten my wires crossed” and never untangled them. (Epilepsy and MAV are both associated with abnormally high brain-activity levels – electrical or chemical – right?)

I wonder if I would have gotten any interesting results had I gotten an EEG.

Right about now, I doubt I have even the electrical activity to power a 5-watt bulb, yet I can’t shake the feeling that I should be, like, hooked up to a generator and providing power to the entire Eastern seaboard, what with the amount of lightheaded “buzzing” I get.

Hey George -

I know that Howie takes Klonopin with his Verapamil. You might want to ask him if that has helped him sleep.

And Hannah, did Propranolol make your sleep more difficult?


Hi Molly,

Nope - propanolol definitely never prevented me from sleeping. It makes me tired, fatigue is a common side-effect, although nothing I can’t handle but I take 80mg, a low dose in migraine terms.

Thanks Hannah for that.

George, I talked to Nance who is doing great on Verap and she had some sleep trouble at the beginning as well. It didn’t last and now she’s sleeping like a baby.


Molly -

I’ve tried Klonopin (at 0.5 mg, the lowest-prescribed dose) a couple of times, though not since I’ve begun taking verap. for MAV. It had a somewhat relaxing effect. (Mom would have me take 1/2 or 1 pill, on rare occasion.) It probably helped me sleep somewhat.

However, that difficulty-sleeping problem I was having seems to have left. Sometimes I wind up on the couch to fall asleep, but so be it.

I actually called the pharmacy a couple of days ago to ask if I could take a sleep aid (like Ambien CR, or an OTC, like Tylenol PM) with verapamil, and they said no, given that the verap. already has caused a decrease in BP and pulse.