l am unable to sleep and my MD will not give me sleeping pills. She said to change my lifestyle! l disagree, and know that my sleeplessness is a result of heart disease.

While it is true that many heart patients suffer from insomnia, it can be caused (or aggravated) by many things. You do not give a lot of details, such as what heart condition u have or what aspects of ur lifestyle ur doctor wants u to change, so l can only offer a few suggestions. Avoid caffeine & chocolate at least 5 hours before bed. Avoid exercise or strenuous activities/chores at least 2 hours before bed. Avoid taking daytime naps. Do something before bed that relaxes you, both physically & mentally, such as a warm bath, a good book, etc. Warm milk, herbal teas, light snacks (not a heavy meal), etc. also help. When u feel tired, go to bed. If u have not fallen asleep in an hour or two, get back up until u feel tired again. It is suggested that u turn off the TV & lights, but some people have more difficulty in the quiet & dark. If u find u must have sound, try using a radio with soothing ''elevator'' music, or a TV show that is boring (Perry Mason used to work for me!). If u must have light & do not want the TV on, use only a small night light or two, or leave the light on in the bathroom or closet. If it is feasible for you, a lot of people find having a lighted fish tank in the bedroom very helpful (watching the fish is often very tranquil). If u find it harder to breathe when you're lying flat because of ur heart condition, use extra pillows or u may even need to sleep in a recliner. The remedy u choose will depend on the root cause of ur sleeplessness.

If you've tried these things & still cannot get to sleep or stay asleep, I'd strongly suggest u get a different doctor. Occasional insomnia is common, & people who suffer an occasional sleepless night really should not resort to medications as most can be addicting. Chronic insomnia, however, is a very real problem & can affect every aspect of ur life. Becoming dependent on sleeping medication is far preferable to chronic insomnia, & many medications r safe for heart patients. In my opinion, ur physician is being judgmental about ur problem. Some doctors view insomnia as a sort of character weakness, like u either want to ''drop out'' of life, avoid ur problems, or r just drug seeking. This is just not always the case.

With a heart condition, l can not recommend u take an over-the-counter sleeping pill, & they r not meant for chronic insomnia anyway. See another doctor. When u call to make an appointment, tell their nurse why u need to see them & ask if the doctor might help with ur problem (to avoid seeing another doctor like the one u already have). In the meantime, keep a sleep ''diary'' to show the doctor. Record how much u sleep each night, times, etc., & what you've tried so far. If the first medication he prescribes does not work, or does not work well, u can call him & let him prescribe something else. It could take a while, but with the right doctor, one who is compasionate & knowledgeable, there IS a solution for you.

l also have a heart condition & had suffered from insomnia for many years, even before the heart condition. My doctor prescribed a couple of things that did not help, then essentially ''blew me off''. l finally changed doctors. l am now on Klonipin 0.5 mg (a small dose) & Temazepam 30 mg, & l easily & safely sleep 7 or more hours per night. l know it makes a world of difference getting a good night is sleep.

l hope this helps you. Good luck & sweet dreams!