Ever since I had shoulder surgery, I have been unable to sleep like earlier. Please help.

Hello doctor,

I am a 31 year old male. Avid weightlifter and I currently weigh about 208 lbs. Ever since I had shoulder surgery, I have been unable to sleep like earlier. I used to fall asleep wherever I was and stay asleep until multiple alarms would go off. These days, I am not able to sleep properly. I sleep for about one to two hours at a time, then wake up and then again sleep. I do this the whole night. It makes me quite tired the next day.

I have had multiple sleep studies done and there is no apnea or lack of oxygen. I have also tried tablet Ambien 12.5 mg and that gets me to three to four hours of sleep without waking up. But, I take that only on those days I know I can stay in bed for more than eight hours to make sure I am not groggy. It does not truly knock me out/make me sleep.

I have also tried Melatonin and Benadryl which showed no effects. I have also tried Buspar to see if that helped. No real effect either. I am getting stumped as to why my sleep cycle has changed and why nothing is working. Please help.

Hello doctor,

Thank you very much for your response. The oddest part is, I used to sleep totally sound and never remember waking up and could function better even with less sleep before surgery. It seems since surgery my sleep cycle has been completely changed. I had a leg surgery long back but that never disrupted my sleep once I recovered.

I do not think there is a huge issue. I have always been one to make sure things are resolved before bed and tend to plan out my next day. But, I have always done that and the surgery has not bothered me.

I did change jobs recently and that has definitely helped me get up early in the morning. The atmosphere at the new job is much better. There is more responsibility and maybe I am stressful as well. I make sure that I get my work done.

I have never been diagnosed with depression or anything but there are times where I feel indifferent and I guess I just do not care. But I thought that stemmed from constantly being tired and frustrated that I could not sleep the way I used to.

I may have a cup of coffee once or twice a week, but that is only during the morning. I stay away from caffeinated drinks in the evening majority of the time.

No smoking ever and maybe a glass of wine or hard cider once every couple of weeks.

No change in the sleeping environment. I have already tried a new mattress and putting a mattress top on and off the bed with no change. My room does have room darkening shades as well. I also sleep alone.

I have been using the same sheets/comforter/pillows which I have used for years, just rotate them when it is time for a laundry.

I also take tablet Zantac in the mornings and sometimes at night. I tried Omeprazole but that caused severe weight gain for me. Therefore, I stopped that and went back to Zantac, the weight came right off again.

My workout and calories are carefully planned as well, as to maintain my weight.

I am not taking pain medicines or anything else. And there is no shoulder pain either. All I take daily is Xyzal 5 mg (for allergy), Zantac 150 mg, and Buspar 10 mg. I have also been trying Ambien CR 12.5 mg. It helps a bit but nothing like normal. I can tell it helps fall asleep quicker and instead of waking up every one to two hours without the pill, I only wake up every three to four hours when taking this tablet. So it does not completely knock me out.