I have always had problems sleeping. it has gotten a lot worse with the tamoxifen.i think it's anxiety about no sleep.with ambien (zolpidem) i lay there for 4 hrs. no tv in room, don't smoke or drink.suggestions?

Other options: Tamoxifen can cause insomnia in about 9% of patients. It sounds like you know about sleep hygiene -- here is a reference for reminders: http://tinyurl.Com/lpcwhxt you might discuss low dose Elavil or sinequan with your physician, especially if Ambien (zolpidem) does not seem to help. By low dose, i mean 10mg - 25mg at bedtime. It may help without causing side effects at that dose.

Exercise: Alot of stress can be relieved with good old fashioned exercise. Try walking for 1 hour after dinner. You will program your body to relax. If you can't go outside then try cleaning inside or even try meditation. Picture yourself relaxing and sleeping well. Talk to your doctor if you find yourself sleeping during the day.