I am having the worst spell of insomnia yet. one day i sleep only 3 hours, next day can't sleep at all. z-drugs & benzos useless due to tolerance. very small town no sleep doc anywhere near me.

Trazodone: Seroquel (quetiapine) and Hydroxyzine are your best options. Remeron if not bipolar. Good luck.

Several options: Insomnia sometimes has a cause that can be figured out ; addressed directly, e.g., depression or sleep apnea. Even lacking a sleep specialist, your family doc or internist should be able to help. Cognitive therapy (cbt-i) can help too. Other meds to consider: sedating antihistamines (diphenhydramine, hydroxyzine) ; sedating antidepressants (trazodone, doxepin, mirtazepine).