Hypersomnolence and my sleep apnea

[NotSleepingBeauty]

Be wary of meds. Many, even those prescribed for sleep have a negative effect on the quality of sleep, Clonazepan for one. Try to reduce the number of drugs as much as possible and know the effects those that you take might have on sleep. Know that depression and lack of quality sleep seem to be related. Treating one, can sometimes help the other, but, again, be mindful of the drugs. Many anti-depressants have a detrimental effect on sleep. Jay

Do you have any information or can you point me to any literature regarding Clonazepan and the quality of sleep? I have been taking it for years. I just recently weaned myself down from 10mg to 5mg. I am wondering if I want to get off this completely or switch to another drug. I also take many anti-depressdents, all of which either cause sleepiness or weight gain. Sometimes I feel like it's a loosing battle.
NSB

[Jay Aitchsee]

Here's a quick reference to start you out. If you google "clonazepam and sleep" you'll find more. To determine crediblity, you should investigate the references cited.

http://en.wikipedia.org/wiki/Clonazepam ... acology-36

The "hangover effect" some experience not only results from clonazepam's considerably long half-life. Like many other benzodiazepines, when taken as a sleep-aid, clonazepam disrupts or interferes with the brain's delta waves. Delta waves signify the brain's slowest waves (~4 Hz) and occur during Stage 4 sleep, which represents humans' deepest sleep state (our muscles are the most relaxed; breathing slows and becomes shallow), and the stage right before R.E.M. sleep and dreaming (Stage 5). Therefore, upon waking, this disruption of Stage 4 delta wave sleep causes a failure for an adequate brain/body rest or "recharge".
[34][35] While benzodiazepines induce sleep, they tend to produce a poorer quality sleep than natural sleep. Benzodiazepines such as clonazepam suppress REM sleep.[36] After regular use rebound insomnia can occur when discontinuing clonazepam.[37]

Jay

[avi123]

Hi Guest (sickwithapnea17),

My thyroid is fine thankfully, so I don't need to take anything for it. I am under the care of a doctor who specializes in functional medicine. She ran the whole panel of thyroid test correctly to determine this. If you are self-diagnosing and self-medicating, this is not a good idea; you really need to be under a doctor's care for this. High or low thyroid levels can cause all kinds of problems with your health. I recommend that you read up on it at this website: http://www.stopthethyroidmadness.com/, it also has information on adrenal dysfunction.

And low blood cortisol levels do not mean that you have adrenal fatigue. It needs to be diagnosed with a 24-hour saliva cortisol test. Think of taking a picture (blood cortisol level) or a 24/7 video (saliva cortisol test). You have to have data for what the adrenal gland is doing over a 24-hour period before you can diagnose adrenal gland fatigue. A low blood cortisol level doesn't really tell you anything regarding adrenal fatigue as it only tests for what the blood cortisol level is at that moment in time.

The cause of adrenal fatigue is unknown. But it is often undiagnosed and is part of other problems. Here's another website with good information. I am not recommending their products, but they have very good information: http://www.womentowomen.com/.

Lisa

COMMENT,

What is a Functional Medicine physician?

When I had Grave's disease= hyper thyroid = thyrotoxicosis, I was seen by a Clinical Endocrinologists.
My disease started at age 45 and lasted till age 65. Then it went away on its own. I took Propylthiouracil Rx. Another option was to reduce the size of the Thyroid by surgery. Treating Thyroid diseases is as easy as fitting a key in a keyhole. That simple, as long as it is not a metastasized Ca. But hyper thyroid could be terminal if not treated in time. Testing for Thyroid problems besides checking those hormones levels in the blood serum is done with a Gama camera and Radioactive Iodine.

A Hypo Thyroid is a co-morbid of sleep apnea.

A goiter (large thyroid) which is not a pathology should be differentiated.

[LoneStar]

Hi Avi123,

Basically a functional medicine specialist treats the entire body as a whole, realizing how different bodily systems (endocrine, gastrointestinal, hormonal, etc.) work together or against each other when dysfunction is present. They tend to focus on a disease and its causes instead of focusing on the symptoms. For a better explanation of functional medicine, go here: http://www.functionalmedicine.org/about/whatis.asp. By the way, functional medicine specialists are MDs.

Often "regular" medicine gets so focused on the trees (a set of symptoms), they lose sight of the forest (the whole body).

Lisa

[archangle]

I'm still using that same machine, still set to those pressures from back in 2003 but now my sleepiness is horrible.

Do you really have an S9 VPAP Auto Bilevel machine? I don't think they were available in 2003. (Maybe I missed something.)

Looks like this:



If so, get the software for it, and check your numbers.

Even if you have an older S8 machine, you should be able to check your AHI numbers on the LCD screen.

It's very possible you have simple sleep apnea and the machine isn't set right to stop your apnea. You or your doctor need to look at the data your machine collects every night, which will give you a lot of info about whether you're still having apneas.

[NotSleepingBeauty]

Here's a quick reference to start you out. If you google "clonazepam and sleep" you'll find more. To determine crediblity, you should investigate the references cited.

http://en.wikipedia.org/wiki/Clonazepam ... acology-36

The "hangover effect" some experience not only results from clonazepam's considerably long half-life. Like many other benzodiazepines, when taken as a sleep-aid, clonazepam disrupts or interferes with the brain's delta waves. Delta waves signify the brain's slowest waves (~4 Hz) and occur during Stage 4 sleep, which represents humans' deepest sleep state (our muscles are the most relaxed; breathing slows and becomes shallow), and the stage right before R.E.M. sleep and dreaming (Stage 5). Therefore, upon waking, this disruption of Stage 4 delta wave sleep causes a failure for an adequate brain/body rest or "recharge".
[34][35] While benzodiazepines induce sleep, they tend to produce a poorer quality sleep than natural sleep. Benzodiazepines such as clonazepam suppress REM sleep.[36] After regular use rebound insomnia can occur when discontinuing clonazepam.[37]

Jay

Wow, you think one of my doctors would have told me that. I tried to step myself down on Clonazepam, and Lamictal, at the same time, I am an idiot, and I completely freaked out yesterday. So now I am going to go back to full strength on the Lamictal, and 3/4 strength on the Clonazepam. I had no idea that breakthrough insomnia could happen. That is the reason that I started taking them in the first place. I will talk to my psychiatrist at my next appt and see what the best way to taper these is, if I can taper them at all. Thanks for the info.

[TheTwinsMom1]

Sadly, I have idiopathic hypersomnia and so far nothing but a strict sleep schedule and Provigil has helped. My AHI is 0.0 most every night but yet I am still exhausted with out my medication. I also have low thyroid and have to make sure that is in check at all times or it gets worse. My doctor said the bad head injury I had as a child could have triggered the hypersomnia.

[NotSleepingBeauty]

Sadly, I have idiopathic hypersomnia and so far nothing but a strict sleep schedule and Provigil has helped. My AHI is 0.0 most every night but yet I am still exhausted with out my medication. I also have low thyroid and have to make sure that is in check at all times or it gets worse. My doctor said the bad head injury I had as a child could have triggered the hypersomnia.

So you are still using CPAP even with the low AHI, that is kind of the situation that I am in. I am trying to regulate my sleep schedule. It's a bummer going to bed at 10pm, but if I go much later than that I don't have a good day.

I have been trying to get Nuvigil covered by my insurance but they have denied me at least twice already. I need to prove compliance with CPAP, so I guess I am on that road now.

Have you seen a neurologist? I have an appt on Friday. I am wondering what to expect.

Idiopathic means that there is no defined cause, correct?
Thanks

[stacyrings]

Have you had your thyroid checked? Not just the TSH, but a complete thyroid panel including T3, T4, free T3/4, etc.? And have your doctors checked you for adrenal gland fatigue with a saliva cortisol test? How are your vitamin D3 levels? If there is a functional medicine specialist in your area, you should consider seeing them.

I've had it checked several times but I don't know what all was checked. I did have my adrenal glands checked I think. Is that where you give a blood sample, go back the next day after taking a pill and give another sample? I have such a bad memory. Everything came out fine in all of that.

My thoughts are with such a high pressure, I have to wonder if you're getting mouth leakage with your nasal mask. I know you say you believe you don't, but it's easy to not notice or realise you're mouth is farting at night.

Try getting a loan of a FF mask: you've got nothing to lose.

My ex has a FF mask he isn't using. I'm working with him to see if I can borrow it.

Welcome to the forum?

Do you have the software to use with your new machine to make sure that at least on paper that things are at least optimal as far as your therapy goes? Leak line and numbers, if elevated, might indicate mouth breathing or other leaks great enough to impact therapy.
Using the software you can spot any areas of therapy which might need improvement. If all the data looks good on paper then we do have to look at other possible contributing factors to not feeling the good numbers like sleep fragmentation, hours of sleep, pain, med and other health issues which have already been mentioned.

I had a problem with sleep fragmentation due to pain. I had great numbers on my software reports but I knew I woke up many, many times during the night due to pain. Anything that messes with sleep will mess with how we feel the next day. So have you used the software to make sure the data looks good on paper and nothing needs work?

I just downloaded the SleepyHead software last week but I didn't really understand much of it. I plan to ask more in a separate question when I get a chance.

What is being done about your periodic limb movement disorder? Have they done iron studies, magnesium level - - - anything???? If your PLMD is anything like what I've suffered, you have my sympathy. My guess is treating your limb movements along with therapeutic cpap treatment would give you a sizeable portion of your life back.

I'm taking Neurotin for the pain in my legs but I don't think it helps the PLMD. I'm thinking it is related to the high dose of Effexor XR that I'm on. I seem to remember reading something that it can cause twitches like this. I've had them for so long and been on Effexor for so long too that I don't hardly notice them anymore. But I do think my neuro was going to wait and see how the new pressures did for my sleepiness first and then when I see him in Feb., he would address the PLMD.

[stacyrings]

I'm still using that same machine, still set to those pressures from back in 2003 but now my sleepiness is horrible.

Do you really have an S9 VPAP Auto Bilevel machine? I don't think they were available in 2003. (Maybe I missed something.)

Looks like this:



If so, get the software for it, and check your numbers.

Even if you have an older S8 machine, you should be able to check your AHI numbers on the LCD screen.

It's very possible you have simple sleep apnea and the machine isn't set right to stop your apnea. You or your doctor need to look at the data your machine collects every night, which will give you a lot of info about whether you're still having apneas.

Sorry if I confused you. I do have a new machine, the S9, that I got about 6 months ago. My pressures didn't change when I got that machine. Before I got that machine I had a different one that I can't remember the name of and I don't have with me now. I had that one for a very long time.

I tried to check the LCD screen for any information and the only thing I could understand was the number of hours I slept the night before. I read in the manual about what you are talking about and I don't think that feature is enabled on mine.

I have since downloaded the SleepyHead software but I really don't understand it.

[stacyrings]

Stacy, I think you've been given some good advice in the foregoing posts. My advice would be to start with the basics. Fix the things you can fix first. If you do indeed have OSA, wear your XPAP and get that under control. Monitor your AI, either through software or from the machine. Learn how control your machine. Be wary of meds. Many, even those prescribed for sleep have a negative effect on the quality of sleep, Clonazepan for one. Try to reduce the number of drugs as much as possible and know the effects those that you take might have on sleep. Know that depression and lack of quality sleep seem to be related. Treating one, can sometimes help the other, but, again, be mindful of the drugs. Many anti-depressants have a detrimental effect on sleep. Work on your sleep hygiene. Don't take naps, wind down before bedtime, have the proper sleeping environment, watch caffeine especially after noon, exercise, etc.
Lastly, but most importantly, have a full blood work up, including a metabolic panel, thyroid panel, iron panel, magnesium, Vitamin D3, Vitamin B12 and if any of these are abnormal, fix them first along with your OSA.
Sleep is a hugely complex function. Not well understood by many. Sleep effects many functions of the body and many functions of the body effect it. I think the only way to successfully manage it is to break it down into basic functions and tackle them one at a time. Research these items thoroughly so that you become the expert and can take an active part in your treatment. Try to use only credible sources for your research; for example, published studies, clinical trials, etc. A relentless Google search on any topic will usually turn these up.

Good luck to you,
Jay

What is AI?

Thanks for the rest of your post. Lots of good information and suggestions!

[mrdynamyt]

I am using the Nuvigil, going on two weeks an it does help me wake up after about half an hour. But every night I dread going to bed because I know when my alarm goes off I am going to be in an absolute fog for the first hour. It just doesn't seem like my Cpap is doing what it used to do even though I just had a sleep study and thy adjusted it up to 14 and added oxygen to my machine. I go to gym most days and bike s soon as I get up but this chronic fatigue feeling me is certainly destroying my quality of life and really making it hard to enjoy anything.