Mental illness diagnosis due to undiagnosed sleep disorder?

roster · Post by **roster** » Wed Jul 11, 2007 7:09 pm

"Core symptoms of sleep-wake disturbances often co-occur in many psychiatric disorders including depression, bipolar disorder, and schizophrenia. Excessive sleepiness, a primary symptom of sleep disorders, is defined as difficulty maintaining wakefulness and an intense drive for sleep even in inappropriate circumstances. Excessive sleepiness is highly prevalent in patients with major depressive disorder (10% to 20%) and atypical depression (36.2%), and is an iatrogenic effect of many psychotropic drugs that may result in impairments including increased motor vehicle accidents and occupational hazards. Patients with psychiatric disorders also represent an "at-risk" population for the development of obstructive sleep apnea, and should be evaluated if they exhibit symptoms of sleep apnea, are overweight, or are on chronic neuroleptic treatment.

This overlap of symptoms and disorders has resulted in a performance gap for clinicians. What tools can aid in differentiating between a primary sleep disorder and psychiatric illness? What questions should clinicians be asking their psychiatric patients to uncover sleep-wake disturbances? What course of treatment should be pursued? When is a referral to a sleep specialist appropriate? In this evidence-based neuroscienceCME TV activity, the experts will provide insights and strategies to aid clinicians in developing and implementing a decision tree for the practical management of sleep disturbances in patients with psychiatric illness. "

http://www.emediawire.com/releases/2007/7/emw538476.htm

Wolfmarsh · Post by **Wolfmarsh** » Wed Jul 11, 2007 7:11 pm

I know all too well about OSA making you insane.

roster · Post by **roster** » Wed Jul 11, 2007 7:23 pm

Wolfmarsh wrote:I know all too well about OSA making you insane.

Yeah, we are not the problem. It is the many doctors/psychiatrists/therapists who don't have a clue.

IBTeri · Post by **IBTeri** » Wed Jul 11, 2007 7:28 pm

Big clue when someone keeps telling there doctor I can't sleep, and if I don't get enough sleep I lose it. I did that for over 20 years and until I got my cpap I never sleep more than an hour at a time if I was lucky. I wouldn't fall asleep until around 4am than would have to be up to take care of kids. So between 4 and 8am I would wake up to go to the bathroom every hour so you can imaging how bad things where?

John_M · Post by **John_M** » Wed Jul 11, 2007 7:42 pm

I will join the club of people with Sleep Apnea and BiPolar.
I was so surprised at this connection that I have started documenting information about this connection.

Its at http://seedwiki.com/wiki/dreamsharing/p ... Id=1005745.

I welcome additions to this information. What I am hoping to do is to build up enough convincing information that people will take these connections seriously.

It took me about three months on CPAPtalk before I become aware of a possibility of a connection. Right now My shrink is reducing my meds slowly and I haven't made it to the psych ward so far.

John M

socknitster · Post by **socknitster** » Wed Jul 11, 2007 7:44 pm

Rooster wrote:

Yeah, we are not the problem. It is the many doctors/psychiatrists/therapists who don't have a clue.

Imagine struggling with undiagnosed osa, being misdiagnosed with depression for 10 years and having a psych tell you that your need for so much sleep was all in your head when you asked for a sleep study?

I was diagnosed 9 months later by my gp.

What is really scary is that I believed him and tried to consciously get less sleep. I could only do it for so long before I was back to 9-10 hours during the week and as many as 14 hours on the weekends. And I was still exhausted. I felt so lost and hopeless until my gp (and YOU GUYS) saved me.

Jen

KAZ · Post by **KAZ** » Wed Jul 11, 2007 7:52 pm

In my case I was in a spiral that not only included sleep deprivation,but also O2 deprivation. I'm sure that I was depressed because I not only could not lose weight, I was adding on more weight until I finally collapsed, and my SA was discovered. Thanks to successful treatment I feel that I am again in control of my life. Great post rooster, it may prevent some being treated for psychiatric illness when proper treatment for SA is the underlying reason. Regards

dinkytink · Post by **dinkytink** » Wed Jul 11, 2007 8:07 pm

My sleep study examiner looked at the symptoms I checked and said that "everyone" checks the box for depression. Makes me wish I had been tested many years back.

Still crazy after all these years!

Susanm · Post by **Susanm** » Wed Jul 11, 2007 8:09 pm

For almost 10 years now my antidepressants hadn't been giving any relief and I've been trying to get help. I told my docs it didn't feel like it was depression, that there was some other problem making me feel this way. The gp I was seeing insisted I just needed to exercise and lose about 20 pounds, and after the tests for anemia, diabetes, and hypothyroidism came back negative, my psychiatrist told me I was just a "low energy" person (I asked if that was a polite term for being lazy, and he said yes). I hate to think of how many miserable and unhappy people suffering from OSA have killed themselves, or tried, thinking that their problems were all in their head and that they would never get any relief. I feel really bad for all the people who are still wandering around in that brain fog, undiagnosed.

andyomega · Post by **andyomega** » Wed Jul 11, 2007 8:47 pm

I can understand someone being accused of being mental. I used to think my neighbors were waking me up on purpose. I even complained about it and was forced to move out of a few places for getting them mad at me.
With the bad dreams too if you have a lack of O2, that will sure make anyone crazy.... or at least seem crazy if they have no idea whats really going on.

SisterShotgun · Post by **SisterShotgun** » Wed Jul 11, 2007 10:15 pm

I went for 12 years of being diagnosed with depression, anxiety, possible Bi-Polar and none of the medication they put me on worked, so they took me off of all medications. Then finally a few weeks ago I went to a new doctor a Naval Flight Surgeon and complained about my always falling asleep during the day and having no energy..She ordered a sleep study, I was afraid she was going to suggest more med's, but no. Sleep study showed moderate OSA and CPAP treatment was needed to help..

I have never felt better in my life!!

I just wish the other doctors in the past would have really listened to me, but I was told because I was within a normal weight there was no way it could be apnea

Babette · Post by **Babette** » Wed Jul 11, 2007 10:41 pm

I've been diagnosed as depressed most of my life. My mother was convinced I was crazy and made me go to shrinks from about age 6 through high school. None of it did anything for me. The drugs had such hideous side effects I wouldn't take them.

Do you want to hear about the dirty OLD man (and I mean OLD - he was an MD in WWII) shrink who wanted me to sit in a darkened room with him while he smoked cigars and he had me describe my masturbatory experiences to him ad nauseum? My mother was furious when she found out I was skipping appointments and she was still paying for them. I won. I didn't have to go back.

As an adult, I've been on Prozac, Zoloft, B-something (what the heck was that?) and now Lexapro.

I really view my "problem" now as anxiety. After hearing a lecture about apneas causing adrenaline surges I'm more and more convinced that OSA was/is inducing my anxiety.

I feel really good right now. But I don't trust it. It could all go away tomorrow. And while my GP is very supportive, she does keep nagging me to lose weight. How do I tell her that as a 6 year old I was still "mentally ill" and wasn't fat yet?

I think OSA is very linked to "mental illness" now, and I'm going to start recommending it to my friends when they whine to me about their "mental" issues that maybe a sleep study might be in order.

Hey! "Got Sleep Study?" t-shirts, anyone? Okay, we already killed that topic.

Best wishes to us all!
B.

tangents · Post by **tangents** » Thu Jul 12, 2007 7:28 am

Put me on the clinical depression list, too.

My question is - why can't they find an easier way to diagnose OSA? I really find it hard to believe that attaching all those sensors is the only way. Does the AVERAGE PERSON need to know more than:
1. Their oxygen levels throughout the night
2. Their breathing pattern throughout the night

A pulse oximeter and a nasal cannula to measure flow could indicate the need for PAP, and an APAP could be used from that point on to regulate.

I believe that doctors would be much more willing to test for it if it were simpler. Look at how often blood tests are performed.

Sorry to hijack your thread, Rooster. Keep on cock-a-doodle-doonig!
Cathy

Issac · Post by **Issac** » Thu Jul 12, 2007 7:30 am

We know untreated sleep apnea causes depression over time, so other mental disorders would not be such a stretch.

Wolfmarsh · Post by **Wolfmarsh** » Thu Jul 12, 2007 8:20 am

Speaking from experience, my OSA caused some nasty hallucinations, memory problems, etc....

It went way beyond depression, although the depression was pretty hard to fight at times.

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