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General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Griff
 
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Anyone Else Referred to Sleep Study By Psychiatrist

Postby Griff on Mon Jan 02, 2006 1:13 am

Let me start by saying how impressed I am with this community of people brought together by a common affliction (sounds awful doesn't it?), and the amazing amount of information and resources you all have amassed here. It's incredible! I've been lurking around, soaking up tons of stuff from this site over the past week, educating myself on my newly discovered affliction - (maybe condition sounds a little better) and actually enjoying the heck out of it (the learning that is). It's made a huge difference on how I am perceiving this whole thing.

As for the subject of my post - I have been diagnosed with depression for the last 12 years, and have been through a half dozen kinds of anti-depressants and just as many psychiatrists and/or psycho analysts in 3 different states - in order to help me manage it. My major complaint to all of them was a lack of energy and an insatiable need for sleep - no matter what time of day it was. Every one of them (with the exception of my current Dr.) labeled me as a severely depressed person, threw medication at me and put me in everything from Nuerolistic Programming to Cognitive therapies - all to no avail. Only until very recently was sleep apnea even considered as a cause (or at least a contributing factor) of my depression, and this by my present shrink (God love her). It was one of the first things out of her mouth when I told her my symptoms and history - SLEEP STUDY - NOW! I just have to wonder if there is truly that large of a scope of ignorance in the psychiatric community as to the affects of sleep apnea, or is there something else immensely more sinister here? I can only hope it was the former and don't even want to consider the latter. After only one week on CPAP I can honestly say that it has done for me what no medicine or psycho-analysing could ever do in 12 years, and I can only see my condition improving from there over the next few months. I feel extremely fortunate for and am forever grateful to my current Doctor for having had enough medical insight to question things other than my state of mind. She is by far the exception to the rule as far as my experience goes.

So - I am curious to know if anyone else out there has had sleep apnea as an ailment suggested to them by someone in the psychiatric field. I'd like to see some numbers on this, because I intend to personally get a hold of each and every one of my past shrinks and therapists to let them know that there are conditions beyond the realm of the the mind that can not only affect behaviors, but be life threatening as well (that's not to say that depression isn't). I'm not saying that their diagnosis of depression in me was necessarily wrong - I do have a strong family history of it, and it's likely that I do suffer to some degree from it - but to not look past the diagnosis of depression - even at the very least getting a simple blood workup done in order to look for obvious medical issues like diabetes or thyroid issues- is to me - for someone who calls them self a medical professional - NEGLIGENT. And I further believe that ANY diagnosis of depression, be it of any degree, be followed up immediately with a mandatory sleep study. Now, I'm by no means harping on the profession as a whole, but there are some obvious deficiencies that need to be corrected. Hopefully it's just a need to enlighten and educate them.

I'll step down from the soap box now and look forward to answers from anyone this might pertain to.

Griff[/b]


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LDuyer
 
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Postby LDuyer on Mon Jan 02, 2006 1:24 am

Griff,

I have to say I was most interested reading your story. It saddens me that you had to go through so much, and apparently needlessly.

I was not one of those like yourself, referred by a psychiatrist.
I can't imagine many are. Even many general physicians don't recognize the symptoms or know much about sleep apnea. I can't imagine psychiatrists knowing much more. But they should.

Depression is a big part of untreated sleep apnea for many people. It may not be the same form of clinical depression suffered by other people, but it is real. Regular physicians who fail to consider sleep apnea as a cause often treat the symptoms without looking at their totality. Same for the mental health community, I am guessing.

You will find many newly diagnosed sleep apneacs having been treated with drugs for depression prior to diagnosis for apnea. I've heard this time and time and again.

I hope you do get more comments from people who have been misdiagnosed for depression rather than diagnosed for their apnea. Contact those past psychiatrists, give them a hard time. Find articles about it, send them to those doctors. Educate them, because they sure need it. Good for you.

Here's one article on the subject:
Click here for link to article

Here's another article about a Stanford study on the subject:
Click here for 2003 article on Stanford study

Here's another Stanford article, more recent, in the Annals of General Psychiatry on the same subject:
Click here for different Stanford study

And here's an interesting article, dated October 2005:
Click here for October 2005 article


Linda

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Griff

Postby sapphireskye on Mon Jan 02, 2006 2:07 am

I was not sent for a sleep study by my psychiatrist, however I suffer from
severe depression and Obsessive compulsive disorder. A psychiatrist I had before moving to Colorado knew I had untreated sleep apnea. He said he had patients who had sleep apnea, and one in particular came off all his psych meds after being treated. He said this patient actually had psychosis. Not only did he come of his psych meds, but all his high blood pressure meds as well.
I do not believe CPAP will cure me, but I believe it will help. I surely think that psychiatrists, or any medical professionals should be obligated to dig deeper to find the cause of things or at least the things that are adding fuel to the fire.

God bless and I really hope this helps you
Chelle


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Postby dsm on Mon Jan 02, 2006 4:33 am

Griff,

What a great story - and I really like your determination to try to set the record straight with former shrinks.

Yes OSA can cause depression. Yes your focus on your doziness & desire for sleep is symptomatic of someone suffering during the day from low blood sat levels at night brought on by any number of triggers but OSA being a primary contender.

Your attitude & awareness will serve you well. I am guessing we will have another very positive contributor here and for that you are more than welcome.

Do be aware of the 'honeymoon period' or what some of us call 'cpapers high' - this is a period of euphoria brought on by the benefits of cpap - can last for weeks or months - if you go through this (am sure you will) enjoy it while you can but at the other end life can be expected to settle down to a more steady pace.

There are many euphoric experiences that people new to cpap can experience. It can be your general energy, strong feelings that you have solved a major life challenge (which has a truth to it), the feeling you can leap tall buildings & do other things you felt far to tired to even contemplate.

xPAP can be a real buzz - if it is, you are well on the way to being in control of your health & wellbeing in ways you may have long longed for.

Welcome !!!

DSM

xPAP and Quattro std mask (plus a pad-a-cheek anti-leak strap)

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Re: Anyone Else Referred to Sleep Study By Psychiatrist

Postby kathleen on Mon Jan 02, 2006 10:53 am

I should have been ... I was mistreated for depression and when treatment didn't work was mistreated for bipolar illness.

It wasn't until several physicians suggested a sleep study that an HMO would approve it.

As a result, I really think ALL physical causes should be ruled out before someone is treated for mental illness.

alphabettie
 

referral

Postby alphabettie on Mon Jan 02, 2006 12:36 pm

I have been battling depression for 20 years. I was lucky to have my symptoms tolerable with prozac and klonopin as needed for anxiety. However, last year I felt a change in my demeanor. I was not only tired but severely fatigued. I went to a new pschyiatrist since I had moved and we worked on becoming relaxed. We discovered that I never relaxed. I complained of not sleeping well and he told me to go to bed with an ambien and get 8 hours a night. Then, miraculously, I went on a trip with friends. They reported that I lightly snored a bit, but more importantly, they said that I was struggling to breathe.
I went to my appointment with this new information and within in a week my psych had me in with a sleep doctor and my first overnight. A week later I was in for my second study with cpap and the rest is history. I have been on cpap almost a month on 12 pressure.
I have had good days and bad days since starting. I have definitely had more energy and less anxiety. I do have an afternoon meltdown around 4 each day but am sleeping about 10 hours per night with and without leaks. (struggle).
I owe my friends a lot for telling me about my breathing as living alone, I never would have figured it out. I do not know if I have had apnea for the last 20 years or not. I do not have the time to try to figure it out. I am 55 and would just like to move on.....to better sleep and a better attitude about life in general....it is easier to tackle whatever needs to be addressed when I have energy to do so. As far as other therapists knowing about apnea, I would say probably this is happening slowly. My absolute favorite shrink did Jungian dream analysis with me and stressed how important sleep was (this was 20 years ago) but I am not sure that sleep medicine was that evolved then.
Keep in touch and let us know how you are progressing. I hesitate to say that my depression will be cured.....but manageable would be nice at the least. Good luck.
Deb


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Griff
 
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Postby Griff on Mon Jan 02, 2006 3:32 pm

Linda - thanks for the links. I intend to print them up and give some folks an edu-ma-cation.

Thanks to everyone else for their response. I think this is worthy of a crusade.....

Griff

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Postby winken blinken and nod on Mon Jan 02, 2006 5:36 pm

In my case the apnea was not causing my depression as much as compounding it. And my depression was masking my apnea.

I have problems with depression and anxiety, as do most of the members of my family. My problems started in my mid-twenties and I've been treated since my early thirties. I have a wonderful psychiatrist who I have been seeing for over 20 years and we have had reasonable success at keeping my symptoms under control.

In looking back, I think my apnea probably started about 15 years ago and about that time I started having many more problems with anxiety and more trouble keeping my mood stable. My doctor has always aimed to keep me on as few meds and as low doses as possible, but I've wound up needing 5 meds to keep me on an even keel.

Then, last summer, my Restless Leg Syndrome got way out of control. So my psychiatrist sent me off to my primary care doctor to get a referral for a sleep study.

I saw the sleep doctor who ordered an overnight study to evaluate my restless legs and to evaluate me for sleep apnea. 'Lo and behold, severe apnea (AHI of 70). Started on APAP two months ago.

My psychiatrist seems to be quite knowledgeable about SDB and she was excited when she got the results as she thinks this might account for struggles we have had getting a good medication regimen going. Now I am in the process of SLOWLY reducing my psychiatric medications. I will always need to take medication (my depression has a definite genetic component), but I will not need as high doses nor as many meds as I am currently on.

I see mine as a case where I started out with a depressive illness but then developed apnea as well. Because I was already struggling with depressive symptoms, it was difficult to distinguish the apnea symptoms as something separate.

SDB is so prevalent, so dangerous, and so easy to treat, it makes sense to me that it should become one of the disorders that is part of health maintenance screening.

You're right Griff, maybe if we all worked to educate our families and friends, and our physicians, we might be able to raise awareness enough to get SDB recognized as something to be considered early when evaluating symptoms.

Sweet Dreams

w, b & n


- Are we there yet? -

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Postby Guest on Mon Jan 02, 2006 8:38 pm

Thankfully, I have been referred by my psychiatrist twice for a sleep evaluation. I have a long-standing history of depression. About 7 years ago when I just wasn't feeling well (requiring 12 hours of sleep, exhausted) despite several different medication adjustments, she suggested a sleep consult. I have and was diagnosed with restless leg syndrome clinically (a sleep study was not done at that time). Medication for that has been extremely helpful and I felt quite a bit better for several years.

This past year however, I felt lousy, exhausted, but not sleepy. However, I have not been sleeping well. Waking frequently (4-8 times per night that I was aware of) with my heart pounding. She suggested another sleep evaluation. Both she and I were thinking that it was probably the RLS/PLMS as I have never been noted to snore. Initially during the sleep consultation, my doctor thought that it was likely the RLS but suggested doing a nocturnal oximetry to make sure that there wasn't anything suggesting sleep apnea. My saturation never dropped but my heart rate rose through the night and was bouncing crazily between 45 and 100 for 30-45 min at a time. A sleep study ensued and no apnea or RLS/PLMS was noted but there were 30 idiopathic arousals per hour. Doing some personal research, upper airway resistance syndrome (UARS) can present in this way and not be picked up on the standard PSG. The pulmonologist has me doing a trial of CPAP which is now in its third week. I am feeling better in some ways but still far from normal. However, I am going to stick with it.


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Postby Tash on Tue Jan 03, 2006 5:11 pm

Griff,
I wasn't referred by a psychiatrist either, but had seen plenty of doctors prior to finally being sent for a sleep doctor.

I have (in retrospect) had OSA symptoms since my teen years. In college, had major sinus problems, and was always tired. Was tested for mono numerous times. in my late twenties, was diagnosed with fibromyalgia (someone told me on a forum that some researchers believe fibro is "undiagnosed sleep apnea"). Two years ago, was treated for depression due to major fatigue (took meds for 6 months, no change in fatigue, and my life was otherwise under control). Went to my gynecologist in October for my yearly exam, asked to be tested for hypothyroid (again, due to major fatigue), it came back negative, my gyn. told me I had PMS and I could take antidepressants to help (no thanks.) Went to a recommended thyroid doctor and insisted that even though my numbers were ok, that I knew I had hypothyroidism - she disagreed, and did me the favor of referring me for a sleep study (which was completed in November - moderate to severe OSA).

I have been using APAP for the last two weeks, and even though it isn't an easy road to follow, I believe I am on the right path, finally. I am grateful for the diagnosis, I am grateful for the treatment, the support on this forum, and the hope I have that I can quit being a walking zombie and actually have some vitality in my life. Like I told the last doctor, I am too young to feel this old (late 30s for anyone trying to figure it out... :) )

Anyhow, stick with the treatment, be proactive, ask questions here (it's a safe place to ask), and stay committed to your health. Best of luck!


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Postby Guest on Tue Jan 03, 2006 6:19 pm

I was sort of referred that way, but I sort of lead my psychiatrist there myself. I suspected sleep apnea and wanted a sleep study done so I brought up the subject.

Turns out that I have a serious case of sleep apnea. They got me setup on cpap that evening because I showed them enough events.

I have only been on cpap for 2 weeks. I hope that this is one of the reasons for my depression and weight gain. I have been able to get off of most of my depression meds aready and now think that I will go all the way.

I do not know if I would have found this out if I had not mentioned. No other doctor said anything, I kept telling them I was tired all the time and really wanted a good nights sleep.

I am remembering dreams for the first time in years!

Scott


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Postby mlgambino on Tue Jan 03, 2006 7:19 pm

I think that the information that everyone has posted here is very interesting. I hope that in the future the mental/emotional symptoms of sleep apnea get greater attention so that more people can be helped sooner.

Did anyone else experience sleep paralysis before they got treatment for their sleep apnea? I had many bouts with it. If it is something you have not experienced take a look at http://en.wikipedia.org/wiki/Sleep_Paralysis The painting near the top of the page pretty much sums up what it felt like for me. I thought I was going crazy, but I have not had any problems with it since I started using my cpap. My aunt was convinced that her new house was haunted because she was having a similar experience. Her problems disappeared as soon as she started using a cpap as well.


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Postby LDuyer on Tue Jan 03, 2006 7:20 pm

Wow, these stories are amazing!

I wonder how many countless people go complaining about exhaustion, and when doctors notice that depression is among the many symptoms they just leap to the conclusion that the depression is the cause. I bet most psychiatrists would say that most depression has a physical cause. Some are due to brain chemistry. But a smart phsychiatrist should look to eliminate all possible physical causes. Years ago they didn't know about sleep apnea. But now, there is enough information available on it, there's no excuse for doctors of any kind to ignore symptoms.

Interesting personal stories, folks.
Interesting painting, mlgambino.


Linda

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Griff
 
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Postby Griff on Wed Jan 04, 2006 12:41 am

Thanks to everyone for their input. I'm seeing, at the very least, a correlation between depression and OSA. I think it's a common symptom of sleep apnea and should be treated as, at least, a possible indicator for it by ALL medical professionals.
If you happen to know of someone that has been diagnosed with clinical depression, you might just suggest that this might be - instead of a condition in itself - an actual symptom of another condition - OSA.

Thanks All,
Griff[/b]

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Postby dsm on Wed Jan 04, 2006 3:12 am

Griff,
Take a bow for triggering a fascinating thread that is a wealth of useful information.

You have succeeded in getting people to open up in ways we don't often see.

This is a very valuable thread. You can chalk up your debut as a great success.

Cheers

DSM
xPAP and Quattro std mask (plus a pad-a-cheek anti-leak strap)

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