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General Discussion on any topic relating to CPAP and/or Sleep Apnea.

Where you misdiagnosed and put on psychiatric medications before finding out you had OSA?

Yes, I was on antidepressants, sleeping, anti-anxiety, etc meds
37
56%
No, I was not on any meds before finding out I had OSA
28
43%
 
Total votes : 65

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jskinner
 
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Initially misdiagnosed

Postby jskinner on Sun Jun 03, 2007 2:30 pm

This is an informal poll to she how common it is to be misdiagnosed and put on psychiatric medications (antidepressants, sleeping pills, anti-anxiety, etc) before finding out that one has sleep apnea.
Last edited by jskinner on Sun Jun 03, 2007 3:11 pm, edited 1 time in total.
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Postby Linda3032 on Sun Jun 03, 2007 2:43 pm

Remember that most of the time you have to click on "vote" twice before you get the message that "your vote has been cast".

I voted no.

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Postby Severeena on Sun Jun 03, 2007 4:21 pm

I was not misdiagnosed, but my original doctor decided to treat me for Narcolepsy instead of the Sleep Apnea my results showed,

I am so thankful my then boyfriend and now husband asked me to get another sleep study because my results showed definitely was Sleep Apnea.

I was on Narcolepsy meds for a year or more.

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Postby blarg on Sun Jun 03, 2007 4:28 pm

I was put on Sonata and told to see a psychiatrist to check out the possibility of BiPolar.

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Isn't life amazing!!!!

Postby John_M on Sun Jun 03, 2007 4:30 pm

I am completely amazed at this twist in my life. Yes I was labelled bi-polar in 1976 and have been messing with psychotropic meds ever since. So I come in to CPAPtalk grateful to be given the opportunity to learn how to deal with tiredness by using CPAP. So I learn and am currently doing AHI's below 1 and sleeping seven hours.

But I am still tired, am going into another heavy depression and am starting up on SSRI's for depression.

And you guys suggest it may be all due to OSA ?

Hmmm.

At any rate the Depression Solution is on its way (used on Amazon.com for about $8 ) and I will sit amazed and wonder what's going to happen next?

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Postby jabberwock on Sun Jun 03, 2007 5:00 pm

I have not voted because I am not comfortable with either of the choices.

I was diagnosed with depression in 2001 and have been on anti-depressants ever since. I was diagnosed with sleep apnia in 2003; however, like so many others here, quickly became frustrated with treatment and gave up on it after only a few months.

With the help of this forum, I have been trying for the past month to manage my therapy and become totally compliant. It may be that OSA is the root cause of my depression and I will no longer need the antidepressants one day. However, I am not, at this point, ready to state that I was misdiagnosed with depression, since I have not yet been convinced that effective OSA therapy will "cure" my depression.

And I'm sure not about to stop taking my meds in order to find out. Anyone who has been treated for depression will understand why :cry:

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Re: Isn't life amazing!!!!

Postby jskinner on Sun Jun 03, 2007 5:33 pm

John_M wrote:And you guys suggest it may be all due to OSA ?


My suggestion is that sometimes people being treated for depression are in fact suffering from OSA and have been misdiagnosed. Depression is a common symptom of OSA (although doctors don't seem that educated about it)

However since I believe depression is a symptom, it could be caused by many other things as well ( thyroid, low B12, psychological problems, etc) That means of course you could have treated OSA and still get depressed due to some other factor.

Certinally anyone that has suffered from depression in the past and finds out they have OSA should review their situation to see if it might have been the solely OSA causing the problems. It some cases it will be, in others it won't
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Postby sharon1965 on Sun Jun 03, 2007 5:53 pm

i was prescribed effexor for a non-existent depression (which i took for six months for reasons that i can't now explain or even understand...desperation? :oops: ) before i smartened up and weaned myself off...my gp wasn't pleased when she found out, and still hasn't acknowledged my osa diagnosis that she missed because she was too busy making me feel like i had brought all my ailments on myself, telling me to eat less, move more and take anti-depressants...what a moron

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Postby tillymarigold on Sun Jun 03, 2007 6:07 pm

Yes, I was diagnosed with dysthymia and put on Wellbutrin XL. They kept upping my dose and it never got better. I finally stopped it and my doctor was going to send me to a neurologist, then I moved across-country and there's a huge awareness of sleep disorders around here, my new PCP got it right on the first try.

I am *also* vitamin B-12 resistant, I have to take sublingual tablets because my digestive system can't process the B-12 in foods or pills efficiently.

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Postby jasper on Sun Jun 03, 2007 7:28 pm

I am lucky enough to have a PMD whose husband also has OSA. She listened to my symptoms, and gave me the info to schedule a sleep study right away.

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I voted yes...

Postby robbieh on Sun Jun 03, 2007 9:10 pm

I've been on antidepressants for over 10 years. They keep me stable. I've tried to get off them 3 times. Each time is like a severe crash that I cannot handle. I wonder if my OSA had been discovered earlier, if I could have avoided a lot of the problems I went through. I'm also on a low dose beta blocker for hypertension which is very well controlled. I take sleeping pills every night.

My hope is that I can get off all my prescription meds in the coming year. First I need to stablize my OSA and get my AHI down to normal. Then in time I will try coming off my meds. I also am very grateful for the support I've received at this site. Knowledge is power!


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Depression and Sleep Apnea clearly linked.

Postby John_M on Sun Jun 03, 2007 9:10 pm

1: Arch Intern Med. 2006 Sep 18;166(16):1709-15. Links
Longitudinal association of sleep-related breathing disorder and depression.Peppard PE, Szklo-Coxe M, Hla KM, Young T.
Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA. ppeppard@wisc.edu

BACKGROUND: Sleep-related breathing disorder (SRBD) and depression have each been independently associated with substantial morbidity, impairment, and disability. The development of clinical strategies for screening and managing depression in patients with SRBD requires elucidation of the association between the 2 conditions. This population-based epidemiological study assesses SRBD as a longitudinal predictor of depression. METHODS: Men (n = 788) and women (n = 620) randomly selected from a working population were evaluated for SRBD by in-laboratory polysomnography and for depression by the Zung depression scale. Results of multiple studies, performed at 4-year intervals, were available for most participants. Sleep-related breathing disorder was characterized by the apnea-hypopnea index (AHI; events per hour) categories: AHI = 0, no SRBD; 0 < AHI < 5, minimal SRBD; 5 < or = AHI < 15, mild SRBD; and AHI > or = 15, moderate or worse SRBD. Depression was defined as a score of 50 or higher on the Zung scale or use of antidepressants. Potential confounding, interacting, and mediating factors were assessed by clinical measurements and questionnaires. RESULTS: In purely longitudinal models, an increase of 1 SRBD category (eg, from minimal to mild SRBD) was associated with a 1.8-fold (95% confidence interval, 1.3-2.6) increased adjusted odds for development of depression. In adjusted models combining longitudinal and cross-sectional associations, compared with participants with no SRBD, the odds for development of depression were increased by 1.6-fold (95% confidence interval, 1.2-2.1) in participants with minimal SRBD, by 2.0-fold (95% confidence interval, 1.4-2.9) in participants with mild SRBD, and by 2.6-fold (95% confidence interval, 1.7-3.9) in those with moderate or worse SRBD. CONCLUSION: Our longitudinal findings of a dose-response association between SRBD and depression provide evidence consistent with a causal link between these conditions and should heighten clinical suspicion of depression in patients with SRBD.


Well I think this means that people with moderate to worse Sleep Apnea are 2.6 times more likely to have depression than the "normal" population

Now is the depression due to having Sleep Apnea? You know, you feel bad you get depressed

or is the Sleep Apnea causing depression by other factors ?

As Sargeant Schultz would say "very interesting"

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Re: Depression and Sleep Apnea clearly linked.

Postby jskinner on Sun Jun 03, 2007 9:35 pm

John_M wrote:Now is the depression due to having Sleep Apnea? You know, you feel bad you get depressed or is the Sleep Apnea causing depression by other factors ?


Indeed that is a tough question to answer isn't it?

Clearly when you can't function normally due to all the effects of sleep apnea it can have a devastating real psychological toll. Equally its clear that the affects of apnea have a direct impact on the brain and there could could very easily be directly causing depression in some fashion.

Its possible both angles could even be a factor...?

robbieh wrote:I've been on antidepressants for over 10 years. They keep me stable. I've tried to get off them 3 times. Each time is like a severe crash that I cannot handle.


In the past when you tried to get off antidepressants how slowly did you do the titration? Its needs to be done _very_ slowly (many months). It takes time for you body to up regulate the receptors that have been eliminated. Most people try to get off to quickly. If you all of a sudden stop over stimulating the existing receptors then there is not enough signal getting through. This typically produces a depression worse than the one that you started with and with a doctor declaring that this is proof that you "need" to be on an antidepressant. Most doctors are completely ignorant that this is in fact part of the withdrawal and not a return of the original depression. I have a book with a whole chapter on this phenomena, I'll see if I can remember the name of it. I went though this 2 or 3 of these withdrawals before I realized this was part of the process. Unfortunately I knew nothing about down regulation at the time (Drs. claimed it was impossible to have withdrawal from ADs back then)

Last edited by jskinner on Sun Jun 03, 2007 10:01 pm, edited 1 time in total.
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Postby ZZZzzz on Sun Jun 03, 2007 10:01 pm

I used to tell people that I thought all of my problems would go away *if* I could only get a good nights sleep.

If I had only listened to myself!

My husband cracked the case finally by mentioning that it sounded like I was "struggling to breathe last night."
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Postby lawdognellie on Mon Jun 04, 2007 1:31 am

In all fairness, although I was on anti-depressants and sleeping meds before diagnosis, I'm still on anti-depressants and I STILL have depression. Unfortunately for me, I inherited it and it's resistant to anti-depressants. The depression led me me gaining a LOT of weight (and maybe the apnea too).

However, my psychiatrist was the one that thought I may have a sleep disorder as well and when he referred me to the sleep doc, she tried to tell me it was JUST depression. I had to sic my shrink on her to get her to run the tests. Surprisingly enough, I did have severe sleep apnea (note sarcasm). And when that didn't fix the problem completely, the sleep doc again tried to claim it was just depression. I threatened her with malpractice (gotta love being a law student) and had her run a PSG and MSLT. I also have spontaneous arousals and idiopathic hypersomnia. I guess I'm just screwed.

Sarah

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