Sleep Stages Question

SleepingUgly wrote:

Patrick A wrote:One of my doctors put me on Neutrontin I was so tired all the time that I could not function at all.

As far as I know, Neurontin for PLMS is used at night, not during the day.

I had a doctor prescribe it and they wanted me to take up to 3 tablets ever 6 hours. All of the other medications I am on currently for other medical problems don't do well with Neurontin. So they switched me to Lyrica same dosage 50 mg. tablets. They do not work well with Plavix or Cumaden and or Lenoxin. I was told to take them at night (the Neurontin) They also wanted me to take them up to 6 times a day.

I was on Neurontin for a few years for a bulging disk in my neck. My limb movements were no better while on it.

Kathy, have you been on dopaminergics? That is the first line of therapy for PLMS.

kteague wrote:I was on Neurontin for a few years for a bulging disk in my neck. My limb movements were no better while on it.

Since diagnosed in 1998, I spent a few years each on Sinemet and Mirapex, and have been on Ropinerole (Requip) this past year. Each gave a degree of relief temporarily, but with increased doses the problems with side effects outweighed the regressing benefits. My time on Neurontin coincided with the time on Sinemet and a short period while on Mirapex. My increasing daytime sleepiness caused me to decide to deal with the neck pain and give up the Neurontin.

Do you have RLS and PLMS? I assume when you say that a particular medicine did not work, you mean for the RLS? Or can you tell whether your PLMS is worse or better, and if so, how?

I thought I understood the distinction between PLMS and RLS (former being the periodic jerks in sleep that are measured on PSG, and the latter being the crawly sensation while awake, which requires report of such sensations). But the way the terms are used, even by the doctors, makes me think that I am wrong. Further, there seems to be no agreement on whether PLMS in the absence of related arousals is clinically significant. One doc even told me that she doubts the PLMS is of significance if there are no daytime symptoms (i.e., RLS). I should probably understand this better, as PLMS were noted on all my sleep studies, and have never been aggressively treated.

kteague wrote:Since diagnosed in 1998, I spent a few years each on Sinemet and Mirapex, and have been on Ropinerole (Requip) this past year. Each gave a degree of relief temporarily, but with increased doses the problems with side effects outweighed the regressing benefits. My time on Neurontin coincided with the time on Sinemet and a short period while on Mirapex. My increasing daytime sleepiness caused me to decide to deal with the neck pain and give up the Neurontin.

Yes, I have both RLS and PLMS (PLMD). The RLS was much better on Mirapex, but the PLMS worsened. The difference between the two is confusing, as even medical professionals sometimes use them interchangeably, and since one can have plm's on their report and not have PLMS/D. Limb movements that happen periodically (yet randomly) while sleeping can be related to breathing efforts, discomfort - any number of reasons.

To the best of my understanding, RLS is a randomly ocurring voluntary movement is response to a sensation. While they are generally experienced during wakefulness, they can intrude into sleep. Movements of true PLMD are stereotypical rythmic involuntary movements almost exclusively during sleep (with some exceptions).

At higher doses of medication my PLMS became wild flailing and even sometimes of enough intensity to cause an almost lurching of my torso. They happened while I was aware of them, even able to count the seconds between them. But once I hit a certain level of wakefulness, they'd stop abruptly. I also experienced some of the compulsive behaviors now warned of with dopamine agonists. The intensity of these symptoms resolved after reducing the med. The presence or absence of arousals is, in my nonmedical opinion, a very good gauge of their signifcance. Problems with unexplained leg pain due to lack of enough rest for those muscles might merit another look. I don't think meds should be automatic, but reserved for when the movements are significantly adversely affecting the person's health and well being.

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Well, at one point I went off Mirapex abruptly, not by intent. Went out of town before my prescription could be refilled, and after a few days turned into a couple weeks, I decided to see if I could manage without it. Big mistake to stop abruptly. Although my prior side effects disappeared, I developed what I guess is a form of synesthesia, a glitch where the wires get crossed between out senses. Neuro doc said it was because I stopped abruptly instead of weaning off. At some point (maybe a few months later?), I agreed with a consulting doctor to do an experiment and go back on the med in a structured manner and see if the flailing returned. For a short period of time, a reasonable dose gave me some relief. Increasing the dose resulted in the return of the exaggerated movements that intruded into technically awke periods, documented by another sleep study. At that point I was transitioned off Mirapex and onto Requip.

It has been maybe 7 years since I took Sinemet. My sleep doc is suggesting that I try adding a small dose of fast acting Sinemet when I wake during the night due to limb movements. I guess I'll give it a try. My concern is that Sinemet is a replacement, generally used when the agonists are no longer effect. At 58 years old, if I exhaust the effectiveness of the replacement, what does the future hold in regards to my disorder and if I should ever develop Parkinson's, for which this drug was developed? Since tomorrow is not promised, I'll delay as long as I can, then do what I've gotta do.

I have read that a vacation from these drugs can extend their effectiveness. My experience is quite limited with that.

Нещодавно я натрапив на ваш блог і читали разом. Я думав, я б залишити мій перший коментар. Я не знаю, що сказати, крім того, що я любив читати. Хороший блог..

kteague,

You mentioned back issues. In my own experience, my back pain makes me wake up A LOT to roll over. The pain actually wakes me up. Sometimes I'm aware of it, sometimes it's related to me by my spouse that I'm groaning in my sleep as I roll over. When this happens, I don't feel rested in the morning, I suspect because the pain keeps from getting enough REM.

YMMV

I see that a spam post by a Kevin.McLoud revived this old thread. Nice to walk down memory lane.

DreamLady - Pain in my back, shoulders and knees used to give me lots of grief at night too. At some point, a change of mattress and/or steroid injections have helped with those issues. Still wake with pain and numbness in my hands (discussed in another thread). Yes, pain can be a real sleep buster.

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Secret Agent Girl,

The only time I tried hypnosis was at least 25 years ago for eating. Had about 3 weeks of noteable change afterward. Not sure if that's about what one should expect or not.

Are you thinking of hypnosis for sustaining sleep or for treating PLMD? If you're saying for sustaining sleep, it's interesting that hypnotic drugs are often used for sleep issues. I don't know enough about how hypnosis works to even have an opinion. I do find I am more open to exploring non pharmaceutical solutions than I once was. Since I've been using the TENS Unit for my limb movements, I am getting significant blocks of sleep, and the wakeups are usually for a potty run. Although I never stopped dreaming, they certainly are prolific lately. Still waiting for daytime sleepiness to resolve.

Are there areas you have used hypnosis for and found it beneficial?

Kathy

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