Laurent_fr wrote: ↑Thu May 27, 2021 3:59 am
Do you think that tossing and turning could be a stress issue and not directly related to OSA ?? My wife, my parents and many others people seems to think I'm a "stressed guy"!! Maybe it's real...
I took benzodiazepines for years, I've quit that sort of meds in 2017, and recently (last year) I also stopped escitalopram.
Do you think it could be related ?
More real than you might think...or want to accept.
While I doubt that the elimination of escitalopram is a factor in the poor sleep itself right now (withdrawal itself for a period of time could have caused additional problems but you should be done with withdrawal by now)....the very reason you were on the medication in the first place could still be a factor.
Not to mention the class of medication that it is in is well known to mess with sleep stages...SSRIs....they are well known to mess with sleep as well as how a person actually feels. They reduce REM stage sleep for one thing.
Then the very reason a person is given those types of mood meds can also be a factor in sleep quality...damned if you do with the meds and damned if you don't.
I don't know how much work you want to devote to evaluating your sleep quality itself. It takes a lot of work and education on your part and even when we do the work we don't always have an easy fix for it because we don't know what the actual cause of the problem (poor sleep quality) might be and to have any chance of fixing the problem we have to know the cause of the problem.
Hell, sometimes when we know the cause of the problem the fix isn't easy. I have first had experience in that area myself.
Sounds to me like you have at least 2 physical health issues going on and perhaps even a bit of mental health issues (stress) going on.
OSA is a very real physical health issue. The easiest to technically fix fortunately.
Frequent arousals/awakenings from sleep...another health issue because it keeps a person from getting the needed amount of each sleep stage....and it may or may not be tied to your response to stress in your life.
I have a very good friend who battled insomnia all her life and then ended up battling OSA as well. She told me that fixing the OSA was the easy part. She told me that getting good sleep was always going to be her greatest challenge and after lots of trial and error and much discussion with her doctor she ended up using one of the newer sleep RX meds on a prn basis. She didn't want to but her insomnia issues were crippling. There is a time and place for medications.
But you have to realize that all medications come with baggage and/or unwanted side effects which may also create new problems with unwanted symptoms. You and your doctor have to evaluate the risk vs reward for adding those meds.
Arousals/Awakenings...you may or may not remember them but they mess with restorative sleep.
Sleep maintenance insomnia...where we have those arousals/awakenings to the point that restorative sleep is hard to get.
I know people seem to really fear the word "insomnia" for various reasons but if you don't sleep good and you know you have a lot of arousals/awakenings/tossing and turning.....sleep maintenance insomnia is what it is called.
You may have got what you thought was 7 hours of uninterrupted sleep last night but I would bet my last dollar that it was more interrupted than you might think.
Everyone has arousals...we just don't always remember them. It's normal to awake after a REM cycle but normally we aren't awake long enough to form a memory. A person can have arousals and not remember them because they fall back to sleep quickly.
What I sense with you...
First of all you were expecting cpap to fix all your sleep issues AND you haven't been consistent with the cpap usage. You quit using it because it didn't do what you wanted which was fix sleep issues that were unrelated to the airway...so you just quit it and compounded a problem by having OSA untreated back into the situation. Shot yourself in the foot.
I sense you want a quick fix....unfortunately most people don't get quick fixes.
I know you probably don't like what I have said above but it's the truth...and a rather ugly truth at that.
You are like my husband...want an immediate fix to whatever problem there is and impatient as hell which causes more stress and compounds the problem. One night...not nearly enough time to expect any sort of fix....need at least 2 weeks straight of those 7 hour nights to be able to expect anything at all. You have to give the body time to heal. It doesn't heal overnight no matter how much we might want it to.
Take the time to read this blog...mainly because she mentions a couple of really good books that I strongly advise that you read them.
You need to educate yourself on your sleep quality issues.
http://adventures-in-hosehead-land.blog ... er_19.html
So a lot in her blog doesn't pertain to your situation but how she goes about learning and dealing with her sleep issues does pertain to you. Read the books she mentions.
As for adding
lorazepam back into the mix....I don't like using benzos unless absolutely no other option is available. They just come with too much baggage and I feel the baggage is unacceptable but that's between a patient and their doctor. Those kinds of meds are more for acute stressors IMHO....death, divorce, loss of job, etc...and not chronic issues where we can't put a finger on the stressor.
Once a week for emergencies...unlikely to cause a problem but what happens is people start gradually increasing frequency and it isn't long before they are on the benzo wagon again.
Did you know the melatonin itself comes with some rather nasty baggage? It comes with some unwanted daytime symptoms as well.
Google melatonin side effects....it's not nearly as benign as people might think and often people take way more dosage than is really needed. Plus it's more of a help you fall asleep drug...not a help you stay asleep drug.
Now they do make a melatonin now that is sustained release which is more of a help you stay asleep drug...but remember it also can come with some baggage that affects how we feel when we wake up. If you feel melatonin helps a bit...maybe try the SR version?????
Worth trying.
I wish there was a quick fix available for you but there isn't. Cold hard fact of life.
You absolutely have to use the cpap machine though to stand any chance in hell of ever sleeping and feeling better but you have to realize and accept the fact that you most likely have additional problems that the machine can't fix so you have to work on those problems separately.
I may have to RISE but I refuse to SHINE.
).
