help with antidepressants for sleep deprivation

[osagirl]

I have sleep apnea, and have been sleep deprived for a number of years. I've had cpap and surgical interventions, which have not helped the severe daytime fatigue i feel every day. If i got into the details this would be a novel. Needless to say, this has done a number on my mental status, as i've become very very depressed from both being tired every day and not being able to function like a normal person. I need to go on an antidepressant, but I was wondering if there is a particular antidepressant that is better for those who are sleep deprived/depressed from lack of quality sleep. I'm assuming theres quite a few people out there who need to take antidepressants as a result of the OSA. Any input would be great, thank you.

[ozij]

osagirl, you posted the same question in August, and when asked, added this info:

I have had my tonsils/adnoids removed, deviated septum corrected, and bi maxillary advancement (jaw surgery, twice actually cause my friend accidently hit me in the face shortly after the first one and i broke my mandible). nothing has worked, cpap at pressure 17 has worked for little amount of time but then i kept getting sinus problems from high pressures. this has gone on for six years so although i would love to not resort to medications, you can imagine after all this and no luck it gets a little "depressing"

That's 6 months ago.

I'm assuming theres quite a few people out there who need to take antidepressants as a result of the OSA.

Actually, there's quite a few people out here who discovered their depression lifted when they got proper CPAP therapy.
And they go proper therapy by tracking their own results.

If I had a sleep doctor who kept me on an automatic machine when I need a pressure of 17, I'd change the doctor, since he should know enough to change me to a bi-level.

If I had maxillomandibular surgery I would definitely want to have another PSG to know how I'm doing.

I'm not clear whether you are still using cpap, whether your surgery worked, or what else is going on.

I am clear about this:

• We here have far more knowledge and experience to help you with your cpap therapy than with medications.
  Machines and diagnoses have changed since 6 year ago -
  Anyone whose therapy is not working properly has to get a data capable machine - which you seem to have - and software to track their data on a nightly basis.

Speaking sinus problems: Check this http://www.neilmed.com - it's about rinsing you sinuses with a saline solution.

Good luck.
O.

[DreamStalker]

Some people look for quick fixes with little blue or red pills when the easiest fix is staring them right in the face ... like your CPAP mask.

[roster]

Some people look for quick fixes with little blue or red pills when the easiest fix is staring them right in the face ... like your CPAP mask.

Agreed.

Someone brought my attention to a television ad for a new drug, Abilify by Bristol-Meyers Squibb. This is an antidepressant to be taken in addition to the antidepressant the patient is already taking. The tv add states, "Since antidepressants are not effective in two out of three cases, you need to take Abilify to help."

So here we actually have a drug company stating that antidepressants are not effective in two out of three cases! I infer that 33% of the time they are effective. I also understand that placebos are effective for 40% of cases.

Yes, there are many people that take antidepressants for OSA. One of my sleep docs says that more than 50% of the cases showing up at the sleep lab for the first time are already taking antidepressants. She believes this is entirely inappropriate and works to get them off medication as the CPAP therapy kicks in.

I was given three different SSRIs before I figured out I had OSA. I took them only short periods because they made me very sick. It was an entirely wrong treatment for OSA. With CPAP therapy, I have no need for medications and can not imagine ever taking an SSRI again.

I am concerned about the effectiveness of your CPAP therapy. Do you have the software for monitoring? Tell us some details about how the therapy is going.

Regards,

[Julie]

You're far more likely to do well if your Cpap is properly set up. You may have been given the wrong mask (possibly needed a "full face" one to counteract mouth breathing while sleeping) or not had it fitted properly, as well as not having been instructed well on how to use the machine. More info, because we think we might be able to 'fix' your problem without drugs.

[osagirl]

no. I have sleep apnea due to anatomically narrow nasal passages as I just recently found out. This is why I mouth breathe ONLY AND why cpap will not work. the nasal passage is ANATOMICALLY TOO NARROW, so you cant STENT open something your NOSE that is just TOO narrow from bone and cartilage deformities. Its not like i have fat around my throat that is soft and can be stented, its actually quite the opposite. So, its not a blue or red pill FIX, i didnt do anything to bring this disorder on myself, like being overweight, ive had it SINCE birth. and cpap contrary to popular belief doesnt HELP EVERYONE. SO please please dont assume, and if your not going to answer my question i really dont need any input on your personal feelings.

[osagirl]

oh, and about it being a quick fix, ive had HALF MY TONGUE REMOVED, UPPP, MY upper and bottom jaws moved forward, and many more. so dont tell me its a quick fix to need medication, youd be pretty resentful and desperate if youve done everything under the sun and still are suffering.

[DreamStalker]

.... Any input would be great, thank you.

[rocketdork]

This would be a fantastic conversation to have with your Doctor. Find one that is knowledgeable about AD medication and request one that will help you sleep if possible.

I'd agree with some of the folks above. We are going to be able to help you with xPAP type questions, but when it comes to other medication, I would imagine that our collective knowledge would help somewhat, but for specifics, your Doctor is going to be the best resource. AD medication is very individual in my experience. Some will help one person, the same one will not help another. The side effects of one medication may be more than you can bear, but another will work just fine.

Remember that Depression is a disease of the Brain, not a state of mind. There is no shame or stigma that should be attached to it. Treatment via a qualified professional is in order.

CPAP therapy isn't for everyone and it certainly sounds like you've explored all the other options. Talk with the Doctor about BiPap therapy as others have, you may find more success with it. If that fails, the only option that it sounds like you haven't tried is a tracheotomy. A drastic step to be sure, but it *will* solve the apnea problems according to this article.

Most of all, be persistent and aggressive in seeking a cure or remedy. Please don't give up, life doesn't have to be this way for you. You have my sympathy for going through what you've been through. I'm thankful that my OSA can be simply controlled with just an irritating machine beside the bed.

[OutaSync]

osagirl,

Please, please, please read this book, by Dr. Mack Jones. It is not a long book. I read it in a couple of hours and I am a slow reader who has to go back and read the page again because I cannot remember what I just read.

http://stopsanow.com/

He has been through what you have been through and he knows what he is talking about. There is another option for people for whom CPAP theray won't work. You may be one of those. But make sure that you have given it your best shot before undergoing any more surgery. If you have high pressures, you should ask your doctor about BiPap therapy. If that doesn't work, there are different machines that might work better for you. Drugs make the problem worse and they can make the apneas longer and more deadly.

osagirl, most of the people on this board can slap a mask(once they find the right mask) on their face and feel better in a few days. Some of us have to dig in a little deeper to find out what works best for us. You have been through far too much already to be stil suffering. What kind of doctor is advising you through this process? Please stay with us. Let's do this one step at a time.

Bev

[ozij]

I've just read through all of osagirl's posts on this forum since she joined, 2 years ago.
An interesting, strange, and saddening read.


O.

[dieselgal]

OSAGIRL, I understand you have some pretty severe issues and I do sympathize but the question of which anti depressant you should try is definitely an issue between you and your Dr. What works for one of us may not be what you should take at all, so definitely see a Dr. that is willing to listen to you and go over your meds list with you.
Good luck.

[DreamStalker]

I've just read through all of osagirl's posts on this forum since she joined, 2 years ago.
An interesting, strange, and saddening read.


O.

I just read them too. Very weird.

If nasal restriction is the problem, why are her doctors performing surgery elsewhere (tongue, jaw, and throat) other than her nasal passages? ... trying to force CPAP to work? and now drugs?

Aren't there surgical proceedures for fixing bone and cartilage deformities of the nasal cavity?

I hope she finds better doctors.

[roster]

.... Any input would be great, thank you.

In the history of mankind, has there ever been a human who, saying that, really meant it?

Make note to self: Never say that.

Criticism: What you say about me.
Constructive criticism: What I say about you.

[roster]

oh, and about it being a quick fix, ive had HALF MY TONGUE REMOVED, UPPP, MY upper and bottom jaws moved forward, and many more. so dont tell me its a quick fix to need medication, youd be pretty resentful and desperate if youve done everything under the sun and still are suffering.

Antidepressants don't treat sleep deprivation. In fact, they don't even treat depression.

If you can't breathe through your mouth and use CPAP, then you need to find a good sleep doc and a good ENT who will work together on a plan for your health. Like the others suggested, the radical solution of tracheostomy should be one of the considerations.

Good luck to you and let us know how things go,