Going downhill, feeling lost

[SnoozyQ]

He is suggesting the 250 mg.

I don't know...I'd like some feedback from him on other possible contributers, but I feel like I'm the over-involved patient....I'm not trying to self diagnose at all, but I can't NOT look into things....no one else will. But, he is the neurologist, what can I possible tell him ???

[SleepingUgly]

You should look into any and all possible causes of your sleepiness and not just slap a wake-promoting agent on top of a possibly fixable problem. But that doesn't mean that you can't look into various causes while on a wake-promoting agent. I don't know your history, other than you referenced anxiety, so I don't know what the possible contributors can be (and even if I knew your history, I wouldn't know). Being sleepy is such a nonspecific problem that can be caused by a myriad of things (depression, metabolic issues, vitamin deficiencies, other sleep disorders, anemia, just to name a few).

[sydneybird]

Hi SnoozyQ, I'm sorry that you are having these issues. I'm no doctor so take this advice for what it is worth.

Your CPAP therapy may need more time to bring you results so stay with it.

During this time I am supportive to using drug therapy as a bridge to get you through the tough time. Any thought about using Ritalin on an as-needed basis to reduce daytime tiredness instead of what you are taking? I like the drug holiday idea as a form of reboot, but make sure it is ok with your doctor because you may have to gradually come off it, but I know anything about your medication and whether this is an issue or not. Go to the nuvigil web site to get your free 14-day trial and discount card and see what happens. Of course, the first 14 days might be great and it too may get less effective, but that seems to be the case with a lot of these types of meds. But you might get 14 good days out of it.

Some people feel that all of life's ills are based on diet choice. Although I don't buy this 100%, if I had issues like yours, I might be willing to try everything and anything.

I would try a diet change to rule out food allergies and insulin issues, even though your blood work may be fine. What I would suggest is the Atkins diet (very little carbohydrates) or even a no carbs diet for a couple of weeks; that means mainly meat/poultry/fish/eggs, no grains at all except maybe no-sugar Metamucil to keep things moving, and no processed foods. The very low carbs will take care of insulin-related issues if there are any, and the meat-based diet will take away gluten and other grain-based allergies if there are any. I've been on Atkins for two years and it worked for me to lose 10% of my body weight with no additional exercise (read no exercise). Now that I am on CPAP I started to exercise and losing more. I know that you didn't say you had a weight problem, but I just wanted you to know that I have some experience with a very low carbohydrate diet. Some people get flu-like symptoms during the first 3 days as a type of withdrawal from sugar. It didn't happen to me. If I was desperate, I would limit my diet to only a few ingredients for those two weeks, like the egg-based diet the low carb guru Jimmy Moore (just Google Jimmy Moore egg fest) did for over a month or two, just eating eggs, butter and cheese, that's it. It won't kill you (might make you healthier) and it will tell you if grains are an issue for you. Eating dairy might be an issue for you so I would abstain from dairy to see if that helps.

If after trying a very low carb diet and you haven't improved in daytime alertness, I would go the opposite of Atkins and go vegetarian with as few ingredients as possible, but no processed foods and meat.

Instead of vegetarian, I may try a juice fast (fruit and veggie juice every few hours with a healthy dose of Metamucil) for a week and reintroduce one food at a time over the next few weeks. I did this about 10 years ago and hadn't felt that I needed/wanted to do it again (especially now that I prefer the low carb lifestyle), but it did make me feel light and airy but the sugar swings with fruit juice gave me up and downs in energy, but I felt cleaned out. I would lean more heavily on the veggie juice than the fruit juice to minimize the sugar swings.

I wish you the best in your journey to good health.

[sydneybird]

I'm all over the place with food.....today I had egg salad (with olive oil light mayo) and mixed fresh fruit for breakfast, a veggie sub for lunch....I don't know what's for dinner.
Diet sodas, or tea w/splenda.....2% milk when I have it.

I don't have the best or worst diet, but no drastic changes that I can note.

I would feel really tired after all of these meals. The carbs (bread and fruit) would make me tired and want to nap in about 20 minutes after eating it. Keep in mind that I am not diabetic and have great blood labs. It is just that the sugars in the bread and fruit would knock me out. Please see my earlier post for suggestions. If it was me, I would drop all carbs starting this very moment for two weeks and see what happens. meat/fish/poultry/eggs, that's it for 2 weeks. Maybe I would add a small lettuce/spinach salad with no carb blue cheese dressing (but that introduces dairy (cheese) or other ingredients which may be an issue for you) or real mayo (real mayo has no carbs; light mayo has sugar). Fat is not your enemy unless combined with carbs; sugar may be. I don't know anyone who has allergy issues with romaine lettuce or spinach but some people have issues with cheese. Other people have issues with artificial sweeteners, so stop artificial sweeteners for the two weeks as well. Drink lots of water.

[Kahfree]

I totally understand the being tired. It seems like being on the cpap machine makes me feel worse than when I was not on it, in terms of sleep deprivation. I hear people talk about how they go to bed and sleep so sound with the mask they don't wake up till the am. I hardly think that will happen to me, even though I have finally found the mask that has been working for me for the last 4 days. I use to wake all the time before unable to breath, but I still felt like I slept.


I hope you can find rest. I believe that being so tired makes me less a social person and more of a homebody.

Kelly

[jules]

As with sydneybird, I would also be having problems with that intake of food. I stay away from all artificial sweeteners and these days no wheat (means no bread), and try to keep it simple. I probably am not as strict as sydneybird about carbs but I have worked on cleaning up my diet more and more.

Stay away from anything processed if you can - keep basic - plain food - take your lunch with you even if it means a can of tuna (no broth in it is preferred which will take some work to find) and some veggies and get away from those diet drinks.

[Goofy]

Have you been tested for diabetes? After eating you want to "crash" is not good. Also I was reading the Provigil vs. Nuvigil on the forum and they both effect everyone differently. Some people even take Ritalin but Adderall (sp) was also one mentioned. Good luck.

[robysue]

SnoozyQ,

I'm so sorry that you are feeling so extremely tired. I do remember that feeling from my first two months on CPAP in particular. And I am so glad that with the progress on treating the insomnia issues, the excessive daytime sleepiness and fatigue and daytime fog are finally beginning to lift for me. I sincerely wish that you very soon find the keys to understanding and addressing and treating the underlying causes of your continuing battle with the constant exhaustion.

I wish I had some suggestions for you to try.

It seems likely to me that there must be something else going on in addition to the sleep apnea, which appears to be well controlled by the CPAP. If I recall from other posts, you are actually sleeping ok now in the sense of getting to sleep and staying asleep all night. The problem is that you still don't benefit from the sleep that you are getting the way you should---in other words, you are still exhausted beyond words during the daytime and still feeling the mental fog when you need mental clarity during the daytime. So a good question for to ask yourself might be: Is there still a problem with fragmented sleep of some sort? Or is there something else that is sapping the strength and energy out of you faster than the CPAP therapy can possibly help you build it back up? And if so, what else could it possibly be?

You've mentioned problems with anxiety and depression in other threads. Both could be sapping more energy out of your system than the CPAP can help you put back in. Anything else? Because all I can come up with is that I think you and your doctors need to start thinking outside the box---the box of, "You have sleep apnea and that must be the cause of your daytime exhaustion. So treat that (well) and all will improve." But thinking outside the box is remarkably hard to do even when you consciously force yourself to do it.

[weaveroflight]

I have used Provigal and it made me jumpy. Nuvigal has been a god send. I have MS which fatigue is a big factor.