Post Traumatic Stress from Apnea

[Goofproof]

Life brings us a mirad of trials, that doesn't mean that they Cause Sleep Apnea or PTS Disorder. We can't spend our lives blaming our problems on other problems, we must deal with them as they come along and get along with life, other problems will soon come to take their place. Hunting for blame doesn't help you get over your problems, it just avoids moving on. Life isn't always fair, it was never meant to be, you just deal with it and wait for the next shoe to drop. Jim

Lucky, it you decide to correctly treat Sleep Apnea, it can extend your life and quality of life, so you can better deal with life's problems.

[NotSleepingBeauty]

[quote="mstevens

I literally split into two persons.

All disagreements about the existence of what used to be called "multiple personalities" aside, any such splitting would have to be figurative and not literal.

OMG! I didn't mean to say that I developed an additional personality! It only happened in that moment that one time. I think it was more disassociative than anything else.

So could this extended traumatic event, watching him die for 2 months, while he was in terrific pain, experiencing hallucinations, and mental impairment, have triggered OSA?

My daughter died at 16 months of age after 4 months of terrible treatment for a malignant brain tumor. Eventually we decided we'd put her through too much, took her off the ventilator, and held her until she became cold. I still have some flashbacks (eg to watching her twitch when they stabbed chest tubes into her) years later. That has nothing whatsoever to do with my OSA.[/quote]

I am so sorry to hear about this painful and traumatic experience. I was certainly not trying to minimize anyone elses experiences. You have my empathy.

[mstevens]

Would you agree that OSA would not, in and of itself, cause "maladaptive behaviors" such as shopping sprees, gambling, and substance abuse to an EXCESSIVE degree (although frankly the term "abuse" sounds excessive...) such as seen in mania?

Yes. If they're already there it can bring them out of the woodwork, so to speak.

Would you agree that you would NOT expect OSA to cause other symptoms of mania (in someone without a proclivity toward bipolar disorder)?

I'm not so sure about this one. I've frequently seen mania-like symptoms in sleep-deprived individuals without a history of bipolar disorder. One of my internal medicine residents always used to spend the evening shopping for makeup when she was post-call (having been up for 34-36 hours). Since irritability, poor concentration, disorganized or racing thoughts, and impulsivity are symptoms of mania (and obviously of a lot of other things), It can actually sometimes be hard to tell if we're seeing mild mania or significant sleep deprivation.

[lcosborn]

This is very interesting. For years, as I said, I exhibited hypomanic behaviors, as I've already described. They didn't go away immediately with treatment; the changes were subtle, and I would suddenly become aware of them in unusual ways. But over the course of the year I've been on the Bipap, they've slowly melted away. I really hope I continue to see these sorts of changes! My interior life, which used to be like a whirlwind, is relatively calm now and stays calm until I have to do "clean up" tasks regarding my past behavior, like contact student loan companies. The clean up work is excruciatingly painful and produces extraordinary amounts of piercing anxiety.

My concentration and motivation don't necessarily seem to have improved much. These continue to be huge problems for me.

One of my questions to mstevens regarding judgment was unclear. I asked how sleep deprivation affects judgment. (He responded: It makes it worse. He, he.) I was curious if the problem with judgment was due to distorted view of reality caused by poor perception, or simply that the racing thoughts and impulsive behaviors precluded a person from fully analyzing situations and the potential consequences of behaving in various ways.

More specifically, I guess what I want to know is this: How can I build trust in my own judgment when for so many years it has seemed so untrustworthy? How do I build faith in myself when I have failed myself and others so many times?

SleepingBeauty, I appreciate you quoting Carbonman's signature: "If your therapy is improving your health but you're not doing anything to see or feel those changes, you'll never know what you're capable of." I needed to hear that, and I also needed to again feel solidarity that what I'm going through is shared. His quote makes it clear that I am not the only one to be shy about reintegrating into life and to need encouragement to take risks.

[kteague]

A lack of self confidence is understandable when our recent experience has shown our abilities to be compromised and predictably inadequate. It was scary for me to begin to take back on some things I had given up on. It was best for me to test the waters with small efforts that would not be earth shattering if they proved too much. (Found that out the hard way.) But confidence is built on the repetition of small successes overtime. As the body and brain recovers, you will gradually see the rested you emerge and get to know yourself in your new reality. Be kind to yourself, and give yourself at least as much grace as you'd give someone else you care about who has been through an ordeal. It is painful to know we have disappointed ourselves and others. I used to feel compelled to explain to people why I'd been such a mess. Now I'm ok with just letting them see who I am now... still a mess but much less of one.

As to prior discussion of understanding what our brains have been through, I think of how knowledge is growing in rehab from traumatic brain injuries and stroke. Seems to me there's been less new understanding of not just sleep deprivation, but sleep deprivation combined with oxygen deprivation and related stress hormones. I can't say I have a basis for feeling that, other than I'm having this discussion here instead of with my medical providers. I fully expect in the not too distant future for there to be a recommended rehab protocol for OSA patients that goes beyond sleep hygiene and even beyond CBT. Just thinking out loud.

[BlackSpinner]

My concentration and motivation don't necessarily seem to have improved much. These continue to be huge problems for me.

More specifically, I guess what I want to know is this: How can I build trust in my own judgment when for so many years it has seemed so untrustworthy? How do I build faith in myself when I have failed myself and others so many times?

Motivation is a learned response that you are going to have to relearn. So is concentration in many ways. You obviously have ways because you almost have a doctorate. Analyze your "behaviour" that allowed you to concentrate. It is all about knowing your strengths.

You rebuild by creating little challenges that you meet successfully. I went through it after I had my hysterectomy which dealt with several years of incapacitating migraines which had turned me from the dependable person to the wacko who disappeared at a moments notice.

One thing I learned in my job as a systems analyst - never look at the big picture too long or you get overwhelmed, focus on the small manageable problems first and build on them.

[mstevens]

I asked how sleep deprivation affects judgment. (He responded: It makes it worse. He, he.) I was curious if the problem with judgment was due to distorted view of reality caused by poor perception, or simply that the racing thoughts and impulsive behaviors precluded a person from fully analyzing situations and the potential consequences of behaving in various ways.

Ah. "By what means" as opposed to "to what extent". Lots of things are harder when you're tired, and even harder when actually deprived of sleep: concentration, focus, filtering of stimuli, mental stamina and perseverance, planning, delaying gratification, recall of past outcomes in similar situations, prediction of likely outcomes under current circumstances, ranking of priorities and values, and of course simply giving a damn right now. Add those things together and you have judgment.

The primary means by which perception of reality is distorted when sleep deprived is via missing important information due to insufficient awareness or concentration. Obviously, decisions based on incomplete data have a good chance of being bad ones. You have to be tremendously sleep deprived to become outright psychotic, though it can happen.

You might be overcomplicating. I don't think it's very mysterious at all how being seriously unrested leads to bad decision-making.

More specifically, I guess what I want to know is this: How can I build trust in my own judgment when for so many years it has seemed so untrustworthy? How do I build faith in myself when I have failed myself and others so many times?

Well, there's the old saying that good judgment comes from having used bad judgment in the past. Really the only thing that helps with confidence is practice. Try to learn from mistakes and move on. Of course, when possible you can bounce things off someone you trust ("Honey, do you think I should buy that motorcycle?" "Do I look stupid in this hat")* to ratify your own perceptions and decisions.

*recent answers from my wife: "Sure, go for it." "Yes. Very."

[chunkyfrog]

We know that many DME's are grateful for our fuzzy thinking when they get to pick out our equipment.