Unanswered Questions

[ironhands]

I am definitely not following some of those guidelines, namely watching TV and reading in bed. What about listening to music at low volume? I absolutely cannot sleep without something to keep my mind occupied. I tend to have trouble with anxiety and listening to the TV or music helps to ease my mind or at least keep it occupied. If not music, what can I do for this?

There we go, that's the cause of your sleep problems right there I suspect. You're not allowing your mind to shut down. If you can't fall asleep without a distraction of some sort, you need a sedative, or, try to find something like meditation to relax you enough to clear your mind.

[Pugsy]

IF (big IF) you are mouth breathing any...it sure isn't much and certainly not enough to impact therapy all that much based on your leak line graphs...they are to die for pretty darn near perfect...make mine look horrible.

Vitamin D deficiency can occur despite ideal diet and sun exposure...not common of course but it can happen. I just toss it out there because you would be surprised at how many people notice an improvement in how they feel with an increase in vitamin D levels when theirs was a bit low. Read up on it and keep that idea on the back burner.

While you are reading....
if your mind doesn't want to turn itself off in a timely fashion so that you can go to sleep and hopefully stay asleep you might have a little bit of sleep onset and/or sleep maintenance insomnia going on....google both to see what I mean.
Not saying it is 100% of your problem but it can sure be a factor in things. Often when people aren't feeling nearly as good as the reports seem to say they should be feeling it, isn't one single item that is 100% responsible for not feeling so great. Often it is a combination of things and figuring what it is and how to fix it takes a lot of detective work.

[robysue]

Thanks for the input jnk. I have never thought about "sleep hygiene." I am definitely not following some of those guidelines, namely watching TV and reading in bed. What about listening to music at low volume? I absolutely cannot sleep without something to keep my mind occupied. I tend to have trouble with anxiety and listening to the TV or music helps to ease my mind or at least keep it occupied. If not music, what can I do for this?

Soft music at a low volume does NOT cause the same kind of problems that a TV does. The TV screen emits blue light which messes with the melatonin cycle, which often causes additional wakes. Same thing with other electronic gadget screens. But you can (usually) turn the screen off an iPod or other MP3 player and a clock radio can be pointed away from you so the light is not an issue.

What other sleepy hygiene guidelines are not yet part of your life?

[bradc]

Sounds like you're in exactly the same situation I'm in. Dealing with depression, boozing it up in the past, still not feeling rested in the morning despite CPAP functioning normally. Been doing the e-cig thing, it's helped my mood, and the stimulant effect has killed off my sleep attacks during the day.

With the multiple awakenings at night, it could be sleep maintenance insomnia, this can be caused by a few things. Blood sugar is one, liver, another, and prostate as well. Could even be anxiety on some level.

Are you drinking before bed? If so, don't. It'll ruin the second half of your nights sleep (despite putting you to sleep earlier). I've noticed whenever I give into gluten cravings (I'm gluten intolerant) my sleep is ruined. Are your B12 levels normal?

If it's the wakeups that're doing this to you, which I assume they are, you need to follow a sleep hygiene program, someone was good enough to post one I see. In addition, and I know this sounds counter intuitive, but a sedative before bed would be beneficial. 5HTP, melatonin, or l-tryptophan should keep those wake-ups at a minimum if taken at night, and 5HTP or L-tryptophan can also be taken in the morning to balance your mood. It boosts the amount of serotonin and will greatly help with depression. Doc said I was probably misdiagnosed as depressed, and it was the sleep issues all along. He literally told me to my face last week "you are not suffering from chronic depression." Sleep issues can really mess with your head.

I'd recommend trying the 5HTP/l-tryptophan before filling the script for prozac, unless you feel really, really depressed, as in, immediate danger. I'm not a doctor, of course, but from my experience with anti-depressants, they only made my sleep issues worse.

I try not to drink anything within an hour or 2 of going to bed and I rarely drink any alcohol. I already picked up the RX of Prozac, only because I did not know what the rx was for until I had already paid and got home. But, I am not taking them because I have been put on enough anti-depressants to know that they do not help. I forgot to mention earlier that I have been taking 10mg of melatonin for about the last week, but I have never had much luck with it. Kudos to you, Sounds like you have found a doctor that will actually listen to you.

As far as I know, my B12 levels are normal. Does a blood test include gluten intolerance or diabetes? If not, how do I go about testing for these?

I will say that quitting nicotine was and still is the hardest thing I have done. I have struggled with quitting for several years. I realized for me it was not an addiction to nicotine, it was a habitual addiction. So, I was not able to just wean myself off it, I had to quit cold turkey.

Do you wake up with a dry mouth? I am wondering if you are breathing through your mouth?

With a nasal mask if you are mouth breathing you are losing your therapy. If you are snoring still that means the airway is not being
held open enough.

Thanks. I use to sleep with my mouth open, but when my machine was set at 13cm it taught me not to open my mouth because I would wake up choking.

Might you also be a diabetic? Quite a few of us on the hose are Diabetics. Diabetics can have concurrent problems with Depression, and both of them need to be treated. Good treatment for sleep apnea can improve the Diabetes (Blood Glucose levels) for most of us.

I have never thought about this, and this actually scares me since I don't have insurance, especially since diabetes runs in my family.

Thank you again to all the responses. This is much more help than I ever expected. The first thing I am going to do is incorporate better "sleep hygiene" starting tonight.

[Pugsy]

Actually Melatonin 10 mg (are you sure it is 10 mg) is a very high dose and it may be counter productive.

Discussed often here on the forum. I don't have that link handy .....anyone have that discussion to the video where the doc says "less is more" when it comes to Melatonin?

Read up on side effects..it isn't as benign as people might initially think.

[Bill44133]

Do you wake up with a dry mouth? I am wondering if you are breathing through your mouth?

With a nasal mask if you are mouth breathing you are losing your therapy. If you are snoring still that means the airway is not being
held open enough.

Thanks. I use to sleep with my mouth open, but when my machine was set at 13cm it taught me not to open my mouth because I would wake up choking.

I would try changing to a full face mask just to be sure you are not leaking through your mouth just to be sure. Since mouth breathing is in your history.

I wish you Well and Good Luck!

[jnk]

The sleep hygiene stuff is more of a guideline thing than a hard-and-fast-rules kind of thing. It is useful information to help you troubleshoot and find what may help you, more than anything.

The stuff about writing down the things bothering you and thinking about them outside the bedroom works wonders for some of the mind-racing-at-bedtime people. Dr. Krakow has some good info in his book on the psychology of sleep and mental approaches to it.

Sleep-maintenance issues can sometimes be helped by hiding the clock so that we don't fool our brain into thinking we expect it to keep up with what time it is all night. And sometimes just learning to accept the occasional wake ups as normal can help us roll over and go back to sleep--no harm, no foul.

Trick is to try things without obsessing about them. The point is to lower sources of anxiety rather than making sleep itself an anxiety-inducing concept.

[robysue]

Trick is to try things without obsessing about them. The point is to lower sources of anxiety rather than making sleep itself an anxiety-inducing concept.

There's a lot of wisdom in this statement.

[bradc]

Thanks for the input jnk. I have never thought about "sleep hygiene." I am definitely not following some of those guidelines, namely watching TV and reading in bed. What about listening to music at low volume? I absolutely cannot sleep without something to keep my mind occupied. I tend to have trouble with anxiety and listening to the TV or music helps to ease my mind or at least keep it occupied. If not music, what can I do for this?

Soft music at a low volume does NOT cause the same kind of problems that a TV does. The TV screen emits blue light which messes with the melatonin cycle, which often causes additional wakes. Same thing with other electronic gadget screens. But you can (usually) turn the screen off an iPod or other MP3 player and a clock radio can be pointed away from you so the light is not an issue.

What other sleepy hygiene guidelines are not yet part of your life?

Watching TV and reading are the big ones. I will watch the clock at times, but that one is not as bad as the other 2. I get regular exercise, I have about as consistent of a routine as possible. I don't drink caffeine much at all. Actually, this was another drastic change as of late. I used to drink 1 to 2 pots of coffee every morning, but I quit drinking anything caffeinated all together.

The TV has already been moved out of my bedroom, and I am going to try listening to rain sounds tonight.

Actually Melatonin 10 mg (are you sure it is 10 mg) is a very high dose and it may be counter productive.

Discussed often here on the forum. I don't have that link handy .....anyone have that discussion to the video where the doc says "less is more" when it comes to Melatonin?

Read up on side effects..it isn't as benign as people might initially think.

.

It is 10mg that I have been taking. I think I'll just quit taking it.

Thanks everyone!

[chunkyfrog]

I also agree with jnk.
For some people, the "rules" merely add more stress.

[ironhands]

The can't really check for gluten intolerance reliably, but you can check for a wheat allergy, or a blood test for celiac, but if your b12 isn't abnormally low, or you aren't getting stomach issues or running to the bathroom after having a few beers or a plate of pasta, it's probably fine. Low B12 can make you feel tired all the time, and interfere with your sleep.

When you say you're tired during the day, is it more of a physical exhaustion, like, your limbs feel like lead, or sleepy tired? If so, we might be talking about atypical depression, which is anti-depressant resistant, and more physical than classical depression. Also causes hypersomnia.

Melatonin is a good first step, but I would highly recommend going with the l-tryptophan (or 5HTP if you can't find the tryptophan) because of the daytime effects as well. At night, it metabolizes into melatonin, and during the day, serotonin, so it acts as a sedative AND as an antidepressant - while you may not be psychologically depressed, you are certainly physically depressed, and the extra serotonin boost will (hopefully) help with that without the negative reactions from the prozac.

[49er]

Actually Melatonin 10 mg (are you sure it is 10 mg) is a very high dose and it may be counter productive.

Discussed often here on the forum. I don't have that link handy .....anyone have that discussion to the video where the doc says "less is more" when it comes to Melatonin?

Read up on side effects..it isn't as benign as people might initially think.

Totally agree as one who felt that taking 2mg the other night caused a depressed mood the next day. Bradc, I am concerned with your history of depression and by taking 10mg, you would be very susceptible to this side effect.

Obviously, I didn't follow the rule but it is best to start with around .33mg of melatonin and slowly work your way up to the ideal dose.

49er

[Pugsy]

http://www.doctoroz.com/episode/why-mel ... your-sleep

I think this is the video where Dr Oz talks about Melatonin dosage.
Less is more in this situation. Dosage of 0.3 to 1 mg if I remember correctly is what is suggested. It's hard to find the 0.3 dose pills though.

[49er]

The can't really check for gluten intolerance reliably, but you can check for a wheat allergy, or a blood test for celiac, but if your b12 isn't abnormally low, or you aren't getting stomach issues or running to the bathroom after having a few beers or a plate of pasta, it's probably fine. Low B12 can make you feel tired all the time, and interfere with your sleep.

When you say you're tired during the day, is it more of a physical exhaustion, like, your limbs feel like lead, or sleepy tired? If so, we might be talking about atypical depression, which is anti-depressant resistant, and more physical than classical depression. Also causes hypersomnia.

Melatonin is a good first step, but I would highly recommend going with the l-tryptophan (or 5HTP if you can't find the tryptophan) because of the daytime effects as well. At night, it metabolizes into melatonin, and during the day, serotonin, so it acts as a sedative AND as an antidepressant - while you may not be psychologically depressed, you are certainly physically depressed, and the extra serotonin boost will (hopefully) help with that without the negative reactions from the prozac.

If bradc has taken prozac or any antidepressant recently, taking l-tryptophan or 5HtP is not a good idea because of the risk of serotonin syndrome. And if he hasn't, it is a good idea as with any supplement to start low and go very slowly with the dose. Many people find they have to take 1/2 the amount of the suggested starting size.

[ironhands]

If bradc has taken prozac or any antidepressant recently, taking l-tryptophan or 5HtP is not a good idea because of the risk of serotonin syndrome. And if he hasn't, it is a good idea as with any supplement to start low and go very slowly with the dose. Many people find they have to take 1/2 the amount of the suggested starting size.

Definitely agree. He said he hasn't started taking the prozac yet, so he should be fine to start taking a small dose. With the history of depression, it may have been misdiagnosed, depending who diagnosed it. When there's sleep issues, it's often difficult to tell whether the sleep issues are causing the depression, or the depression is causing the sleep issues, which is why the supplements I recommended would likely give a positive result since it handles both to some degree. Of course, I don't think any of us on here are actually doctors