mental health doesn't equal sleep disorder

[catbirdgirl]

That's not the greatest title in the world, but I'm working on a presentation for work (Employee Assistance Program) about mental health and sleep disorders....

What I really need to know is what are the red flags, things that your doctors have made mistakes on, things that we as phone counselors should know that if we hear this, we should add "get a sleep study" to the list of things the client should do rather than just see a counselor and psychiatrist.

Any suggestions?

This will be going to a group of EAP counselors and screeners who frequently talk to people dealing with many and myriad problems over the phone, helping them get connected with services.

I am going to distill down answers and present them. I'm thinking about basically explaining a couple of the major disorders, and their main symptoms, and the red flags.

thanks in advance for your help.

[Guest]

Still "foggy" and tired and listless after taking anti-depressants for years.

Continued weight gain, despite efforts to exercise and diet.

Morning headaches.

Continual use of over the counter sleep meds, or requests for prescription sleep meds over a long period of time.

These were my symptoms. It wasn't until I added "Mom says I snore like a freight train" that they gave me a sleep study.

I should have one probably 10 years ago.

Cheers,
B.

[Pineapple]

FATIGE - those of us who have been long suffering do not call it "daytime sleepiness"

Headaches - no one ever asked me when I was having my headaches.

Inabilty to think straight (confusion).

Sweating - my GP said I was in menopaus, good thing I called the gyn and he ruled that out.

Muscle pain.

Weight gain.

Depression, mood swings, panic attacks.

I'll add that I don't snore, nor did I think I ever woke up gasping - this is probably the main reason I went so long undiagnosed, even my fresh out of med school doctor didn't think you could have apnea without snoring and gasping.

[kteague]

Good to hear of efforts like yours. Below are a few threads you may be able to glean some common themes from. For me, excessive daytime sleepiness, short term memory loss, disjointed thinking, frequent bad dreams all related to breathing, weight gain and HBP that all spiraled downward were in retrospect warning signs.

I think the dilemma for providers is that while some with OSA have been misdiagnosed with psych disorders, some with psych disorders happen to also have OSA.

viewtopic.php?p=217969&highlight=psych#217969
viewtopic.php?p=216496&highlight=psych#216496
viewtopic.php?p=216494&highlight=psych#216494
viewtopic.php?p=215152&highlight=psych#215152
viewtopic.php?p=190137&highlight=psych#190137

[catbirdgirl]

this is why I'm doing this- to suggest a sleep study in addition to the mental health issue that we are already addressing. no one said not to address said thing.

[SleepGuy]

Take copies of the Berlin Questionnaire and have everyone take it in order to screen for OSA. It's 90% predictive of OSA--a little 10 question one page flyer. Seriously--90% of the people who score at high risk based on the little questionnaire will have OSA diagnosed at the sleep lab. I have mainstream medical references to back that up if anyone doubts it.

Here's the pdf link:

http://www.pur-sleep.com/uploads/Berlin ... nnaire.pdf

This version is complete with instructions for scoring. Print, copy, and distribute widely.

Screening for OSA need not be a complicated process! It's actually a piece of cake!

[Panhandler]

I'll second the motion on the Berlin Questionnaire. It's so simple that it's hard to believe how effective it is.

Another possible symptom is frequent urination at night. I was up 4-5 times a night, vs. 1 after CPAP. I think it's because once awakened, we're trained to check the condition of our bladder and empty it.

Good for you, putting this in front of EAP staff. A good place to catch OSA.

[JZ]

The EAP counselors should be aware that not everyone with sleep apnea fits a "profile" or has the full set of symptoms. Because I was not overweight (OK, OK, just a little overweight), did not wake up gasping, and did not have morning headaches, for years I rejected the notion that I might have sleep apnea.

Janna

[SleepGuy]

The EAP counselors should be aware that not everyone with sleep apnea fits a "profile" or has the full set of symptoms. Because I was not overweight (OK, OK, just a little overweight), did not wake up gasping, and did not have morning headaches, for years I rejected the notion that I might have sleep apnea.

Janna

I could not agree more--all the more reason to use the Berlin Questionnaire as a simple and effective screening tool. For example, gender is not a weighted factor in the questionnaire, nor is age.

[ywp]

That questionare prevented me from getting treatment for several years. It said I was a ok. In reality I had many years of practice of limping by.

How sleepy are you while watching TV? Give me a break

I didn't have headaches. I could stay awake when I had too.

Biggest clue was I had no dreams. Morning I would get false ulcer symtoms. Morning foggy mental state. bad short term memory. Days off work I could sleep 18 out of 24 hours.

[mazsdps]

[quote="Panhandler"]I'll second the motion on the Berlin Questionnaire. It's so simple that it's hard to believe how effective it is.

Another possible symptom is frequent urination at night. I was up 4-5 times a night, vs. 1 after CPAP. I think it's because once awakened, we're trained to check the condition of our bladder and empty it.

Good for you, putting this in front of EAP staff. A good place to catch OSA.

[SleepGuy]

That questionare prevented me from getting treatment for several years. It said I was a ok. In reality I had many years of practice of limping by.

How sleepy are you while watching TV? Give me a break

I didn't have headaches. I could stay awake when I had too.

Biggest clue was I had no dreams. Morning I would get false ulcer symtoms. Morning foggy mental state. bad short term memory. Days off work I could sleep 18 out of 24 hours.

I think we must be talking about different questionnaires.

The Berlin Questionnaire does not ask anything about sleepiness while watching TV or headaches.

Like I said, it has been proven to be 90% predictive of OSA--so 9 out of 10 people who score at high risk on the questions will have OSA.

That said, I'm not sure about the "false negative" potential for the Berlin Questionnaire--meaning how many people who score below "high risk" actually have OSA.

Good Luck! It's an fantastic screening tool.

[Guest]

Being a very concrete person, and being rather tired this AM because I DIDN'T GET ENOUGH SLEEP LAST NIGHT I thought I'd post the link here for the Berlin Quetionnaire, in case anyone else was wondering where it was, too. I, of course, went immediately to the Collective Wisdom, and FAQ areas of this forum, and didn't find it. Had to process that Bret was referring to his own website. (MORE COFFEE, PLEASE!!!)

(Insert WWW & DOT) pur-sleep.com/content/?id=30

The PDF for the Questionnaire itself is:
(Insert WWW & DOT) pur-sleep.com/uploads/BerlinQuestionnaire.pdf

Since I'm at work, and posting as a Guest, I can't post URLs.

Anyway, if I can stay awake tonight, I'll repost this as a separate thread and then upload it to the Red "FAQ" section of this forum. Unless someone with more energy than I beats me to it today. Please feel free.

LOL,
Babette - Who really doesn't MIND that she was kept up late by a charming young man last night.... But I still want to take a shower in coffee this AM.

[Guest]

Prior to being diagnosed with OSA I had severe anxiety and headaches. Looking back I realize that I was so fatigued that it was producing both of these symptoms.

I cannot tell you how many doctors I saw and how many times I was told I was just a anxious woman who needed to relax a little.

[kteague]

Forgot to mention, I would with increasing frequency wake up in a fit of coughing, trying to catch my breath, as if something had gone down the wrong way.