Two Questions: BackSleeping & Sleeping Pill Recommendations?

[DavidCarolina]

Ive been on Resmed Automatic cpap with full-face mask, varying humidity, and pretty good overall success. My AHI is down to 1.3 per night--i get monthly results from my local sleep doctor--and was diagnosed at Mayo Clinic Sleep Center in Jacksonville.

Current Problems:
-Im a natural mouth-breathing back sleeper with a deviated septum. Has anyone had success either with Septum surgery OR with rigging up tethering to wrist to prevent flipping over onto back during sleep mode? Last night I had one of my worst apneas EVER while on the mask (10.0 pressure) after flipping onto my back, snoring, and then having apnea. Jerked up out of bed, and stood up with mask on, pulled machine off bedstand which caused hose to pull out of insert.


--Before all this, I used to use basic Unisom sleep tabs about 4 nights a week (doxolymate succinate). Now Im afraid to do anything that hampers normal respiration. Can anyone recommend a sleeping pill, and dosage level for a 220 pound man (six feet) that might be effective that wont slow my breathing down? I was given Seroquel at one point, and that junk almost killed me after one night--total zombie--so Ive basically gone off all other meds. I do use Klonopin as needed when the apnea is messing up my central nervous system. I should add that I also have an gastro problem called "leaky gut" or permeable small intestine that causes auto immune problems and food allergies. Still working on solving that problem. (getting proper bacterial gut count right, and healing absorption capability is a long-term project). But regardless, it causes the same type of central nervous system "agitation" and "respiration" problems. When it rains, it really pours in life.

[robysue]

Given all your other medical problems, I think you really ought to talk to a doctor---preferably your sleep doctor or your PCP or both---about sleep medications---both OTC and prescription ones. Since you take Klonopin as needed, it will be important to establish that whatever sleeping medication you take does not have drug interaction problems with the Klonopin, which as I understand it is pretty sedating itself.

Regardless of what sleep medications (OTC or prescription) recommended by your doctor(s), I think you also should give serious thought to cleaning up your overall sleep hygiene. Even marginal improvements in your sleep hygiene should help whatever sleep medication you decide to take work more effectively. You can find out more about sleep hygiene at http://www.umm.edu/sleep/sleep_hyg.htm . Read through the suggestions and pick a few that seem like reasonable lifestyle changes that you're willing to make for the time being. The two simplest changes---which often do make a real difference are:

• (1) kick the tv and all other electronic gadgets OUT of the bed room and use the bed only for sleeping andsex, and
  
  (2) go to bed only when you are sleepy and learn the difference between feeling sleepy and feeling tired or exhausted---they are not the same thing.

As for recommending specific sleep medications? Well, I try to avoid them as much as I can. When I started the intense fight against the severe insomnia that set in with the start of my CPAP therapy, my PA and I designed a largely drug free approach. In the last 4 1/2 months, I think I've taken maybe 3 or 4 Ambien back in January and 2 or 3 Sonata since the beginning of February. I am, however, now taking 1 mg of melatonin nightly right now. Don't know if it's really doing anything, but melatonin is also not heavy-duty stuff since it is made by the body and 1 mg is a very, very low dose.

[vette76]

I use 6 mg of melitonin and i also take a benidryl thye seem to help me. It takes the edge off of the days stress and my mind seems to settle down faster.

[bkdraft]

It was recommended here on the forums to take 1000mg of Calcium and 1000mg of Magnesium 2 hours before going to bed. This has worked very well for me, and its actually good for you. But,,,,,in you situation you should consult your Dr to make sure its OK.

[Katt]

I am not sure if this helps any ... but I went to my doctor for sleeping issues before being diagnosed with apnea .... and I have found the meds he prescribed help my mind settle nicely - mylan-zopiclone - it is a small dosage but it helps shut my mind down enuff for sleeping .....

I have found I am still working on the balance - the one helps me fall asleep but they don't keep me asleep based on the apnea ... I am very new to the whole thing so my body & habits are still adjusting.

But as the others have suggested, it is very important to speak to your doctor based on the combination of issues.


I am just posting to say there are options, it is a matter of getting the right info and help to find what works for you safely with everything going on for you.

[roster]

Current Problems:
-Im a natural mouth-breathing back sleeper with a deviated septum. Has anyone had success either with Septum surgery OR with rigging up tethering to wrist to prevent flipping over onto back during sleep mode?

I did/do both. Surgery to reduce enlarged turbinates and correct double deviated septum was one of the best things I ever had done. If you are in Charlotte, I can recommend a great surgeon. If you have not been evaluated by a good ENT, you definitely should. He should scope the nasal airway. If you have any symptoms of allergies he should test you.

Since the surgery I breathe most of the night through my nose. But I use a FFM for the few times my mouth opens. It has opened some recently due to spring pollen allergies causing nasal congestion.

Every night I wear a small backpack containing a large rigid plastic bottle to make sure I do not roll onto my back. Works well and allows me to run a much lower pressure.