My miracle drug!!!

[GoofyUT]

As many of you have known, I was diagnosed on March 31st after a foolish split-night study during my last night in the hospital following a fairly serious heart attack. The results of that silly study was that I had moderate OSA (AHI=23) and I was started on xPAP therapy with a Fisher and Paykel HC608 CPAP set to my titrated and prescribed pressure of 10 cmH2O. I was issued a used Activa mask, but I switched to a Swift one week later. After a few weeks with the F&P, I switched to a ResMed S8 AutoSet Vantage after complaining to my sleep doc about frequent awakenings with the F&P because I found the air that it was delivering to be "stuffy", which I think was caused by the integrated heated hose. I stuck with the S8 experimenting with APAP -v- CPAP mode since I, since having started xPAP, NEVER was able to get a good night's sleep, or sleep through the night.

I was very fortunate to have the opportunity to acquire a Remstar Auto w/Cflex in virtually brand new condition, and at the same time, got another Activa (this time with the shallow cushion) to switch off with my beloved Swift. Though I liked the Remstar better (I'll post more about this later), I still wasn't sleeping through the night. I talked with my internist about this, and she gave me some samples of Ambien CR, which I tried for a few few nights and found that I fell asleep quickly (never a problem, though) but awakened just as frequently, though I did have some retrograde amnesia. I stopped taking the Ambien after a few nights since it was doing nothing for me.

I got the chance to discuss this with my moron sleep doc during my first and ONLY contact with him 3 months after he diagnosed me, and he suggested 0.3 mg of melatonin when I awakened. This too, had NO beneficial effect whatsoever.

I've bored you for too long. To make a LONG story short, last Saturday, I experienced a fairly extreme stressor. So, anticpating a poor night's sleep, I took 0.5 mg of alprazolam (Xanax) that I had from a two year old script. I SLEPT LIKE A BABY!!!!! No awakenings, no trips to the john, just a good night's sleep and I woke up feeling rested and refreshed. FIRST TIME SINCE I STARTED THIS INSANE JOURNEY THAT I SLEPT THROUGH THE NIGHT. Now, this was especially significant since I had had the kind of day before that would have ensured that ANYONE would have had a sleepless night, much less a hosehead.

I've continued to take 0.5 mg of alprazolam every night since, and, I'VE SLEPT THROUGH THE NIGHT LIKE A BABY EVERY NIGHT SINCE!!!!!!! Its been a full week now so I'm fairly convinced that this is NOT a fluke. I feel wonderfully refreshed when I awaken and feel fresh, rested and alert during the day.

Here's the bottom line: I'VE TRIED EVERYTHING!!!! CPAP, APAP, ResMed, Respironics, Activa, Swift, HC431A, Hybrid, UMFF, and loe and behold, 0.5mg of alprazolam did the trick for me. My internist was kind enough to order me some more, since my moron sleep doc didn't, as usual, return my calls.

Hope this helps someone.

Chuck

[Guest]

that drug should last you a couple weeks:

Contraindications:
Myasthenia gravis, acute narrow angle glaucoma.

Precautions:
Not recommended in pregnant women, nursing mothers, patients < 18 years of age, psychotic or depressed patients, individuals prone to drug or alcohol abuse. Use with caution in elderly or debilitated patients and those with impaired renal or hepatic function. Avoid abrupt withdrawal of alprazolam. For repeated cycles of therapy, perform periodic blood counts and hepatic function tests.

Side effects:
Drowsiness, dizziness, coordination difficulties. Release of hostility and other paradoxical effects such as irritability and hallucinations may occur with benzodiazepines.

Interactions:
Co-administration with antifungal agents such as ketoconazole or itraconazole is not recommended. Nafazodone, fluvoxamine, cimetidine (consider Xanax dose reduction). Fluoxetine, OCs, sertraline, diltiazem, macrolide antibiotics (exercise caution).

Patient tips:
Warn against concomitant use of alcohol and other CNS depressants. Caution re dizziness, drowsiness (NB driving).

Precautions

Elderly and debilitated patients, or those with organic brain syndrome, have been found to be prone to the CNS depressant activity of benzodiazepines even after low doses. Manifestations include ataxia, oversedation and hypotension. Therefore, medication should be administered with caution to these patients, particularly if a drop in blood pressure might lead to cardiac complications. Initial doses should be low and increments should be made gradually, depending on the response of the patient, in order to avoid oversedation, neurological impairment and other possible adverse reactions.

Alprazolam should not be administered to individuals prone to drug abuse. Caution should be observed in all patients who are considered to have potential for psychological dependence. Withdrawal symptoms have been observed after abrupt discontinuation of benzodiazepines. These include irritability, nervousness, insomnia, agitation, tremors, convulsions, diarrhea, abdominal cramps, vomiting and mental impairment. Since these symptoms may be similar to those for which the patient is being treated, it may appear that he has suffered a relapse upon discontinuation. It is suggested that alprazolam should be withdrawn gradually if the individual is suspected of having become dependent, or the drug perhaps has been used in prolonged high doses.

Suicidal tendencies may be present in patients with emotional disorders, particularly when depressed and that protective measures and appropriate treatment may be necessary and should be instituted without delay.

Alprazolam should not be used in patients suspected of having psychotic tendencies since excitement and other paradoxical reactions can result from the use of anxiolytic-sedatives in these patients. As with other benzodiazepines, alprazolam should not be used in individuals with physiological anxiety or normal stress of daily living but only in the presence of disabling manifestations of an appropriate pathological anxiety disorder.

These drugs are not effective in patients with characterological and personality disorders or those with obsessive compulsive disorders. Alprazolam is not recommended for the management of depressive or psychotic disorders.

If treatment is necessary in patients with impaired hepatic or renal function, therapy should be initiated at a very low dose and the dosage increased only to the extent that it is compatible with the degree of residual function of these organs.

If alprazolam is administered for repeated cycles of therapy, periodic blood counts and liver function tests are advisable.

Since benzodiazepines may occasionally exacerbate grand mal seizures, caution is required when used in epileptic patients and an adjustment may be necessary in their anticonvulsive medication. Abrupt withdrawal of alprazolam should be avoided.

Benzodiazepines may potentiate or interact with effects of other CNS acting drugs such as alcohol, narcotics, barbiturates, nonbarbiturate hypnotics, antihistamines, phenothiazines, butyrophenones, MAO inhibitors, tricyclic antidepressants and anticonvulsants. Therefore, if alprazolam is to be combined with other drugs acting on the CNS, careful consideration should be given to the pharmacology of the agent involved because of the possible additive or potentiating effects. Patients should also be advised against the simultaneous use of other CNS depressant drugs and should be cautioned not to take alcohol during the administration of alprazolam.

[GoofyUT]

IMPORTANT SAFETY TIPS!!! Thank you.

[snoozie_suzy]

Chuck,
So happy for you!!!! You've been seeking a solution for this "other" sleep problem for quite some time.

I have used Xanex for panic attacks for over 20 years. I don't use it daily, but boy does it help to calm the body down.

I would think such a low dose of it wouldn't leave you groggy the next day either.

Congrats on finally sleeping thru the night!
Suzy

[Goofproof]

You might try splitting the dose in half, maybe you could get by with it, and that would cut down of side effects. Jim

[Guest]

I am happy that you found something that works for you.

I have suffered with anxiety for many, many years and I have used attivan or clonopin for easily 15 years. For most of that time I had to fight with my doctors who insisted that these medications were addictive and/or stopped working after a short period. Be that as it may, it certainly was not my experience. I MUST keep my anxiety in check and, IMHO, I would rather be addicted to attivan than continue to suffer from anxiety and insomnia. Finally, I went to the a sleep doc - considered the best sleep doc around - and she said "you have sleep problems due to anxiety and of course you should take sleep meds". That was the first time anyone ever told me that.

Curiously, in all these years, I have never had a xanax. Well, I drone on again ....

Jerry

[Jere]

Woops, that was me who guested.

[GoofyUT]

I say this only as one man, not as a psychologist, but I am NOT concerned about adversities or addictive potential at the rate of 0.5mg at hour of sleep, ONLY. Now, I am NOT a physician or an osteopath, so this is only ONE MAN'S OPINION, but MAN, does 0.5 mg alprazolam HS work for me!!!

Take this for what it's worth.

Chuck

[Wulfman]

Congratulations, Chuck!

Glad to hear you found your "Miracle Drug" (sleep aide).

Best wishes,

Den

[GoofyUT]

Thanks Den!!!

You've been a GREAT help too!!

C

[lawdognellie]

I would rather be addicted to attivan than continue to suffer from anxiety and insomnia.
Jerry[/quote]

A good doctor should know that there is a difference between drug addiction and drug dependence. Drug dependence refers to a physiological dependence, which is not really a big deal. It is only addiction when a person wants a drug at the expense of family, friends, quality of life, etc....


Sarah

[DreamStalker]

I was very fortunate to have the opportunity to acquire a Remstar Auto w/Cflex in virtually brand new condition, ... Though I liked the Remstar better (I'll post more about this later) ...

First of all, congrats on your finding a miracle drug that helps you to sleep.

In a previous post you commented on the superior human interface of the ResMed which is good to know. However, I will have my first follow-up visit with my sleep doc on Tuesday and will be asking him to switch out my rental S8 Elite CPAP to an APAP machine. I am very interested in your ResMed/RemStar APAP evaluation and would really like to know more on your thoughts regarding the two algorithmic approaches.

I realize that one's choice of algorithms will depend largely on the individual's OSA characteristics not unlike the selection of a mask, but I still think having a user's perspective such as yours may still be very useful to others unable to evaluate the two machines as you have.

Could you please post a brief preview of your evaluation regarding the algorithms so that I may discuss this issue half-way informed with my sleep doc?

Many thanks,

[GoofyUT]

Have been awaiting the arrival of my DT3500 card reader from Hong Kong so that I could query the data in my Remstar Auto and share some objective comparative data with this community, rather than simply providing my subjective impressions of the two machines. It's been nearly two weeks since the card reader shipped, so hopefully, I'll have it on Monday and will post Monday evening in time for your consultation.

PM me f you haven't seen what you need from me by the time of your appointment, Roberto.

Chuck

[ufo13]

DreamStalker (Roberto):

While waiting for the critique by Chuck you can also read a post (June 23,06) I did in relpy to Orange-man's thread of 6/22/06 on the subject of the 2 machines in question BOTH of which I have owned and used. You may find this info helpful! Also do a SEARCH of your topic and much information will be gleened by reading the posts of the other great people here on this very subject! It will help YOU form a very GOOD opinion of what you want to buy!

All the best,

Steve,
ufo13

[DreamStalker]

Thanks Steve (ufo13). I read the very good info in your discussion. I have searched for this topic but I get a great many hits that are irrelevant to the specific info I am after. I am aware of the fact that EPR is not available in auto mode and that EPR follows your breathing closer than C-Flex from reading various posts including yours.

However, I want to know more about what Chuck has already alluded to in a previous post regarding the difference between the algorithm portion of the “auto”. For example he has said that the ResMed is more aggressive at responding to snoring (I think that is how I interpreted his comments). However, at this point, I don’t know if that is an important feature for me to consider or not.

Basically, I want to be able to track my own progress or lack there of while using xPAP and from what little I understand, an “auto” is prerequisite for this kind of tracking and also for titrating (perhaps I’m confused?). Anyway, I would think that the type of algorithm used plays an important part in interpreting the daily results of an xPAP session. Furthermore, I think that understanding the difference between the two algorithms will help me to request one over the other when I discuss the issue with my sleep doc on Tuesday.

So, for now, I will continue to wade thru the posts looking for bits of info and anxiously await for the mother load (Chuck’s review or preview).

Thanks again,

Welcome the wonderful world of dreams …

- roberto