Unexpected Negative Effects (Psychological) of Using CPAP

[FinallyUsingCPAP]

Hi everybody.

I have been--finally--using my long-prescribed CPAP machine, and in a very short time it's more or less turned my sleep around. I'm not tired during the day, I'm rested, my metabolic reactions to food feels balanced, increased lung capacity...a bunch of stuff. Granted, it's only a week, but still. Amazing.

The only negative physiological side effect so far is aerophagia, which I think I will be able to fix. However, I have had a really crippling psychological side effect, one I didn't expect. The *opposite*, in fact, of what you might expect.

Like many people with apnea, I live with a fair amount of depression and anxiety. But I discovered when my inability to sleep well was taken away my emotions suddenly became really overwhelming. I think that for a very long time now I have used the sleep deprivation and tiredness as my "drug" of choice--if you see what I mean. I didn't think I was, but I was using my tiredness to keep from feeling some things, or even just to provide distraction or something else I had to do, since when you're that exhausted all you can do is deal with that.

So take away the crutch and...bam. I got walloped with a series of increasingly desperate, bleak, and completely depressive episodes that eventually culminated in an emergency psych visit and some meds. The funny (hah) part is that when I felt fine this past week...I felt really good. Not manic, but better than I normally did. A bit high off all the oxygenation. But then the bleakness would set in and I would feel worse than I ever have in my life. I've never ever had depression like that, I will be thrilled if I never feel that bad again. I'm scared now even writing about it.

I have been doing every possible thing to help myself. Continuing to get sleep, eating okay despite some loss of appetite, seeking help, talking to friends (eventually...took me a few days to identify this, obviously), taking vitamins, etc. But it's still been awful and I can still feel the depression nibbling at my heels all the time, obviously. I'm exhausted emotionally from fighting back the negative thoughts.

Has anyone ever experienced anything like this? It's the kind of thing that being a little forewarned about might have helped, but I honestly don't know how common this kind of reaction is.

Even if it isn't a very common reaction, I am telling this story in case it might help somebody else. I'll probably tell the sleep lab too. The CPAP machine has really helped me, but it's been miserable too.

[OCNorsk]

I didn't have that happen to me, but it sounds awful. I certainly wouldn't have expected it either. I would say hang in there until you can used to your new life for awhile. I don't know where you live but whenever I feel lousy I just go outside and walk. I think outside air and some "nature" can help make one feel connected. Walking in some studies has proven to be as effective as anti-depressants. (I read it in a magazine, it's not medical advice. But it works for me.) I wish you the best. Many people on this board have great ideas and support.

[Captain_Midnight]

Finally - - You present an interesting story; and one that might be quite useful to anyone with similar results.

I have a question or two for you, if you don't mind. Do you have any data reporting capability from your machine? Do you have any idea if you have any leaks from your mask or mouth? And, do you think that you still might be having some apneic events, even with the xpap therapy? Finally, do you humidify, and if so, do you use a high heat setting.

The reason I ask is I'm wondering if your system is set up to give you optimum therapy.

Like many others here, for example, I needed to have my pressure changed from what it was first titrated. When I suspected that the pressure wasn't what I needed, my doc arranged a week's at-home titration with a recording autopap. Made a huge difference. And, I figured out how to minimize leaks (methods vary for individual apneic patients), and I also learned from a few of the veteran posters that some folks need heated humidity, some do better with out heat (I'm in that camp), and others do best with no humidity at all.

There are many ways to tweak the set-up, and it pays to be sure that your therapy is optimized.

I also wanted to mention something entirely different.

OSA really stirs up hormone systems and other body chemicals, and it's always possible that some issues take a while to level out.

Along with that, there's the possibility of pre-existing conditions or OSA-related conditions.

The literature is a bit divided on this, but there are some reports of a relationship between OSA and hypothyroidism. If we are to assume that this is a possibility, then it's something that every OSA patient might want to be on the watch for; and to "rule out" if symptoms similar to hypothyroidism occur.

If you google hypothyroidism and depression, you get lots of hits. Here's just one.

http://www.umm.edu/patiented/articles/h ... 0038_6.htm

Effects of Hypothyroidism and Subclinical Hypothyroidism on the Mind

Depression. Depression is common in hypothyroidism and can be severe. Some psychiatrists suspect that even subclinical hypothyroidism may contribute to depression. The two disorders may have some common physiological basis. Adding thyroid hormones to antidepressants may hasten a depressed patient's recovery, even in some patients who have not been diagnosed with hypothyroidism. Hypothyroidism should be considered as a possible cause of any chronic depression, particularly in older women.

Since hypothyroidism can be difficult to diagnose, I thought that I'd mention it. Your docs may have already ruled it out.

Good luck, and thanks for relating your important experiences. Stay with it and please stick with this forum to keep all updated on your progress.

Regards all - -


.

[KevinMWHM]

In my mid 20's I had the hardest time ridding myself from a drug addiction. I had a bunch of other problems I had to tackle but the biggest was the drug use. After kicking that I would often feel worse and wondering why I quit and my shrink at the time would use the analogy of a car with smoke coming from the engine. You know there's something wrong, but until you take step one and open the car and let the smoke clear, you can't fix anything else.

Now that you're working on the biggest problem, (your sleep), are there other aspects of your life that the sleep problem was masking? If nothing is glaring as a priority, start fixing little things. Remember, if you think you're at the bottom, it can only get better!


-Kevin

[Gale Hawkins]

Quote from OP, Like many people with apnea, I live with a fair amount of depression and anxiety.

Does anyone know of any research that shows this to be a cause/effect thing or just due to many people live with a fair amount of depression adn anxiety or is it just not a proven statement?

[Violet]

FinallyusingCPAP,

BINGO! Boy, I know where your coming from.

For me, I have just recently realized that I have been keeping unresolved sad issues stuffed deep down inside me for nine years. My sleep deprivation helped me hide.

Since starting therapy 12/6/08, all the walls that protected me from sad feeling have been coming down. I'm waking up, I'm feeling the sadness again and have realized it's time for help in order to move on.

PCP recommended I start with talking with a social worker and then they can decide if I need to talk with another professional Dr.

Therapy? It's good, a work in progress, and I'm working on it, numbers, pressure, nasal mask, new FFM #'s etc.

[roster]

Quote from OP, Like many people with apnea, I live with a fair amount of depression and anxiety.

Does anyone know of any research that shows this to be a cause/effect thing or just due to many people live with a fair amount of depression adn anxiety or is it just not a proven statement?

IMO, there is no reasonable doubt about this statement: "In our population there is a high incidence of people living with a fair amount of depression and anxiety caused by untreated sleep apnea."

There are plenty of horror stories on this forum. There is this current discussion on another site: http://www.sleepguide.com/profiles/blog ... 786&page=1 . The testimonials by Dawn and Banyon are similar to what I personally experienced.

You can find research on the web that shows a correlation between untreated sleep apnea and depression/anxiety. There is also plenty of rationale. For instance, sleep apnea causes sleep deprivation and there is plenty of evidence about the connection between sleep deprivation and mental illness. Sleep deprivation is a very old technique for torture of prisoners.

On top of this add oxygen desaturation and excess adrenalin. There is plenty of solid evidence that sleep apnea can destroy mental health as well as physical health.

[Gale Hawkins]

Quote from OP, Like many people with apnea, I live with a fair amount of depression and anxiety.

Does anyone know of any research that shows this to be a cause/effect thing or just due to many people live with a fair amount of depression adn anxiety or is it just not a proven statement?

IMO, there is no reasonable doubt about this statement: "In our population there is a high incidence of people living with a fair amount of depression and anxiety caused by untreated sleep apnea."

There are plenty of horror stories on this forum. There is this current discussion on another site: http://www.sleepguide.com/profiles/blog ... 786&page=1 . The testimonials by Dawn and Banyon are similar to what I personally experienced.

You can find research on the web that shows a correlation between untreated sleep apnea and depression/anxiety. There is also plenty of rationale. For instance, sleep apnea causes sleep deprivation and there is plenty of evidence about the connection between sleep deprivation and mental illness. Sleep deprivation is a very old technique for torture of prisoners.

On top of this add oxygen desaturation and excess adrenalin. There is plenty of solid evidence that sleep apnea can destroy mental health as well as physical health.

Rooster clearly sleep apnea can and DOES destroy health on all levels. I just did not understand how using a CPAP machine and over coming the effects of sleep apnea would make depression worse. I found the opposite in my case.

[roster]

........ I just did not understand how using a CPAP machine and over coming the effects of sleep apnea would make depression worse. I found the opposite in my case.

Gale, I am with you on that one. Sorry for "preaching to a choir member".


I have the same questions as Captain Midnight:

.......I have a question or two for you, if you don't mind. Do you have any data reporting capability from your machine? Do you have any idea if you have any leaks from your mask or mouth? And, do you think that you still might be having some apneic events, even with the xpap therapy? Finally, do you humidify, and if so, do you use a high heat setting.

The reason I ask is I'm wondering if your system is set up to give you optimum therapy. .........

Without monitoring software, "FinallyUsingCPAP" may not have his apnea well treated. It could still be "plain old obstructive sleep apnea" causing all of his psychological problems. I hope this thread does not go on a wild goose chase before the effectiveness of his CPAP therapy is verified.

[Babette]

Good thread, thanks for posting it. I've now got some food for thought. Like several other forum members, I felt so good after starting therapy, I really had hope of getting off my psych meds. With the help of Socknitster, I weaned off Lexapro onto Prozac, with the intention of weaning off Prozac slowly, until I was using nothing. That was over a year ago.

I've tried to wean off Prozac, but I start to panic and have increased anxiety. My doc says it doesn't correlate. I say I'm emotionally addicted to my little blue pill.

All of your experiences are very interesting. I need to go mull on this awhile. Thank you so much for posting this!!!!
Babs

[queenmaggie]

Depression is an imbalance in brain chemicals. It can be caused by Sleep Apnea, it can be worsened by it, and it can also have nothing to do with it: If as the writer believes her depression was overwhelmed by her exhaustion, once she starts feeling more energetic, the imbalance could become more pronounced.
My first suggestion is to fit in some extra aerobic exercise. It has been noted that getting out and using your muscles (swimming, walking or running, dancing, almost anything that gets you moving) will enhance your mood.
I take anti depressants, and am feeling a lot better since starting the CPAP about a month ago. I am, however, noting more, and more intense dreaming. I suppose I am making up for lost time. I also have found that taking supplements of omega three oils (flax seed oil, or fish oil) really helps my depression: I understand that the omega threes are the precursors that the body turns into the seratonin that can be so imbalanced in one's brain.
No matter what you do, keep talking to your doctor and take your antidepressants. If they aren't working, get the Doctor to try a different type. Best of luck.

[roster]

Depression is an imbalance in brain chemicals. ..........

Can you provide links to the research showing this?

[Gale Hawkins]

Depression is an imbalance in brain chemicals. It can be caused by Sleep Apnea, it can be worsened by it, and it can also have nothing to do with it: If as the writer believes her depression was overwhelmed by her exhaustion, once she starts feeling more energetic, the imbalance could become more pronounced.
My first suggestion is to fit in some extra aerobic exercise. It has been noted that getting out and using your muscles (swimming, walking or running, dancing, almost anything that gets you moving) will enhance your mood.
I take anti depressants, and am feeling a lot better since starting the CPAP about a month ago. I am, however, noting more, and more intense dreaming. I suppose I am making up for lost time. I also have found that taking supplements of omega three oils (flax seed oil, or fish oil) really helps my depression: I understand that the omega threes are the precursors that the body turns into the seratonin that can be so imbalanced in one's brain.
No matter what you do, keep talking to your doctor and take your antidepressants. If they aren't working, get the Doctor to try a different type. Best of luck.

Well worded post with sound information. Fish/flax seed oils saved the day for me along with CPAP.

[Violet]

Seems to me there are different types of depression. Some are brought on by events, e.g. divorce, or loss of a child. Would a "Reactive Depression" be considered to have a chemical imbalance involved in this as well?

[Guest]

Have you been diagnosed (or checked by a qualified doctor) for bipolar disorder? With bipolar, the sleep cycle is extremely important to mood control. Possibly by changing your sleep patterns so quickly, you caused a mood cycle to hypomanic and then to depression. This type of depression is like what you described and can come on very quickly. If you have not seen a good psychiatrist, you should IMMEDIATELY. This is a clinical depression and not something that you can just wait out or talk yourself out of. My son has bipolar and the proper medication saved his life.