Post Traumatic Stress from Apnea

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
mstevens
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Re: Post Traumatic Stress from Apnea

Post by mstevens » Thu Jan 05, 2012 9:42 am

lcosborn wrote:So mstevens, I have a few more questions.

How do you think sleep apnea (or sleep deprivation) affects compulsive behavior, like shopping or gambling or substance abuse?

How does sleep apnea (or sleep deprivation) affect judgment?

What is the difference between epinephrine and norepinephrine?

Why did they change the name from adrenaline to epinephrine?
I wrote a brilliant, incisive, and insightful response to this that, brilliantly, I seem not actually to have posted...

I'm traveling out of the country at the moment, but I'll see if I can recreate something soon.

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NotSleepingBeauty
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Re: Post Traumatic Stress from Apnea

Post by NotSleepingBeauty » Thu Jan 05, 2012 10:32 am

What about things going the other way? Can a traumatic event trigger sleep apnea?

I have been experiencing fatigue symptoms that have gotten worse and worse since 2007 when my father passed away. The cause of his death was hospital acquired MRSA. He went to the hospital in January with back pain and passed away in March almost to the day of his admission. He had a skin infection at an IV site that moved into his blood. It eventually moved into the vertibrae that had a compression fracture, which was the reason for his admission. By the end he had a lung infection requiring a chest tube, and his kidneys were shutting down.

He was 61 and I was 38. When the hospital called us to come say goodbye I literally split into two persons. There was the adult me who buried my head in my husband's chest and cried, and the 7 year old me huddled on the floor at the foot of the bed listening to my mother tell him it was OK to go and screaming "No, it's not OK, no part of this is OK".

So could this extended traumatic event, watching him die for 2 months, while he was in terrific pain, experiencing hallucinations, and mental impairment, have triggered OSA?

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SleepingUgly
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Re: Post Traumatic Stress from Apnea

Post by SleepingUgly » Thu Jan 05, 2012 11:18 am

NotSleepingBeauty, I'm so sorry for your loss. I don't see how an event like that, painful as it was and likely still is, can affect your airway. The only means I can imagine could even remotely be at play is if you gained weight following his death, in which case it's the weight, not the loss.
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lcosborn
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Re: Post Traumatic Stress from Apnea

Post by lcosborn » Thu Jan 05, 2012 11:20 am

I am extremely grateful for these comments, and I really needed support and solidarity around this. I have had EDS and other symptoms for 27 years, and memory and concentration problems going back to first grade. I was the classic supposedly "gifted" child who was continually punished for non-performance.The refrain of my childhood: "If only you would apply yourself..." Little did they understand, and little did even I fully understand, the Herculean effort it took me just to make it through the day and perform the most basic life tasks.

My current emotional task is to make sense of all of this, to construct a coherent life narrative that creates some order out of chaos. SleepingBeauty puts it like this, and this is part of what I need to sort out:

"There are symptoms that are clearly directly caused by OSA (e.g., sleepiness) and those that can be caused by OSA (e.g., memory problems, irritability, depressive symptoms, anxiety, etc.). Then there are the consequences to our lives of long-term untreated OSA (e.g., damage to careers from poor job performance, social impairment, etc.)."

Carnage was another word she used; I'd add devastation, rubble, ruin. Now my task is to rebuild.

Rebuilding is hard, partly because I don't know who I am anymore. Throughout my life, I developed a whole series of coping strategies, consciously and unconsciously, that shaped my identity. Getting the diagnosis was liberating, but also created a lot of confusion. I don't know what parts of my mental and physical life, maybe even my personality, were determined or shaped by sleep deprivation.

I can't and couldn't have predicted the subtle and surprising changes I would undergo with proper treatment. This sounds like BlackSpinners reference to sleep deprivation studies.

For example, I used to lose my keys multiple times a day. I tried a million strategies to develop habits so that I wouldn't lose my keys, but to no avail. One day I realized that since going on the Bipap, I had only lost my keys one time in the previous 6 months!

I also used to spend money compulsively. I would get lost in big box stores for hours. I would spend hours on Amazon.com or eBay. One day, about 6 months after I went on the Bipap, my husband asked me if I had opened up a credit card without telling him about it. He said my spending had dropped so drastically on our shared accounts he was scared that I had a hidden card somewhere. I didn't even try to stop spending money; I just found that the volume on my compulsions had been turned way down. Now I can go in and out of Walmart quickly and find long sojourns to Target boring. I continue to be massively in debt however, nearly all of it student loan debt (it is hiding a great deal of compulsive spending) from a doctoral program I was kicked out of the same month I got the sleep apnea diagnosis. (The lost doctoral program would be a big part of the carnage. I couldn't maintain the focus I needed to bring my dissertation to completion.)

I also used to be extremely sensitive to physical spaces. If my office was painted an ugly color, for example, it would drive me into a state of madness. Disorder would make me crazy. I would tidy up other people's spaces and drive them nuts. I would begin projects in my mother's house, which as you can imagine would cause major conflict. I once totally gut-rehabbed an office I had in an old building, and it cost me several thousand dollars. Everywhere I went, I would mentally paint and knock out walls. I never, ever do that now. In fact, post-Bipap I lived in a room in an older house that had extremely ugly, busy, old-fashioned and peeling wallpaper complete with water stains. In the past I would have actually stripped that wallpaper off the walls without the landlady's permission, it would have made me crazy. But it didn't even bother me at all. I didn't feel the slightest urge to paint and order things. This all sounds as strange to me as it probably does to you, believe me. I had no idea where that compulsion to paint and clean came from. But I don't have it now. I don't go into someone's office and want to re-organize their books, or re-arrange their furniture. For years I thought and behaved that way; now such things don't even remotely occur to me.

I used to speed while driving all the time. If I was in a car, I was going 10-20 mph over the speed limit. Worse still, I was often eating, texting, applying makeup and talking on the phone at the same time. I once got two speeding tickets in a single week. Now I go the speed limit without even trying. I didn't even notice it at first, but after a few months, I was suddenly thunderstruck by the fact. My hands are always at 10 and 2, and yet I made no conscious effort to be a better driver. I just am.

I think I got into a bit of a state of learned helplessness over the years. My behavior and interior life were erratic, out of control, in ways they no longer are. But for years I was constantly putting massive effort into "getting things together" and failing in my attempts. After awhile, all that effort just seemed futile. Worse still, I developed extreme aversions to painful areas of my life. Dealing with my money issues sends me into a panic state, even though without trying my spending and debting have fallen dramatically. After years of being unable to do simple things like not lose my keys, I lost faith in myself and my abilities. I've been fired from jobs and have strained relationships directly due to sleep apnea. Bosses don't like finding you asleep under your desk at work, friends don't like finding you asleep on their couch at their kid's first birthday party, family members don't like it when you conk out right after opening Christmas presents.

The other day I went to see a psychologist to start trying to make sense of all of this. I described some of my aversions to her. She said, "Has anyone ever told you that what you are describing sounds very typical of people who are trauma survivors?" I burst into tears, surprising myself. I've been through hell, but a trauma survivor? I was never even insulted as a child. I wasn't abused, raped, didn't witness violence, haven't had any major accidents, don't abuse substances. But I do feel like a traumatized person. I feel like something traumatic has happened to me.

That's why I got on these message boards and looked up PTSD. I wanted to try to make sense of her comment, my reaction to it, and what it could mean. I need to figure out what things are symptoms of apnea, what things are consequences of apnea, and what things are related to some other condition that may or may not have been exacerbated by the apnea.

Mostly, I was looking for what I found: a little bit of solidarity, a feeling that at least part of my experience was shared. Thank you all so much. I am tremendously grateful to all of you for your wisdom and kindness, and to mstevens for clearing things up for me regarding PTSD. The fewer diagnoses I have, the better!

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SleepingUgly
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Re: Post Traumatic Stress from Apnea

Post by SleepingUgly » Thu Jan 05, 2012 11:22 am

mstevens wrote:I wrote a brilliant, incisive, and insightful response to this that, brilliantly, I seem not actually to have posted...
I also wrote a brilliant, articulate response that got lost in cyberspace, which is why I had to post my inarticulate, lousy response in its place.
Never put your fate entirely in the hands of someone who cares less about it than you do. --Sleeping Ugly

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lcosborn
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Re: Post Traumatic Stress from Apnea

Post by lcosborn » Thu Jan 05, 2012 11:25 am

mstevens, looking forward to your brilliant, incisive, and insightful response to this. SLeepingUgly, thanks for your self-described less stellar effort, which was much appreciated by me!

NotSleepingBeauty, I am also sorry for your loss.

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SleepingUgly
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Re: Post Traumatic Stress from Apnea

Post by SleepingUgly » Thu Jan 05, 2012 11:43 am

lcosborn, I can relate to some parts of what you wrote about, such as the monumental efforts to get things done (and failing), the loss of confidence in oneself, etc. On the other hand, some of what you describe I honestly cannot imagine being caused solely by OSA.

Carbonman has this as his signature: "If your therapy is improving your health but you're not doing anything to see or feel those changes, you'll never know what you're capable of."

Are you functioning well now? If so, is it possible to look forward toward the possibilities, rather than backwards toward the "rubble" and the precluded possibilities? It doesn't have to be mutually exclusive, if in fact working through some of what you've been through helps you to move forward. On the other hand, I can also see where a lot of focusing on the past can keep you from moving forward and seizing the second chance you've been given.

If you still are having issues, which it sounds like you are from your original post, but your OSA treatment is optimal, perhaps other reasons for your troubles should be explored while you're making the best of the parts that have improved.
Never put your fate entirely in the hands of someone who cares less about it than you do. --Sleeping Ugly

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NotSleepingBeauty
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Re: Post Traumatic Stress from Apnea

Post by NotSleepingBeauty » Thu Jan 05, 2012 11:52 am

Wow, the symptoms you describe above are very similar to mine. When I was young I hated the word "potential"! I had great potential but never seemed to put in the effort. I have been working under the impression that I had/have ADD.

Perhaps it has been a sleep disorder all the while. I used to have awful nightmares (I grew out of them), I was a big sleep walker (grew out of that too), I clench and grind my teeth both while asleep and awake, I suffered insomnia in my early 20's for about 2 and a half years. I would go 2 - 3 days with only bits and snatches of sleep, now I have this awful fatigue, brain fog, memory loss, and lack of concentration. I also had/have a slight problem with dyslexia. I always failed math and spelling because I would flip numbers and letters from what was written on the blackboard. You are never going to solve a math equation if you wrote the problem down incorrectly.

I was resigned to the fact that I was just a lazy person. I hope I start feeling better soon so I can participate in life again.

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SleepingUgly
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Re: Post Traumatic Stress from Apnea

Post by SleepingUgly » Thu Jan 05, 2012 12:23 pm

I think the process is this: treat the disorders we know about to the best of our ability. Then see what's left. Try to treat what's left to the best of our abilities. Play the hand we have to the best of our abilities, and don't waste what's left of our lives longing for a different hand--the hand we thought we would have, or the one we wish we had. AND--and this is a challenge for me--don't forget Carbonman's signature because there is a very real danger of not taking chances because years of experience tells us we can't handle it. Maybe things are different now.

(Do I have to practice what I preach?!)
Never put your fate entirely in the hands of someone who cares less about it than you do. --Sleeping Ugly

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BlackSpinner
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Re: Post Traumatic Stress from Apnea

Post by BlackSpinner » Thu Jan 05, 2012 12:35 pm

lcosborn wrote:
My current emotional task is to make sense of all of this, to construct a coherent life narrative that creates some order out of chaos. SleepingBeauty puts it like this, and this is part of what I need to sort out:


Carnage was another word she used; I'd add devastation, rubble, ruin. Now my task is to rebuild.

Rebuilding is hard, partly because I don't know who I am anymore. Throughout my life, I developed a whole series of coping strategies, consciously and unconsciously, that shaped my identity. Getting the diagnosis was liberating, but also created a lot of confusion. I don't know what parts of my mental and physical life, maybe even my personality, were determined or shaped by sleep deprivation.

The other day I went to see a psychologist to start trying to make sense of all of this. I described some of my aversions to her. She said, "Has anyone ever told you that what you are describing sounds very typical of people who are trauma survivors?" I burst into tears, surprising myself. I've been through hell, but a trauma survivor? I was never even insulted as a child. I wasn't abused, raped, didn't witness violence, haven't had any major accidents, don't abuse substances. But I do feel like a traumatized person. I feel like something traumatic has happened to me.

I need to figure out what things are symptoms of apnea, what things are consequences of apnea, and what things are related to some other condition that may or may not have been exacerbated by the apnea.
I quoted some things here. Because I have worked with people who had to make major life changes. First I congratulate you on how you have managed (by applying your self to the BIPAP treatement) to turn around a lot of your life. Yes You did that by doing the right thing. You chose to make the difference.

You are not the person who you were before. It is not necessary to find this person because even if OSA had not happened you still wouldn't be that person - life happens. The cause of the symptoms is also not important - they happened and focusing on exactly what caused what is a waste of energy. You don't need to find a blame for what happened, you just need to accept that it did happen.

What you really need to focus on is "What can I learn from these experiences?" . After all we don't want to waste the time we spent on them. Now you focus on defining who and what you want to be. Like driving, we look to where we are going, not down in front of us and we only look back to check if anything is catching up.
from a doctoral program I was kicked out of the same month I got the sleep apnea diagnosis. (The lost doctoral program would be a big part of the carnage. I couldn't maintain the focus I needed to bring my dissertation to completion.)
When you get yourself more together you may want to revisit this with your diagnosis in hand. That is if this is still what the new you wants to do with its future.

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Re: Post Traumatic Stress from Apnea

Post by NotSleepingBeauty » Thu Jan 05, 2012 12:40 pm

Very sound advice.

I will admit that I do shy away from doing some things because I am afraid that they may cause me to fall asleep at work the next day.

I've only been CPAPing for 3 weeks so far. I am waiting to feel some consistent benefits. Right now it's like I have good day and bad days, but I don't seem to be stringing the good ones together yet.

Great Topic!

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Re: Post Traumatic Stress from Apnea

Post by mstevens » Thu Jan 05, 2012 7:46 pm

lcosborn wrote:mstevens, looking forward to your brilliant, incisive, and insightful response to this.
As long as everyone realizes I was lying through my teeth about the brilliance. Otherwise there's going to be plenty of disappointment.

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Re: Post Traumatic Stress from Apnea

Post by mstevens » Thu Jan 05, 2012 7:52 pm

lcosborn wrote:How do you think sleep apnea (or sleep deprivation) affects compulsive behavior, like shopping or gambling or substance abuse?
Setting aside the fact that those things aren't really technically compulsive, sleep deprivation can certainly impair impulse control, which makes a person more likely to engage in maladaptive behavior.
lcosborn wrote:How does sleep apnea (or sleep deprivation) affect judgment?
It makes it worse.
lcosborn wrote:What is the difference between epinephrine and norepinephrine?
How much detail do you want? It's sort of like asking the difference between a camel and an alpaca.
lcosborn wrote:Why did they change the name from adrenaline to epinephrine?
They didn't. At least not everywhere. Outside the US you're still much more likely to hear "adrenaline" (and "noradrenaline"). There used to be a US brand of epinephrine called "Adrenalin". That's way too close to "adrenaline" so in the US we use "epinephrine" in medicine. Obviously, people still say "adrenaline" outside of medicine.

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Re: Post Traumatic Stress from Apnea

Post by mstevens » Thu Jan 05, 2012 7:58 pm

NotSleepingBeauty wrote:What about things going the other way? Can a traumatic event trigger sleep apnea?
No.

OSA is not psychological in origin.
NotSleepingBeauty wrote:I literally split into two persons.
Of course you didn't.

All disagreements about the existence of what used to be called "multiple personalities" aside, any such splitting would have to be figurative and not literal.

Literally splitting in two would have left a terrible mess on the floor and killed you.
NotSleepingBeauty wrote:So could this extended traumatic event, watching him die for 2 months, while he was in terrific pain, experiencing hallucinations, and mental impairment, have triggered OSA?
No.

Many, many people have similar experiences. Most of them don't develop OSA.

My daughter died at 16 months of age after 4 months of terrible treatment for a malignant brain tumor. Eventually we decided we'd put her through too much, took her off the ventilator, and held her until she became cold. I still have some flashbacks (eg to watching her twitch when they stabbed chest tubes into her) years later. That has nothing whatsoever to do with my OSA.

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Re: Post Traumatic Stress from Apnea

Post by SleepingUgly » Thu Jan 05, 2012 8:36 pm

mstevens wrote:
lcosborn wrote:How do you think sleep apnea (or sleep deprivation) affects compulsive behavior, like shopping or gambling or substance abuse?
Setting aside the fact that those things aren't really technically compulsive, sleep deprivation can certainly impair impulse control, which makes a person more likely to engage in maladaptive behavior.
Would you agree that OSA would not, in and of itself, cause "maladaptive behaviors" such as shopping sprees, gambling, and substance abuse to an EXCESSIVE degree (although frankly the term "abuse" sounds excessive...) such as seen in mania?

Would you agree that you would NOT expect OSA to cause other symptoms of mania (in someone without a proclivity toward bipolar disorder)?
Never put your fate entirely in the hands of someone who cares less about it than you do. --Sleeping Ugly