Bipolar Disorder, lyme disease, SA, and insomnia - Help!

[dormirjespere]

Have a new wrinkle to add to the mix. I not only have central apnea, and OSA, but have bipolar d/o. If I don't get a good sleep 7.5 - 8 hrs/nite, say, don't sleep one night at all, or only a ragged hr in 8 on bipap, it sets me on a cycle where I just won't sleep. Not unless I take a sleeping pill for a day or two to break the cycle. I avoid taking sleeping pills like the plague. But it has resulted in me getting in messes like I'm in right now, where I'm not sleeping at all except maybe 1-2 ragged hours in a 48 hr time period. I tried everything last nite to no avail: warm bath, soft music, tried to sleep in recliner with TV on very low (often helps me sleep), and finally tried sleeping on the couch (where I can fall asleep in a heartbeat usually w/o bipap. I had no success until finally I took 2 pain pills, and flexoril. I was in considerable pain, but know pain pills and muscle relaxants also are to be avoided as well. But my back and shoulders were screaming in pain from lyme disease, chronic, and my shoulder which I just had major surgery on 2 mos ago was also quite painful. I finally fell asleep for maybe 4 hrs. But I feel like I haven't slept at all. I won't be able to drive again today. That's 2 days this week.

I am under terrific stress, have been unemployed 3 mos - had to have major shoulder surgery, and have been looking for a job in my field, precious little there. My funds are almost exhausted. So my stress level is off the scale. But if I don't get this insomnia in check, I'll never get a job. I can't function at all, and can't drive.

I know the psychiatric meds I take further depress respiration, but I have no choice but to take those. And I only take a sleeping pill maybe 4-5x/yr. How dangerous is it when I take it? How about the pain pills and the muscle relaxant? I know both of them are pretty bad to take as well. But can you give me an idea just how dangerous it is to take them? I've been in tears alot with all of this going on. If I hadn't taken the pain pills last nite, and the flexoril, I wouldn't have gotten any sleep at all.

[BlackSpinner]

You need to sit down with your doctor and go over the meds you take. A pharmacist can tell you about the meds and their interactions too.

You need sleep so not taking sleep meds is counter productive. Only when you have your other issues under control can you start tapering off the sleep meds.

[dormirjespere]

Thanks Blackspinner. I will do so. I've been on the same psych meds for many years. My sleep doc, whom I've only seen once (just changed docs), didn't make mention of my meds and their effects on the SA. But I will talk with him about that too in my appt this week. At the moment, I'm just totally frustrated with everything. And depressed. Thank God for all of you. Just found this site yesterday.

[robysue]

I agree with BlackSpinner that under the circumstances, you need to take those sleeping pills and break the current cycle of not sleeping very much.

As for a longer term goal of getting the 7.5-8 hours of continuous sleep you crave, you may need some professional help from either your sleep doc or the doc who is treating the bi-polar condition since the cycles of "not sleeping at all" may be related to the bi-polarism. And you need to talk to both docs about the posslble affects of drugs on your multiple conditions. And talk to a pharmacist about drug interactions since it sounds like you are on some potent stuff.

In the long run, you may need to adopt a rather rigid sleep schedule with a fixed wake up time and a fixed bedtime. And you may need some help in figuring out how to break the cycle of very fragmented sleep while lying in bed for 8 hours. If you lie in bed for 8 hours and only get 3 or 4 hours of sleep, that's likely adding to your problems.

[Mary Z]

I have Bipolar disorder. Presently on klonopin, lamictal, and zoloft. They are life saving. I am suicidal without them.
They probably change with my sleep architecture, but in prescribed doses do not (usually) cause respiratory depression.

[BlackSpinner]

Another thing is that once you do start sleeping you need to keep a careful eye on your medication because once you are sleeping properly your body may change the way it interacts with the meds. Start keeping a detailed journal of your emotions and how you feel physically so you have something to compare it too.

And when you meet with your doctors have the complete list of medications written in detail down with a copy for them.

[dormirjespere]

Thanks Robysue, Mary and Blackspinner,

I do appreciate your suggestions. Robysue, you brought up a number of excellent points. And I'll definitely need to write all this down so I can present it to both my psychiatrist as well as sleep doc. And Blackspinner, I think it was you who suggested keeping the diary of emotions, meds, and sleep patterns. Another excellent idea. I will do so as of now. And Mary, thanks for your input as well, and for letting me know I'm not the only one out here dealing with BP, as I struggle to get the right meds, dosages, and manage to sleep as well! And whomever said it, it was an excellent point that as my sleep, pressures, etc. come under control, that the med dosages may need to change as a result of that as well. You've all given me excellent information and support. Thanks!