OSA and mental illness, anyone else? Lets exchange tips!

[Matty332]

G'day,

I was just wanting to know if there is anyone else on this forum that suffers from comorbid mental illness along with the OSA? I am just wanting to know so we can exchange advice and tips with dealing with them both because I am starting to learn that my OSA effects my mental illness greatly and I am just starting to learn exactly how it does that everyday.

I will start, so I suffer from severe OSA that is treated with an s9 with constant pressure 20. My AHI was about 120ish but is 0.4 with the CPAP so the CPAP completely negates it but only if I have NO mask leaks at all and use %100 compliance. If there are leaks I feel terrible the next day and I have worsened mental illness symptoms and palpitations that may last for 2 days (only going away after two more good night with no leaks and %100 CPAP compliance) I also suffer from OCD and anxiety with depersonalization and depression (depression and depersonalization on rare occasion). Sometimes I am so tired in the evening at about 9pm after a hard days work I fall asleep watching TV for 3 hours without the CPAP on the couch (then wake up and go and put it on) and I may expect severe depersonalisation the next day when that happens too.

So, OSA is bad enough but mental illness and also psychotropic drugs that treat it can complicate and confuse things a bit. So I think it is important to exchange information on dealing with these things.

Anyone else?

[Matty332]

Seriously no-one else? Looks like I am the only one here.

If there are others and you are worried about the stigma of posting, it's 2012 and anyone who judges and sees mental illness as a weakness deserves to live in the medieval times. Ah well it was worth a try!

[BlackSpinner]

It is Sunday. It can be a slow day.

I was just depressed and it cleared up with my cpap machine in a few weeks. So I am not much help.

[SleepyToo2]

G'day Matty332. Not sure how much I can help you - I don't have any psychiatric disorders that I know of. However, I am a pharmacist, and have worked in psychiatric hospitals in the UK and in New Zealand. I know that psychiatric disorders are as much an illness as diabetes, or pretty much any other disease, so I do sympathize with your difficulties. I also agree with you that there needs to be discussion about sleep apnea management in patients who have a number of comorbidities - not just those you are referring to. What I have noticed on this and other forums is that people needing pressures of 20 cm to eliminate their apneas may actually do better with a more advanced machine. I do not know whether you would need a bipap or an ASV - that is something for experts in dealing with high pressures to suggest. Whatever, you will need to discuss it with your doctors, although from what I recall, in Australia you may not be able to get the bipap without paying a lot yourself? If you are able to afford it, of course, that would be an option worth considering. I do hope this helps you, and perhaps prompts others to respond on the area that they know about.

[geezerpop]

Matty332:

You have raised a great issue. I am sure there is a connection. Lets face it, the police (of many countries) and military, as well as spy agencies have used sleep deprivation to drive their prisoners nuts in order to get them to cooperate and give them information or help.

Certainly, there must be a connection between sleep apnea and mental health issues. I was never in the medical field and do not have access to whatever research has been done. Maybe if I get some spare time I can start digging through medical sites on the web.

I am sure, speaking from personal experience, that my sleep apnea contributed to my states of depression over the years. I was, thankfully never hospitalized. I do recall that the meds the doctors prescribed 28 years ago (before I got a CPAP three years later) to treat possible central nervous system apnea along with OSA were pretty nasty in their side effects. I quit the medicine because #1 it made no difference with apneas, #2 it messed with my head, and #3 had other side effects with other bodily systems. I was on the med for about 5 weeks before I took myself off and when I saw the doc about a week later and told him, he made no effort to try to get me to use it. He said something to the effect that they had to try it because I might have had a beneficial effect. With no benefit there was only the down side of bad side effects.

The web and this forum, is fairly annonymous, so there should be some others who will chime in when they discover this thread.

[lazer]

Seriously no-one else? Looks like I am the only one here.

If there are others and you are worried about the stigma of posting, it's 2012 and anyone who judges and sees mental illness as a weakness deserves to live in the medieval times. Ah well it was worth a try!

Sorry, I did read your post earlier but didn't realize what comorbid mental illness refered to and thus, didn't realize that myself suffering from depression, anxiety, sleep disorder, and high cholesterol fell into that bracket.

I'm currently in another one of many battles trying to settle back in to an effective depression/anxiety med. I've been posting a good bit of my current history in the "Effexor - Side effects..." sorry can't even remember what I titled it now thread lately about my ordeal with various meds and dosages.

Technically or "Medically" whatever... speaking, I don't really qualify for the OSA treatment my doctor and I have pursued because my AHI has been under 5 during two seperate sleep studies over the past aprox 5 years. The initial study was an in lab study which I never progressed past stage 1 sleep throughout the night. The second most recent study was at the begining of this year done in-home through a company called Novasom over a 3 night period. It also indicated lack of certain stages of sleep (I believe stage 3? and REM) however the AHI index remained a bit below 5 at around 2.9 thus I didn't fit into the "Qualification" criteria to get equipment paid through the insurance. With that said, my doctor has continued to be in my corner in hopes of getting my sleep improved that he feels still has an impact on my other conditions, most notibly the depression and anxiety and being on so many meds... And I have finally found a DME also willing to work with me somewhat but that's a whole other story which I've posted about in other thread(s).

So yea, I'm very much interested in any tips, medicines, whatnot as per your OP. I can tell you that since starting on the APAP, I have started dreaming again which I hadn't before treatment and am generally feeling a bit more rested and more energetic during the day. At first, the depression/anxiety seemed to be taking a turn for the better but in the recent weeks, life's stressors have kicked in again along with the shuffle of meds so that aspect is not really heading in the right direction at the moment.

Of course, it doesn't help matters that I've acquired a bad "head cold" since Thursday and have pretty much been couped up in the house.

[kteague]

While I've never been treated for a mental illness, I've had a couple docs note in my chart that I had depression. Also, there was a medication I was on for a few years that caused compulsive addictive type behaviors. When I went off the meds those inclinations ceased. Though I was irate when I found out I had gone through that experience unnecessarily, I do in a way appreciate the experience as it gave me a better understanding of what some people go through whose symptoms are not medication induced. Really changed my perspective and helped me be less judgemental.

I think in some cases chronic sleep deprivation and the effects of OSA can appear as mental illness and lead to misdiagnosis, or in other cases may exacerbate existing conditions. Some on here have reported that everything that had been controlled went out of whack when they started on CPAP. The medication dose that worked for the oxygen starved and sleep deprived brain may not be the dose that works best for a rested and healthier mind. If there are changes in mental status, this discussion would be good to have with the prescribing doctor. Several years ago there was a thread on here about how many were referred for a sleep study by a psych doctor. Was a fascinating thread. If I can locate it I'll post it.

[Mary Z]

I have bipolar disorder, diagnosed in 2005, before that I was only diagnosed with depression which has been lifelong. I also have benign essential tremor with a deep brain stimulator to control the tremors in my hands. My bipolar disorder has been devastating since 2005- I am only now starting to feel more normal. I started on CPAP in 2008. I never noticed any effects on my mental illness from CPAP. My mental illness is 85% controlled with meds. I went on an ASV machine in March, 2012 in hopes of decreasing day time sleepiness and looking for some improvement in lingering depression. I can't honestly say that any type of PAP therapy has caused an improvement in my symptoms. I think using my ASV is important to my sense of well being and to my health.

[myconoclast]

I also suffer from depersonalization/derealization (along with depression, PTSD, and social anxiety.) Lack of sleep the night before definitely makes it more likely that I will slip into a dissociative state the next day. A lot of the time, I feel like I am floating around in a dream. Or, I'll feel like I am observing the world through a thick pane of glass.

When I first started seeing my therapist, he asked about sleep apnea because the symptoms of depression can mimic the symptoms of untreated sleep apnea. Then, a few months ago, I started having nighttime "hallucinations" where I would wake up the middle of the night and still be dreaming. So I would know that I was awake and in my bed, but I would see things like people walking around in my room or dragons up on the ceiling. Mostly I would know they weren't real, but sometimes I would be fooled- I saw my cat on my nightstand, but when I went to pet him my hand went right through him- it was freaky. My therapist again suggested that I have a sleep study, and I finally went to humor him. I've only had three nights of PAP so far, so I can't really say if it is going to help my mental health at all yet. Let's hope, though

[ChicagoGranny]

I was just wanting to know if there is anyone else on this forum that suffers from comorbid mental illness along with the OSA?

The traditional definition of comorbid means the condition exists independently from the first condition.

From what I have read depression is often caused by OSA. So it is not a comorbid condition.

There are some better articles about this but here is what I found for now - http://doctorstevenpark.com/a-surprisin ... depression

[chunkyfrog]

I guess that's why diabetes is not considered comorbid--as there is an established causal relationship.
Funny they didn't make that distinction with HBP. Could have saved themselves---wait! What am I saying?
Never mind.

[-tim]

I know someone who was dating someone with untreated sleep apnea and I expect it didn't do anything for her mental health.

[VikingGnome]

OSA and mental illness CAN BE comorbid. Yes, 60% of OSA patients suffer depression. But OSA and mental illness can coexist as independent entities.

I have had mental illness since childhood. Inaccurately diagnosed as schizophrenia at age 18, I spent 10 years on some very awful antipsychotic durgs and tricyclic antidepressants that did nothing for my mental illness but made me gain 100 pounds. Despite this, I was able to finish college. I was finally properly diagnosed as Dissociative Identity Disorder and PTSD from childhood sexual abuse. All my medications were changed and things got much better. I went to graudate school and earned Ph.D. and worked for 12 years as a university professor. Then I was diagnosed as Bipolar and have been on Lithium and Klonopin. These prevent any manic episodes. I am being titrated off Effexor as it has had serious effects on my sleep cycles.

I was diagnosed with moderate sleep apnea 12 years ago and put on CPAP. I can honestly say that OSA did not cause me to be overweight and did not cause my mental illness. The medications caused me to gain weight. I believe I have had OSA all my life. I have been a loud snorer for decades before OSA diagnosis. I always thought my daytime sleepiness was due to my medications. Now, all 4 of my living siblings are on CPAP as well as my mother. We have all been told we have unusually small airways (nose, throat, and trachea) causing OSA.

OSA and psychtropic medications can be a complex balancing act. Many of the psych meds can interfere with the normal sleep cycle, suppressing REM and deep sleep altogether. The meds can also cause you to be sleepy during the day. So, is daytime sleepiness due to meds or inadequately treated OSA? Disrupted sleep can cause an increase in mental illness symptoms. I have had two occasions where I was almost psychotic due to lack of restful sleep. I didn't need antipsychotic drugs. I needed more REM and Deep Sleep. 16 hours of just light sleep per day wasn't adequate.

You need your sleep doc and psychiatrist to talk to each other. They both need to understand what is going on. Your psychiatrist needs to be cognizant of the effects the medications being prescribed can have on your sleep architecture. Your psychiatrist needs to see the results of your sleep study. If there is no REM or DEEP sleep, medications need to be adjusted or changed.

Unfortunately for many patients, the sleep doc and the psychiatrist are treating a patient totally independent of each other. And neither one gets a true picture of what is is going on with you. So the patient is not getting proper treatment for either condition.

[Teresa55]

well for what it's worth I will share a little of my story, if nothing else, you will know you are not alone. I have snored VERY loudly for yrs. prior to CPAP, my kids let me know for sure. In fact, one time when I was in the hosp.( totally unrelated) the staff kept coming in asking me is someone bringing your machine, and like 5 minutes later they'd ask again, because apparently I could be heard on the opposite side of the ward. However, before I sought help with the apnea I was diagnosed with clinical depression which was bought on by insomnia. I had started to seriously consider suicide so I went for help. I have come to terms with the fact that I will take my antidepressant for the rest of my life, that was a very hard pill for me to swallow. While I have been using the CPAP for 15 yrs. to currently,even so I still have some kind of sleep issue. I never sleep 8 hours, not even close. I wake up in the morning barely able to keep my eyes opened. I have a problem getting to bed because my brain won't shut down, I'm super tired but if my brain won't let up then it is pointless for me to attempt to go to bed, as I only get more frustrated and end up back up. Most of the time I get about 4 hours a night. I'm continuosly trying to find answers. Now if anyone reading this feels bad let me add some of my known conditions, depression,sleep apnea, diabetes,high cholest. high blood pres., hiatal hernia,diverticulitis, acid reflux, emphsema,asthma,smoker, and personally I think they ALL play a part on each other. So.... you are never alone. P.S. Truly, I do feel extremely blessed though.

[The Choker]

Everything that you say in this part of your post -

I was diagnosed with moderate sleep apnea 12 years ago and put on CPAP. I believe I have had OSA all my life. I have been a loud snorer for decades before OSA diagnosis. I always thought my daytime sleepiness was due to my medications. Now, all 4 of my living siblings are on CPAP as well as my mother. We have all been told we have unusually small airways (nose, throat, and trachea) causing OSA.

Disrupted sleep can cause an increase in mental illness symptoms. I have had two occasions where I was almost psychotic due to lack of restful sleep. I didn't need antipsychotic drugs. I needed more REM and Deep Sleep. 16 hours of just light sleep per day wasn't adequate.

Your psychiatrist needs to see the results of your sleep study. If there is no REM or DEEP sleep, medications need to be adjusted or changed.

makes this statement dubious -

I can honestly say that OSA did not cause ... cause my mental illness.

You cannot know what life would have been like had you not had OSA "all of your life". Your mental health might have been very different.

You have suffered terribly. All the best to you going forward.