A psychiatrist thinks an OSA patient has also hypochondria

@Steven Park: I appreciate you a lot to drop by and shed some lights here.

I'll use some better moments of my concentration to digest your words and come back with replies.

Thanks

Great post Dr. Park. Maybe you can do a future blog entry regarding how patients who have trouble with their pap therapy due to the reasons you mentioned get pegged as a hypochondriac as papzombie did by the team of doctors he/she was working with.

Thanks again for writing it.

WOW, thanks to Robysue and Dr. Parks for their fabulous posts. How interesting.

I want to thank Robysue for her help with my insomnia and xPAP issues.

I want to thank Dr. Park for first turning me on to xPAP therapy for resolution of my nighttime reflux and poor sleep issues. I am a big fan of his books and blog.

I just want to say that I think UARS sufferers really need to be aware of the possibility that their brains may be interfering with their xPAP therapy. The reasons for this are many: poor sleep habits, hypochondria, insomnia, hidden desires to hold on to symptoms, other medical issues, etc. Of course, this may require a level of self-awareness that not many of us can achieve. I for one, am finding that this xPAP journey is resulting in knowing myself much better than I ever did before. It can be a long, painful process.

Because it seems to me that there are 2 ways to attack the problem: Devise a machine that can respond to any and all manner of obstructions before one's brain can interfere OR train the brain to calm down, get rid of it's neurosis, and trust the machine. I am meditating a lot on this concept right now.

PEF wrote:WOW, thanks to Robysue and Dr. Parks for their fabulous posts. How interesting.

I want to thank Robysue for her help with my insomnia and xPAP issues.

I want to thank Dr. Park for first turning me on to xPAP therapy for resolution of my nighttime reflux and poor sleep issues. I am a big fan of his books and blog.

I just want to say that I think UARS sufferers really need to be aware of the possibility that their brains may be interfering with their xPAP therapy. The reasons for this are many: poor sleep habits, hypochondria, insomnia, hidden desires to hold on to symptoms, other medical issues, etc. Of course, this may require a level of self-awareness that not many of us can achieve. I for one, am finding that this xPAP journey is resulting in knowing myself much better than I ever did before. It can be a long, painful process.

Because it seems to me that there are 2 ways to attack the problem: Devise a machine that can respond to any and all manner of obstructions before one's brain can interfere OR train the brain to calm down, get rid of it's neurosis, and trust the machine. I am meditating a lot on this concept right now.

Do you have a link that supports your point that in UARS sufferers, brains may be interfering with pap therapy due to hypochondria, hidden desires to hold onto symptoms, and neurosis? Since I feel I have UARS in addition to sleep apnea, I have done alot of reading on it and have never come across those reasons.

By the way, they unintentionally come across as blaming the patient which I find surprising coming from you since you have criticized doctors in the past.

49er

49er wrote:Do you have a link that supports your point that in UARS sufferers, brains may be interfering with pap therapy due to hypochondria, hidden desires to hold onto symptoms, and neurosis? Since I feel I have UARS in addition to sleep apnea, I have done alot of reading on it and have never come across those reasons.

There are so many conflicting articles about UARS that I hesitate to quote anything. However, quite a bit of the literature describes hypersensitivity to upper airway sensations during sleep. UARS suffers are also often described as individuals suffering from depression, anxiety, somatic complaints (hypochondria), insomnia, fibromyalgia, chronic pain. So there are a lot of issues here to complicate treatment. Maybe "complicate" would have been a better word to use than "interfere". But it doesn't take much of a stretch to conclude that our brains may be contributing to sleep problems via this hypersensitivity. Part of my treatment plan is definitely to try to calm down my brain.

49er wrote:By the way, they unintentionally come across as blaming the patient which I find surprising coming from you since you have criticized doctors in the past.

I don't understand what you mean about "blaming". It is certainly not the patients fault if they have characteristics that complicate treatment. I did not mean in any that I am to blame for my sleep problems. But I certainly am responsible to cooperate to resolve any other issues, medical or psychological, that interfere with my treatment.

By the way, and this may draw down more criticism, I do think the OP here has a strong tendency toward hypochondria (health anxiety) as well as extreme sensitivity. It takes one to know one and I am one also. At some point the OP will need to address that.

Sorry if I offended in any way.

This thread is getting new information from different angles. Thanks for stopping here.

@PEF: Could you please describe your "hypochondriac" tendency ? I'll check whether or not I have some similarity. Thanks

I forgot one part of the lab test: severe bronchial hypersensitiveness (I responded positively on a metacholine provocation test with a PD 20 of 0,060mg), and I have an IgE (Immunoglobullin E) of 121, resembling a para birch syndrome.

Sure, papzombie. I know I have tendencies toward hypochondria. In fact I belong to a very helpful on-line forum called TMSwiki.org. They deal with a form of somatic complaint called, TMS or tension myositis syndrome, which is really a type of hypochondria. The word "hypochondria" has a bad connotation, so it is called something else. Most of these people have pain or other uncomfortable bodily sensations that don't appear to have an organic cause. Often, like me, these people could not express negative feelings, like anger, in childhood, so these feelings tend to be suppressed and often manifest in the form of chronic pain. The theory is that the mind (brain) can cause pain all by itself (actually proven in various tests).

People like us worry unnecessarily about any unusual or uncomfortable "bodily noise" that we detect. We are much more than normally concerned with health issues and we are frequent targets of medical quacks. We tend to extrapolate and catastrophize about our health issues. Another thing we do that we never should is to "google" often about diseases we may imagine we have.

Because I have become aware of my hypersensitivity to bodily noise or sensations, I am able to handle this reasonably well. But at times I still experience extreme anxiety over medical tests, etc. Of course, I did have an endocrine disorder called "hyperparathyroidism" which was not caught by my doctors, even my own husband, for about 10 years. This disease tends to turn people into hypochondriacs, but I was one before that.

Lots of different aspects on this thread. Makes for interesting reading whether is resolves the OP's specific problems or not. I too had to deal with reactive airways early on. Was lucky that the issues didn't persist and I adjusted to CPAP fairly quickly.

On hypchondria... Used to work in the emergency department of a hospital as a registration clerk. Something I was told in training stuck with me. Being the first person a patient would see upon arrival, the nurses wanted to make sure I was equipped to make critical decisions. I was instructed to always err on the side of caution and listen to my gut when something seemed "off" as illness doesn't restrict itself to only those whose report seems reliable. One incident embedded that in my mind. The squad brought in a very large and very drunk man who complained of chest pain. The EMT reported to the nurses and doctor that when they rolled him onto the cart he had belched loudly and had not since complained of pain. It was assumed he had indigestion, but just to cover their behinds an EKG was ordered while he was placed in a multibed general treatment room. When the EKG was done things went crazy with hurriedly moving him to a crisis care room and getting his family back to see him before it was too late. While hypocondria and other issues can complicate diagnostic efforts, assuming nothing is wrong can be a mistake.

Hi,

I'm not a doctor but read a lot about this stuff in my own quest to get refreshing sleep.

You might want to ditch the antipsychotics, but stay on the trazadone, and try lamictal or lithium. Antipsychotics can change your REM sleep and make your apneas worse. When doctors say medications will help you sleep better, they don't mean improving your sleep architecture, which is the important part of sleeping better. Or, see if you can switch trazadone for Amitriptyline. Trazadone has a tendency to be less effective for some even if it worked great at the beginning.

I don't think you can be a hypochonriac if your complaint is that you feel fatigued every day. One of the criteria for it is learning about diagnoses, etc, and being pre-occupied, but that is silly considering that the treatments are just lousy and doctors don't know how to help. It seems more natural rather than ignoring it and accepting one's fate.

I'd follow up on the liver issue though. These drugs an effect your liver function. In my experience even if the doctors say they don't, there is usually lots of evidence that they can and do.

Good luck.

History with a Psychiatry
- No sign of ADHD (unlike suggested by my GP)
- Suspected problems are: depression, anger disorder, anxiety disorder
- I was given the choice of Mirtazapine (3.5mg/day), Trazodone (light dose), or Quetiapine to treat those psychologist problems and also to help my sleep.
- I opted for Mirtazapine 3.5mg, used for 7 days, then increased to 7.5mg since 3 days. No clear sign of betterness.

Didn't read the replies before I posted...Very informative post from Dr. Parks back there!!

Hi OceanBlue: thanks for dropping by.

My complaints are consistent: most of them are present since at least 32 months (my GP's report shows it), while I only came to know I have OSA since 10 months. Does Google add up something to my complaints ? No, it only gives me, since 8 months, the "correct" name (i.e. the more widely used name) for the elements of my complaints.

What I complain now about my head's weird feeling viewtopic.php?f=1&t=114079&st=0&sk=t&sd=a#p1103260, I remember having it since 2006, but only now I could find the pattern on when that weird feeling become severe.

PEF: does this description match with a hypochondriac ?

robysue wrote: My guess is that you simply dislike "stale" or "stagnant" air, and having the window open allows for fresh air to come into your bedroom.

Given that I have a bronchial hypersensitiveness, could there be something in the air that I am sensitive with ? Just brainstorming.

My psychiatrist withdrew her remark on my "possible hypochondria", after hearing my argument: "that it's less than 6 month since I started reading religiously about OSA and the related health issues". !!!

I think it's difficult for her to evaluate the psychology of a patient coming from a different culture.

Last night was with AHI > 1, I remember tossing a lot, my brain was full of train of thoughts.

WHOLE NIGHT


Although SH says RERA is small, when I zoom in to some period of high Vibratory Snore, I see some unstable flow rate: there are moments of sudden change in flow rate, however I don't see my body moving at those moments.

ZOOMED IN AT SOME PERIOD WITH MORE VIBRATORY SNORE


Question: are these moments the RERAs that are not detected by this CPAP machine ?