Sleepiness and Reading a Computer Screen

I am one of those people who in spite of a BIPAP machine and treatment for periodic leg movements are frequently sleepy.

The major symptom I notice is inability to keep eyes open or to focus them. This is especially apparent trying to work at the computer. I am in my sixties and the accommodative power has gone down, as is normal.

I was wondering if any of you know any treatments or good ways to function with this condition. Although not always as alert as I would like to be, I find I can lay down and listen to a recorded book even when I cannot read a computer screen easily. If I look away a few second I can get a few seconds more of looking, but this is obviously ineffective. Unlike some with excessive day time sleepiness, I do not worry abut falling asleep at wheel driving (except on long trips), or even when watching TV.

Doctors have been of little use. The sleep specialists will do a sleep study and prescribe a BIPAP and Provigil (up to 600 milligrams a day) as well as Requip for the periodic limb movements. My eye doctors will do a refraction and adjust the glasses but offer no explanation beyond if you are sleepy it is hard to focus (nor have the ones I have talked to over the years shown much interest in other possibilities). I notice sometimes when at the computer or on an exercise bike I quit seeing at time. I just go a ZEO (see separate discussion) and it reports I am awake half the night (although I don’t believe it).

My questions are two. Do any of you know of a rare condition that produces these eye symptoms that the specialists may have missed or been unaware of?

If not, do any of you have any suggestions for improving functioning when you do need to get things done at the computer?

When my sleepiness was at its worst, I experienced symptoms much as you describe. Seemed when I was in that struggle between awake and asleep I couldn't focus or make sense of what I as seeing. Getting my cpap treatment to be effective took care of much of that, and although the sleepiness still overwhelms me, I don't seem to spend time in the state of struggle. Then again, I just give into. It was when I fought it it happened. Oddly, my high doses of Mirapex caused my brain to have trouble relegating sleep activities to sleep and wake activities to when awake. I was having rythmic jerks of my head when driving. My neuro doc said I was driving while asleep, but I think it was more that my limb movements of sleep intruded into my wake time, or the lines had become blurred between awake and asleep for me. Once I quit working and allowed myself to give into the desire to sleep, the oddities lessened. Do you think you could be having microsleeps that cause your visual "disconnect"?

Have you been back for a sleep study with your cpap and taking Requip? Just wondering how detrimental your limb movements are to your sleep. Mine are not well controlled and my sleep still stinks. Did you go the route of checking your ferritin level and taking magnesium and calcium to see if you could help the limb movements at all?
Kathy

Prof Ed,

Sounds to me like your therapy is (for whatever reason) "ineffective".

Please fill out your profile with your equipment and machine settings.

Right off hand, two things come to mind.......you have a nasal mask and you're leaking your therapy air out your mouth while you're sleeping.....OR.....your pressure settings are not optimum.......in that order. (could even be BOTH)


Den

Wulfman wrote:Prof Ed,

Sounds to me like your therapy is (for whatever reason) "ineffective".

Please fill out your profile with your equipment and machine settings.

Right off hand, two things come to mind.......you have a nasal mask and you're leaking your therapy air out your mouth while you're sleeping.....OR.....your pressure settings are not optimum.......in that order. (could even be BOTH)


Den

Den sounds like he's on the right track, IMHO. I don't think your therapy is maximized.

Thanks for advice. I don't thnk my problem is only the apnea since I think that is under control. I do get the apnea rate below 5 with the auto bipap. Most of the time I see the inspiration is at the minimum of 13.5 although a couple of days ago it did jack it up and gave a prolonged period (three hours where it hit 17. I could jack theinspiratin pressure up further, probably reducing the occasions when I was being awakened by apnea as the machine moved the pressure up.

There probably is some mouth leak since I frequent do wake up with a dry mouth in spite of taping, but I doubt if that is causing the problem.

I was hoping someone knew of something eye related, but apparently not.

Hi, I would like to suggest that you see a neurologist, but not about apnea. I think you should get your eyes checked, but also look into the (probably hugely unlikely) possibility of a condition called myasthenia gravis, which can show up on occasion with symptoms you described. As I said, it's unlikely because it's quite rare, but it never hurts to check into things and your MD will likely have other ideas.

I'd follow the advice so far here and get your therapy effectiveness checked out. But if it turns out that it's simply an issue of your eyes getting tired from the computer screen, I can tell you that I have experienced something similar. For some reason the computer screen can really tire my eyes out. I don't feel tired, but my eyes would get strained. I had LASIK done years ago, and remembered something that the doctor said. He reminded me to take a vitamin supplement for my eyes (mainly because I was fair skinned, and blue eyed, and needed to guard against macular degeneration).

Anyway, I found a supplement that I swear by now. It's Nutrilite Vision Health, and I noticed a big difference with eye fatigue at the computer. When I run out of the vitamin, I can tell that my eyes again get tired.

Of course I don't think this is a place to advertise, and I don't want to abuse this forum by putting a link. But if you PM me, I can give you details if you want. They really made a difference for me.

Thanks. I appreciate the suggestion on myasthenia gravis, since I had not considered that possibility.

I would be curious why a vitamin supplement might affect me in this case. I am familiar with the possible role of lutein and other carotenoids in protecting the eye and A in night vision but I do not see how it might affect eye strain or the ability to focus.

I spend a lot of the day working at computer screens. I find falling asleep at the computer is the number 1 worst problem I have. Although there has been a lot of improvement, I am not even close to eliminating this problem. I also spend a lot of time in front of conventional TV monitors. They have a slower scan rate than computer monitors, and they also put me to sleep. Everything I work with is CRT's, which work by having a very fast moving spot of light. Your eye's persistence of vision is what makes a picture out of that fleeting spot of light. Even so, there is a 'flicker' your brain sees and you don't.The faster the beam spot moves, the less flicker your mind perceives. This is why CRT monitors especially tire people out. Other monitor types flicker as well, but in different ways. LCD monitors are the closest thing we have to a display that doesn't flicker.

I have the same problem. At times I feel as if I just can't keep my eyes open any longer. It really only happens at work or home in front of the computer. I talked to my eye doctor about it and she did a test that showed that my eyes are very dry. She suggested using eye drops (Systane Ultra or something like that) 2 - 4 times a day to keep my eyes moistened. This has helped quite a bit. I think the feeling of sleepiness comes from the pressure like feeling in my eyes when they are dry and the effort I have to put in to keeping my eyes open. Might be worth a try to see if eye drops can help you out.

Karen

I also did get the suggestion of drops from my eye doctor. A quick test showed no effect, but perhaps I should keep trying.

I have the added disadvantage of having Fuch's Corneal Dystrophy. While mine is not severe, it does defocus everything I look at. So, I have eyestrain pretty much all the time. Especially considering a big part of my job is looking at TV monitors and finding what's wrong with the picture On place especially, I sit 18 inches from a 25 inch monitor (that cost $4,000 new!), and have a bunch of knobs in front of me to adjust the cameras I am controlling to look right on the monitor. The last 10 days, I have been doing this for several hours a day while we tape a 26 episode TV series.

I started the supplement because I knew that I needed something since I was fair skin and blue eyes, and needed to have as much UV protection as possible. I know the supplement has Lutein, but I'll try to find out more information for you. But I definitely noticed a difference in my eye strain / tiredness in front of the computer. I could tell the most difference when I ran out and didn't take them. After that point, I was sold on it. But again, I was told by my eye doctor that it would be good for me to take supplements for my eyes.

Now, starting CPAP therapy for OSA definitely helped me get rid of afternoon fatigue. But the specific eye strain seemed ot me unrelated for me.

Here's some info directly from Nutrilite:

Nutrilite® Vision Health with Lutein contains lutein at levels clinically tested and shown to support healthy vision function and visual acuity. This antioxidant-rich formula helps protect eyes against free-radical and UV-damage to promote good eye health.

Nutrilite® Vision Health with Lutein includes:
An exclusive, high-value combination of vitamins and plant nutrients.
Lutein at levels clinically tested to support healthy vision.
Black currant and vitamin A to help maintain healthy eyes.
Bilberry to promote healthy blood vessels in the eye.

Your profile show you having the software and reader, maybe posting the dailies from it would help us guess whats up, Den has a likely answer. i also have threationed to use pinhole glasses, to lesson eye strain, I also take vitamins for the eyes but in heavy doses. jim

OK ... now I've GOT to try the pinhole glasses!