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the 5 nap test... is an MSLT

Great! I agree with the above posts. Check sleep first, then have an internist do a complete workup and then if those two things don't show anything a psychiatrist is the next step. I'm not saying she shouldn't take any meeds, but it should be a last resort. What is her diet like? Is she eating quality proteins and veggies, or just junk? Because a junk-only diet could be part of the problem. Neurotransmitters are made from amino acids--our bodies make those from protein. If she isn't eating much protein or if she isn't digesting it well, this could cause all kinds of problems.

Keep it up!

She's been on antidepressants for years under careful guidance from a good psychiatrist. She has had complete thyroid tests and is well educated in nutrition, and complete blood workup. The reason we are looking into sleep related disorders are, we aren't sure weather she is depressed as a result of sleep problems, or the sleep problems are being caused by depression. Sort of a vicious circle. We always had heard that when your child/adolescent sleeps all the time it is because they are depressed. But maybe the fact is she has a sleep disorder which is causing her to be depressed. I never even considered sleep apnea as a possibility until I was diagnosed myself recently.

It sure sounds like you are on the right track! It sounds like she is in good hands. I wish my own parents had shown such concern for my well being when I was a teen. She is a lucky girl.

Is she on stimulants for the ADHD? If so, they will need to be stopped prior to the sleep study. Also, have you discussed with the doctor the potential impact of her antidepressants on the sleep study findings?

Hopefully the doctor follows the guidelines that if they find something in the night time sleep study, they will not do the MSLT (the naps) the next day.

Exactly, sleepingugly. She will be off any stimulant medication for a week before the study. And if they find out something is going on in the night time study, the second study won't happen. Yes he is aware of the antidepressants possibly affecting the results, but weening off of them could take a long time to prevent harsh withdrawal symptoms. So they're going to see how she does with anti dep's only.

Sounds like you have found a competent doctor, which is half the battle (actually, more like 9/10ths...). I hope you get to the bottom of this. Keep us posted.

You should be aware that nearly all antidepressants can have a negative effect on sleep, decreasing the amount of rem and slow wave sleep. However I recently read of a study that showed that adding supplemental tryptophan or 5-HTP (under a doctor's supervision only because some people think this could cause serotonin syndrome, though I am skeptical of this) reversed these issues completely.

This makes sense. Tryptophan and 5-HTP are precursors for serotonin. Antidepressants work to keep serotonin in the neural synapse. If there is very little serotonin available this explains why antidepressant-resistant depression occurs in so many people. You can't keep serotonin in the synapse if there isn't any available.

I have read at least one doctor saying 200 mg of 5-HTP is safe to take with antidepressants and I would recommend a slow release variety like natrol or Jigsaw brands as these are the only ones I am aware of that offer time release.

I will try to find this study I mentioned and link to it here. I have a busy day in store, but I will do my best.

Because I have so little sws and rem sleep I got off my SSRI and switched to welbutrin which doesn't affect sleep according to all the studies I read on pubmed. I take a bunch of amino acids which are neurotransmitter precursors: 5-HTP, L-tyrosine, tryptophan, taurine, theanine, DLPA. I also take rhodiola and eleuthero ginseng for energy and b vitamins and magnesium malate (among a few other things). I have chronic fatigue syndrome. But this combination of amino acids has helped me like no antidepressant ever has. If you are interested, the book, "what your doctor may not tell you about depression" was very helpful to me and an easy read and not expensive on amazon.

Personally I think depression is strongly correlated to digestion. As my stomach and bowel problems got worse over the years so did the mood problems. And since neurotransmitters are made from the amino acids found in protein, it only makes logical sense. It isn't a deficiency in Prozac, but serotonin!

I have to go now, but will try to find and post the study later!

Jen

http://www.ncbi.nlm.nih.gov/pubmed/11022398

This is the article I mentioned.

Interestingly, if you go to http://www.pubmed.com and type the words: fluoxetine, sleep and tryptophan into the search engine, a whole bunch of interesting things come up including some studies about using various antidepressants in treating sleep apnea, specifically central sleep apnea which I thought were interesting to read, though I don't know how seriously we could take them.

Personally I think it makes more sense to take the precursors for neurotransmitters in the form of amino acids or simply increasing protein intake and taking digestive enzymes (to help insure the protein is being broken down adequately) rather than taking drugs which have such unknown and far reaching effects. However, I'm still taking an antidepressant myself as I'm still trying to learn about and navigate this unknown arena.

As a side note, I was just reading through some interesting abstracts on pubmed about Omega-3 supplementation and the research showing how effective it is in high doses for treating depression, chronic fatigue syndrome and even schizophrenia. It seems that cell membranes are made up of lipids and the cell membranes work and communicate better when they are composed primarily of omega-3's which the Modern American Diet is sorely deficient in. Several studies showed a decrease in the size of certain areas of the brain (structural changes) with the high doses of omega-3's along with remarkable remittance of symptoms--often in 6 weeks or less. Only one abstract mentioned dosage: 10 grams per day for 6 weeks. That would be 10 fish oil capsules a day, over the counter. Which is a lot. Personally I take krill oil which is absorbed by the body better so you can take a lower dose and get the same effect. Supposedly it is 10 times more concentrated in it's effect (according to Dr. Mercola) so 1 gram of krill would have the same effect. It is far more expensive per bottle, but probably works out to about the same per dose. Also krill are less likely to be contaminated with toxins because they are so small and they are one of the world's largest biomasses so they are unlikely to become endangered because they reproduce so quickly.

Ok, that is all for now.

Jen

By the way, why don't we hear about these studies that give possible solutions to illnesses without the use of drugs? Drug companies have too much power. They bombard doctors offices with free crap and free meals and all the latest drug data. The universities who are doing REAL, BASIC science do not have the financial means to disseminate the information. Modern docs are so overworked and overbooked they don't have time to read the journals. It is a sick system! Our bodies are not deficient in drugs, but nutrients. We need to eat better, nourish ourselves and look for natural solutions because the docs won't be doing it for us.

Daughter is finally going for her sleep study this week. Wednesday night will be night one, and the only night if they find she has a disorder early on. She will stay for the nap study on Thursday if needed.

Yes, having very recently been diagnosed with severe sleep apnea and still waiting for prescription and equipment I must say that at one time I though; Oh big deal, so I may be missing a bit of sleep, how bad can it be? Then as time goes on your wife tells you things are getting worse but you ignore her, you feel tired but ignore that too as that is not that unusual anyhow and then you start having bad headaches every morning and they start to cause you to take time off work so to start to look into things. You arrange a sleep study and find out that not only do you have sleep apnea, but it is very bad, enough so as to have your drivers license suspended as you are considered a bigger risk than a drunk driver.

Now roll back to the beginning, if there is any question then get things checked out. At least sleep apnea is treatable with very good success and most people don't need to know you sleep with a hose attached anyhow.

Now having done lots of research I can say with a high degree of certainty that sleep is MUCH more important than most people realize. Please don't delay and push her to at least get tested, then take things from there.

Thanks for keeping us current, and please let us know how it turns out.

It is possible that she has sleep apnea, One of the reason causing sleep apnea is your airway is blocked during sleeping, in this case, you can use CPAP machine during sleeping to keep your airway open. You need to let her go to a sleep clinic to do a test. Find out more about Sleep Apnea and CPAP machine.

Man, it sounds all too familiar to me. Found out I had SA at 22, knew I had sleep problems since I was a young teen, around 12-14 years old. Get it early, I'm sure glad I did.