The insomnia monster raises its head again and again ....

This is a fascinating topic--I'm glad I checked it out.
If only we understood why some people have such trouble getting to sleep and others simply drop off as easily as drinking water.
You poor dears suffer so much--my empathy nerves twinge.
My darling husband has somewhat the same difficulty; though not as severe.
The references listed sound very promising. I am familiar with meditation, and have found it a great comfort.

I feel for those that can't get to sleep as this is the major problem my wife has, she get's tired and sleepy but just can't shut down to sleep. She's been on various meds to try and help but they all have their own unwanted affects. After a sleep study she was diagnosed with insomnia and put on Imovane and although that helped, after being on it for almost 3 years it had lost its effectiveness and we were very worried about getting her off it although according to the documents it is not supposed to be addictive. She is now on Seroquel which she takes only when needed and it helped get her off the Imovane without problems. I am hoping that she may agree to go see the same sleep doctor I last saw, he was fantastic and thorough whereas the other sleep doctor spent no more than 5 minutes with you on any visit and was more interested in his clinical trials and profit, not the patient's health.

We both have mixed issues with many of the meds and after the experience with the previous sleep doctor and the Imovane even more so. It's too bad that sleep as a whole still seems to be so poorly understood and something that we all take for granted. I've learned how much it can impact things first hand suffering from sleep deprivation due to recently diagnosed severe sleep apnea for which I am still awaiting treatment but pushing hard.

She has always had problems getting to sleep and once she gets to sleep she seems OK, able to sleep a full nights sleep (when she can ignore my snoring like a jet engine) but we question the quality of her sleep. She has frequent headaches which we both believe are mostly a result of the poor sleep. This is why she has interest in the autogenics.

I too have found this thread interesting as it relates closely to what I see my wife go through.

Happy New Year, RS!

The good thing is, staying up late is perfectly acceptable on New Year's Eve!

There seems to be a few anectdotal reports of insomnia associated with topiramate.

And oddly, a case or 2 of RLS:

http://www.springerlink.com/content/u4t844r254h178j6/

I see in a review of your posts you are aware of rebound insomnia after taking benzodiazepine-class pharmaceuticals. Had a similar experience after trying a little klonopin for RLS. Took a number of days to get back to normal.

How about Bright Light Therapy? Get about 10,000 lux.

Based on your sleep study, you look more like a UARS (low AHI, big RDI).

Also, the issue(s) seems to be approaching Delayed Sleep Phase Syndrome caliber. If so, then a different appraoch might need to be considered (keep moving the whole sleep block ahead till you get back to normal).

Have you thought of melatonin? That might be a little more benign, but in spite of people shoving that stuff down like M&Ms, I don't believe it has really achieved "official" confirmation as a treatment for sleep disorders (not SBDs, just plain "SDs").

Except for...

http://www.ahrq.gov/clinic/epcsums/melatsum.htm

...DSPS.

Going back to read more of your posts. 370 more to go.

BTW, did you know that staring at a computer screen burns up melatonin?

And also, that getting outside even it's cloudy can get you an effective dose of lux?

Thanks for checking out her posts and being on the case, NotMuffy. I look forward to learning from your observations. Your mention of increased outdoor activity in the morning is an important one that has helped a lot of people, I think.

NotMuffy,

Thanks for the series of interesting posts. I'll follow up with all your suggestions, even the ones I don't comment on here.

In particular,

There seems to be a few anectdotal reports of insomnia associated with topiramate.

And oddly, a case or 2 of RLS:

http://www.springerlink.com/content/u4t844r254h178j6/

I've gone back and looked through my ResScan and Encore Viewer data. The one lovelerly thing about being on CPAP is that I've got hard data about exactly when I actually went to bed, tried to go to sleep, gave up in the sense of turning the machine off (and got out of bed), and came back to bed. With ResScan, I can even pretty much get a decent idea of when I fell asleep because the wave form settles down into a different pattern. The current insomnia monster broke out big time in late November a bit before Thanksgiving and about a month before starting the topiramate. Now the topiramate may be aiding and abetting the insomnia monster, but there is some evidence that the topmiramate is also helping with the vertigo monster. So I'm not at this point ready to banish the topiramate until the follow up with the neurologist who prescribed it unless some other more definite side affect of the topiramate raises its head.

RLS was not a problem on any of my sleep tests and does not seem to keep me awake. There have been rare days in the past where my legs just could not get comfortable in bed. But the last time I remember this happening was actually several years ago. And if I recall correctly, the trigger was a nasty skin rash. So it was rather easily explained and the situation resolved itself when the rash itself (finally) resolved itself.

I see in a review of your posts you are aware of rebound insomnia after taking benzodiazepine-class pharmaceuticals. Had a similar experience after trying a little klonopin for RLS. Took a number of days to get back to normal.

This is why I'm approaching the Ambien with such caution. I will only use Ambien to prevent having TWO disastrous[/i] nights in a row, where disastrous really does mean just that: Where I have tried---sans Ambien and without success to get to sleep---for several hours and have typically lost my emotional cool at some point during the night---and as a consequence have problems functioning during the next day. I do not intend to take Ambien two nights in a row; I am truly that worried about the potential of inducing long-term rebound insomnia if I start taking Ambien on a regular basis. I figure if I can get a night of less than disastrous sleep, then I really don't need Ambien the next night.

How about Bright Light Therapy? Get about 10,000 lux.

Ah, I am in Buffalo and it is winter and it is Dark all the time. Yes, LIGHT is a huge issue for me. My hubby has suggested this more than once. I have noticed that when we've got a nice snow cover on the ground, it's easier for me. Alas, it rained yesterday and our snow is gone. Any tips on how to go about doing light therapy?

Based on your sleep study, you look more like a UARS (low AHI, big RDI).

I've been thinking this off and on. One thing that's continued to strike me as odd, though, is that on CPAP that the ration of machine reported events is heavy on A and light on H. On the S9, almost ALL events were OAs. Most nights the S9 would report NO Hs at all. The PRS1 usually catchs at least a few H's, but often records many more OAs than Hs. And this runs counter-intuitive to everything I've read about how titrations are done. But I'm outlier in so many other ways. So what's one more, eh?

BTW, did you know that staring at a computer screen burns up melatonin?

Cutting out the computer time AND tv time late at night is one of my New Years Resolutions. Since bedtime's officially at 1:30AM. I hope to sign off officially no later than 11:00pm from now on.

Ah, I am in Buffalo and it is winter and it is Dark all the time. Yes, LIGHT is a huge issue for me. My hubby has suggested this more than once. I have noticed that when we've got a nice snow cover on the ground, it's easier for me. Alas, it rained yesterday and our snow is gone. Any tips on how to go about doing light therapy?

There are various place that sell light therapy lights for SAD -"seasonal affective disorder" depressions. Also the blue glasses are supposed to help.

Robysue. I too had a terrible problem with insomnia.My dr. prescribed trazadone first ,which work good the first two times I took it the I ended up with migranes so I stopped taking it ,went back to the dr. and he prescribed Lunesta ,again worked good for about a half a dozen times then I began getting flu like symptoms so I stopped taking it. My girlfriend was watching the Dr Oz show one day and he recommended Two tablespoons of tart cherry juice concentrate mixed with a little water everynight before bed for insomnia ,when she told me about it I kinda laughed at her ,but she said what could it hurt? I tried it and I have been using it for almost 4 months now it works like a charm no more insomnia for me , you can get tart cherry juice concentrate online or most health food stores I highly recommend it! turnsout tart cherry juice is high in melotonin. Give it a try and good luck!

Robysue, A lot of different ideas have been thrown around here. I figured why not throw out another one...

I am sure you understand the need for balance in the body. Have you considered the balance between mental and physical fatigue?

If, at the end of the day, you have physically exhausted yourself, you usually fall asleep quickly. But, if the day has only brought mental exhaustion, this can actually act like a stimulant and keep you from sleeping.

Looking back on your sleep disorder experience so far, my astute observations (and please take this in the humorous manner they are intended) indicate that you are wrestling with equipment, juggling various information from published articles and peoples experiences, trying to made sense of the data you are collecting, and are becoming more and more MENTALLY frustrated with your (lack of) progress. Add to this the frustration of not being able to achieve your goal of be "adjusted to xPAP" during your winter break and the anticipation of the additional MENTAL load you are going to have to shoulder when school starts back up and you may be beating yourself up quite badly.

It may be that your fatigue is out of balance. You are mentally fatigued and that drags down your physical stamina, but perhaps you need some physical fatigue to balance your huge mental efforts...

During the holiday period I think that people become "fat and sassy." Schedules get disrupted, wonderful fests are planned and consumed. Visits with family and friends are extended. "Research" and posting on forums begin to move up in priority. In general the physical workout schedule gets pushed back to the back burner of the stove.

While "breaking a sweat" may not solve all of your issues, it may bring them back into better balance.

Be sure to give yourself some adjustment time to get back into balance. Hard physical exercise without conditioning leading up to it can trigger migraines and other health issues.

There are two ways to achieve balance. One is to remove weight from the heavy side. This is where meditation comes in, but you have been blasting down the sleep issue path for over 3 months now and are still going full steam. Meditation can help, but it may also be effective to strive to achieve balance by adding weight to the light side. This is where physical activity comes in.

This is a very "off the wall" idea, and I hesitated throwing it out. I was hoping you would find something that worked for you based upon all the other good ideas presented. In spite of being an unusual concept, I have seen it help many people who were having temporary issues with insomnia. Unfortunately, I am not aware of any scientific studies that back this idea up.

robysue wrote:
I figure if I can get a night of less than disastrous sleep, then I really don't need Ambien the next night.

So what happened?

The suspense is killing me.

M.D.Hosehead wrote:

robysue wrote:
I figure if I can get a night of less than disastrous sleep, then I really don't need Ambien the next night.

So what happened?

The suspense is killing me.

Less than disastrous is a decent descriptor, while good is overly optimistic.

I didn't start to get sleepy until around 1:45 am, and so I took the Ambien at 1:50. It took me a good 15 to 20 minutes to fall asleep and I really didn't feel any more drowsy with the Ambien than without it. But (and this is an important but) at the END of that 20 minutes the tickle in the back of my throat was still under control and it was NOT making me get angry. And my husband didn't need to turn over. So I was able to drift off to sleep just before I would have needed to get out of bed under the "If you haven't fallen asleep and you're still awake after you think you've been trying to get to sleep for 30 minutes, get out of bed and go into a different room" rule kicked in.

I woke up three times. I thought I got back to sleep in about 5 to 10 minutes each time. I thought I turned the System One off and on once as part of fixing a leak in the middle of the night during one of the three times I woke up. One of the others was to turn over and the third was getting pretty close to wake up time (7:30) as I recall.

The Encore data, however, says otherwise. Now in the data shown below, t=0 is basically 2:00 AM Buffalo time---the time I went to bed and turned the machine on.

Now as I said earlier, I know I woke up three times. I thought they were each for about 5, maybe 10 minutes. Best as I can recall, every time I woke up, I had the mask on and the System One was running. I most certainly do NOT remember turning the PRS1 off for 20 or 30 minutes around 4:30 or 4:40 in the morning, nor do I remember taking the mask off at this time. I don't remember putting the mask back on at 5:00 am either (if that's what I did), although I do remember a SINGLE wake up that I would have guessed to be at either 4:30 or 5:00 where I momentarily turned the machine off (to take care of a leak) and then turned the machine back on---rather like like what happens about 5:20 (t=3.2 on the graph). And I don't remember any leaks being anywhere near as big as the ones near t=2 and t=3 on this graph either.

So I've got that mysterious 20 minute gap in the blower time on the S1. [I'm feeling my alter ego is more like Richard Nixon than Daniel Schorr this morning.]

But I was able to get out of bed by 7:40. Remember, my official "rigid" schedule is supposed to be WAKE UP and OUT OF BED by 7:30 and try to be IN BED by 1:30 AM and ASLEEP by 2:00 AM. I'm feeling mildly loopy and my ears feel funny. But that could well be the weather front that's coming through. Or the topiramate. Or the CPAP pressure. Or my hypersensitivity to other things.

Sleep quality? Other than that mysterious 20 minute gap, I'd say it was "ok" Don't feel like the REM-time was up to normal in either time or quality, but I do feel a bit more rested than usual. AHI is higher than it's been running, but hardly outrageously so. And my "normal" AHI numbers are likely to be abnormally low because after all, if you are awake, you're much less likely to stop breathing, aren't you?

So all in all, I don't plan on taking the Ambien tonight. I do plan on blocking out some serious time for yoga or some other physical activity that also helps me consciously focus on relaxation techniques as well tonight since I actually have to start "easing" back into work on Monday even though my official semester doesn't start for another couple of weeks.

As to that twenty minute gap, I plan on posting about it under a different thread later today 'cause there's a very specific data-based question I've got concerning it.

HoseCrusher wrote: If, at the end of the day, you have physically exhausted yourself, you usually fall asleep quickly. But, if the day has only brought mental exhaustion, this can actually act like a stimulant and keep you from sleeping.

Looking back on your sleep disorder experience so far, my astute observations (and please take this in the humorous manner they are intended) indicate that you are wrestling with equipment, juggling various information from published articles and peoples experiences, trying to made sense of the data you are collecting, and are becoming more and more MENTALLY frustrated with your (lack of) progress. Add to this the frustration of not being able to achieve your goal of be "adjusted to xPAP" during your winter break and the anticipation of the additional MENTAL load you are going to have to shoulder when school starts back up and you may be beating yourself up quite badly.

It may be that your fatigue is out of balance. You are mentally fatigued and that drags down your physical stamina, but perhaps you need some physical fatigue to balance your huge mental efforts...

You have hit a very important nail on the head here HoseCrusher. One I'm very keeny aware of. One my dear hubby has been nagging me about. And you and he are right: My MENTAL frustrations combined with my lack of real, quality (the good kind of) physical exhertion have left me with the bad kind of physical exhaustion. Our own kids fly the coop back to college tonight and tomorrow morning. [Yes, that's early, but they're both on oddball college schedules---one's got a so-called 4-1-4 schedule and the other is at a place with a spring semester than starts early enough for graduation to be in April.] Since the host student's high school classes start on Monday, we can all treat Sunday as the end of the holidays. That will help.

And---a positive change in insurance allows my husband and I to actually re-join the local Aquatic center at price we can afford. And hubby loves (yes loves) to go. So I'll have someone to make me go. Getting more physical exercise other than the weekly trip to the ski slopes will help get the physical and mental balance back to a much more healthy balance. And that should provide me with some very useful ground troops in my ongoing campaign against the insomnia monster ...

robysue wrote: So I've got that mysterious 20 minute gap in the blower time on the S1.

Robysue? Does your machine have auto-off set to on or set to off? It's just a thought is all.

Auto Off and Auto ON are both set to OFF because I can't stand them.