Posted by EyesWideOpen on January 25, 2009, at 13:24:40
Hi all. First-time poster here.
So, I have a number of issues that cause significant issues with my sleep:
1) Apnea, that has been treatment resistant.
2) Severely fragmented sleep structure, with no Stage 4 sleep, and little Stage 3 and REM sleep. Alpha intrusions are suspected.
3) Chronic myofascial and post surgical pain, exacerbated by lack of restorative sleep.
4) Dysautonomia.
5) Recent addition of Selegiline has exacerbated problems related to falling asleep.I have pretty much tried most of the on-label and off-label sleep meds, without success: benzos, hypnotics, traz, amytriptiline, mirtaz, seqoquel, neurontin, lyrica, cyclobenzaprine, OTC meds, supplements, and herbs.
I have developed somewhat of a tolerance to benzos and hypnotics, and, in any event, they don't help me get Delta sleep. Amytriptiline causes anticholinerigic side-effects, including racing pulse; cyclobenzaprine does the same. Trazodone causes headaches and general hangover. Mirtaz causes massive weight gain. Lyrica helps, but causes significant weight gain and constipation, and major brain fog. Seroquel causes substantial hang over, weight gain, and blood glucose issues (and I am already pre-diabetic from elevated catechols from dysautonomia).
Recently, I began a trial of RX selegiline (capsules) at 5 mgs per day, to help EDS and fatigue. This has exacerbated issues re falling asleep. I just reduced my dose to ~2.5 mgs per day, after taking 3 days off, which did make falling asleep with benzo easier. Today is first day on 2.5 mgs. (Taking 5 mgs every other day didn't help.)
GABA receptors have been compromised from chronic use of GABAergics.
If anyone can offer any suggestions, I am open to them, and would be thankful. The only drug that has consistently worked is Seroquel (even at 12.5 mgs), but as mentioned, it causes weight gain and issues with blood glucose; I don't want to use it on an ongoing basis, and I find coming off of it poses a real challenge, as it renders other meds less effective.
I recognize solving these issues is no easy task. (Heck, I've been at it for 3 years now.) I suspect that I suffer from the same issues that many with CFS and Fibromyalgia suffer from. (I can't afford Xyrem.)
Thank you in advance for any help.
poster:EyesWideOpen
thread:876086
URL: http://www.dr-bob.org/babble/20090104/msgs/876086.html