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Re: questions about sleep clinic » Jai Narayan

Posted by Penny on February 6, 2004, at 18:37:55

In reply to questions about sleep clinic for Penny, posted by Jai Narayan on February 6, 2004, at 15:34:48

First, let me tell you why exactly I had a sleep study - I was unable to stay awake all day whether at work or at home, whether active or not. I nearly fell asleep while walking around a home improvement store with a friend of mine. I would almost fall asleep while driving. And I was tired all the time - but even if I appeared to get 8 or more hours of sleep, I still didn't feel rested the next day. Plus, I was waking up multiple times a night and having trouble going back to sleep on occasion. My pdoc suspected maybe restless limbs, based on what I told him, but my gp thought sleep apnea (which I didn't agree with), and she referred me to the sleep clinic.

> In the long run was the sleep clinic worth the time and money?

Not really

> How was it to do the sleep clinic?

There was nothing to it - spent the night and a day in the hospital (technically 'outpatient', meaning I was responsible for my meals) - they hooked me up to all kinds of wires - I had electrodes on my legs, arms, side and all over my head - the head ones were glued on, which was quite pleasant :-b. I also had these things that were just inside my nostrils to measure the amount of air going in and out of my nose, or something like that. Plus, they videotaped me all night. Which was also pleasant :-b. The next day I had a multiple sleep latency test, where I had to take multiple naps about 2 hours apart.

> Did it cost you bundles of money?

My insurance covered most of it, but I still owe about $600 to the hospital - about $300 for the night study and $300 for the sleep latency test the next day.

> What have you learned?

That I don't have sleep apnea or restless limbs. That I do have 'alpha-delta' sleep, meaning I wake up, though not completely, off and on throughout the night for no apparent reason.

> Did you end up with something that works?

Not as a result of the sleep study.

> have you tried: Trazodone or Ambien? If so at what miligram?

I've taken Trazodone at up to 100 mgs (I think). It became too sedating for me, even at 25 mgs. Ambien knocks me out, but even though I've experienced insomnia, my problem was the inability to wake up easily and/or refreshed in the morning, so it was suspected that I wasn't getting restful sleep. I tried melatonin - didn't phase me. Hydroxyzine was one of the best - can get really low doses and I didn't find it overly sedating. I think drugs tend to stay in my system longer than they should. Geodon was helpful somewhat, especially if I was feeling upset (due to my depression). I tried Seroquel as well, but it was overly sedating. Tried Sonata, but it didn't phase me. I tried Dramamine - too sedating, Tylenol PM, which I can take but only at half the recommended dose, and regular benedryl (which is the active ingredient in Tylenol PM - diphenhydramine. Hmmm....I think that might be all the sleep meds I've tried, but don't hold me to that...

My pdoc also put me on Provigil, which is commonly prescribed for narcolepsy, to assist my wakefulness. It worked at first but then stopped working, even after we got to the highest dose. He tried Adderall XR (or is that SR?) and that sent my mood crashing, resulting in my week long stay in the hospital just prior to the sleep study.

The stupid 'sleep docs' that I saw at the sleep clinic told me in the follow-up that they didn't really have any good recommendations - perhaps I could try breaking a 5 mg Ambien or warm milk before bed. Sure. His other recommendation was to 'get my psych meds regulated.' Uh...cause, darn, doc, I haven't been trying to do that forever now!!! So, essentially, he didn't tell me anything I didn't already know.

Now I'm taking Strattera which I would swear is helping with my alertness problems. I am also relaxing at night and taking my mind off my worries by listening to books on tape or CD. I particularly like fantasy or children's books - sort of the bedtime story thing. My therapist is even loaning me her Harry Potter books on CD. That, really, has made more of a difference than anything. I have been sleeping better, and not having the trouble falling asleep while driving or while sitting at my desk at work. I can't really pinpoint one thing that's made a difference - I try to keep a pretty normal bedtime, I have caffeine in the morning, but I try to limit it and have no caffeine after 5 p.m. Everyone tells me that exercise would help, but, well, I'm pretty much sedentary right now, so I can't speak to that, though times when I was exercising regularly I couldn't tell too much of a difference. Plus I realized that, in order to really feel refreshed the next day, I need at least 9 hours of sleep. I'm not a 6 or 7 hour a night person - it just doesn't work for me.

Wish I could tell you something more. I know that insomnia sucks - when I first took trazodone it was because I had been awake - completely awake - for three days. I was a walking zombie, shaking all the time, a total mess, and my pdoc at the time put me on trazodone. I slept like a baby with my first dose, and slept good the next night, but after that, it was almost as if it began to build up in my system, b/c even as I lowered the dose and even as I took it earlier and earlier in the evening, I couldn't wake up easily the next day and I was in a fog. Which I hate. If I can't think anyway, what difference does it make if I'm sleeping or not?

I do think that a sleep study would be beneficial if it is suspected that you have sleep apnea. My grandmother has it, and after she got her C-PAP machine, she was sleeping so much better and was much more able to stay awake all day the next day. But, since I didn't really have anything in particular that explained my fatigue and sleep problems, the study wasn't really helpful for me, except to rule things out, and I'm not sure I needed them ruled out anyway (I think I already knew those weren't the problems).

I hope you are able to find some answers to your sleep problems.

P


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URL: http://www.dr-bob.org/babble/social/20040131/msgs/310274.html