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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by paxvox on August 4, 2001, at 20:39:03
Do any of you have weird days on weekends, or other days you sleep later or stay up later than during the work week? I am very ritualistic about my sleep schedule (ok, OCD perhaps). I like to be in bed by 9:30 as I have to get up at 5:30 M-F. The rub comes on Sat. when I feel like sleeping in, but actually feel "guilty" staying in bed. Perhaps that is not the right emotion, maybe fearful. You see, when I have had panic attacks, with one exception, they have come on times I have had to vary my sleep schedule, or chose to sleep in. Is it possible to have that tight a circadian rhythm? As I never get more than 5 hours of sleep a night during the week (wake at 12, 3, 4, 5 and then get up at 5:30) I feel tired, and WANT to sleep in on Sat. Any thoughts or anyone with similar problems?
Posted by susan C on August 4, 2001, at 21:03:13
In reply to Wacky moods from sleep pattern changes?, posted by paxvox on August 4, 2001, at 20:39:03
The reading and my own experience has been the more routine I have the better off I am whether it is sleep (the biggest one) regular time for walks (walkies) exercise, eating, nap, etc. This goes for the people around me also. I notice I have a harder time with mood on weekends when my family is around and it isn't as quiet. Spouse also sleeps in. I try to stay to the same time schedule. the shift from daylight savings and back sets me off, my son coming home at 3am and making enough noise to wake me has been the latest puzzle I am trying to solve.
I guess the best thing is to do a test, try it one way, then try it another. Like with medication. I don't know if it would be OCD if it helped with stablizing you?
Have you talked with pdoc about sleep pattern and your frequent waking? One area of interest might be sleep apnea, or snoring, it can wake you up in addition to the person you are with. I snore and use nose strips which help.
> Do any of you have weird days on weekends, or other days you sleep later or stay up later than during the work week? I am very ritualistic about my sleep schedule (ok, OCD perhaps). I like to be in bed by 9:30 as I have to get up at 5:30 M-F. The rub comes on Sat. when I feel like sleeping in, but actually feel "guilty" staying in bed. Perhaps that is not the right emotion, maybe fearful. You see, when I have had panic attacks, with one exception, they have come on times I have had to vary my sleep schedule, or chose to sleep in. Is it possible to have that tight a circadian rhythm? As I never get more than 5 hours of sleep a night during the week (wake at 12, 3, 4, 5 and then get up at 5:30) I feel tired, and WANT to sleep in on Sat. Any thoughts or anyone with similar problems?
Posted by Mitch on August 5, 2001, at 9:55:49
In reply to Wacky moods from sleep pattern changes?, posted by paxvox on August 4, 2001, at 20:39:03
> Do any of you have weird days on weekends, or other days you sleep later or stay up later than during the work week? I am very ritualistic about my sleep schedule (ok, OCD perhaps). I like to be in bed by 9:30 as I have to get up at 5:30 M-F. The rub comes on Sat. when I feel like sleeping in, but actually feel "guilty" staying in bed. Perhaps that is not the right emotion, maybe fearful. You see, when I have had panic attacks, with one exception, they have come on times I have had to vary my sleep schedule, or chose to sleep in. Is it possible to have that tight a circadian rhythm? As I never get more than 5 hours of sleep a night during the week (wake at 12, 3, 4, 5 and then get up at 5:30) I feel tired, and WANT to sleep in on Sat. Any thoughts or anyone with similar problems?
I have bipolar and I have to be careful not to stay up too late, or let myself sleep in too long, AND I need to take some Klonopin at bedtime to make SURE I sleep through without awakening or it sets off worse mood cycling.Mitch
Posted by Maisy on August 5, 2001, at 17:40:05
In reply to Wacky moods from sleep pattern changes?, posted by paxvox on August 4, 2001, at 20:39:03
I think I know what you are talking about. I had panic attacks and this would disrupt my sleep cycle for days. So I've become ritualistic about my sleep times. When I don't fall asleep soon enough or if I go to bed too early I worry that I might not get enough sleep and set off panic attacks (although rationally I know this is not true). I've read that you can become phobic about things that are associated with your panic attacks. I also have a sort of 'fear' of having a cocktail or two. I get tense about having a panic attack, because I think if I do I will not be able to take my antiaxiety med because I had a drink. I've had one major bout of depression and I joke that I have post-traumatic stress syndrome from it, but sometimes I feel it is not a joke at all. Sorry for the rambling. Good luck to you.
Posted by terra miller on August 5, 2001, at 23:06:47
In reply to Wacky moods from sleep pattern changes?, posted by paxvox on August 4, 2001, at 20:39:03
not intentionally keeping this short, but sounds like somebody who's on wellbutrin. :-) you ok?
-terra
Posted by paxvox on August 6, 2001, at 8:29:51
In reply to Re: Wacky moods from sleep pattern changes? » paxvox, posted by Mitch on August 5, 2001, at 9:55:49
> > Do any of you have weird days on weekends, or other days you sleep later or stay up later than during the work week? I am very ritualistic about my sleep schedule (ok, OCD perhaps). I like to be in bed by 9:30 as I have to get up at 5:30 M-F. The rub comes on Sat. when I feel like sleeping in, but actually feel "guilty" staying in bed. Perhaps that is not the right emotion, maybe fearful. You see, when I have had panic attacks, with one exception, they have come on times I have had to vary my sleep schedule, or chose to sleep in. Is it possible to have that tight a circadian rhythm? As I never get more than 5 hours of sleep a night during the week (wake at 12, 3, 4, 5 and then get up at 5:30) I feel tired, and WANT to sleep in on Sat. Any thoughts or anyone with similar problems?
>
>
> I have bipolar and I have to be careful not to stay up too late, or let myself sleep in too long, AND I need to take some Klonopin at bedtime to make SURE I sleep through without awakening or it sets off worse mood cycling.
>
> Mitch
Hey Mitch,
Please elaborate,if you will, on what your "mood cycling" entails. It would be helpful for me.
Posted by paxvox on August 6, 2001, at 8:33:58
In reply to Re: Wacky moods from sleep pattern changes? » paxvox, posted by terra miller on August 5, 2001, at 23:06:47
> not intentionally keeping this short, but sounds like somebody who's on wellbutrin. :-) you ok?
>
> -terraYes, do you think that is a cause?
Posted by Mitch on August 6, 2001, at 9:34:05
In reply to Re: Wacky moods from sleep pattern changes? » Mitch, posted by paxvox on August 6, 2001, at 8:29:51
> Hey Mitch,
> Please elaborate,if you will, on what your "mood cycling" entails. It would be helpful for me.Pax,
Sure, I have BPII (maybe cyclothymia really) rapid-cycling with three-week cycles throughout the year. I also have what they call a DME pattern, that is I tend to get depressed rather suddenly for several days (4-6), then I recover rapidly from it (one day!) into a mild hypomanic phase that lasts from 3-5 days that fades gradually away into a relatively normal (euthymic) period for about a week-ten days and then I slide into the depression again. Also, I have two seasonal depressive episodes overlaid on top of that that can become major D. They last from three-eight weeks twice a year and occur in late Fall and early-mid Summer. I have mood charted and it takes a very predictive course (over the last 25 years).
SSRI antidepressants (and others to lesser extent) seem to make the peaks and troughs deeper, but don't appear to effect the cycle length (or frequency). I also have mood variations during the day as well. For instance when I am hypo I usually don't get revved up until later in the day. When I am depressed I have trouble waking up and I have a lot of early morning awakenings. I don't know if it is the chicken or the egg here, but I do know that my sleep quality/quantity the nite *before* seems to mirror how I feel the following day. So sleep is a major thing for me to monitor.
Mitch
Posted by paxvox on August 6, 2001, at 10:21:12
In reply to Re: Wacky moods from sleep pattern changes? » paxvox, posted by Mitch on August 6, 2001, at 9:34:05
So sleep is a major thing for me to monitor.
>
> Mitch
Wow! So how long did it take to figure all that out? I must claim ignorance of BPD diagnostics (perhaps I qualify?).I always thought people I have known to be BP to have distinct "up" or "down" periods that were of some duration, I guess I never thought about the rapid cycling variety. Perhaps that is the direction my Pdoc is leading me(?) but he has NEVER even suggested anything of that nature, just depression, OCD and perhaps a little GAD. WEllbutrin and Tranzene have been my meds for last 2+/- years. Sleep quality and quantity have never drastically improved. I am, however, going to rule out some general physical problems with my GP that may cause my frequent wakings (e.g. Benign Prostitis) that makes me feel like I need to pee, but never enough to clear me out so to speak). I seem to wake at the end of dream cycles before the next sleep stages begins (at least it's my understanding that REM sleep is the latter stage of the sleep cycle). I occasionally have some "hyper" moods, but not like I want to go out and do anything really heavy, more like rapid thiking and leg tapping. This could be an affect of the Wellbutrin, however. I would just like to be able to go to sleep and sleep 7 or 8 hours straight (heck, I'd settle for 6!). IS that too much to expect w/o putting me on these off-label meds?
Posted by Mitch on August 6, 2001, at 11:24:41
In reply to Re: Wacky moods from sleep pattern changes? » Mitch, posted by paxvox on August 6, 2001, at 10:21:12
> Wow! So how long did it take to figure all that out? I must claim ignorance of BPD diagnostics (perhaps I qualify?).I always thought people I have known to be BP to have distinct "up" or "down" periods that were of some duration, I guess I never thought about the rapid cycling variety.
I have always had mood disturbances even as a child. I figured the cycling out when I was a teenager. I started having the seasonal major depressions and noticed "hyper" episodes interspersed through the year, so I just started making marks on the calendar-good days-bad days and the pattern emerged. I didn't get treatment for it until I had a depressive episode with "mixed features" (agitation+severe insomnia) when I was 20.
Perhaps that is the direction my Pdoc is leading me(?) but he has NEVER even suggested anything of that nature, just depression, OCD and perhaps a little GAD. WEllbutrin and Tranzene have been my meds for last 2+/- years. Sleep quality and quantity have never drastically improved. I am, however, going to rule out some general physical problems with my GP that may cause my frequent wakings (e.g. Benign Prostitis) that makes me feel like I need to pee, but never enough to clear me out so to speak). I seem to wake at the end of dream cycles before the next sleep stages begins (at least it's my understanding that REM sleep is the latter stage of the sleep cycle).
Well, that sounds like early morning awakenings to me for sure-very notorious for people with depression. You might consider getting a polysomnogram done (a sleep study). You possibly could have sleep apnea-are you real drowsy during the day? Did you start the Tranxene first to help sleep and then you were still drowsy during the day and then got the Wellbutrin added? Hmmm.
I occasionally have some "hyper" moods, but not like I want to go out and do anything really heavy, more like rapid thiking and leg tapping. This could be an affect of the Wellbutrin, however. I would just like to be able to go to sleep and sleep 7 or 8 hours straight (heck, I'd settle for 6!). IS that too much to expect w/o putting me on these off-label meds?
When I get a little high I don't do anything really drastic either, usually I just get to cutting up with people and acting silly-I will hear remarks like I wish I had some of what you're on! Stuff like that. When my highs are the most pronounced (spring), my sleep is actually quite solid, but relatively brief (say six hours). If it wasn't for the seasonal depression (esp. the dreaded mixed stuff) on top it I may not have sought any treatment.
I would strongly suggest a sleep study (with EEG) first to rule out sleep apnea, etc. before you tinker with any more meds.
Mitch
Posted by paxvox on August 6, 2001, at 12:30:41
In reply to Re: Wacky moods from sleep pattern changes? » paxvox, posted by Mitch on August 6, 2001, at 11:24:41
Thanks for the info, Mitch. No, I have had sleep problems for a decade+. I had the old-school ADs then Prozac (but no other SSRI)then the Wellbutrin. Doc didn't give me any Benzos until afer the Wellbutrin, because of the anxiety-related problems it exacerbated. First Klonopin, which was fine, then the clorazepate, which I think is weaker. However, now he wants to get me off them all together because I am "tolerant" to their effects, according to him. I have never increased the dose, or used them "recreationally". Don't get him. I have considered the sleep-study deal, and am going to try to rule out some possible physical causes, as I said in previous post. I always attributed sleep problems to my mind that never seems to want to stop thinking, not necessarily worrying. That's probably why Doc wants me on the mood stabilizers like those he has tried, but I have not liked: Neurontin, Topamax and Depakote to name a few. I really don't think he sees me enough to really know me and actually listen to what I am telling him.
Posted by paxvox on August 6, 2001, at 12:30:54
In reply to Re: Wacky moods from sleep pattern changes? » paxvox, posted by Mitch on August 6, 2001, at 11:24:41
Thanks for the info, Mitch. No, I have had sleep problems for a decade+. I had the old-school ADs then Prozac (but no other SSRI)then the Wellbutrin. Doc didn't give me any Benzos until afer the Wellbutrin, because of the anxiety-related problems it exacerbated. First Klonopin, which was fine, then the clorazepate, which I think is weaker. However, now he wants to get me off them all together because I am "tolerant" to their effects, according to him. I have never increased the dose, or used them "recreationally". Don't get him. I have considered the sleep-study deal, and am going to try to rule out some possible physical causes, as I said in previous post. I always attributed sleep problems to my mind that never seems to want to stop thinking, not necessarily worrying. That's probably why Doc wants me on the mood stabilizers like those he has tried, but I have not liked: Neurontin, Topamax and Depakote to name a few. I really don't think he sees me enough to really know me and actually listen to what I am telling him.
Posted by terra miller on August 6, 2001, at 13:06:29
In reply to Re: Wacky moods from sleep pattern changes? » terra miller, posted by paxvox on August 6, 2001, at 8:33:58
> > not intentionally keeping this short, but sounds like somebody who's on wellbutrin. :-) you ok?
> >
> > -terra
>
> Yes, do you think that is a cause?
if you are taking the wellbutrin too late in the evening, it sure could be the cause. and if you aren't exercizing or doing something physically active from time to time while on the wellbutrin you could have building up energy that doesn't let you get into the right sleep patterns. (personal experience) -terra
Posted by terra miller on August 6, 2001, at 13:12:21
In reply to Re: Wacky moods from sleep pattern changes? » Mitch, posted by paxvox on August 6, 2001, at 10:21:12
>WEllbutrin and Tranzene have been my meds for last 2+/- years. Sleep quality and quantity have never drastically improved. I am, however, going to rule out some general physical problems with my GP that may cause my frequent wakings (e.g. Benign Prostitis) that makes me feel like I need to pee, but never enough to clear me out so to speak).
ok, this is interesting. i know for me that if my dose of wellbutrin is too much then i get that "pee-thing" you mentioned, and when i lower the dose i don't have it. i also get "that" if i take too much "serotonin effecting" meds at the same time. ie: i can't take serzone with wellbutrin. i can't take buspar with wellbutrin. i can't take trazodone with wellbutrin. i can't take serzone by itself too high. i can't take wellbutrin by itself too high. and i know nothing about tranzene. and it is good to see your GP. but thought you might benefit from this information.
-terra
Posted by Kingfish on August 6, 2001, at 16:02:17
In reply to Re: Wacky moods from sleep pattern changes? » paxvox, posted by Mitch on August 6, 2001, at 11:24:41
> Mitch:
Sorry, kind of jumping in here and getting off topic, but your postings here are very helpful to me. Your postings have always been helpful to me, actually, but to see that someone has followed their moods this closely is encouraging. You seem to really know what is happening.
It is motivating to me to do the same. :)
- K.
Posted by Kingfish on August 6, 2001, at 16:07:19
In reply to Wacky moods from sleep pattern changes?, posted by paxvox on August 4, 2001, at 20:39:03
> I am Bipolar and I think sleep is definitely closely related to my moods. One of the Bipolar sites (I'll see if I can find it) has onfo re: Circadian Rythyms and Bipolar Disorder. It's a little far out there, claiming that that's what the disorder is all about, but it does seem to be part of the problem - we have trouble sleeping (unipolar included, I would think).
Prozac has put me in a similar position re: waking up every 4 to 5 hours, so I empathize. :( I'm not sure what the solution is, except to talk to your pdoc.
Good luck!
- K.
Posted by Mitch on August 7, 2001, at 0:28:02
In reply to Re: Wacky moods from sleep pattern changes? » Mitch, posted by Kingfish on August 6, 2001, at 16:02:17
> > Mitch:
>
> Sorry, kind of jumping in here and getting off topic, but your postings here are very helpful to me. Your postings have always been helpful to me, actually, but to see that someone has followed their moods this closely is encouraging. You seem to really know what is happening.
>
> It is motivating to me to do the same. :)
>
> - K.Good deal! Hardly off topic at all.
Mood-charting is very useful. It is also a good idea to write down your meds and their dosages on the chart as well (and when they change). That way if something goes haywire you can look back through your charts and it is easier to determine what may be causing a problem (medwise), and also to eliminate psycho-social factors (or consider them) contributing to mood-swings.
Mitch
Posted by Kingfish on August 7, 2001, at 5:11:52
In reply to Re: Wacky moods from sleep pattern changes? » Kingfish, posted by Mitch on August 7, 2001, at 0:28:02
Getting off-keel (sp?) again, so it's probably a good time to start.
Also didn't sleep very well last night. :)
Thanks again.
- K.
This is the end of the thread.
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