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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 23 of 23. This is the beginning of the thread.
Posted by linkadge on April 28, 2005, at 12:11:35
If all effective AD's supress REM sleep, does this mean that we are getting less REM sleep than normal nondepressed people, or do depressed people go through more REM sleep to begin with.
Linkadge
Posted by Phillipa on April 28, 2005, at 19:00:59
In reply to If all effective AD's supress REM sleep....., posted by linkadge on April 28, 2005, at 12:11:35
Good question. I'm listening. Fondly, Phillipa
Posted by bark2323 on April 29, 2005, at 14:17:18
In reply to If all effective AD's supress REM sleep....., posted by linkadge on April 28, 2005, at 12:11:35
I think depressed people do get more REM sleep. I know they get it sooner in the night at least. And I think wellbutrin is one AD that actually increases REM sleep.
matt
Posted by linkadge on April 29, 2005, at 16:32:20
In reply to Re: If all effective AD's supress REM sleep....., posted by bark2323 on April 29, 2005, at 14:17:18
The only reason I ask, is that all AD's seem to create a terrable inballence with me in that I am waking up ever 5-10 minautes.
Linkadge
Posted by Colleen D. on April 30, 2005, at 19:25:56
In reply to If all effective AD's supress REM sleep....., posted by linkadge on April 28, 2005, at 12:11:35
> If all effective AD's supress REM sleep, does this mean that we are getting less REM sleep than normal nondepressed people, or do depressed people go through more REM sleep to begin with.
>
>
> Linkadge
I have read that depressed people go through more REM sleep to begin with. I can't provide you with a link right now but I think I searched for: (+depression +REM +sleep) and came up with quite a few sites addressing this issue.Colleen
Posted by Chairman_MAO on May 2, 2005, at 10:18:46
In reply to If all effective AD's supress REM sleep....., posted by linkadge on April 28, 2005, at 12:11:35
Wellbutrin enhances REM sleep.
Posted by FredPotter on May 2, 2005, at 16:36:52
In reply to Re: If all effective AD's supress REM sleep..... » linkadge, posted by Chairman_MAO on May 2, 2005, at 10:18:46
I've read this too. Depressed people ruminate by day and dream by night. I understand ECT also knocks out REM sleep somewhat (or completely). The argument I read was that dream-time rumination needs reducing if depression is to lift. I presume Wellbutrin is for atypical depression where REM is not exaggerated or may even be too little . ramble . .
Posted by linkadge on May 2, 2005, at 17:45:09
In reply to Re: If all effective AD's supress REM sleep....., posted by FredPotter on May 2, 2005, at 16:36:52
Thats why I think relapse is so high.
Rumination solves problems. I have found AD's are great escape drugs in that they are good at distracting you from your problems.
Without solving your problems, you're bound to relapse.
Linkadge
Posted by Phillipa on May 2, 2005, at 18:49:03
In reply to Re: If all effective AD's supress REM sleep....., posted by linkadge on May 2, 2005, at 17:45:09
I like to dream. I can usually interpret why I had the dream by the things going on in my life. I always know when my stress is too high and there is a problem to be solved. These are nightmares. Fondly, Phillipa
Posted by FredPotter on May 2, 2005, at 20:17:25
In reply to Re: If all effective AD's supress REM sleep....., posted by linkadge on May 2, 2005, at 17:45:09
> Thats why I think relapse is so high.
>
> Rumination solves problems. I have found AD's are great escape drugs in that they are good at distracting you from your problems.
>
> Without solving your problems, you're bound to relapse.
>
>
> Linkadge
>
I think this is an important observation
Posted by gromit on May 3, 2005, at 3:05:36
In reply to Re: If all effective AD's supress REM sleep....., posted by FredPotter on May 2, 2005, at 16:36:52
> I've read this too. Depressed people ruminate by day and dream by night. I understand ECT also knocks out REM sleep somewhat (or completely). The argument I read was that dream-time rumination needs reducing if depression is to lift. I presume Wellbutrin is for atypical depression where REM is not exaggerated or may even be too little . ramble . .
Regardless if I'm taking and AD or not I don't dream anymore, haven't for many years now. Does this mean I'm not getting enough REM sleep? It's not all bad, I don't wake up thinking oh man, did I really kill all those people or was it just a dream (they WERE dreams, thank god). The flying dreams and Carmen Electra groupie type dreams are gone too though which is a negative.
More seriously, is a lack of REM sleep a symptom of something else going on? Assuming I don't get enough REM sleep what kind of problems could this cause if any?
Thanks,
Rick
Posted by Declan on May 3, 2005, at 4:10:09
In reply to Re: If all effective AD's supress REM sleep....., posted by gromit on May 3, 2005, at 3:05:36
Do you think that as you get older you dream less, and less vividly?
Posted by Phillipa on May 3, 2005, at 16:48:41
In reply to Re: If all effective AD's supress REM sleep....., posted by Declan on May 3, 2005, at 4:10:09
No! Last night I had nightmares again toward morning. I forget what they were now but they all had to do with problems I'm dealing with in real life. It's funny how a dream takes people from your past and puts them in your dreams as examples let's say of what the person in your past did to you and what someone else is doing to you now. Does this make sense? Fondly, Phillipa
Posted by Chairman_MAO on May 5, 2005, at 16:59:27
In reply to Re: If all effective AD's supress REM sleep....., posted by gromit on May 3, 2005, at 3:05:36
That's interesting. Even on 200mg/day of Parnate, I still had dreams. I think it's virtually impossible to knock out REM sleep for me. Oh 75mg/day phenelzine, I can nap and dream during the day sometimes! If lack of dreaming is indicative of AD response, then I have never fully responded to anything.
However, I suspect the real picture is far more complicated than that. The alternative, of course, is that my neurochemistry is just really bizzarre. I tend to think both the former and the latter might be the case. ;)
Posted by university on May 16, 2005, at 0:11:33
In reply to Re: If all effective AD's supress REM sleep..... » gromit, posted by Chairman_MAO on May 5, 2005, at 16:59:27
i just got my polysomnography results back; the results show that i spend 95% of my sleep time (8.1 hours) in stages 1 and 3. The other 5% was in REM, and my sleep was very disturbed during that time. Also, the REM sleep occured just before waking up in the morning! I had zero stage 3 or 4 sleep.
I've been reading a lot about REM sleep and depression, and, it seems to me, that the there isn't a consensus about the correlations. For example, some experiments seem to indicate that REM sleep worsens depression because it's the only stage of sleep wherein our brains are as active as when awake--and they (our brains) are mulling over the same, depressive thoughts...etc. And since most ADs inhibit REM sleep--especially MAOs--some think that that also points toward REM sleep being detrimental to a depressed person. However, other ADs that work actually increase REM sleep. And another group found that REM sleep was the only time that depressed (hence, "helpless") monkeys could excercise "search" behavior, and thus improve their perceived helplessness during conciousness.
Yet another study shows that most depressed inpatients and outpatients have short "REM latentcy" periods; they go into their first period of REM shortly after falling asleep (normally, about 90 minutes pass before first REM). These clinicians think this could be a "marker" for depression--even in never/nondepressed people.
I have NO idea. Who knows? Some think that we "process" thoughts, emotions, information, memories, etc. during REM sleep. But if we're processing these things *negatively,* as depressives tend to do while conscious, it makes sense that REM sleep might be detrimental. But who knows how we're "dealing" with stuff in dreams anyhow?
It's all very fascinating to me. I'd love to be hooked up to all that stuff (EEG, EKG, etc.) every night for a period of time--then compare the polysom. results with a daily mood/meds/events journal! But at $3,000 a test, I don't think Blue Cross will indulge me :(
Incidentally, I have read in many places that REM sleep facilitates memory consolidation and other cerebral events that would tend to enhance one's memory/cognition. This could explain why my memory--especially serial memory (e.g., 'phone numbers)--has become so poor over the 12 years I've been on Prozac. But another study I read, which was roundly accepted (by medical orthodoxy, FWIW), indicated that REM sleep has nothing to do with memory consolidation, etc.
Maybe, a long time from now, people with psych. disorders will look back on our times and feel the sympathy we feel for those who lived in earlier centuries--who endured excorsisms, skull-drilling, and other, barbarous "treatments" for depression... :/
Posted by Jakeman on May 16, 2005, at 9:27:06
In reply to Re: If all effective AD's supress REM sleep....., posted by university on May 16, 2005, at 0:11:33
> i just got my polysomnography results back;
>I did a sleep study last night and am eager to get the results. It felt like I barely slept at all but the tech said I slept several hours. Has your Dr. made any recommendations based on your polysomnography? I often wake feeling very tired and unrested, I'm guessing that I'm not getting enough stage 3 & 4 deep sleep. My Dr. has mentioned Xyrem as a possible treatment.
The issue of REM sleep and depression is confusing to me at this point. As an aside, I know of two people that are heavily into meditation and martial arts who function happily on 4 hours sleep per night.
best regards, Jake
Posted by university on May 16, 2005, at 21:32:08
In reply to Re: If all effective AD's supress REM sleep..... » university, posted by Jakeman on May 16, 2005, at 9:27:06
> > i just got my polysomnography results back;
> >
>
> I did a sleep study last night and am eager to get the results. It felt like I barely slept at all but the tech said I slept several hours. Has your Dr. made any recommendations based on your polysomnography? I often wake feeling very tired and unrested, I'm guessing that I'm not getting enough stage 3 & 4 deep sleep. My Dr. has mentioned Xyrem as a possible treatment.
>
> The issue of REM sleep and depression is confusing to me at this point. As an aside, I know of two people that are heavily into meditation and martial arts who function happily on 4 hours sleep per night.
>
> best regards, JakeWhat's Xyrem?? Yes, the sleep lab MD advises CPAP therapy. For the diminished REM, absent 3&4, and increased 1&2, she can't really advise anything but clinical correlation, since it's anybody's guess what's responsible (though Prozac is probably the main factor).
But I'll be very pleased if CPAP therapy "cures" my excessive daytime sleepiness, which is why I had the study done in the first place. I've been on sundry stimulants (methylphenidate right now) for this ESD.
My insurance--Blue Cross PPO--won't cover a CPAP machine for me 'cause my apnea index was too low (I had more hypopneas than actual apneas). So I'm looking into just buying one (about $800).
Good luck--let us know what the results are. And make sure you ask the lab for a copy of the results. If you have any questions, I'd be glad to tell you what I've learned...
JM
Posted by Jakeman on May 17, 2005, at 23:21:40
In reply to Re: If all effective AD's supress REM sleep....., posted by university on May 16, 2005, at 21:32:08
> > > i just got my polysomnography results back;
> > >
> >
> > I did a sleep study last night and am eager to get the results. It felt like I barely slept at all but the tech said I slept several hours. Has your Dr. made any recommendations based on your polysomnography? I often wake feeling very tired and unrested, I'm guessing that I'm not getting enough stage 3 & 4 deep sleep. My Dr. has mentioned Xyrem as a possible treatment.
> >
> > The issue of REM sleep and depression is confusing to me at this point. As an aside, I know of two people that are heavily into meditation and martial arts who function happily on 4 hours sleep per night.
> >
> > best regards, Jake
>
> What's Xyrem?? Yes, the sleep lab MD advises CPAP therapy. For the diminished REM, absent 3&4, and increased 1&2, she can't really advise anything but clinical correlation, since it's anybody's guess what's responsible (though Prozac is probably the main factor).
>
> But I'll be very pleased if CPAP therapy "cures" my excessive daytime sleepiness, which is why I had the study done in the first place. I've been on sundry stimulants (methylphenidate right now) for this ESD.
>
> My insurance--Blue Cross PPO--won't cover a CPAP machine for me 'cause my apnea index was too low (I had more hypopneas than actual apneas). So I'm looking into just buying one (about $800).
>
> Good luck--let us know what the results are. And make sure you ask the lab for a copy of the results. If you have any questions, I'd be glad to tell you what I've learned...
>
> JM------------------------
I believe Xyrem (aka GHB) was approved for treatment for narcolepsy but is being presribed for other sleep disorders such as insomnia and excessive daytime sleepiness. Because the DEA/FDA has fears about it being abused the distribution is tightly controlled. Maybe someone who's taking it can correct me, but I believe it has to be ordered directly from a central pharmacy. The main drawback is that you have to take it two times a night, but apparently its been a godsend for some people.
You mention Prozac...I believe my insomnia started over 10 years ago when I first started on Prozac. The problem was manageable at first but has progressively gotten worse. Recently I started taking Elavil and Lunesta at night and
and my sleep has improved somewhat, though not great.Good luck to you too with the CPAP. Maybe you can try one for a while before you actually buy it. Yes I may have some more questions when I get my results. I'm going to call the lab tomorrow and make sure they send me a copy. That's the least they can do for the $500 I had to pay out-of-pocket.
-J
Posted by Jakeman on May 26, 2005, at 14:03:52
In reply to Re: If all effective AD's supress REM sleep....., posted by university on May 16, 2005, at 0:11:33
My study showed 3.9% of sleep time in REM., 6.6% in stage 1, 89.5 in stage 2, 0% in stage 3 and 4.
I had 49 "arousals" and 14 awakenings; 0 apneas, 29 hypopneas, Apnea-Hypopnea Index 10.5. Mean oxygen 93%, minimum 83%. My total sleep time was only 166 minutes. The diagnosis is obstructive sleep apnea, hypoxemia, absence of slow-wave sleep, poor sleep efficiency. They want me to do another sleep test witha a nasal CPAP.It took me 52 minutes to go to sleep and I slept only 2 1/2 hours, with medications-- Elavil and Lunesta. The report did not address this, but it appears to me that I have the twin devils of apnea AND insomnia. I'll probably try the CPAP device to see if it helps... but I've can't imagine sleeping regularly with this contraption because I'm such a light sleeper.
best- J
> i just got my polysomnography results back; the results show that i spend 95% of my sleep time (8.1 hours) in stages 1 and 3. The other 5% was in REM, and my sleep was very disturbed during that time. Also, the REM sleep occured just before waking up in the morning! I had zero stage 3 or 4 sleep.
>
> I've been reading a lot about REM sleep and depression, and, it seems to me, that the there isn't a consensus about the correlations. For example, some experiments seem to indicate that REM sleep worsens depression because it's the only stage of sleep wherein our brains are as active as when awake--and they (our brains) are mulling over the same, depressive thoughts...etc. And since most ADs inhibit REM sleep--especially MAOs--some think that that also points toward REM sleep being detrimental to a depressed person. However, other ADs that work actually increase REM sleep. And another group found that REM sleep was the only time that depressed (hence, "helpless") monkeys could excercise "search" behavior, and thus improve their perceived helplessness during conciousness.
>
> Yet another study shows that most depressed inpatients and outpatients have short "REM latentcy" periods; they go into their first period of REM shortly after falling asleep (normally, about 90 minutes pass before first REM). These clinicians think this could be a "marker" for depression--even in never/nondepressed people.
>
> I have NO idea. Who knows? Some think that we "process" thoughts, emotions, information, memories, etc. during REM sleep. But if we're processing these things *negatively,* as depressives tend to do while conscious, it makes sense that REM sleep might be detrimental. But who knows how we're "dealing" with stuff in dreams anyhow?
>
> It's all very fascinating to me. I'd love to be hooked up to all that stuff (EEG, EKG, etc.) every night for a period of time--then compare the polysom. results with a daily mood/meds/events journal! But at $3,000 a test, I don't think Blue Cross will indulge me :(
>
> Incidentally, I have read in many places that REM sleep facilitates memory consolidation and other cerebral events that would tend to enhance one's memory/cognition. This could explain why my memory--especially serial memory (e.g., 'phone numbers)--has become so poor over the 12 years I've been on Prozac. But another study I read, which was roundly accepted (by medical orthodoxy, FWIW), indicated that REM sleep has nothing to do with memory consolidation, etc.
>
> Maybe, a long time from now, people with psych. disorders will look back on our times and feel the sympathy we feel for those who lived in earlier centuries--who endured excorsisms, skull-drilling, and other, barbarous "treatments" for depression... :/
>
>
Posted by Phillipa on May 26, 2005, at 18:21:18
In reply to Re: my sleep study results » university, posted by Jakeman on May 26, 2005, at 14:03:52
Jakeman, I know what you mean. I've often wondered if they did a sleep test on me and said i needed a CPAP I couldn't possibly wear it. Not with insomnia. Fondly, Phillipa
Posted by Jakeman on May 27, 2005, at 21:01:00
In reply to Re: my sleep study results » Jakeman, posted by Phillipa on May 26, 2005, at 18:21:18
> Jakeman, I know what you mean. I've often wondered if they did a sleep test on me and said i needed a CPAP I couldn't possibly wear it. Not with insomnia. Fondly, Phillipa
No doubt. Jesus I wake up when my pillow gets twisted in the wrong direction.
-J
Posted by Phillipa on May 27, 2005, at 21:13:36
In reply to Re: my sleep study results » Phillipa, posted by Jakeman on May 27, 2005, at 21:01:00
I have to laugh. Sorry. So what are you going to do? I know I'd throw that thing on the floor after about l minute. Patience is not one of my virtues. Fondly, Phillipa
Posted by Jakeman on May 27, 2005, at 21:57:01
In reply to Re: my sleep study results » Jakeman, posted by Phillipa on May 27, 2005, at 21:13:36
> I have to laugh. Sorry. So what are you going to do? I know I'd throw that thing on the floor after about l minute. Patience is not one of my virtues. Fondly, Phillipa
Hey Phillipa, laughing is good. I haven't gone back to the sleep doctor yet, I just got the lab results (after much hassle). But I've got a ream of questions for him. Like figuring out a way to sleep on my side all the time (the test showed my breathing was obstructed while sleeping on my back). Or a mouth piece that sets my jaws in alignment for better breathing (my dentist already suggested some time ago but I didn't want to pay for it). As much as I hate going to doctors I'm trying my best to not get discouraged.
best wishes- J
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