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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
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.
Posted by bulldog2 on January 25, 2009, at 16:18:18
In reply to Another Insomnia Thread -- Selegiline Implicated, 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.Did the neurontin help? It's more weight neutral than lyrica..
Posted by Phillipa on January 25, 2009, at 16:56:23
In reply to Another Insomnia Thread -- Selegiline Implicated, posted by EyesWideOpen on January 25, 2009, at 13:24:40
Hi Welcome to Babble just FBS can be a problem. Hope someone pops in with a great suggestion for you. Any other medical conditions. Love Phillipa
Posted by Phillipa on January 25, 2009, at 16:59:17
In reply to Re: Another Insomnia Thread -- Selegiline Implicated » EyesWideOpen, posted by Phillipa on January 25, 2009, at 16:56:23
Oops sorry meant CFS. Love Phillipa so you're thinking the selegiline is the problem????
Posted by EyesWideOpen on January 25, 2009, at 17:52:17
In reply to Re: Another Insomnia Thread -- Selegiline Implicated, posted by bulldog2 on January 25, 2009, at 16:18:18
Thanks for the replies.
Neurontin did nada, for pain or sleep. I never went up to the higher levels (over 1,000 mgs), but I dont have any confidence in it for me, whatsoever.
Phillip, I don't believe I have CFS, though there is a much overlap between dysautonomias and CFS & FMS, including orthostatic intolerance, sleep disturbance, body pain, and fatigue.
And I do think Selegilene has exacerbated the issue. Though I tend to think that Selegilene may be somewhat helpful in addressing daytime sleepiness and fatigue.
My primary issues are the dysautonomia, sleep apnea, severely fragmented sleep, herniated discs, chronic headache, myofascial and post-surgical pain, and impaired cognition and memory. Possible TBI.
I have a script for LDN and am contemplating that -- for pain and chronic inflammation, not sleep, which I understand it disturbs in the beginning.
Thanks for any insight.
Posted by desolationrower on January 25, 2009, at 21:59:20
In reply to Another Insomnia Thread -- Selegiline Implicated, posted by EyesWideOpen on January 25, 2009, at 13:24:40
baclofen would probably help as a sleep aid, although it might be bad for the apenaea
-d/r
Posted by EyesWideOpen on January 26, 2009, at 23:16:52
In reply to Re: Another Insomnia Thread -- Selegiline Implicated, posted by desolationrower on January 25, 2009, at 21:59:20
> baclofen would probably help as a sleep aid, although it might be bad for the apenaea
>
> -d/rD/R, thanks. Do you take Baclofen, and if so, at what dose? Did you not develop tolerance, as some suggest? Do you think it's a relaxant that an ortho surgeon would be familiar with, and prescribe? And does it come in generic in the States?
This is a med that has been on my list to check out, given the suggestion that tolerance does not develop and it can be helpful for restorative sleep.
Thanks much.
Posted by desolationrower on January 28, 2009, at 0:23:14
In reply to Re: Another Insomnia Thread -- Selegiline Implicated, posted by EyesWideOpen on January 26, 2009, at 23:16:52
haven't taken it myself, no
-d/r
Posted by tealady on February 4, 2009, at 4:35:32
In reply to Re: Another Insomnia Thread -- Selegiline Implicated, posted by EyesWideOpen on January 25, 2009, at 17:52:17
I have a script for LDN and am contemplating that -- for pain and chronic inflammation, not sleep, which I understand it disturbs in the beginning.
>
> Thanks for any insight.
Hi there,
any chance you can keep me updated re your ldn if you try it. Also who prescribed your ldn? I'm in Oz so I dont need the docs name, just wondering what kind of doc is prescirbing it?
I've started a thread on alter on ldn
http://www.dr-bob.org/babble/alter/20081006/msgs/877763.html
before I realised it was talked about on this board.
If you could add how your are going it would be fantastic!
Thanks.
This is the end of the thread.
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