Posted by Kenny Koala on January 24, 2005, at 11:16:28
In reply to REM sleep/Prozac/PLMD?, posted by shoebox on January 24, 2005, at 9:48:16
> For the past several months I have had trouble staying awake during the day. I averaged a 2-hour nap every day around the same time (early afternoon), even though I was getting my usual 8 hours overnight. I had no other symptoms that could account for such fatigue.
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> I finally went to a sleep clinic and stayed overnight, hooked up to all manner of wires. They expected to find sleep apnea. The results: I woke up over 150 times. Approximatley 30 of those times, it was due to mild sleep apnea. Another 20 seemed to be caused by PLMD--Periodic Limb Movement Disorder--and that left 100 or so "wake-ups" unaccounted for. The real kicker: I never reached Stage 3 sleep, never mind stages 4 and 5, because of all the wake-ups, and was told I had experienced virtually no REM sleep.
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> My insurance won't cover any additional evaluations (at least not any overnights at the clinic), because of the "mild" sleep apnea DX.
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> The doctor at the sleep clinic was flummoxed as to the 100 "idiopathic" wake-ups, and I don't know what my next move is.
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> [I'm BPII and was on 80mg Prozac, 300mg Lamictal prior to my most recent pdoc appt.]
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> My pdoc decided to decrease my Prozac from 80mg to 60mg and add Wellbutrin SR 150 mg., figuring Prozac has a reputation for REM sleep spoilage. I've been on the new RX for about two weeks now, and can't say there's been any marked improvement, though I feel more "alert" thanks to the WB.
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> What else could be causing the interruption of my sleep besides sleep apnea and PLMD? That's the question. Has anybody had to deal with this type of thing?
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Reduced or nil Stage 4 sleep is a side effect of all SSRI's & Effexor, not just Prozac. Excess agonism of Serotonin 2A receptors(5-HT2A) by the increase in Serotonin levels is the cause. The cure is rather simple, take a low doseage of something that is a 5-HT2A antagonist. Amitriptyline, Doxepin, Remeron, Trazodone or Trimipramine would be my first choices. Most antimigraine & antipsychotic drugs are 5-HT2A antagonists too. 5-HT2A receptors also control other body functions such as temperature control, anxiety & orgasm.
poster:Kenny Koala
thread:446722
URL: http://www.dr-bob.org/babble/20050124/msgs/446763.html