Posted by ncrainbow on May 13, 2008, at 17:45:52
In reply to Re: Medication Management: Episode 1, posted by smart.drug on May 13, 2008, at 2:58:53
> >ncrainbow,
> Wow... sounds like you're in a similar kind of mess as me. My problem is, I'll try ANYTHING, except for two classes of medications: SSRIs, and benzos. I refuse to touch them. But for the sake of brevity, I'll just say that benzos, as a class, suppress REM, so I don't want to try one for my sleep issues.
>
> Anyway, what you're describing to me sounds like narcolepsy... what happened, though? The sleep study found you negative for it? Well, in any case, I'm not a doctor. At any rate, I'd like to stick to sleep issues for now. I'll discuss other issues with you in subsequent episodes, unless you'd like to e-mail/IM some time?
>
> P.S. This is finals week for me, so that means lots of all-nighters. So I won't be able to implement any sleep hygeine measures in the immediate future. Also, it's kind of hard for me to avoid computer/TV before bedtime--but I agree that avoiding them can be beneficial. I just wonder whether the benefit of a medication can outweight the sum total of sleep hygeine measures?Okay...more on sleep issues ..here is my deal....
Although my score of 5 on the sleep latency study was indicative of narcolepsy, there are lots of factors that can cause day time sleepiness that have to be ruled out before the diagnosis can be made. Plus, there are some potential drawbacks to carrying a narcolepsy dx.
I have never found a drug that could improve the quality of my night time sleep enough that I wasn't sleepy during the day. In fact, I think night time sleep quality is one factor in my daytime sleepiness but definitely not the main or only one.
So, here are my experiences (separating out night time sleep from day time sleep:
Night time:
Falling asleep:
The things that interefere with my falling asleep are 1) missing the sleepy window..i.e., staying up during the hour my body is naturally slowing down, 2) electronic stuff like laptop and tv makes my mind racy and even though I feel sleepy after watching it, I just don't fall asleep, 3) guilty thoughts, stress about something left undone (which for me is practically everything since I live a pretty disorganized life), 4) caffeiene, and 5) hormonal stuff...a couple days of the month before i start, I bascially CAN'T fall asleep.Staying Asleep/Falling Back Asleep if woken:
The things that interefere with this are usually more physical or material....too hot, too cold, room is stuffy, allergies bothering me, little light on smoke alarm, flashing light reflecting from bathroom appliance, partner snoring, etc. I often wake up around 2:30 and then stay awake until 5:00 a.m. or so. I don't do this as much now on the klonopin bit it still happens maybe once a week.Daytime sleepiness
#1 cause is avoidance of a task that is too big for me to break down...here is where the ADD comes in, i.e. inability to tune out all other thoughts to focus just on getting up getting dressed and going to work.Most days, I lie in bed wondering about whether I should take a shower first or eat breakfast,weighing the benefits of each, pondering what to wear which leads to thoughts and guilt about the growing piles of laundry which leads to thoughts about which load to tackle first which brings me to wondering whether I should just skip work and stay home and do laundry (more guilt about messy house and being a bad mom and partner)or go to work but maybe wait until after shower to start at least one load of laundry and then trying to decide if I need to buy gas on my way to work and where my ATM card is since I couldn't find it last night, more guilt about messy lifestyle....after about fifteen minutes of pondering, I am exhausted and feel physically unable to get up without an hour of more sleep....then I basically wake up an hour later, and do it all again...changing some of the details or the things I am pondering or feeling badly about but basically the same.
#2 Cause of daytime sleepiness - Inability to rest any other way but in a horizontal position pondering things....basically I go at 100 miles an hour most of the day, interacting with the kids, playdates, juggling stiuff at work (I am a lawyer so lots to juggle), socializing, talking on the phone , tunneling in on the net, etc....When I feel overstimmed or like I need a break, I automatically start craving a nap...its the only way I can turn it all off and escape. I can't say for sure, but I would bet the farm that my craving is as strong as one someone might have for a cigarette, drink, or any other kind of fix.
Napping or going back to sleep in the morning for me mimics how most addictions affect people's lives. I wake up every morning promising I won't do it (even though I know I will), it negatively affects my ability to parent and be a partner, I hide the quantity of it from friends and colleagues, I am always coming up with ways to avoid it but bascially end up feeling powerless over it, and lastly, there are moments where I feel like there is NOTHING I would enjoy as much as a nap. I have tried provigil, traditional stimulants, caffeine, and all of them wind me up so I am not as "sleepy" but still leave me with all the racy thoughts or the hypomania that make me crave naps in the first place so I end up having less enjoyable, more agitated naps but I still take them. Of the lot, dexedrine was the best but still not perfect.
My new PDOC thinks napping for me could be equated to depression for rapidly cycling cyclothymia (low grade bipolar) so after failing on Lamictal due to evil rash, I am trying Wellbutrin. The Klonopin was prescribd since I basically just stopped 8 years worth of an SSRI cold turkey (over 2 weeks)...with the added benefit that Klonopin is supposed to regulate mood.
poster:ncrainbow
thread:828752
URL: http://www.dr-bob.org/babble/20080510/msgs/828941.html