Posted by johnj on December 16, 2003, at 11:23:28
In reply to Re: Sleep Problems, Ron » Larry Hoover » johnj, posted by Larry Hoover on December 16, 2003, at 9:28:23
Hi Larry,
Good to hear from you. It feels good to connect with people who are experiencing the same thing and I appreciate your thoughts and insight. Of course, I have some more questions for you.> HI Larry (and Ron too)
>
> Just got back on and read the thread between you two. I hope you both are doing well and we all find our healing path. Sometimes despair is so great.
>
> larry, well it seems you and I are in the same boat as far as the sleep things goes. I have struggled trying to find something for the last 2.5 years.
>
> I have been away for awhile and for the last 9 weeks have been waiting to do my sleep study. I did it last week and the results, or lack thereof, were almost devastating. I expected something and the only thing I had was a lack of deep sleep,not caused by sleep apnea. I had hoped for some dx and there was none. The only thing that keeps me going is the remeron giving me kind of a "who cares attitude". I seem to have to numb myself to stay functional.<Actually, that is a finding. If you're not getting into stage 3 and 4 sleep, you're not getting restorative sleep. And, you won't be releasing hGh and other control hormones, so your whole endocrine system gets out of whack. For people with that pattern, benzos like Restoril (tenazepam) can actually increase deep sleep, whereas they decrease it in normal people.>
What about other meds besides benzo’s for sleep? Ambien or sonata? There are two new ones coming out that are supposed to be really good. One thing I don’t know, and what scares me, is that maybe I am treating symptoms not the problem. Does my work stress or not such a fullfilling career cause me anxiety/depression? Is something wrong with my marriage? When I was feeling good for that time in the summer nothing about my job or marriage seemed wrong or unable to handle. I just want to be able to show my wife the real me again and just wake up looking forward to the day.
> When I added 15mg of remeron last spring and started using a mouth guard since I grind my teeth(I probably mentioned it before). But, I lost the mouth guard and slowly started to feel worse, hence the doc thinking I had apnea. For about two months I was yawning naturally and sleeping through my alarm. Everything took a dive when I lost my mouth guard. So the dentist made me a new one, different style, and it gave me so much tension in my forehead.
<Then it doesn't fit right. You should get him to replace it, or try to match the one you lost.>
My thoughts exactly. It just didn’t seem to fit my pattern of having something work for 10 days or two weeks, then quit. With the mouthguard I slowly edged into deeper sleep over a two month span. My alarm clock was waking me up. I was groggy, but awakened after showering. This was very close to what I experienced pre depression/anxiety. The first night I didn’t use the mouthguard I feel asleep fine, but awoke with a twinge of head tightness and a tad bit of anxiety. Not enough to impair me, but it slowly has gotten worse. And with the new mouthguard worse tightness, I have experimented off and on with this and the same results each time. Just had to ditch it in the end and grind away.
> The excercise still makes my insomnia worse, just not that day it happens a day or so later. I think the lack of deep sleep is what hurts me. My body is repairing itself. The one non-drug, supplement thing I long for eludes me still. The fatigue and muscle loss concern me a great deal.
<One of the effects of prolonged sleep deprivation is decline in testosterone (in males). You should get your bioavailable testosterone level measured. The results may surprise you. You may also want to complete a short questionnaire called ADAM.>
http://www.conturo.com/be_core/content/journals/u/data/2003/0401/adam1.html
It identifies a symptom cluster presumptive of testosterone deficiency, not necessarily restricted to the aging effect.I will give this a look, thank you very much.
> All I get from the docs are "excercise will help". Well it used to but not anymore. It is tough to know what to do.
<There is a concept applied in exercise for e.g. chronic fatigue sufferers....the finger pattern. If you look at your hand, it's finger space finger space....if you exercise one day, take the next day off. If you exercise two days, take two days off. This lets your body get the rest it needs. Also, you may be exercising to exhaustion without realizing it. Don't compare your exercise level to others. Just because other people do two hours a day does not mean it's appropriate for you to do so. Cut back by a third, and see if that helps.>
I only do tai chi and it is a very light workout. My theory is I am just not recovering due to lack of deep sleep and the demands on my body disrupt my sleep. If I tried to do any weightlighting or running I wouldn’t last 5 minutes.
> I sometimes think maybe paxil could help the anxiety/gad, but ssri's scare me and cymbalta is still a know show.
>
> Larry, is your PTSD causing you anxiety and hence insomnia?
<I see my PTSD in terms of a symptom cluster. Insomnia is also associated with chronic fatigue and fibromyalgia, and I have symptoms of all three. I don't separate them, though doctors might.I have low grade anxiety all the time, but that is inseparable from the effects of the insomnia, IMHO. If my insomnia remits, so does the anxiety. My symptoms wax and wane together, pretty consistently.>WOW, we are identical in that respect. If I sleep well, my anxiety levels drops, and I handle stress much better. I always feel I am a few nights of good sleep away from feeling just feeling fine.
> I seem to "sleep" 7 hours, but wake up bushed.
<That's the lack of stage 3 and 4 sleep.>
Bingo! Just what I thought. Again, my body is not repairing itself. They told me at the sleep clinic that I had very little…..Theta waves I believe? They told me exercise should improve deep sleep, but not for me at this point. They mentioned my meds may be a problem. But, I was ok for years and then had sleep problems again that led to the extra tranzene and remeron.> I also have funny eye twitches, and muscle twitches from lack of sleep. Lack of sleep takes it toll. Have you tried a low dose of remeron?
<Not low dose. It made me impotent (which I will not accept), so I ditched it. I've got some left (30 mg tabs).....hmmmmm.>
> I know you tried it in the past, but at what dose?
<My episodic memory sucks....I don't remember for sure, but I think I started at 30, and went to 45 after two weeks. My declarative memory is still good, but episodic memory is a real problem for me.>> At least I get to sleep it just isn't as restorative as I need. I also take lithobid and tranzene(which the doc thinks) might mess up my deep sleep.
<It does in some people. >
Do you think both the lithobid and tranzene could affect my deep sleep?
> Take care of yourself and hopefully I will have the energy to keep looking. My wife is not handling things very well and I sometimes wonder if she will leave. I wouldn't blame her as the meds make me intolerable and grumpy and short tempered. Thanks to remeron my sex drive has diminished to almost nothing.
<At low dose? Darn. There goes that idea.>
Larry, 15 was definitely better than 30 mg for me in the sex department. I am thinking of cutting to 11.25 mg. 30 mg stopped me dead in my tracks. It is tough, I need to be at least functional at work so if sex has to go I have no choice at this time. I am thinking of trying tryptophan. Did you get the ultrapure? Not a bad price. It is for horses, any concerns about that? I am a little afraid of seratonin syndrome since I take remeron. Doc says give any supplement a try, but with the remeron, lithobid, and nortryptline it is scary. One thing I didn’t like is the rebound insomnia I had after discontinuing the remeron, that is when the doc just raised my tranzene.
> Peace to you both, and may a miracle find us all.
>
> johnj
Thanks john.And for the record, zyprexa is unacceptable for me. It is activating me after four days.
Sorry to hear that Larry, Ron suggested that to me. I find myself having a lot of paradoxial experiences with meds and supplements too.Thanks Larry, good luck to us both!
poster:johnj
thread:286464
URL: http://www.dr-bob.org/babble/alter/20031204/msgs/290522.html