CPAP and Sleep Aids

[Fosco]

"That said, I want to clarify what you said in the first post.

You were NOT diagnosed with sleep apnea when the docs started giving you sleeping medication, right? CORRECT

Then when you WERE finally diagnosed correctly, they didn't help you stop them, but just told you to take less, right? CORRECT, and I deduced from my doctors comments that ALL apnea/cpap patients also take meds, hence my original question.

Now you've been using it a while but were never told you needed to revisit the sleep doc, right?" CORRECT, I was told that once I had a cpap I'd rarely if ever need to go back to the doc.



FYI, I am now seeing the 6th doctor (GP's and specialists) since my apnea became a problem in the late 90's. I always take all my history and elaborate on my issues but they seem to have heard it all before. My complaints have been addressed but there have been no solutions. I know a great deal about what meds I take and have often suggested changes. I have had the impression from their evaluations of me that ALL people with apnea just never quite sleep right and the CPAP is just a tool to reduce the drug dependence. I took a way-too-early retirement due to my being unable to work. Raising my CPAP pressure recently (on my own and after finding information here on the forum) has dramatically improved my sleep more than any other single action in all those years. For this, I thank all of you for your contributions that have helped me understand that I did not have a good pressure setting or good doctors.

I have many times attempted to gradually reduce my pill use and my success has been limited to a few nights. The total dosages are lower compared to pre-cpap but I am still far from fully functional due to after-effects. My trade-offs for the past 4 years have been either: 1) take meds, sleep well and be groggy or 2) reduce meds and not sleep well and be drowsy. Both suck. It is a daily guess on my part how much meds to take to sleep just well enough to meet the challenges of the next day. Usually, I am wrong to some extent. However, I may soon be able to reduce meds again because of the higher pressure I'm using.

I will press once again for a sleep study sooner rather than later. Without this forum, I would not know one half as much as I do and I can now take better care of myself. Thank you all for your suggestions.

[greatunclebill]

"That said, I want to clarify what you said in the first post.

You were NOT diagnosed with sleep apnea when the docs started giving you sleeping medication, right? CORRECT

Then when you WERE finally diagnosed correctly, they didn't help you stop them, but just told you to take less, right? CORRECT, and I deduced from my doctors comments that ALL apnea/cpap patients also take meds, hence my original question.

Now you've been using it a while but were never told you needed to revisit the sleep doc, right?" CORRECT, I was told that once I had a cpap I'd rarely if ever need to go back to the doc.



FYI, I am now seeing the 6th doctor (GP's and specialists) since my apnea became a problem in the late 90's. I always take all my history and elaborate on my issues but they seem to have heard it all before. My complaints have been addressed but there have been no solutions. I know a great deal about what meds I take and have often suggested changes. I have had the impression from their evaluations of me that ALL people with apnea just never quite sleep right and the CPAP is just a tool to reduce the drug dependence. I took a way-too-early retirement due to my being unable to work. Raising my CPAP pressure recently (on my own and after finding information here on the forum) has dramatically improved my sleep more than any other single action in all those years. For this, I thank all of you for your contributions that have helped me understand that I did not have a good pressure setting or good doctors.

I have many times attempted to gradually reduce my pill use and my success has been limited to a few nights. The total dosages are lower compared to pre-cpap but I am still far from fully functional due to after-effects. My trade-offs for the past 4 years have been either: 1) take meds, sleep well and be groggy or 2) reduce meds and not sleep well and be drowsy. Both suck. It is a daily guess on my part how much meds to take to sleep just well enough to meet the challenges of the next day. Usually, I am wrong to some extent. However, I may soon be able to reduce meds again because of the higher pressure I'm using.

I will press once again for a sleep study sooner rather than later. Without this forum, I would not know one half as much as I do and I can now take better care of myself. Thank you all for your suggestions.

if 6 different doctors are not treating you right or giving bad advice or whatever is going on, then some pieces of this puzzle are missing. i don't get it.

[Fosco]

if 6 different doctors are not treating you right or giving bad advice or whatever is going on, then some pieces of this puzzle are missing. i don't get it.
[/quote]

This may seem naive, but I have to ask. Do you mean that normal cpap users are able to be fully functional during the day and don't have to take meds to sleep????

[PaulaO2]

When I first started, I wasn't told to go back, either. I was told to attend a meeting of other CPAP users (I never did) and that was that.

No, I've never taken any pill for sleep apnea. It is contraindicative.

Sometimes, docs will prescribe a small dose to take during the sleep test to enable the person to actually SLEEP for the test.

Sometimes, docs will prescribe something to help us sleep due to other conditions.

But that's all I've ever heard of prescription wise. I know some folks try various stuff like...what was that juice someone was drinking because Dr. Oz said to do it? Anyway, there's lots of OTC things to do to help with sleep. The side effects of some of these newer sleep meds just are not worth it. I just looked up the 'benzo' you mentioned and, when used for insomnia, is not recommended for more than a few weeks. And that it is highly addictive.

And it may be you've not stopped taking the pills long enough. It can take a while. And it will be awful, more than likely.

Many of us do just fine using a CPAP. Many take a while to get used to it. Many get used to it right away. Many love their machines and cannot imagine life without it. Others wish they could get rid of it. That's the way the CPAP ball bounces.

As to the sleep test, it might be easier to request an oximeter to determine/prove if a sleep test is warranted. Are you seeing a sleep doc (pulmowhatsits) or some other doc?

UncaBill - I have a chronic condition. I have been seen (and misdiagnosed, or re-diagnosed, or combinations thereof) by so many docs, it is unreal. Alleged specialists who cannot deal with a patient who does not fit their box. Pain docs, orthopedists, neurologists, rheumatologists - and that's just within the past year. So I can see how someone who was misdiagnosed for 10 yrs would have a long list of docs they have seen and another of those docs that did not do the right thing. Add to it the addiction to the medication? He is being judged before the doc even sees him.

That is going on the theory that this person is being truthful and I would rather believe it is true until proven otherwise.

[Fosco]

I find myself astonished................................no pills?

I am not seeing a sleep specialist doctor now but a GP who seems to have my best interests in mind. It has been long assumed that I was not seeing a specialist because all that could be done for me had already been done. And that I'd have to continue the benzos until I was ready to give up a substantial period of time to detox - like up to a year - with no assurance that life without them would be substantially better (I would just have to be happy not sleeping well).

[Sleepster]

Sedatives make obstructive sleep apnea worse. But I still take them occasionally. I have Lunesta, which I might take once or twice a month. I have about ten pills left, and when they're gone they're gone. No refill available. I also get a rebound effect. That is, if I take a Lunesta tonight to help me sleep, I'll have trouble sleeping tomorrow night. So, I don't take them unless I absolutely have to.

I also have 0.5 mg Clonopin. I was given those for anxiety and tension headaches. Now that I'm on CPAP therapy I really don't have anxiety anymore. I'll take one of them every once in a while as needed.

I'll take benadryl on occasion as a sleep aid.

I take 25 mg of amitriptylene every night. This is for tension headaches, but it also helps me sleep.

I think now, more than ever before, that my headaches were orginally caused by obstructive sleep apnea and its side effects. I don't know that for sure as I've been on CPAP therapy for only just over 5 months now. Time will tell.

[PaulaO2]

The CPAP use should help you to sleep better. Goodness knows *I* certainly sleep better!

I have bad insomnia and considered medication but opted to use behavioral therapy instead. I learned a lot about sleep hygiene, internal clocks, and the like! I have to regularly reset myself or the insomnia gets worse and worse.

[49er]

I am very curious about the use of sleep aids in conjunction with CPAP. My apnea went undiagnosed for 10 years before my first CPAP. I was given ever-increasing amounts, combinations, and rotating doses of prescription medication in an effort to "cure" my problem. The list of drugs is lengthy. After getting a CPAP 4 years ago, my dosages decreased but I still need them because I am addicted, the CPAP is not set correctly, and I didn't know I needed followup professional care. (Yes, I was still prescribed massive quantities of benzodiazapines by a physician but he never asked about the CPAP!) I am now trying to wean myself off of the benzos after so many years and it is difficult. I am also trying to find good holistic professional care.

I would like to know about the use of sleep aids by other members:
Prescription meds and high or low dosages?
Non-prescription, OTC meds?
Importance of bed-time rituals, diets, caffeine intake, etc.?

...and most importantly (for me):
Is anyone able to completely stop taking prescription meds after getting their CPAP dialed in???

I am using trial/error to raise my CPAP pressure to the correct level and want to know if I am stuck taking sleep aids forever. Success stories would be helpful. Thanks!

Hi Fosco,

I was able to slowly taper off of 4 psych meds which included two sleep meds but no benzos. I am still having sleep issues but I think that has more to do with my apnea issues and trying to adjust to the apap machine.

What you might want to do is do a google search of Benzo withdrawal boards. I am not sure which one is the best, since I never used Benzos.

Also, you might want to go to surviving antidepressants withdrawal board and look for a poster named Rhi, who is very knowledgeable and has had experience tapering off of benzos. Since this is my first post, I am not allowed to provide a direct link.

For those of you who say I am advising Fosco to practice self medicine, unfortunately, trying to find a doctor who is knowledgeable about psych med tapering is like trying to find a needle in a haystack. Many of them taper their patients way too fast and as a result, people find their way to withdrawal boards who are alot more helpful than many doctors sadly.

Feel free to pm me further for support.

49er

[JumpStart]

Good morning, Fosco. I know you have been working with a GP on your meds, and they may all work well together. However, even if your pharmacy handles ALL prescription medications, it is useful to sometimes check elsewhere to see if there are conflicts, or if some foods are contraindicated. You can google for "drug conflicts" and find a host of sites which let you list your medications and then give a report. One I have used is here (I think I can post a non-commercial site here - if I am wrong, and it is removed, just google, as I said.) And this is not to say you don't need to reduce medications - just a quick check on any conflict issues while doing so.

[SuperSleeper]

On the issue of mood-altering drugs, I read in several places that up to 1/3 of all American adults have recently taken or are currently taking mood-altering drugs.

I have relatives who currently take mood-altering drugs, and from what I've seen, they are no longer "themselves" after taking these substances. In many cases, they seem way overly "happy" and giggle or laugh for no reason at all (at inappropriate times as well) and often are incapable of carrying on a logical conversation (they often make bizarre statements or veer off on strange tangents during a conversation). Yeah, I suppose it helps them feel less depressed, sad or anxious, but these drugs make them act like whacked-out lunatics incapable of carrying on a rational conversation without seeming "strange" to the person they're talking to.

Interesting article I found just from a Google search... I'm quoting the first part of the article, because the last part is attempting to sell health program, but I think the info in the first part is interesting at least:

The Drugging of America:
Debunking the myths and propaganda about
anti-depressant and anti-anxiety medications

As if there are not enough pressures inherent to living in the 21st century, there is an alarming political and economic crisis going on in this country that very few people have acknowledged. It has to do with drugs. And I’m not talking about the selling of drugs in our nation’s streets. I’m referring to the selling of drugs in doctors’ offices nationwide.

Americans are needlessly being debilitated by medications prescribed by their doctors. Rather than treating the cause, well-meaning physicians are treating the symptoms of stress with hundreds of millions of prescriptions for anti-depressants and tranquilizers worth billions of dollars. The current stress management drug "cocktail" appears to be a mixture of antidepressant and anti-anxiety medications, such as Prozac, Zoloft or Paxil with Xanax, Klonopin or Ativan. These drugs are not a panacea. They are both psychologically and physically addicting and can produce serious side effects, some which include withdrawal, rebound anxiety, insomnia, and mental and physical dysfunction (the same symptoms they are supposed to provide relief from). In addition to those just mentioned, the list of possible side effects for these drugs is extensive. The 2000 Physician’s Desk Reference lists symptoms ranging from headaches, nervousness, sweating, dizziness, nausea, diarrhea, vomiting, rash and itching to chest pains, bleeding, fainting, disorientation, confusion, muscle spasms, tremors, seizures, numbness, hair loss, memory loss, impotence and weight gain.

Did you know that:

* According to a recent survey half of psychiatrists admitted to prescribing an anti-depressant after seeing a patient for less than three minutes.
* Psychiatrists admit that antidepressants are over prescribed for people who don’t need them.
* 80% of Prozac prescriptions are written by general physicians who lack psychiatric training.
* Anti-depressant prescriptions account for $11 billion in annual revenues to pharmaceutical companies.
* Antidepressant and anti-anxiety medications rank 5th and 10th respectively, of all drugs prescribed in the US.


Pharmaceutical companies:

* Underwrite 30% of the American Psychiatric Association budget;
* Spend approximately $10,000 per physician per year on "education" — in fact, the majority of physicians learn information about drugs from drug salespeople and drug advertisements;
* Provide financial and other incentives to physicians for prescribing their drugs in the form of free gifts, trips, meals and entertainment;
* Influence the uneducated public to ask for drugs with sophisticated TV and print advertisements that glorify the effects of prescription drugs;
* Are quietly acquiring managed care companies as well as companies that administer the prescription-drug component of health insurance plans;
* Pay private clinics, organizations and universities that conduct drug trials for them


The economic consequences behind the increasing trend to prescribe this type of medication are hard to miss. With billions of dollars at stake, what kind of tactics will these companies employ to protect their financial interests?

Especially when one considers that pharmaceutical companies underwrite 30% of the American Psychiatric Association budget and spend multi-millions of dollars on sophisticated advertising and public relations campaigns to promote these drugs. Another alarming fact is that pharmaceutical companies are quietly acquiring managed care companies as well as companies that administer the prescription-drug component of health insurance plans. This translates into more pressure for drug therapy. And what about conflict of interest?

Even more troubling is the fact that many of these drugs are being prescribed by general physicians who are not trained in understanding relevant symptoms or providing critical support services that should accompany drug treatment. Often, the only knowledge physicians have about these drugs comes form reading marketing literature provided by the drug companies themselves.

Even when tranquilizers, antidepressants and other mood-altering drugs are prescribed by trained psychiatrists, it is often done without considering options to drug therapy. For the most part, psychiatrists then simply monitor the patient by requiring 15-minute office visits every few months. The bottom line is that most doctors don’t stop to consider whether there are other effective, non-invasive lifestyle, and psychotherapeutic strategies that might be employed. They simply don’t know any better than what the pharmaceutical companies tell them. So the treatment of choice is to tell the patient to pop a pill. And not just one pill or one kind of pill.

The FDA and Drug Approvals

Now consider how the Food and Drug Administration (FDA) approve these drugs. The drug companies themselves are responsible for conducting drug trials and reporting the results to the FDA. Drugs like Prozac, Xanax and others, although prescribed to millions of people on a long-term basis, are approved by the FDA based on test results with as few as 100 subjects taking the drug for as little as four weeks. Internationally known psychiatrist and author Peter Breggin has long been an outspoken critic of this process. In his books Toxic Psychiatry and Talking Back to Prozac he describes in detail the serious flaws in these studies and in the drug approval process itself.

Breggin reports that Xanax, originally purported to be a safe, nonaddicting, antianxiety drug, was tested on 226 subjects for a period of eight weeks. In reading the actual research report he found that the drug company counted only the first four weeks of the study. The drug company discarded results from subsequent weeks, which showed that in a comparison between subjects receiving the drug and those receiving a placebo (sugar pill), the drug subjects experienced "severe withdrawal and rebound reactions, including an increase in anxiety and in phobic responses, plus a 350 percent greater number of panic attacks." Xanax has since been proven to be highly addicting and associated with death when combined with alcohol or other sedatives."

"Chemical Imbalances" are Unfounded

Would it shock you to know that the case for psychiatric drugs has never been proven? In fact, there is no real proof that chemical imbalances exist in the brain or that they cause "mental illness." Current theories about serotonin levels and their effects on mood are based on inference only. As we practitioners know, there are no medical tests to measure these supposed chemical imbalances. In his book, Broken Brains or Wounded Hearts, Dr. Ty Colbert extensively examines the evidence supporting the medical model of mental illness and concludes:

"... the truth is that researchers have never discovered a single defective gene or accurately identified any chemical imbalance that has caused an emotional disorder; nor have they ever proven that brain abnormalities are responsible for even one emotional disorder. In fact, the National Institute of Mental Health openly admits that the causes of schizophrenia, depression, mania, anxiety and hyperactivity are unknown."

Warning: Withdrawing suddenly from psychiatric medications can cause serious emotional and physical side effects and should be undertaken with medical supervision.

Treating the Symptoms Not the Cause

Prescription drugs as a treatment for stress, anxiety and mild to moderate depression are only a "Band-Aid" approach. Although drugs may provide short-term relief, it reduces people’s motivation to understand and overcome their underlying problem. In some cases, people are being prescribed medication when they are going through normal stresses of life — as if it were abnormal to feel grief when we lose a loved one or a job, or to feel anxious when we make life changes like getting a divorce or raising children. For some people, taking a pill translates into a personal belief that there is something elementally wrong with them, or that they are incapable of solving their own problems. It encourages people to numb out their bad feelings, just as they would with over-eating, smoking, alcohol, and street drugs. At its worst, taking pills teaches people that they are helpless to cope with their feelings without the help of mood altering drugs.

Not everyone wants to or needs to take a pill to manage stress, nor is it in their best interest to do so. The current "instant fix" being prescribed by physicians is leaving people feeling powerless over their own bodies and hopeless about their ability to control their lives.