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+--- Thread: Still struggling..but I'm here (/Thread-Still-struggling-but-I-m-here)
RE: Still struggling..but I'm here - mollete - 07-17-2015
(07-16-2015, 10:01 PM)PositiveMe123 Wrote: It would have been the right thing to do to give SuperSleeper, the Administrator of this forum, the last word.
But I am simply trying to follow SuperSleeper's advice on giving advice:
(07-16-2015, 12:01 PM)SuperSleeper Wrote: Giving out "advice" is not 'against the rules' on Apnea Board.
If you will review the OP's other posts, you will find:
(07-11-2015, 05:13 PM)mzdawn74 Wrote: I do have some ambien right now. It is from when I was hospitalized in April for suicide ideation.
And my "advice" is that this person does not need random "advice" of starting/stopping Schedule IV drugs in hopes that things will miraculously get better.
My further "advice" is that a close examination of the NPSG in order. Since Sleep Efficiency has dropped from 85.0% to 37.7% on CPAP, one wonders if the appropriate "advice" is to stop CPAP instead of pharmaceuticals (Is positional therapy an option? Dental appliance? Certainly aggressive weight loss program. Did the poor sleep quality contribute to false readings (including the nadir O2 sat)? With "low snoring" are ANY of the events obstructive? Do we need to go crazy with AHI 10.5 (mild sleep apnea (AHI 5-14) is treated if there is EDS, and my "advice" is that if CPAP is dropping SE from 85.0 to 37.7, ya kinda better start rethinking what the goal here is)?
RE: Still struggling..but I'm here - 49er - 07-17-2015
Quote:I still can't sleep for more than a few hours at night, even after trying melatonin, ambien, and last night ativan. I have an appointment scheduled with my former psychiatrist on the 27th, but that's almost 2 weeks away. Hopefully he can prescribe something to help with this anxiety and insomnia.
Mollette,
These meds did not appear to working for Dawn and that is why I advised her to stop them and wait to meet with her psychiatrist. I inferred she was taking them on a PRN basis which would make them easier to stop. But of course, one can't assume anything and if I had to rewrite this post, I would have advised her to make sure that if she has taken anything on a long term basis to consult with a physician about tapering slowly if her desire was to stop the meds until she saw the psychiatrist.
I hope instead of focusing on this, that we can discuss the rest of the points you have made which are definitely worth considering. To be honest, I wondered if it was worth considering a dental device but for various reasons which are too long to get into, I held back with that advice. So I am glad you mentioned it as a possible solution.
Anyway, I hope we can use this thread to focus on how best to help Dawn as it is about her.
RE: Still struggling..but I'm here - mzdawn74 - 07-17-2015
(07-17-2015, 04:50 AM)mollete Wrote:(07-16-2015, 10:01 PM)PositiveMe123 Wrote: It would have been the right thing to do to give SuperSleeper, the Administrator of this forum, the last word.
But I am simply trying to follow SuperSleeper's advice on giving advice:
(07-16-2015, 12:01 PM)SuperSleeper Wrote: Giving out "advice" is not 'against the rules' on Apnea Board.
If you will review the OP's other posts, you will find:
(07-11-2015, 05:13 PM)mzdawn74 Wrote: I do have some ambien right now. It is from when I was hospitalized in April for suicide ideation.
And my "advice" is that this person does not need random "advice" of starting/stopping Schedule IV drugs in hopes that things will miraculously get better.
My further "advice" is that a close examination of the NPSG in order. Since Sleep Efficiency has dropped from 85.0% to 37.7% on CPAP, one wonders if the appropriate "advice" is to stop CPAP instead of pharmaceuticals (Is positional therapy an option? Dental appliance? Certainly aggressive weight loss program. Did the poor sleep quality contribute to false readings (including the nadir O2 sat)? With "low snoring" are ANY of the events obstructive? Do we need to go crazy with AHI 10.5 (mild sleep apnea (AHI 5-14) is treated if there is EDS, and my "advice" is that if CPAP is dropping SE from 85.0 to 37.7, ya kinda better start rethinking what the goal here is)?
So what you are saying is that the cpap is making my sleep quality worse? I disagree, I have been struggling with insomnia now off and on since this began four years ago. Plain and simple with or without cpap, my sleep sucks!
Are you also saying that my sleep apnea doesn't meet the needs for cpap since it's considered mild? My doctor told me sleep apnea is sleep apnea. I'm stopping to breath more than normal, with oxygen destats, and it's causing body/brain damage on a nightly basis. Is he wrong?
Let me say this all you are really doing is increasing my anxiety about this whole situation, and I really don't appreciate it.
I don't know what your angle is here, if you are trying to help me, or play devils advocate? By the way what do all of the abbreviations you used mean? I'm still learning all of this stuff with a severely under functioning brain, so any explanation in laymen terms would be highly appreciated.
I thought the point of this forum is to help people to continue using cpap, not discourage them.
RE: Still struggling..but I'm here - 49er - 07-17-2015
Dawn, my apologies as I think what I just wrote has contributed to your anxiety. Please disregard what I just said.
Again, my profuse apologies.
49er
RE: Still struggling..but I'm here - mzdawn74 - 07-17-2015
(07-17-2015, 06:14 AM)49er Wrote: Dawn, my apologies as I think what I just wrote has contributed to your anxiety. Please disregard what I just said.
Again, my profuse apologies.
49er
What are you apologizing for? The fact you were agreeable that cpap might not be needed in my case? How were you and mollete able to come to this conclusion? Is it because I'm having difficulty sleeping? This problem existed before cpap was even brought into the picture. As I stated I've had issue with poor sleep for almost 4 years now.
My sleep efficiency dropped that night because I was in a strange bed, with a mask blowing air up my nose, and was very anxious. I mean correct me if I'm wrong, others have experienced the same thing at their titration study.
This all really concerns me that this whole time I've been coming here opening up my heart and sharing my isdues, for everyone to say to me keep up with the cpap you will see results, to now reading that this therapy might not be my solution.
I'm really exhausted by all of this...
RE: Still struggling..but I'm here - mollete - 07-17-2015
(07-17-2015, 06:10 AM)mzdawn74 Wrote: So what you are saying is that the cpap is making my sleep quality worse? I disagree, I have been struggling with insomnia now off and on since this began four years ago. Plain and simple with or without cpap, my sleep sucks!
But I did not say that. Your sleep studies said that.
(07-17-2015, 06:10 AM)mzdawn74 Wrote: help
OK.
Your psychiatrist is probably going to give you another jarful of drugs. Most of them are renown for making sleep worse. Consequently, I would recommend that you simultaneously see a Board-Certified Sleep Specialist with a sub in CBT-I. IMHO a massive dose of cognitive behavioral therapy (and it's like an 8-pronged approach) will prove invaluable, and he/she would also be able to tell if if the drug cocktail you get from the psychiatrist will help or harm sleep quality.
RE: Still struggling..but I'm here - 49er - 07-17-2015
Dawn,
I just sent you a PM as I felt it was easier to discuss the issues.
RE: Still struggling..but I'm here - mzdawn74 - 07-17-2015
Yes, my sleep efficiency was lower on the night with cpap. But that was due to being in a strange bed, wires everywhere, a mask blowing air up my nose, being anxious, and my normal sleep issues.
The psychiatrist can prescribe all of the jar fulls of medication he wants, but it is ultimately up to me if I take them. I have been down that road before and know very well the side effects of most of the medications used. I just am trying to cover all possible options.
My neurologist is a Board Certified Sleep Specialist, and he seems to think my insomnia is coming from the sleep apnea, which is in turn causing the anxiety and depression. What a lovely cycle! He does not want me taking anything for sleep, at least as far as our last app in June. But, I believe if I go to him and explain just how bad this is getting he might see things differently.
RE: Still struggling..but I'm here - mollete - 07-17-2015
(07-17-2015, 06:10 AM)mzdawn74 Wrote: I thought the point of this forum is to help people to continue using cpap, not discourage them.
Sure, but CPAP is not the cure-all, results vary (based to large extent on the severity of sleep apnea) and there are plenty of people who argue that mild OSA not be treated. 49er will retrieve the pro-con debate articles.
Further, there are viable alternatives. If, for instance, all your breathing events were on your back, and none on your side, then positional therapy would be an excellent option. Dental devices are also a good choice for mild-moderate sleep apnea.
There are 2 generally bad things that happen with OSA-- catastrophic cardiovascular events and issues related to EDS (OK, "sleepy"). If you examine the data, catastrophic CV events occur if AHI > 30 (see Yaggi and others). And if you're telling me your sleep WAS bad, and this therapy is objectively cutting that number in half, then you need a better plan than just hang in there.
So I'd approach this from 3 directions:
Make sure that any anti-depressives are "sleep-friendly";
Get a massive dose of CBT-I; and
Optimize the OSA treatment (but based on the current information, I do not know what that is).
RE: Still struggling..but I'm here - mzdawn74 - 07-17-2015
(07-17-2015, 06:52 AM)mollete Wrote:(07-17-2015, 06:10 AM)mzdawn74 Wrote: I thought the point of this forum is to help people to continue using cpap, not discourage them.
Sure, but CPAP is not the cure-all, results vary (based to large extent on the severity of sleep apnea) and there are plenty of people who argue that mild OSA not be treated. 49er will retrieve the pro-con debate articles.
Further, there are viable alternatives. If, for instance, all your breathing events were on your back, and none on your side, then positional therapy would be an excellent option. Dental devices are also a good choice for mild-moderate sleep apnea.
There are 2 generally bad things that happen with OSA-- catastrophic cardiovascular events and issues related to EDS (OK, "sleepy"). If you examine the data, catastrophic CV events occur if AHI > 30 (see Yaggi and others). And if you're telling me your sleep WAS bad, and this therapy is objectively cutting that number in half, then you need a better plan than just hang in there.
So I'd approach this from 3 directions:
Make sure that any anti-depressives are "sleep-friendly";
Get a massive dose of CBT-I; and
Optimize the OSA treatment (but based on the current information, I do not know what that is).
I never said that my sleep was cut in half, so I'm not sure where you got that information from. I still get the same 4 hours of interrupted sleep. Yes. I did have a night or two with issues like stuffy nose and chipmunk cheeks, but I've dealt with those issues.
If mild apnea shouldn't be treated, why was I given a cpap machine? Why does my doctor believe that a majority of my issues are coming from sleep apnea?
I know you can't answer for my doctor, but it just doesn't make sense to me. I have read of many people who suffer from mild apnea, and have benefitted from therapy.
I just want a solution/relief of my symptoms..that's all nothing more nothing less. From what your telling me it's pointless to use this machine. I don't know anymore...thanks.