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SleepyChick's Blog

The Battle Wages Onwards

This sleep disorder thing is tough. I grew up with a mental illness. I pretty much have that little bit under control. Actually, it's been under control for a long time, and I've had very few problems with it. That wasn't the case for my adolescence, but compared to the mental illness, this sleep disorder thing is tough.

I think a lot of it probably has to do with the fact that when I was diagnosed with the mental illness, I was young, adaptable, and the drugs were so archaic and barbaric I don't remember the hell I went through. Honestly, I don't remember a whole lot of that period.

I do remember sleeping a lot. But not really having too much trouble with it. I snored. I have always been a snorer (I wear CPAP now, and I am overweight, but my doctors suspect I would have had apnea even if I had kept the weight off).

Sleeping back then was an escape... It was truly a depression sort of sleep. Now, sleeping is just... A sentence. It's something I have to do whether I want to or not.

And most of the time, I don't want to. There's a whole life out there waiting to be lived, and I'm stuck in bed!

That's why it ticks me off to no end when the doctors suggest I'm depressed. They've stopped doing it recently, but up until about six months ago it was their first line... "Well, you're depressed..."

Noooo. No. Believe me, I know depression. I've been depressed. This is not it. I lay in bed now, trying to fight to get up, to keep my eyes open, to be able to go out in the yard and weed... to be able to walk the dogs.... to be able to paint... write... sing. And I can't get my head off the pillow. And it's like, there is so much I want to do!

When I was depressed, that wasn't the case.

And I don't feel at all hopeless. Frustrated beyond belief, but not hopeless.

Sometimes I think it would be easier if I were depressed. Not that I'd wish that on anyone. But somehow... I guess being on this side of the mental illness, I know it's treatable. This sleep stuff... I'm not so sure about.
Published Monday, June 04, 2007 7:14 AM by sleepychick
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Comments

 

Sleep Doc said:

wow. This is an indictment (though perhaps well-deserved) of us sleep docs. It breaks my heart for your to write, "...mental illness, I know it's treatable. This sleep stuff... I'm not so sure about." And you may be right. Sometimes, I think we have oversold what we can do.
However, I'd like to offer my perspective. My experience with patients who have some of the complaints that you have is that their medication side effects are causing or contributing to sleep symptoms. Nearly every medication used to treat mood disorders has a profound effect on sleep structure and on daytime alertness. Not only that, but "periodic limb movement disorder" (which you report that you have) is a side effect of nearly every antidepressant. As a Sleep Doc, I think that medications come in only 2 categories: those that cause insomnia, and those that cause daytime sleepiness. My bet is that you are taking some of both!

June 26, 2007 3:20 PM
 

sleepychick said:

Hi sleepdoc,

Thanks so much for your input. I do know about the PLMD/antidepressant link, and my sleep doc (who is an AWESOME doc, I am so lucky) would love to have me switch to a less active sort of antidepressant, but unfortunately, this seems to be the one that really really works for me. Plus, I am on antipsychotics (the new atypicals... SO MUCH better than the old ones!)

I have been on the med combination I'm on for about five or six years. The sleepiness started (although I've always been a sleepy person) about three years ago.

The more I think, lately, the more I think the drugs have affected my brain, both positively and negatively. I was dx'd with my MI at 15, in 1988. That means I was prescribed things like stelazine, melaril, thorazine and (the really horrible) haldol. None of those drugs did much for me, but I was stuck taking them. When the newer atypicals came out, esp. Abilify, life really turned around.

Sleepiness was a battle with the drugs, but drug induced sleepiness, I can't quite explain... always FELT LIKE drug induced sleepiness.  This... this is an entirely different animal. This feels like it's a level deeper in the brain than the drugs, if that makes any sense. Although I understand completely that no one really truly gets how those drugs work, and they could have permanently altered my brain on a lower level. So what I am feeling may be drug related sleepiness, but does not correllate in any way to the dosages I am taking any more.

Maybe now it's a form of brain damage? I don't think we'll really ever know at this point.

My PLMD, according to my sleep doc, is quite mild. My RBD, which reared its ugly head much more emphatically when I was put on a prophalactic migraine med, seems to have calmed down again... But I also feel that is *probably* related to the drugs in the long term.

There's just a lot going on with me. I can't blame the doctors for being confused... And I do appreciate that my sleep doctor understands that A) I am not depressed currently and B) that I just can't go off these meds.  There is a lot there to figure out. I used to just get so fed up when doctors immediately said "You are depressed."  I am so relieved to have good doctors now. Even if they're not entirely sure what the issue is.



June 27, 2007 3:56 AM
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About sleepychick

I'm a 34 year old woman with multiple sleep disorders (sigh). Sleeping's been a lifelong sort of love hate thing for me. I had my first polysomnography in 2001, and I was told I was "fine." Turns out, from my history and the muscle tone that the PSG returned, I showed signs of REM Behavior Disorder. Fast forward three years, where my neurologist, on hearing my reports of ungodly fatigue (more like someone turned up the gravity) and daily headaches, declared I needed a sleep study. That time they found moderate obstructive apnea. Did my CPAP titration, wear it dutifully. But I was still so tired. I mean, tired like I was smote from on high. So two weeks ago, I had a re-titration. They discovered (this time) I needed my CPAP turned up and I have Periodic Limb Movement in Sleep Disorder. I also have an extremely abnormal sleep architecture. What I wouldn't give to sleep through the night!

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