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Dr. Bob is Robert Hsiung, MD,
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Posted by deniseuk190466 on October 14, 2007, at 4:15:27
In reply to Re: CPAP, SSRI's and benzos.... » LostBoyinNCBecksDark, posted by cactus on October 11, 2007, at 17:48:34
I thought sleep apnoea just affected large people so I've always counted myself out from that particular condition as I'm slim.
Can slim people have sleep apnoea?
Denise
Posted by Ashley B on October 15, 2007, at 8:52:13
In reply to Sleep apnoea - what type of people does it affect?, posted by deniseuk190466 on October 14, 2007, at 4:15:27
Yes, slim people can have sleep apnea.
I've thought about getting tested myself, but it's very expensive. I used to stop breathing in my sleep, mentally awaken but be unable to physically move, and stay that way for a few seconds. It was frightening.
Posted by Mathia on October 15, 2007, at 9:35:27
In reply to You people are suckers, posted by LostBoyinNCBecksDark on October 11, 2007, at 2:22:01
YO,
Well if you are on an ssri, your post definitely shows me its not helping. I dont think the sleep apnea thing is working either. Not saying its not helping you sleep and thats great. Just an observance from reading your post, you seem like your fed up and disgusted at this point after trying everything to be happy. And dont get me wrong I have my own thoughts on the whole psycology world and all the ssri's but just seems like your frustrated. Ive been there, dont give up and good luck.
Posted by FredPotter on October 15, 2007, at 19:45:53
In reply to You people are suckers, posted by LostBoyinNCBecksDark on October 11, 2007, at 2:22:01
I agree with much of what you say Eric. I've suspected I have obstructive sleep apnoea for a while. My little boy likes to share my bed when he comes to stay and he told me I snore, flail my limbs and stop breathing, then start with a snort. Who needs a sleep laboratory when I've got him? My Dr has finally agreed to commit me for a sleep test. I would have thought given my son's observations they could give me a CPAP thingy now. I have a plastic tongue cap but it cuts into the connective tissue and I'd wake up with it having fallen off
Fred
Posted by Mathia on October 15, 2007, at 20:27:03
In reply to Re: You people are suckers » LostBoyinNCBecksDark, posted by FredPotter on October 15, 2007, at 19:45:53
The sleep apnea thing can be a problem. You should check into it. I think its mainly a problem with your heart possibly stopping. I had sleep apnea, had a (I forget whats its called now) nose, disectimy, etc. Bottom line, helped my sleeping, not my depression. Still was depressed after.
Goodluck
Matt
Posted by cactus on October 16, 2007, at 1:54:34
In reply to Re: Sleep apnoea - what type of people does it affect?, posted by Ashley B on October 15, 2007, at 8:52:13
Yes larger people are more prone to it but I'm quite slender and one of my co workers is a stick insect and he has it too. It has improved my sleep but my bouts of depression still come back. It is not a cure for depression but it does help take the edge off.
Posted by karendee on October 16, 2007, at 21:00:28
In reply to Re: What my sleep doctor said, posted by LostBoyinNCBecksDark on October 11, 2007, at 18:49:37
well, it seems like you still have a pretty major personality disorder
Posted by cactus on October 17, 2007, at 2:29:32
In reply to Re: What my sleep doctor said, posted by karendee on October 16, 2007, at 21:00:28
> well, it seems like you still have a pretty major personality disorder
What makes you say that?
Posted by cactus on October 17, 2007, at 5:02:43
In reply to Re: What my sleep doctor said, posted by karendee on October 16, 2007, at 21:00:28
Posted by Dr. Bob on October 17, 2007, at 20:07:03
In reply to Re: What my sleep doctor said, posted by karendee on October 16, 2007, at 21:00:28
> well, it seems like you still have a pretty major personality disorder
Please don't post anything that could lead others to feel accused or put down.
But please don't take this personally, either, this doesn't mean I don't like you or think you're a bad person.
If you or others have questions about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please first see the FAQ:
http://www.dr-bob.org/babble/faq.html#civil
http://www.dr-bob.org/babble/faq.html#enforceFollow-ups regarding these issues should be redirected to Psycho-Babble Administration. They, as well as replies to the above post, should of course themselves be civil.
Thanks,
Bob
Posted by Dinah on October 18, 2007, at 10:14:52
In reply to Re: Sleep apnoea - what type of people does it aff, posted by cactus on October 16, 2007, at 1:54:34
It might not cure depression, but it helps a lot with nighttime anxiety. I used to wake up all the time with panic attacks and OCD thoughts. That stopped after I started using my CPAP.
I'm assuming that I would wake up, heart pounding, and then my brain would search for a reason and find one.
I'm heavy now, but I wasn't when the nightime anxiety started. Plus my sleep study showed central apnea as well as obstructive apnea. So I'm guessing I had it when I was thinner.
Posted by elanor roosevelt on October 18, 2007, at 22:15:34
In reply to Re: What my sleep doctor said, posted by karendee on October 16, 2007, at 21:00:28
thank you karendee
Posted by LostBoyinNCBecksDark on October 19, 2007, at 12:55:55
In reply to Sleep apnoea - what type of people does it affect?, posted by deniseuk190466 on October 14, 2007, at 4:15:27
> I thought sleep apnoea just affected large people so I've always counted myself out from that particular condition as I'm slim.
>
> Can slim people have sleep apnoea?
>
> DeniseDenise, sleep apnea is extremely common and awareness of it until recent years has been poor. It occurs in men, oftentimes men who are overweight and have thick necks...17" in circumference. But it occurs in women as well. One group of women who need to especially watch out for sleep apnea are those who have hypothyroidism. There has been some association between having hypothyroidism and sleep apnea. There is also some speculation that women are being underdiagnosed because women are self conscious about snoring and less likely to admit to their doctor they snore.
If you have depression/anxiety problems that seem to be chronic, a sleep study is probably in order no matter who you are. It can certainly make a lot more sense than the medication merry go round for years and years and years as so many do without success. A lot of primary care doctors are uneducated about sleep apnea and wont bother referring you to a sleep medicine specialist unless you take matters into your own hands.
There are two main groups of specialists who gravitate towards sleep medicine. The first are Neurologists...they tend to be focused more on restless legs syndrome, narcolepsy, central sleep apnea and other nervous system based sleep disorders. The second type of specialist in sleep medicine are pulmonary doctors and these are the guys who have pioneered treatment for obstructive sleep apnea...anytime you arent getting proper oxygenation a pulmonary doctor is going to be interested. Personally, I prefer pulmonary based sleep medicine doctors, at least to start off with.
Eric
Posted by LostBoyinNCBecksDark on October 19, 2007, at 12:59:36
In reply to Sleep apnoea - what type of people does it affect?, posted by deniseuk190466 on October 14, 2007, at 4:15:27
A lot of women dont believe they have sleep apnea, but there has been an association between hypothyroidism and sleep apnea. If you have hypothyroidism with depression or hypothyroid with unresolved symptoms despite your thyroid scores being technically "OK," you might want to consider getting screened for apnea
Posted by LostBoyinNCBecksDark on October 19, 2007, at 13:09:56
In reply to Re: You people are suckers, posted by Mathia on October 15, 2007, at 9:35:27
> YO,
> Well if you are on an ssri, your post definitely shows me its not helping. I dont think the sleep apnea thing is working either. Not saying its not helping you sleep and thats great. Just an observance from reading your post, you seem like your fed up and disgusted at this point after trying everything to be happy. And dont get me wrong I have my own thoughts on the whole psycology world and all the ssri's but just seems like your frustrated. Ive been there, dont give up and good luck.Oh yeah? Well not long after I started CPAP, suicidal thoughts stopped occurring. My irritability decreased dramatically as well. I stopped feeling agited like I used to. And it has been consistent as well...none of this "poop out" stuff that you get with psychopharmacology.
Also, I was mildly drunk when I posted that stuff and to be honest, I get crazy when I drink.
Eric...no longer clinically depressed
Posted by LostBoyinNCBecksDark on October 19, 2007, at 13:24:18
In reply to Re: You people are suckers, posted by Mathia on October 15, 2007, at 20:27:03
> The sleep apnea thing can be a problem. You should check into it. I think its mainly a problem with your heart possibly stopping. I had sleep apnea, had a (I forget whats its called now) nose, disectimy, etc. Bottom line, helped my sleeping, not my depression. Still was depressed after.
> Goodluck
> MattHey man...
Sleep apnea has a whole lot more to do with your heart stopping. I will copy and paste from the WebMD website some of the problems associated with sleep apnea:
"What Are the Effects of Sleep Apnea?
If left untreated, sleep apnea can result in a growing number of health problems including:
* Hypertension
* Stroke
* Heart failure, irregular heart beats and heart attacksIn addition, untreated sleep apnea may be responsible for poor performance in everyday activities, such as at work and school, motor vehicle crashes as well as academic underachievement in children and adolescents."
Sleep apnea is also associated with metabolic syndrome and treating apnea can help type II diabetes:
http://diabetes.webmd.com/news/20050301/sleep-apnea-treatment-may-improve-diabetes
AND sleep apnea treatment oftentimes helps depression...sometimes dramatically:
http://www.webmd.com/depression/news/20050912/treatment-for-sleep-apnea-may-ease-depression
"At a Florida sleep center, 50 patients were recently asked to use CPAP for four to six weeks. The patients' depression symptoms improved during that time, according to a study in Chest.
The researchers' recommendations:
* Screen people with depression symptoms for obstructive sleep apnea.
* Screen people with obstructive sleep apnea for depression."
Posted by LostBoyinNCBecksDark on October 19, 2007, at 13:32:36
In reply to Re: Sleep apnoea - what type of people does it aff, posted by cactus on October 16, 2007, at 1:54:34
> It is not a cure for depression but it does help take the edge off.
Eh...I would disagree with this statement. While sleep apnea does not cure all depression cases, it does fix a good percentage of them. I know it has helped my depression dramatically. And totally gotten rid of feelings of agitation and severe irritability I had.
There is A LOT of literature out there that suggests a strong association between depression and sleep apnea. I am not saying that every case of depression, sleep apnea is the cause or exacerbating factor...far from it. I am saying it is a cause or exacerbating factor in a certain percentage of depression/anxiety cases.
In cases of treatment resistance, it certainly makes sense to screen for sleep disorders like obstructive sleep apnea. And to TREAT it aggressively. I just dont understand why many psychiatrists will put their patients through endless medication trials, when its obvious that something else is wrong.
Look at it this way. If you have treatment resistant depression and you are disabled from it, do you think you will ever recover as long as your sleep architecture remains severely disturbed as is the case in sleep apnea? If you never get any slow wave "deep stage sleep" do you really believe antidepressants are going to significantly help? If you are regularly getting oxygen desaturations during your sleep...straining your brain, heart and blood vessels...do you really believe medications are going to help "treatment resistant depression?"
Eric
Posted by LostBoyinNCBecksDark on October 19, 2007, at 13:39:20
In reply to You people are suckers, posted by LostBoyinNCBecksDark on October 11, 2007, at 2:22:01
Most psychiatry medications severely interfere with sleep architecture. Most antidepressants make it difficult if not impossible to get into slow wave sleep. Benzos like klonopin also play havoc with sleep architecture. Most psychiatry meds block CPAP from having its full and maximum effect...getting you down into those deep stages of sleep that allows you to recover and wake up feeling refreshed and undepressed.
The only psych meds I know about that dont destroy slow wave sleep are the atypical anti-psychotics. And a few antidepressants like Remeron, Serzone and trazodone.
Furthermore, sedating psychiatry meds like benzos causes your throat muscles to relax during sleep...potentially causing or exacerbating obstructive sleep apnea. Opiods are the worst meds for obstructive sleep apnea, as these drugs can really relax the airway.
Eric
Posted by LostBoyinNCBecksDark on October 19, 2007, at 13:41:05
In reply to Re: What my sleep doctor said, posted by karendee on October 16, 2007, at 21:00:28
> well, it seems like you still have a pretty major personality disorder
Drunk personality disorder?
Eric
Posted by LostBoyinNCBecksDark on October 19, 2007, at 13:46:51
In reply to Sleep apnoea - what type of people does it affect?, posted by deniseuk190466 on October 14, 2007, at 4:15:27
I just do not understand why so many psychiatrists put their patients through grueling, never ending drug trials when its obvious something else is wrong. A lot of psychiatrists worry about piss ants when elephants are stomping them to death.
Eric
Posted by Dr. Bob on October 20, 2007, at 0:31:00
In reply to Re: sleep architecture destroyed by psych meds, posted by LostBoyinNCBecksDark on October 19, 2007, at 13:39:20
> Benzos like klonopin ... play havoc with sleep architecture.
Please don't exaggerate.
But please don't take this personally, either, this doesn't mean I don't like you or think you're a bad person.
If you or others have questions about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please first see the FAQ:
http://www.dr-bob.org/babble/faq.html#civil
http://www.dr-bob.org/babble/faq.html#enforceFollow-ups regarding these issues should be redirected to Psycho-Babble Administration. They, as well as replies to the above post, should of course themselves be civil.
Thanks,
Bob
Posted by LostBoyinNCBecksDark on October 20, 2007, at 1:27:52
In reply to Re: benzos and slow wave sleep, posted by LostBoyinNCBecksDark on October 20, 2007, at 1:20:59
"J Clin Psychiatry. 2007;68 Suppl 5:13-8.
A physiologic basis for the evolution of pharmacotherapy for insomnia.
Roth T.
Sleep Disorders and Research Center, Henry Ford Hospital, Detroit, MI 48202, USA. troth1@hfhs.org
Insomnia is a highly prevalent disorder with consequences for the patient's physical and mental health, daily function, and job performance. Although the exact pathophysiology of insomnia is unknown, recent research has demonstrated that normal sleep and wakefulness are controlled by reciprocal inhibition by different brain regions. This sleep-wake control system offers multiple therapeutic targets for the treatment of insomnia; currently, most research and available hypnotic agents target gamma-aminobutyric acid (GABA) on the sleep side of the switch. Historically, drugs have evolved from benzodiazepine receptor agonists to nonbenzodiazepines to, most recently, selective extrasynaptic GABA(A) receptor agonists. However, these drugs have a differential impact on characteristics of sleep. Among the compounds that modulate the benzodiazepine-sensitive GABA(A) receptors, benzodiazepines suppress stage 3-4 sleep, whereas nonbenzodiazepines have no substantial effect on these stages of sleep. Recently, work on GABA agonists indicates that they increase stage 3-4 sleep. This has been demonstrated via sleep-stage scoring as well as with spectral analysis. Further, this increase in stage 3-4 sleep is associated with a decrease in stage 1 sleep and arousals from sleep. Thus, the GABA agonists may not simply promote sleep, but consolidate it as well. The clinical utility of the increase in slow-wave sleep and the sleep consolidation it produces warrants further investigation."
Posted by Sigismund on October 20, 2007, at 15:39:48
In reply to Re: traditional benzos suppress slow wave sleep, posted by LostBoyinNCBecksDark on October 20, 2007, at 1:27:52
>Recently, work on GABA agonists indicates that they increase stage 3-4 sleep. This has been demonstrated via sleep-stage scoring as well as with spectral analysis. Further, this increase in stage 3-4 sleep is associated with a decrease in stage 1 sleep and arousals from sleep. Thus, the GABA agonists may not simply promote sleep, but consolidate it as well.
Is this Ambien/zopiclone/zolpidem(?) they're talking about here?
Posted by Dr. Bob on October 20, 2007, at 20:47:26
In reply to Re: please be civil » LostBoyinNCBecksDark, posted by Dr. Bob on October 20, 2007, at 0:31:00
> Follow-ups regarding these issues should be redirected to Psycho-Babble Administration.
Here's a link:
http://www.dr-bob.org/babble/admin/20070817/msgs/790397.html
Thanks,
Bob
Posted by Jeroen on October 24, 2007, at 15:02:14
In reply to Re: med merry go round doesnt work, posted by LostBoyinNCBecksDark on October 19, 2007, at 13:46:51
hi, your post made me laugh my ... off
you're right Eric, don't worry
good luck in finding a EMH startrek alike doctor programmed with over 2 billion medical cures programmed inside his matrix...he scans you with a scanner to see whats wrong in your head,
too bad this doesn't exist yet, i think LOT of people would be happy
This is the end of the thread.
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