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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by LostBoyinNC43 on March 6, 2013, at 11:18:49
It is absolutely unbelievable. I am a very compliant CPAP user, basically 100% compliant. I have been on CPAP now since Fall 2007 and it changed my life for the better, moved me from a chronic, "treatment resistant depressive" to where I was able to do things again. For the first time since late 1997 when I originally fell apart.
Anyway, my equipment support people, called my "DME," originally gave me a nasal mask. That is standard when first starting CPAP. I found out I was really severe "mouth leaker" and for the first week on CPAP, went thru all these adjustments, first they gave me a chinstrap to wear with the nasal mask to keep my mouth closed during sleep. That absolutely did not work. Then they gave me a "full face mask." Something called a Resmed Quattro full face mask. Its probably the best overall full face mask on the market in the USA.
The Quattro full face mask shut down my mouth leak cold the first night and I started having good quality sleep for the first time since late Fall/early winter 1997. Ive been on that Quattro mask since late summer 2007, without missing a beat. I tried going back to a nasal mask a few times in 2008, but it never worked Id always wake up with severe dry mouth, wake up with mouth leak and feel "depressed and hungover" during the daytime. And also extremely irritable.
So recently, I decide to try something called "combination therapy," where you use a loose fitting nasal mask in combination with an oral appliance that moves your lower jaw forward. I started the nasal mask first, wondering if anything had changed in the four or five years since I used a nasal mask.
I woke up today feeling like HELL. Feeling like I used to feel before CPAP, in the old days. When everyday was like Id wake up with dry mouth, feel hungover and super depressed all day long, wake up with GERD and a sore throat, feel agitated and irritable as hell.
So Im ABANDONING this "combination therapy" CPAP experiment and going back to the tried and true Quattro full face mask that has served me well since 2007. I never feel this way anymore as long as I use the Quattro full face mask and use proper CPAP pressures.
Moral of this post: It really is a big reminder how much untreated or improperly treated sleep apnea affects my mood and overall way I feel, mentally AND physically.
Felt like I had to get this off my chest. Maybe someone else can learn from it if they have "treatment resistant" depression. It might really be, at least partially, obstructive sleep apnea!
Eric AKA "LostBoyinNC"
Posted by Phillipa on March 6, 2013, at 12:27:44
In reply to CPAP affects my mood like crazy, posted by LostBoyinNC43 on March 6, 2013, at 11:18:49
Eric I've heard that sleep aphnea is very prevalent. Didn't know it effected depression. But I would guess you are now getting quality sleep. Phillipa
Posted by Hugh on March 6, 2013, at 12:38:25
In reply to CPAP affects my mood like crazy, posted by LostBoyinNC43 on March 6, 2013, at 11:18:49
A friend of mine had been depressed for years. His wife noticed that he would stop breathing at times during the night, so she made him go to a sleep lab, where they hooked him up to the monitors and let him go to sleep. They woke him up after four hours, told him he had severe sleep apnea, and had him use a CPAP for the rest of the night. My friend woke up in the morning, feeling better than he'd felt in years, and thought, "I'm back!" And he really has been a new person since he started using a CPAP. His brother also had sleep apnea, but refused to have it treated, and died in his sleep of a heart attack, very likely caused by his sleep apnea.
A lot of people with sleep apnea hate the CPAP and refuse to wear it. Some of them can be helped by the Pillar Procedure. A dentist implants some stents in the soft palate, which stiffen the soft palate and reduce snoring.
Posted by Phil on March 6, 2013, at 14:04:13
In reply to Re: CPAP affects my mood like crazy, posted by Hugh on March 6, 2013, at 12:38:25
I need to have a sleep test. I'm pretty sure I have sleep apnea as was the rest of the psych ward.
Posted by LostBoyinNC43 on March 6, 2013, at 14:21:22
In reply to Re: CPAP affects my mood like crazy, posted by Hugh on March 6, 2013, at 12:38:25
I actually saw a dental sleep medicine guy last week. It was for an initial exam to get fitted for a prescription oral appliance to treat my sleep apnea. Ive long known about the pillar implant surgery, but just to let you know something. That is not the "gold standard" for sleep apnea. The gold standard for sleep apnea is properly titrated CPAP or Bipap. There is also a lot of evidence based medicine out there that says significant weight loss helps sleep apnea. Also, reducing sedating medications and booze, there is a ton of evidence based medicine for eliminating or reducing those sedating drugs and booze. Then again, reducing booze and a lot of sedating drugs (benzos, anti-histamines, etc.) is also important for successful treatment of depression!!
The reason I switched over to a nasal mask in fact, was due to I was going to try an oral appliance with nasal CPAP. And have less tight headgear and mask. It did not take me long, a few nights, to quickly find out I only do well on the full face masks.
Im telling you, sleep apnea untreated can REALLY do a bang up job on my mood, my thinking in general, my hypertension...hell I totally fall apart if my CPAP system is not set up properly. I just dont get the therapy I get from a nasal mask that I get when I use a full face mask.
LostBoyinNC
> A friend of mine had been depressed for years. His wife noticed that he would stop breathing at times during the night, so she made him go to a sleep lab, where they hooked him up to the monitors and let him go to sleep. They woke him up after four hours, told him he had severe sleep apnea, and had him use a CPAP for the rest of the night. My friend woke up in the morning, feeling better than he'd felt in years, and thought, "I'm back!" And he really has been a new person since he started using a CPAP. His brother also had sleep apnea, but refused to have it treated, and died in his sleep of a heart attack, very likely caused by his sleep apnea.
>
> A lot of people with sleep apnea hate the CPAP and refuse to wear it. Some of them can be helped by the Pillar Procedure. A dentist implants some stents in the soft palate, which stiffen the soft palate and reduce snoring.
>
> http://www.pillarprocedure.com
Posted by LostBoyinNC43 on March 6, 2013, at 14:25:51
In reply to Re: CPAP affects my mood like crazy, posted by Phil on March 6, 2013, at 14:04:13
> I need to have a sleep test. I'm pretty sure I have sleep apnea as was the rest of the psych ward.
I would recommend it highly. If I'd been treated for sleep apnea when it was originally diagnosed with it in 2000, I'd have saved myself many years of pain and suffering.
If youve failed a bunch of psych meds and you snore and feel real tired or fatigued in the day and your sleep quality is subjectively poor, a sleep medicine specialist can possibly do wonders for you. It happened to me and I had given up by 2007, basically. I had written myself off by 2006/2007 as a lost cause, no hope for proper treatment.
I just posted this today because I had a little flareup yesterday and today and Im quickly reminded how much of my "mind" and mood is dependent on compliance with my CPAP gear.
Eric
Posted by Phil on March 6, 2013, at 14:32:14
In reply to Re: CPAP affects my mood like crazy, posted by LostBoyinNC43 on March 6, 2013, at 14:25:51
Posted by Hugh on March 6, 2013, at 15:10:44
In reply to Re: CPAP affects my mood like crazy, posted by LostBoyinNC43 on March 6, 2013, at 14:25:51
> If I'd been treated for sleep apnea when it was originally diagnosed with it in 2000, I'd have saved myself many years of pain and suffering.
My friend with sleep apnea had been on a couple of antidepressants. They hadn't helped, and one, nortriptyline, made him feel suicidal. After one night of using the CPAP, his depression of seven or eight years was gone. There are probably millions of people suffering from depression because of untreated sleep apnea.
Posted by LostBoyinNC43 on March 6, 2013, at 16:16:42
In reply to Re: CPAP affects my mood like crazy, posted by Hugh on March 6, 2013, at 15:10:44
There are probably millions of people suffering from depression because of untreated sleep apnea.
>Yep. No doubt.
LostBoyinNC
Posted by SLS on March 6, 2013, at 16:50:09
In reply to Re: CPAP affects my mood like crazy, posted by LostBoyinNC43 on March 6, 2013, at 16:16:42
> > There are probably millions of people suffering from depression because of untreated sleep apnea.
> Yep. No doubt.What causes sleep apnea?
Do you have any ideas as to why this is so common? Is it a societal thing? Are too many of us overweight?
How old were you when sleep apnea first emerged? In what ways is your depression improved since employing a CPAP? Is it limited to energy level?
Thanks. Your posts are very helpful.
- Scott
Posted by LostBoyinNC43 on March 6, 2013, at 19:00:11
In reply to Re: CPAP affects my mood like crazy » LostBoyinNC43, posted by SLS on March 6, 2013, at 16:50:09
I was originally diagnosed formally in 2000. But not treated until 2007. I had all the symptoms of sleep apnea when my "mental problems" first developed in late 1997, but at that time did not recognize the symptoms and the area I live in did not have any sleep medicine specialists I could go to back then.
The sleep medicine profession believes sleep apnea is way underdiagnosed. It is expensive though and doing CPAP therapy is expensive and high maintenance...compliance rates with the CPAP gear are only around 50%. I put a lot of work into CPAP, keeping the gear cleaned, changing masks every two to three months, changing hoses and filters. There is just a lot to it.
The overall results for me have been good to excellent, however. One bad thing about it, for me, is I have to use a full face mask as I mentioned and the full face mask is not like wearing a regular nasal CPAP mask, not as comfortable as a nasal mask.
It has improved my "depression" across the board. In all different ways. I still take an SSRI, but many symptoms and complaints I used to think were purely psychiatric went away completely within days of starting CPAP therapy. It truly was amazing, the overall results.
Sleep apnea is caused by a combination of obesity and also, the shape of your airway and jaw. Some people just have enlarged tissues in the back of the throat and are prone to having an obstructed airway when they become unconscious during sleep. The obstructed airway leads to oxygen desaturations during sleep, but you dont recognize them as that. You have to go to a sleep study or wear a recording oximeter during a night of sleep to detect the oxygen desaturations. The oxygen desaturations cause fragmented, shallow and poor quality sleep that basically amounts to chronic sleep deprivation, longterm.
Any kind of sedative medication makes sleep apnea worse. Booze makes sleep apnea much worse. Many common psychiatry medications make apnea worse, benzos and anti-insomnia drugs specifically. Also many OTC drugs worsen it, anything that makes you drowsy like anti-histamines like OTC benadryl really makes my pressures spike.
If I dont use CPAP even one night, I feel basically like I used to in the old days the next day. I also dont feel well if I use a nasal mask instead of a full face mask.
Losing a lot of weight helps it, I went thru a two year period in 2008 and 2009 where I lost fifty pounds and kept it off for about two years. I continued using CPAP during that period, because the weight loss did not get rid of my apnea, but it did help it. And my mood REALLY improved during most of that two year period.
I'd look into a sleep study if I were you, if you have not already done it. I cannot imagine not having had a sleep study or two if I had the sorts of complaints a lot of people have on this and similar psychiatry message boards.
LostBoyinNC
>
> Do you have any ideas as to why this is so common? Is it a societal thing? Are too many of us overweight?
>
> How old were you when sleep apnea first emerged? In what ways is your depression improved since employing a CPAP? Is it limited to energy level?
>
> Thanks. Your posts are very helpful.
>
>
> - Scott
Posted by LostBoyinNC43 on March 6, 2013, at 19:07:25
In reply to Re: CPAP affects my mood like crazy, posted by LostBoyinNC43 on March 6, 2013, at 19:00:11
If you are male, if your neck circumference is 17" or more and you snore, you probably have some degree of sleep apnea. For females, its 16" or more and snoring. A lot of females dont like to admit to ANYONE that they snore so a lot of them refuse to get treated because it is "unlady-like" to them.
My neck circumference was over 17 inches when I was rediagnosed in 2007. It has gone up to close to 18 inches circumference a few times. When I lost around fifty pounds, I got my neck circumference down under 17 inches, close to around 16 inches. The thicker your neck, generally the higher the chance you have excess tissue in your airway.
And loud, heavy snoring is the dead give away.
Eric
Posted by bleauberry on March 7, 2013, at 14:34:05
In reply to CPAP affects my mood like crazy, posted by LostBoyinNC43 on March 6, 2013, at 11:18:49
I've never learned much about sleep apnea. What exactly is it? How does it happen?
Posted by LostBoyinNC43 on March 7, 2013, at 20:32:25
In reply to Re: CPAP affects my mood like crazy, posted by bleauberry on March 7, 2013, at 14:34:05
> I've never learned much about sleep apnea. What exactly is it? How does it happen?
Google it and research it like you do with psych meds. There is ton of info out there from mainstream sources and apnea.
I went back to my normal mask last night, a full face mask. Woke up feeling normal again and felt fine today. I swear, CPAP is like friggin magic or something. Worst side effect is a tight face mask and tight headgear. And its expensive. I swear by it.
Eric
This is the end of the thread.
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