(07-16-2014 06:39 PM)Realtor 1 Wrote: I have read Roby Sue's Blog and for last 13 month I have tried anything & everything humanly possible to get some sleep but nothing works.
I'm sorry that you are having so many on-going problems with insomnia and that nothing I've suggested seems to have helped.
Quote:Have tried different diet, Lost 75 lbs, I eat very healthy, done moderate exercise,
When do you exercise?
Quote:taking all types of herbs & herbal teas, Prescription Medicines but m stumped. Have worked with a shrink & taken depression medicine, Cat scans, 2 Mri's. all type of tests. Only 2 issues have been found one is sleep Apnea(I have been PAPing for 1 yr now) & H-pylori Bacteria (For that I have taken the anti-biotic tri-pac last yr and the Quadruple Therapy this yr but H-pylori is still there. A part from that no other physical Ailment has been diagnosed.
While you mention working with a shrink and herbs and prescription medication, you have NOT talked about any of the following things concerning your sleep problems. And they may be far more important than you think they are:
1) Sleep schedule
. Do you have a regular wake up time and a regular bedtime that you attempt to stick with every day, including your days off? Or does your bedtime or wake up time vary dramatically on days off vs work days?
2) Caffeine and alcohol consumption
. Both can pretty drastically affect the quality of sleep, and many people are very reluctant to admit that very moderate amounts of either might be aggravating their sleep problems.
3) Worrying too much about the sleep, particularly when in bed
. Yeah, I know it's tough to try to "let go" of the worrying when the sleep is really bad. I've had my own real battles with "letting go" of the sleep log that I kept for 2 1/2 years. But eventually I got to the point where I realized that the log had become part of my problem, rather than part of the solution. It was very useful for the first 12-15 months. I'm not sure it continued to be of much use after that, and after most
of my insomnia problems were addressed in some fashion, the sleep log did trigger more focus on my sleep than I really needed. I'm not saying that I don't still have insomnia problems (I do), but on most nights, the insomnia problems don't keep me from getting enough sleep to feel decent in the daytime.
4) A description of what kind of insomnia you're dealing with
. Many (most) of the herbs & herbal teas and Prescription Medicines can work reasonably well to address sleep onset insomnia, but they're not particularly effective at tackling sleep maintenance insomnia problems. And they're even less effective in dealing with "wake too early for the morning" insomnia.
5) Possible circadian rhythm problems
. Sometimes people mistake problems they're experiencing from delayed sleep phase issues or advanced sleep phase issues as insomnia. And most insomnia treatments won't do much to "fix" a circadian rhythm problem. Delayed sleep phase is when your body doesn't get sleepy enough by your desired bedtime: You want (or need) to go to bed by midnight, but the body is not sleepy enough to get and stay asleep until it's 3:00 AM. Advance sleep phase is the opposite. The body wants to wake up before your desired wake time: Your body is ready to WAKE UP (for the day) at 4:30AM regardless of when you went to bed because the body really wants to sleep from 8:30pm - 4:30am. Often times, people with an advanced sleep phase problem will say that they're very tired and sleepy in the evening, but they just gut it out until a more "reasonable" bedtime of 10:30 or 11:30, but once they wake up at 4:30, they just can't get back to sleep.
Quote:My family doctor has given up on me and I have not visited her office since early this year. I do have my follow up appointment with the sleep doctor in a few days
A good place to start the conversation about the insomnia with your sleep doc is with the following:
A) When do you want (or need) to be asleep? As in when do you think bedtime should be and when do you think wake up time should be? Are these times driven by the need to be up and functioning for a job?
B) An accurate description of the problem: Do you have trouble getting to sleep at your desired bedtime? Do you have multiple short wakes throughout the night? Do you have one or more very long wakes on most nights? Do you wake up too early and find yourself unable to get back to sleep?
C) A complete list of prescription sleeping medications that you have already tried: What medication? What dose? How long did you take it? Why did you discontinue it?
D) A complete list of herbs and supplements that you have already tried: Which herbs/supplements? What dose? How long did you take each herb/supplement? Why you discontinued each herb/supplement? Did you take combinations of herbs/supplements? If so, what combinations have you tried.
It may help your sleep doc provide better suggestions for treatment if you can drop the list of previously tried prescription medicine and herbs/supplements by his office and tell the receptionist that you'd like the list added to your medical records and that you'd like the sleep doc to review the previously tried medicines before your appointment.
Quote:and I can try to ask for the Provigil to work with the Fatigue.
Your sleep doc may be willing to prescribe the Provigil since you've been PAPing for a year without much improvement in terms of daytime fatigue. Whether your insurance will cover it is another issue altogether, and not all will.
But the sleep doc may very well want to focus on treating your insomnia/lack of sleep issues first before jumping to prescribing the Provigil: It is usually prescribed for a sleep apnea sufferer only when the OSA patient still has issues with daytime fatigue even though he/she is compliant with PAP therapy (you are) and is sleeping reasonably soundly with the PAP machine (you are not).