Anyone With Arousals Mainly in REM Stage

[faith]

I am looking for some help.

I have 22 arousals per hour and they all occur during REM stage. The rest of the sleep stages are virtually clean. I had a doctor today tell me that I should see a Fibromyalgia doctor. She said there are some new breakthroughs in treating these arousals with drugs. 

11 years ago, my health declined to the point of being mentally and physically disabled from a lack of deep sleep. A doctor who dabbled in autonomic disorders and sleep was able to get me enough deep sleep to no longer be disabled. He achieved this with..
Doxepin 25 mg
Mirtazapine 7.5 mg
Clonidine 0.3 mg

The REM stage arousals started to send me into AFIB two and half years ago, and my sleep struggled. My autonomic doctor changed my meds to...
Mirtazapine 15 mg
Quetiapine 100 mg
Amytriptiline 20 mg

While that has got my sleep stable again. I recently had another 2 AFIB episodes. Every episode has occurred after waking up after sleeping for 70 to 90 minutes. 

Each time I tried CPAP, it led to me feeling worse. The last time, I stayed compliant every night for two months, and then I went into tachycardia. I stopped after that.

Everything seems to be tied to these REM Stage arousals. If anyone has any experience with this, then please give me some insight.

[ardenum]

It's the first time i see a doctor prescribe more then one antidepressant type medication at a time. Tried doxepin, it's too strong, i got mirtazapine in my drawer but its even stronger so i dont touch it. I'm using zolpidem at the moment. I also have issues with REM sleep but I have yet to find a solution, if i take 10mg doxepin i usually don't get any dreams but then I can't wake up during the day, not a problem with zolpidem, but on that I get REM sleep and it's exhausting.

How did your doctor measure if you have deep sleep, did you do multiple sleep-EEG's to monitor if you respond to the treatment?

[Hydrangea]

If you're spending a lot of time in REM, and you're not feeling rested during the day, have you looked into Narcolepsy?

[faith]

My doctors measure stage sleep by polysomnography.

[Sleep2Snore]

My doctors measure stage sleep by polysomnography.

At least they did it with the right machine.  Was this done while using the medicine?
I think it has to be done while medicated.  Maybe a machine that records your sleep at home in Auto mode.
If they can't do it in hospital, ask for an auto cpap machine you can take home so they can see what is going on during sleep.
I know you said you can't/don't like using the cpap, but it might let them/us know what is going on.

[faith]

I have has full sleep studies before and after medication. Before medication, I was only able to stay sleeping for about 6 to 7 hours. With medication, I stay asleep for 10 hours. 

At 6 to 7 hours a night before, I was mentally and physically disabled. At 10 hours, I am functional, but I still have progressive health problems. Essentially, the doctors could not solve the arousals/apneas from occurring during REM sleep. The out of the box solution was to have me sleep longer with more REM stages. Even though the additional REM stages had disturbances, it was giving me enough deep stage sleep to make me functional.

[ardenum]

I'm confused, REM isnt deep sleep. There are pills that increase deep sleep(stage3/4) and decrease REM. That's what you want to get.

Here's an overview : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2824211/

[chill]

I've been on Pregabalin to treat nerve pain.  It works for the pain and really made me sleep well.  Unfortunately, it also made me stupid (cognitive impairment).  In the end, I decided that I was better at work with worse sleep.  

[ardenum]

I've been on Pregabalin to treat nerve pain.  It works for the pain and really made me sleep well.  Unfortunately, it also made me stupid (cognitive impairment).  In the end, I decided that I was better at work with worse sleep.  

If you hit a certain pain level, you can turn form a 150IQ to 70 really fast.

[yrnkrn]

I've been on Pregabalin to treat nerve pain.  It works for the pain and really made me sleep well.  Unfortunately, it also made me stupid (cognitive impairment).  In the end, I decided that I was better at work with worse sleep.  

Had you tried Gabapentin once daily at evening only?
Its T1/2=6h is about ideal for night function only.