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Medications and Sleep
#1
Medications and Sleep
I have obstructive sleep apnea and I developed a case of Central Sleep Apnea which I tracked down to a medication quetiapine (aka seroquel).   

However, trying to get off of Seroquel, I've done it several times now and I feel so much better!   That is until about 10 days later and I'm completely exhausted and can barely remember my name.   I'm sleeping fine.   I usually wake up once in the night between 2-3, but that's completely normal for me.   The rest of the time, I sleep so deeply that I miss emergency phone calls, etc. 

I've reduced my dose from 200mg to 33mg/night.     Sadly, I still have some awful dreams and Stephen King seems mild by comparison.   

I've also tried  amlodipine which works great for about 10 days and then I seem to also run into issues with my sleep architecture. 

The CPAP shows no issues with my sleeping.   Just steady breathing except for some leakage when I change position. 

Question:   What doctor or specialist could diagnosis and treat these problems?    I have a feeling that a standard sleep clinic is going to do a sleep study and then tell me everything is fine as my daytime tiredness is subjective and my apnea is well treated.
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#2
RE: Medications and Sleep
Seroquel is a powerful anti-psychotic which is also very sedating (widely abused as a street drug for this reason). It’s quite habituating, and it’s likely you’ll need to drop the dosage slowly over months if you are having the side effects you’re describing. You’ll likely need to see a psychiatrist or a rehab clinic to do this.

I have some experience, after dropping off an even higher dosage years ago. 

Good luck
Geoffrey Rush as Philip Henslowe, (Shakespeare in Love) "I don't know. It's a mystery."
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#3
RE: Medications and Sleep
(09-13-2021, 03:05 PM)Dawnstar Wrote: Seroquel is a powerful anti-psychotic which is also very sedating (widely abused as a street drug for this reason). It’s quite habituating, and it’s likely you’ll need to drop the dosage slowly over months if you are having the side effects you’re describing. You’ll likely need to see a psychiatrist or a rehab clinic to do this.

I have some experience, after dropping off an even higher dosage years ago. 

Good luck


I've never heard of it being a street drug.   Wild.   I'm amazed at what some people consider to be recreational, but then I don't even like weed. 

Yes, I've been weening off for months (if not a year) on a tapered bases.   I originally started to treat my extreme anxiety and migraines that resolved itself when I divorced.    I've had sleep quality issues my whole life which appear to be progressive, so I was ecstatic to find something that would allow me to have nourishing sleep.    "Sleep without sleeping" is a term a coined decades ago. 

Thanks for the response.
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#4
RE: Medications and Sleep
I was weaned off a dosage twice as high over six months. Six months wasn’t nearly slow enough, and I ended up having to take anti anxiety drugs for several months following before it was even tolerable.

Dropping off too quickly is likely to result in panic attacks, sleeplessness, paranoia, and severe anxiety. 

Be careful and seek guidance
Geoffrey Rush as Philip Henslowe, (Shakespeare in Love) "I don't know. It's a mystery."
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#5
RE: Medications and Sleep
I would look for a doctor specializing in sleep disorders (vs a sleep doc). Most sleep docs around us specialize in sleep apnea and not some of the other sleep issues. My wife has a lot of CAs due to her opioid use for chronic pain. The first two sleep docs couldn't identify the association. The first one admitted that my wife was behind his capabilities (at least he was honest about it) and the second had no clue. Her current doc has really been delving into her meds and their interaction with each other.

If you don't have one, you may also want to find a good neurologist. My wife is getting a second opinion on a couple of her pain issues as we have found a neurologist who is also a pain specialist.

Anytime you visit your doctor, bring an updated drug list to include EVERYTHING (drugs, OTC, supplements) you are taking. My wife's sleep doc noticed an interaction between two drugs and their levels which was actually causing the problem than taking care of it. Hopefully, you are already doing this one.

If you have a university with a college of pharmacy, talk to them and see if they do medication reviews? We have taken advantage of the one they have near us every so often and have gotten a wealth of information about my wife's meds.
Homer

Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies. Monitors are also Advisory Members, just with Extra Work assigned.

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#6
RE: Medications and Sleep
Homerec - How on earth could that sleep doc NOT make a link to her opioids?! That's literally the number 1 risk associated with their use, respiratory depression...!

Dawnstar: Seconded about finding a GOOD sleep doc, not one whose idea of "sleep disorders" is OSA and that anything else is "lifestyle" or something. I'm glad you're feeling generally better without the medication. I have family and friends who are taking it for some pretty impressive mental health issues, and it does wonders for those - but yeah, 30 minutes after taking it and they're out cold for 12 hours.
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#7
RE: Medications and Sleep
Ratchick,

Yep - that is one of the many reasons we fired that particular sleep doc. That and having no clue what she was doing. We found out later her DEA license had been suspended due to some odd going ons at the spa where she had been previously. Every time we went in her staff tried to sell us on So-Clean. My wife's current sleep doc filed a complaint on this one for sloppy recorded keeping as when we requested records be sent over, what was sent was worthless and we were told that is all there is. And this was after a little over a year. You could never talk to anyone as they let everything go to voice mail and then call you back when they got around to it (maybe). Oh, and they erased the SD card every time she went in.

My wife's current doc knows what she is doing and is working with the neuro doc to get things under control.  Supposedly the neuro doc is also a pain specialist (we see her next week for the first time). Once we get the chronic pain under control, the sleep will fall into place. There are many nights when my wife doesn't get any real sleep even with the machine.
Homer

Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies. Monitors are also Advisory Members, just with Extra Work assigned.

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#8
RE: Medications and Sleep
(09-14-2021, 12:18 PM)Homerec130 Wrote: I would look for a doctor specializing in sleep disorders (vs a sleep doc). Most sleep docs around us specialize in sleep apnea and not some of the other sleep issues. My wife has a lot of CAs due to her opioid use for chronic pain. The first two sleep docs couldn't identify the association. The first one admitted that my wife was behind his capabilities (at least he was honest about it) and the second had no clue. Her current doc has really been delving into her meds and their interaction with each other.

If you don't have one, you may also want to find a good neurologist. My wife is getting a second opinion on a couple of her pain issues as we have found a neurologist who is also a pain specialist.

Anytime you visit your doctor, bring an updated drug list to include EVERYTHING (drugs, OTC, supplements) you are taking. My wife's sleep doc noticed an interaction between two drugs and their levels which was actually causing the problem than taking care of it. Hopefully, you are already doing this one.

If you have a university with a college of pharmacy, talk to them and see if they do medication reviews? We have taken advantage of the one they have near us every so often and have gotten a wealth of information about my wife's meds.

Thanks!   I'll keep looking.   I'm currently in a smallish city of 50K, but I'll keep looking.
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#9
RE: Medications and Sleep
Oh my goodness Homer - that's awful.
I really hope the pain doc is a good one. I know how hard it is to manage severe chronic pain (and when it keeps you from sleeping, it IS severe) and finding a decent pain doc can be a little like hunting for hens' teeth... or good sleep docs. LOL Fingers crossed that this new doc will be able to help your other half (Marge? Big Grin )

Sorry for hijacking your thread, Powernap and good luck with the search.
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