Saturday, April 17, 2010

Sleep Results

Sorry, Paul, no pic of me with a cpap mask on...I don't have sleep apnea! Apparently I don't have hypopnea either, despite what the tech said. What I *do* have is periodic leg movement disorder. My legs twitched or moved about 23 times an hour, resulting in 20 or so arousals, or movements from one stage of sleep to a lighter stage. Which, of course, sums up to I sleep like crap. It's kind of hard to get deep, restful sleep when your sleep stage is interrupted every three minutes or so.

Anyway. So now we are in the "try to fix it" part of the process. The first thing we're doing is having me take clonazepam at night. It's an anti-convulsant with muscle relaxant and anti-anxiety side effects, to stop the leg movement. We started out with a .5mg dose at night, and if there aren't significant benefits, we'll jump up to 1mg.

And let me tell you, I have noticed a difference! I am beginning to feel more rested. I'm not completely exhausted all day long. I have been on this med for a week, and I am very pleased. There still needs to be some tweaking, I do still get tired later in the day, and can easily take a 1.5 hour nap or so, but it's still SO much better. And that was on the .5mg dose.

Last night I bumped up to 1mg. And I overslept! I slept from about 9:30 to about 6:30 or 7. I don't know if that is related in any way to a bunch of stress I've been going through lately or what, but it was interesting. I'm more tired right now than I have been the last several days, but as I've also just gotten up, it could just be that. So we'll give it a bit of time. I might try the 1mg again tonight, depending on how the rest of the day goes.

I know I have about 15-16 years of sleep debt to make up, so I don't expect to feel all energetic and "cured" overnight (no pun intended). But a little better every day would be great, and not to fall any further behind also.

If overall we're not happy with how the clonazepam works, we'll move on to a dopominergic, which increases dopamine and reduces muscle contractions. Other possibilities, after we've worked on reducing the PLM, is to try a stimulant to counteract the daytime sleepiness. These include Provigil or, believe it or not, Ritalin! But that's ages down the road. First let's see how this one does. :)

So there ya go, peeps, my sleep results. I KNEW something was messed up with my sleep! Now to just tweak til it's all better. mk

Wednesday, April 07, 2010

To sleep...perchance to dream...

So. We all know I have these sleep issues. And exhaustion issues. Well, my therapist (love this guy!) put the two together and asked me if I had done a sleep study, which I hadn't. So he told me to TELL my doctor to refer me to the sleep clinic. And they did!

So on March 23rd, I headed over to the sleep lab for an overnight. They showed me to this little room with a giant saggy bed (that was a SleepNumber bed, but I never got around to actually playing with that), and an attached bathroom that had the biggest freakin toilet I have ever seen. Seriously. Huge. Apparently they get some rather large clients. This toilet is certified to hold up to 2000 pounds. Really. And naturally, I didn't bring my camera with me to share pictures.

Anyway, this older gentleman with a very quiet, soothing voice attached over 20 wires to me, mostly on my scalp and face, oh, and upper chest. I had one above one eye, below the other eye, nasal prongs up my nose (to monitor air intake), a sound monitor taped to my throat (to register snoring), two bands across my upper chest and abdomen (to monitor breathing), electrodes attached to my shins (to see about periodic limb movement, also known as restless leg syndrome), a heart and blood-oxygen monitor clipped to my index finger. I was seriously wired for sound. All of these wires were gathered behind and up on the top of my head and then ran to a box hanging from an IV pole next to the bed. I told the somnographer that I really, REALLY wished I had brought my camera so I could get pictures and blog this. (see, I was thinking of you!)

So then I took my meds, put my mouthguard in (and let me tell you, I felt some sexy), made sure my cell phone was off (it would interfere with the equipment. couldn't use my iPod, either), the guy ran a few tests from the control room, came back and adjusted a few things, and we were set. He shut the lights out from the control room and I settled down to sleep.

Which, amazingly, I actually did!! I woke up with no idea what time it was (no clocks in the room), but after a bit (I think his name was David) came on the intercom & told me he thought we were done, and he gradually brought the lights up. Then he came in to disconnect me.

He had told me the night before that they needed at least six hours of sleep activity to call it a full study. I was really worried they wouldn't get that from me, but apparently they did! Yay me!

I asked him if he had any observations he could share, knowing that he can't give me any official results, and after agreeing to that disclaimer, he told me some stuff.

I spent most of the night sleeping on my stomach, although sometimes on my sides. I didn't sleep on my back at all. And I often slept with my head tilted way back, like to open my airway more. I had delayed-onset REM sleep, like my body was trying to avoid hitting that stage of sleep, because that is when the most instances of any airway restriction happens. And sure enough, I had marked reduction in air intake, about 50%. (I researched and learned that this is called hypopnea)

That was pretty much all he gave me, I think. Then he was all done with the wires, he left the room, I got dressed, he escorted me out, and I went home and took a shower to get all the gunk out of my hair that held the wires on (it was like came out really easily), and took a nap (it was 6am). The only thing that I had to remind me of the night was this fairly big, really bright red rectangle on my throat with a little circle in the middle and lines extending on either side, from the tape that held on the sound monitor. It lasted until the next day. I completely forgot it was there when we went to the store later that night to pick up pizza. Wonder what they thought (it's a tiny country store, they all know me).

I go in on Friday and learn my official results (I've also asked for a copy of the report...yeah, I'm a geek). The most likely treatment, if it *is* hypopnea, is the same as for sleep apnea: wearing a breathing mask at night, called a CPAP (continuous positive airway pressure). It looks like a fighter pilot mask, attached to a tube, attached to a machine you keep next to the bed. Man, I am gonna be so sexy and attractive at night! I guess it's a good thing there's nobody on the other side of the bed. :P

BUT. Some of the symptoms of hypopnea may include excessive daytime sleepiness, depression, forgetfulness, mood or behavior changes, trouble concentrating, loss of energy, nervousness, and morning headaches. Hello! All the stuff I've been complaining about for YEARS. Could be cured!! Which will be so incredibly awesome!!!! (and yes, I'm a tiny bit pissed that nobody thought of doing this years ago)

Anyway, I'll know more Friday, and yes, I will (try to) keep you posted!!!! mk

Holy Crap....TWO MONTHS...really?

Man, I am neglecting the hell out of this blog. It's funny, too, because I *think* of posts all the time...then I just seem to forget whenever I'm anywhere near a keyboard.

OK, so I'll post a few now. Sorry to barrage you with them after such an absence, but if I don't do it now, I'll forget again.

mk =)