Help me stay asleep!

February 9, 2009 8:29 AM

I haven't slept through the night in at least 3 years - I need some help around sleep apnea, restless leg syndrome, and sleep studies.

For as long as I can remember, I've generally woken up 4-6 times per night. As a result, I'm exhausted all the time - the final straw was when my sister, who has two toddlers, told me that the bags under my eyes are worse than hers....

I have fairly good sleep hygiene (I think), and it's gotten better lately - left the stressful consulting job and have a pretty standard 9-5 that I can leave behind when I leave the office. Very low stress, go to bed/wake up at the same time, no caffeine at all (though I sometimes break this when I need a kick to stay awake in the office), exercise 4 times a week, and I've lost 20 pounds since I left the old job - I'm now 5'11" and 170 lbs, and 29 years old.

I don't have problems falling asleep, but I do have problems *staying* asleep. When I wake up, I don't have problems breathing, but I usually roll over and go back to sleep. According to wifey, I don't snore unless I've had a few too many drinks, or am sick.

Now, finally, the question(s): I feel like a sleep study is going to be a self-fulfilling prophecy, in that I'm not going to be able to sleep because everybody's staring at me and I'm covered in electrodes. Is this true? Is there any middle step between reading-ask-mefi-and-getting-sleep-advice and the sleep study itself? Is there an alternative to CPAP if I do have sleep apnea? Many of the older posts say that the device can be hard to get used to, and the hissing can annoy significant others. I don't want to rely on meds to sleep, but I'm starting to run out of options.

I spent about 30 mins last night reading older posts about this, but couldn't come to a solid conclusion about the questions above - apologies if it's duplicative...might just be my sleepless-haze that made me miss it. Thanks in advance.

posted by um_maverick to health & fitness (16 comments total)

It is harder to fall alseep while getting a sleep study, but that doesn't mean you won't learn anything from doing it. They told me for instance that I shouldn't even bother trying to sleep on my back because it'll never happen.

Regarding apnea, I had my tonsils and uvula removed and my septum un-deviated to open up airways. It helped a lot. Right after the surgery I'd get 5-6 hours of sleep and wake up totally refreshed because that's how much sleep I was used to getting in 8-9 hours of rest.
posted by valadil at 8:41 AM on February 9

You may not have sleep apnea from your desc - don't fret about the CPAP yet. For RLS/Insomnia there are meds they can try. Go get a sleep study or a referral to a sleep center; they might want to do a consult before the study.
posted by Weighted Companion Cube at 8:57 AM on February 9

You don't mention trying medications? I have similar tendencies, and Lunesta helps me stay asleep.
posted by stupidsexyFlanders at 9:24 AM on February 9

Apnea doesnt really wake you up. It might if youre out of breath, but if your big symptom right now is the inability to stay asleep then thats not one of the major signs of apnea. The sleep study should be able to figure out whats wrong, if its not psychological.

A sleep study isnt a big deal. When Ive gone I was exhausted from getting poor sleep that I slept pretty well. YMMV, of course.

CPAP is the most prescribed treatment for sa, for many reasons, some of which have to do with profitibility. People with mild sa can just teach themselves to sleep on their sides. Others can just lose weight. People who cant or dont like CPAP can use a dental appliance.

>I don't want to rely on meds to sleep, but I'm starting to run out of options.

You might want to try a little melatonin and/or valerian root at night. If that doesnt help or if it makes matters worse then you should talk to your doctor and he can refer you to a sleep clinic.
posted by damn dirty ape at 9:25 AM on February 9

I had problems staying asleep, too, and found that my cure was white noise. Specifically, a small fan placed strategically in the master bath. The only downside is that I have to take the fan with me if I'm over-nighting somewhere, but the full-night's sleep is very much worth the hassle.
posted by cooker girl at 9:46 AM on February 9

Don't discount the value of a sleep study.

It might well be very helpful in your case. While you may have more trouble getting to sleep in the lab for the reasons you note, chances are you won't stay up through the whole process. Once you finally do get to sleep (and you will, as do most all the other people who go through it), it might still help differentiate things like sleep apnea and restless leg or other causes of your problem. Remember, it's a test specifically performed on people with sleep problems and the results of the test are specifically interpretable in that population, of which you are a member. So there's no reason to think you're going to do any differently with it or that it's somehow less valuable in your particular case.

Until you can figure out what the problem is (by getting tested), I wouldn't worry about treatments. It's really putting the cart before the horse and adding potentially needless anxiety. While sleep apnea is a possibility, a lot of what you describe might also suggest otherwise.
posted by drpynchon at 9:47 AM on February 9

How often do you exercise? Regular exercise could help get rid of some of your pent up energy.
posted by ascetic at 10:15 AM on February 9

I had a sleep study done a few years ago and was pretty nervous about it for the reasons you mention above. Surprisingly, the room I stayed in at the hospital was decorated like a cozy bedroom with a reading lamp, a comforter, and other cute "homey" things. Between that and bringing my own pillow, I was able to relax. There are different things hooked up to you but nothing uncomfortable. I fell asleep faster than I thought and then the sleep tech woke me up early in the morning. I would most definitely recommend looking into this. The results were extremely interesting and now I'm not tired all day :) I know it seems like a big hassle to set up and actually do, but it could be one night that changes your life and looking back on it, I really wish I had done mine sooner.
posted by whitetigereyes at 10:19 AM on February 9

I haven't slept through the night in about 25 years. I'm 33. Yay me. I have the same troubles that you do, it seems. I'm able to fall asleep relatively easily, but will wake up in the middle of the night - multiple times and it usually takes me no less than an hour to fall back to sleep. It's horrendous. I feel for you.

I have never done a sleep study, although maybe I should. My sleeping habits are good ones. Caffeine isn't in my diet at all. I exercise regularly. I am otherwise healthy. Except I'm constantly fatigued and on some days non-functional because the lack of sleep just piles up and knocks me down.

My saving grace through all of this has been Benedryl - diphenhydramine hydrochloride. I pop one or two (25-50 mg) before bedtime. It doesn't keep me asleep (although it helps drastically), per se, however, when I do stumble out of the sleep mode, it has turned off something in my brain that allows me to then quickly get back to sleep. I still wake up a few times a night, but I'm not up for hours at a time.

Best of luck to you. If you do end up doing the sleep study, follow up!
posted by Sassyfras at 10:59 AM on February 9

Go and see your doctor. He'll be able to go over your options with you, including sleep studies and medication.

And don't fret about having trouble sleeping at the sleep study. It's designed specifically for people who have trouble sleeping, so everyone feels the way you do about going in. One lousy night, if it turns out that way, is probably worth it if it helps you in the future.

If it is something like sleep apnea, it could be dangerous to let it go on unchecked.
posted by Relic at 11:15 AM on February 9

Thanks for all of the answers - I've considered the melatonin/valerian option, and maybe I'll give that a whirl. Weighted Companion Cube, is a 'sleep center' just the place that they do the study? Sassyfras, I'll definitely let you know what I wind up doing. The standard "go see your doctor" option is potentially less effective for me, because I just switched to a new doctor, so he doesn't know most of my history. I know, I know, that's not an excuse...I'll probably wind up making an appointment for a physical, and discussing it then.
posted by um_maverick at 11:54 AM on February 9

I'm not sure about your insurance but as a side point: if you get a sleep study, see if they can do everything in a single night.

Some places do one night for evaluation, then another night to tune the CPAP machine if that ends up being their recommendation. Other places can do both in one night. Given the expense of a sleep study (if your insurance doesn't fully cover them), it's financially advisable to do it all in one go.
posted by aramaic at 12:44 PM on February 9

I didn't think I'd be able to sleep during my sleep study, but I did. For a lot of sleep disorders, only a couple hours of sleep are all that's needed to diagnose the problem(s).

Not snoring is no indication that you don't have sleep apnea, by the way. If you do have it, getting treated is essential. Severe obstructive sleep apnea is life-threatening and can cause brain damage, as well as car accidents and all kinds of other problems. Other forms of sleep apnea are less scary but still nothing to mess around with. Treatments for the various forms of sleep apnea run the gamut from CPAP and CPAP-like machines to surgery (an option I'd take if I could, but I'm not a candidate) to mouthpieces. CPAP is kind of annoying. Better than fatigue and brain damage and, y'know, DEATH? Uh, yeah. Of course. Modern machines are fairly quiet. We also have an air filter in the room and the air filter is louder. No big deal.

Anyway, don't talk yourself out of the solutions before you even know what the problem is. Go to a sleep specialist and see what they say, OK?

Good luck! I hope you feel better soon.
posted by wintersweet at 3:26 PM on February 9

My home-medicating advice:

1- I have used Melatonin for many years now. My problem was falling asleep, not staying asleep. Works great for that- it's sort of like magic, you are just completely, naturally tired. Might try one of the time release varieties.

2- I have an on-again, off-again relationship with Benadryl. It works great, but for me, long term use makes me feel depressed. I try to limit its use to those times when I simply must sleep.

3- Booze. I find that alcohol, darn near every time, causes me to not sleep well with these exact symptoms. On the other hand, it helps with the getting to sleep problem. I try to avoid it.

4- Lights. I have an affinity for bright light, and found that turning them down near bedtime helped with all manners of sleeping.

5- I also will occasionally do the "fuck it, I'm starting my day" thing if I sleep restlessly and find myself staring wide-eyed at the ceiling at 4am. I find that it usually makes for a good night's sleep the next night. But I don't suffer from this type of insomnia very often, I imagine it would be fairly devastating to try to do this every night.
posted by gjc at 5:34 PM on February 9

What about temperature? Being too warm can wake me up too early. And being too cold makes it hard to fall asleep. Too many blankets and pajamas makes it easy to fall asleep, but four hours later I'm too warm and wake up. Does that sound familiar?
posted by conrad53 at 11:11 PM on February 9

I wasn't waking up as often as you, but I would always have to get up around 2am to take a piss. Then maybe around 4 or so. I thought I had a bladder issue. I also snore, like a freight train carrying elephants through an artillery range. I'd doze off behind my computer at work, sometimes I'd close my eyes in the car. If I sat down on the couch to watch TV, I'd doze off.

My sleep study was actually pretty great. It was a private office, and the room was just a bedroom. Bed, nightstand, lamp, chair. They attached EEG and EKG leads to my chest and head. Then I had a trap around my chest to monitor the rising and falling of my chest. I wore a tshirt and some shorts to sleep.

They had a microphone and a camera over the bed, but I couldn't see them. I read a book for a few minutes, and after I felt tired enough, I went to sleep. They woke me up about 1 1/2 hours later and told me that I had "The Apnea"! A tech helped me put on a mask and I tried to use a machine for the rest of the night. I thought it would be hard, but I was so damned tired I didn't care. I slept like a rock for the first time in years, and actually woke up early.

I tolerate the machine well and it's been wonderful getting up on time for work, or being able to have a weekend where I wasn't in bed all day. No one could understand that I was so tired, and not just lazy.

I don't know if you have apnea, I don't know if the machine is for you, I just know that getting enough sleep has been heaven. I would encourage you to investigate this with your doctor, and if he doesn't take your concerns seriously enough, consult a sleep professional yourself.
posted by wrnealis at 4:28 PM on February 26