How do I get to the bottom of my sleep disorder?
December 16, 2013 4:52 PM Subscribe
I have a health care problem that is fairly ambiguous that deals with sleep.
Basically, roughly since puberty (i.e. beginning of high school or a little before) I have been exhausted on anything less than 10 hours of sleep, and I don't sleep more than 3 consecutive hours more than a handful of times a year (generally this means getting up to use the bathroom, sometimes it can mean full on insomnia.)
I had my very large tonsils out hoping to deal with potential apnea, and things improved but have gotten very bad again. My wife says I don't snore (I realize this doesn't rule out apnea, but it seems like a relevant anecdote.)
My sleep schedule seems to shift very easily, and I am more wakeful in the middle of the night. An ideal sleep schedule for me would probably be something like 4am - 2pm, but even this ideal schedule will shift on it's own.
I suppose this is two separate problems in the end:
1) I can't seem to sleep regularly on a normal schedule, i.e. 11pm-7am or something similar.
2) I can't sleep more than 3 consecutive hours more than a few times a year, usually when I have gotten to a point of utter exhaustion.
The first problem I feel I share with others, the second I can't seem to find anything about online, possibly I am searching for the wrong things?
I am self employed, so I have managed to build my life in a way that accommodates this problem, but I have two small children that would benefit from me being on a normal, regular schedule and a wife that deserves a more normal life.
I have discussed this with my doctor, and he prescribed me Ambien, which I didn't fill because I don't generally have a problem going to sleep if I've been awake long enough. He seemed to think the problem could be related to sleeping too much, which just kind of made me think the conversation was hopeless because he didn't seem to understand at all. If I sleep 8 hours a day I literally feel sick after a day or two and seriously struggle. I also didn't see Ambien as a long term solution, and I'm not that interested in solutions that would only fix things in the short term.
Other relevant points - I exercise. I've run five half marathons in the last few years, and I run regularly, I play tennis twice a week, I lift weights semi-frequently. I do drink caffeine (diet soda, probably 2-4 a day. I realize this is an issue, but often it feels like the only way I can function?)
Is there a benefit to doing a sleep study if it turns out not to be sleep apnea? Part of me hopes that's what I have just because there is a solution. Reading up on other disorders and it often sounds like you just have to learn to live with it.
I've been extremely successful professionally and I have a happy, loving family despite what often feels like a significant handicap, and I daydream sometimes about what I could accomplish if I slept like a normal human being.
I'll take any advice, thank you. I've lived with this my entire adult life, and there are times I just can't even imagine living like this for another 30-40 years.
I had my very large tonsils out hoping to deal with potential apnea, and things improved but have gotten very bad again. My wife says I don't snore (I realize this doesn't rule out apnea, but it seems like a relevant anecdote.)
My sleep schedule seems to shift very easily, and I am more wakeful in the middle of the night. An ideal sleep schedule for me would probably be something like 4am - 2pm, but even this ideal schedule will shift on it's own.
I suppose this is two separate problems in the end:
1) I can't seem to sleep regularly on a normal schedule, i.e. 11pm-7am or something similar.
2) I can't sleep more than 3 consecutive hours more than a few times a year, usually when I have gotten to a point of utter exhaustion.
The first problem I feel I share with others, the second I can't seem to find anything about online, possibly I am searching for the wrong things?
I am self employed, so I have managed to build my life in a way that accommodates this problem, but I have two small children that would benefit from me being on a normal, regular schedule and a wife that deserves a more normal life.
I have discussed this with my doctor, and he prescribed me Ambien, which I didn't fill because I don't generally have a problem going to sleep if I've been awake long enough. He seemed to think the problem could be related to sleeping too much, which just kind of made me think the conversation was hopeless because he didn't seem to understand at all. If I sleep 8 hours a day I literally feel sick after a day or two and seriously struggle. I also didn't see Ambien as a long term solution, and I'm not that interested in solutions that would only fix things in the short term.
Other relevant points - I exercise. I've run five half marathons in the last few years, and I run regularly, I play tennis twice a week, I lift weights semi-frequently. I do drink caffeine (diet soda, probably 2-4 a day. I realize this is an issue, but often it feels like the only way I can function?)
Is there a benefit to doing a sleep study if it turns out not to be sleep apnea? Part of me hopes that's what I have just because there is a solution. Reading up on other disorders and it often sounds like you just have to learn to live with it.
I've been extremely successful professionally and I have a happy, loving family despite what often feels like a significant handicap, and I daydream sometimes about what I could accomplish if I slept like a normal human being.
I'll take any advice, thank you. I've lived with this my entire adult life, and there are times I just can't even imagine living like this for another 30-40 years.
Best answer: Is there a benefit to doing a sleep study if it turns out not to be sleep apnea?
I think the benefit would be a diagnosis, or at least getting closer to one. It would help doctors treat you, even if it doesn't show sleep apnea. I think there are varying types of sleep studies (some which can pretty much only diagnose sleep apnea; some of which can give more detailed information about how you sleep, etc.). But, IANAD, so I could be wrong on this and defer to others' opinions.
Reading up on other disorders and it often sounds like you just have to learn to live with it.
Hopefully this is not the case! But if it is, I would think hard about just dismissing treatments like Ambien out of hand. Even if it's just a treatment rather than a cure, something like that could really improve your quality of life.
posted by schroedingersgirl at 5:15 PM on December 16, 2013
I think the benefit would be a diagnosis, or at least getting closer to one. It would help doctors treat you, even if it doesn't show sleep apnea. I think there are varying types of sleep studies (some which can pretty much only diagnose sleep apnea; some of which can give more detailed information about how you sleep, etc.). But, IANAD, so I could be wrong on this and defer to others' opinions.
Reading up on other disorders and it often sounds like you just have to learn to live with it.
Hopefully this is not the case! But if it is, I would think hard about just dismissing treatments like Ambien out of hand. Even if it's just a treatment rather than a cure, something like that could really improve your quality of life.
posted by schroedingersgirl at 5:15 PM on December 16, 2013
Best answer: I agree that you need to find a long term cure or solution, but that does not preclude you from finding a short term one in the interim. Consider taking the Ambien.
Seconding this. Even if you weren't sure about the Ambien, it would make sense to at least get a second or third opinion. Pursuing a short term solution won't stop you from getting to the bottom of the underlying problem and hopefully finding a long term solution or cure.
posted by schroedingersgirl at 5:17 PM on December 16, 2013 [1 favorite]
Seconding this. Even if you weren't sure about the Ambien, it would make sense to at least get a second or third opinion. Pursuing a short term solution won't stop you from getting to the bottom of the underlying problem and hopefully finding a long term solution or cure.
posted by schroedingersgirl at 5:17 PM on December 16, 2013 [1 favorite]
Best answer: Your situation sounds simultaneously confusing but also basically like how my (non live-in) boyfriend sleeps. He's up and down a lot and if left to his own devices will sleep about 3 am until 1 or 2 in the afternoon but go back and forth between seemingly light sleep and deeper sleep. I have never seen someone so able to sleep at the drop of a hat but also unable to get long-term sleep on a consistent schedule at night.
He got a sleep study recently which was ... inconclusive, but its a really idea to go though with it. The "I wake up exhausted" is usually a tip-off but there are a lot of other things that could be going on. My suggestions are the same as JohnnyGunn's
- take the Ambien or find a doctor that you feel that you have a rapport with and work on strategies
- this should allow you to ease back on the caffeine and see if that has any effect
- it will also allow you to operate in your household on a more regular schedule which is something you say you want
- you don't mention this at all, but if you're a marijuana smoker you might want to ease back on that and see if it has any effect
posted by jessamyn at 5:17 PM on December 16, 2013
He got a sleep study recently which was ... inconclusive, but its a really idea to go though with it. The "I wake up exhausted" is usually a tip-off but there are a lot of other things that could be going on. My suggestions are the same as JohnnyGunn's
- take the Ambien or find a doctor that you feel that you have a rapport with and work on strategies
- this should allow you to ease back on the caffeine and see if that has any effect
- it will also allow you to operate in your household on a more regular schedule which is something you say you want
- you don't mention this at all, but if you're a marijuana smoker you might want to ease back on that and see if it has any effect
posted by jessamyn at 5:17 PM on December 16, 2013
Response by poster: No drug use, and very little alcohol consumption.
I was trying to be comprehensive and now I realize I kind of mangled the explanation on the 3 consecutive hours thing, so to elaborate:
- Last night I slept from 430am - 2pm, but I was up for short periods at 730, up at 930, and then up finally again at 2 for good. The stretch from 930am - 2pm is the longest consecutive period of sleep I can remember getting in the last few months, which is what got me to thinking about posting this question.
posted by imabanana at 5:23 PM on December 16, 2013
I was trying to be comprehensive and now I realize I kind of mangled the explanation on the 3 consecutive hours thing, so to elaborate:
- Last night I slept from 430am - 2pm, but I was up for short periods at 730, up at 930, and then up finally again at 2 for good. The stretch from 930am - 2pm is the longest consecutive period of sleep I can remember getting in the last few months, which is what got me to thinking about posting this question.
posted by imabanana at 5:23 PM on December 16, 2013
Best answer: There is absolutely a benefit to having a sleep study even if it does not diagnose you with obstructive sleep apnea (which it might well do, despite your lack of loud snoring). For one thing, it could potentially diagnose you with central sleep apnea, which is a serious condition that can cause all kinds of very unpleasant symptoms.
Even if the sleep study does not result in a diagnosis of OSA or CSA, it will at the very least rule those two conditions out so that your doctors might better refine their search for the cause of your symptoms.
posted by Juffo-Wup at 5:25 PM on December 16, 2013
Even if the sleep study does not result in a diagnosis of OSA or CSA, it will at the very least rule those two conditions out so that your doctors might better refine their search for the cause of your symptoms.
posted by Juffo-Wup at 5:25 PM on December 16, 2013
Best answer: GPs tend to have a significant number of patients who have sleep issues. Unfortunately for narrowing it down via the internet, they can manifest from obstructive (e.g. sleep apnea), psychiatric (stress or mood disorders like depression), neurological (circadian rhythm disorders such as delayed sleep phase), or substance-induced causes (caffeine, alcohol, benzos, hypnotics like ambien).
A large population of patients become dependent on sleep aids so I would recommend against starting it if you are presently functional with work and personal life until you're better able to narrow down a diagnosis. Your age is a relevant factor as well.
First steps would be to get evaluated for sleep apnea and ensure that you have no other concurrent medical conditions that may be contributing to your poor sleep. Next would be to attempt lifestyle modifications such as cutting out caffeine and improving sleep hygiene (e.g. only sleeping in the bedroom, no electronics before bed, sleeping at the same time, white noise from fans, etc.). Blue light therapy, melatonin and other over the counter remedies have been shown to have marginal benefit.
Sleep studies definitely can help narrow down the cause, but until you get further evaluated, they may not provide helpful diagnostic information.
posted by palionex at 5:26 PM on December 16, 2013
A large population of patients become dependent on sleep aids so I would recommend against starting it if you are presently functional with work and personal life until you're better able to narrow down a diagnosis. Your age is a relevant factor as well.
First steps would be to get evaluated for sleep apnea and ensure that you have no other concurrent medical conditions that may be contributing to your poor sleep. Next would be to attempt lifestyle modifications such as cutting out caffeine and improving sleep hygiene (e.g. only sleeping in the bedroom, no electronics before bed, sleeping at the same time, white noise from fans, etc.). Blue light therapy, melatonin and other over the counter remedies have been shown to have marginal benefit.
Sleep studies definitely can help narrow down the cause, but until you get further evaluated, they may not provide helpful diagnostic information.
posted by palionex at 5:26 PM on December 16, 2013
Best answer: According to Wikipedia, Ambien's half-life is 2 to 3 hours. That may not be the best source for information, but that's certainly my experience with Ambien. It puts me to sleep, but only for about 3 hours. I tend to wake up a lot, and find Ambien pretty useless. So if you're going to use prescription drugs, you might be a lot better off with something like Xanax or Klonopin.
posted by still_wears_a_hat at 5:26 PM on December 16, 2013
posted by still_wears_a_hat at 5:26 PM on December 16, 2013
Best answer: I don't see how you can make rational decisions on punctuated sleep. Take the Ambien for a couple of nights and re-think your situation. I take Ambien, and it keeps me asleep. Still up at dawn, but that's a feature, not a bug, for me.
posted by Ideefixe at 5:27 PM on December 16, 2013
posted by Ideefixe at 5:27 PM on December 16, 2013
Best answer: You should absolutely do the sleep study! Sleep apnea can have very serious health consequences, so you at least need to rule that out. Many people have sleep apnea and don't snore, so don't rely on that as an indicator.
Even if you don't have sleep apnea, the sleep study will be able to look for other sleep disorders. You are unfortunately correct in that many sleep disorders are not as "treatable" as sleep apnea, and that the study may find issues with your sleep without providing you with a specific diagnosis. But it will still provide you with useful information about what's going on and give your doctors a direction to go in. There are plenty of medical and psychological/behavioral interventions for sleep issues beyond the CPAP machine.
I saw a sleep therapist as well as a sleep doctor after my sleep study and I thought the therapist was really helpful. They helped me implement better sleep hygiene and work through a lot of the cognitive distortions and emotional distress that cropped up around struggling to sleep each night. It was more useful in the short term but I would recommend it if you can find one.
posted by fox problems at 5:52 PM on December 16, 2013
Even if you don't have sleep apnea, the sleep study will be able to look for other sleep disorders. You are unfortunately correct in that many sleep disorders are not as "treatable" as sleep apnea, and that the study may find issues with your sleep without providing you with a specific diagnosis. But it will still provide you with useful information about what's going on and give your doctors a direction to go in. There are plenty of medical and psychological/behavioral interventions for sleep issues beyond the CPAP machine.
I saw a sleep therapist as well as a sleep doctor after my sleep study and I thought the therapist was really helpful. They helped me implement better sleep hygiene and work through a lot of the cognitive distortions and emotional distress that cropped up around struggling to sleep each night. It was more useful in the short term but I would recommend it if you can find one.
posted by fox problems at 5:52 PM on December 16, 2013
Best answer: Is there a benefit to doing a sleep study if it turns out not to be sleep apnea?
Yes, very much. It produces a continuous graph of breathing, movement, and brain activity, which is very descriptive of your sleep cycles and can, in themselves, show problems. While the medical field isn't really sure why we sleep, they've got a pretty good profile of good vs. bad sleep.
Try the sleeping pills, too. As someone who dealt with my own and my wife's sleep issues, I can say with great confidence that improving your sleep makes a huge difference in how the world looks, and no options should be off the table.
posted by fatbird at 6:13 PM on December 16, 2013 [1 favorite]
Yes, very much. It produces a continuous graph of breathing, movement, and brain activity, which is very descriptive of your sleep cycles and can, in themselves, show problems. While the medical field isn't really sure why we sleep, they've got a pretty good profile of good vs. bad sleep.
Try the sleeping pills, too. As someone who dealt with my own and my wife's sleep issues, I can say with great confidence that improving your sleep makes a huge difference in how the world looks, and no options should be off the table.
posted by fatbird at 6:13 PM on December 16, 2013 [1 favorite]
Best answer: Definitely worth doing the sleep study! Narcolepsy, restless leg, central sleep apnea, they are all things you want to KNOW about, and can certainly be treated, if not cured.
Sleep medicine is a bit of an odd field, since its pretty new. Sleep doctors can be psychiatrists, respirologists, or neurologists. You can pick and choose based on what you would like, but, if it were me I would want a chest-doc reading my study.
posted by cacofonie at 7:12 PM on December 16, 2013
Sleep medicine is a bit of an odd field, since its pretty new. Sleep doctors can be psychiatrists, respirologists, or neurologists. You can pick and choose based on what you would like, but, if it were me I would want a chest-doc reading my study.
posted by cacofonie at 7:12 PM on December 16, 2013
Best answer: Get the sleep study done! A comprehensive one - where you spend the night in a lab - doesn't just check for sleep apnea. They check for narcolepsy, restless leg syndrome, and all sorts of things that can rob you of a good night's sleep.
It sounds like you are not getting GOOD sleep - waking up to urinate every night is not normal, unless you have an enlarged prostate. And you should be waking up refreshed. Since you are not, it sounds as if you are not getting good quality sleep.
In the short term, take the Ambien. To avoid the infamous side effects, you need to take it and then go straight to bed. Most of the sleep-walking, sleep-cooking, sleep-shopping, etc. caused by Ambien occur either because the person taking it was drinking alcohol at the same time, or took the Ambien and stayed up doing whatever instead of going to bed. The Ambien should allow you to get some, hopefully better, sleep until you can address the underlying problem.
My story: I had chronic, severe insomnia; I was also getting up to pee nearly every night (and I wasn't drinking gallons of beer!). I pushed for an in-lab sleep test. My problem? Severe sleep apnea. I now have a CPAP and my sleep is so much better in both quality and quantity. I hardly ever get up to use the toilet anymore, my dreams are much more pleasant, and my sleep is refreshing - and best of all, I can actually get to sleep!
posted by Rosie M. Banks at 5:52 AM on December 17, 2013
It sounds like you are not getting GOOD sleep - waking up to urinate every night is not normal, unless you have an enlarged prostate. And you should be waking up refreshed. Since you are not, it sounds as if you are not getting good quality sleep.
In the short term, take the Ambien. To avoid the infamous side effects, you need to take it and then go straight to bed. Most of the sleep-walking, sleep-cooking, sleep-shopping, etc. caused by Ambien occur either because the person taking it was drinking alcohol at the same time, or took the Ambien and stayed up doing whatever instead of going to bed. The Ambien should allow you to get some, hopefully better, sleep until you can address the underlying problem.
My story: I had chronic, severe insomnia; I was also getting up to pee nearly every night (and I wasn't drinking gallons of beer!). I pushed for an in-lab sleep test. My problem? Severe sleep apnea. I now have a CPAP and my sleep is so much better in both quality and quantity. I hardly ever get up to use the toilet anymore, my dreams are much more pleasant, and my sleep is refreshing - and best of all, I can actually get to sleep!
posted by Rosie M. Banks at 5:52 AM on December 17, 2013
Best answer: I'm not a doctor, but the gradual shifts in your sleep cycle sound like they could be related to a sleep phase disorder, specifically non-24 hour sleep-wake disorder. It's worth talking to a specialist to find out what's really going on, including whether treatments are available. In the case of non-24-hour sleep-wake disorder, some use melatonin or UV treatments (similar with SAD treatments), though of course you should pursue this with a specialist to ensure this is what's really going on and not another disorder or medical problem.
posted by PhoBWanKenobi at 7:39 AM on December 17, 2013
posted by PhoBWanKenobi at 7:39 AM on December 17, 2013
Best answer: 2-4 sodas a day is pretty excessive in my opinion. Cut back or cut it out if you can.
posted by cellphone at 8:00 AM on December 17, 2013
posted by cellphone at 8:00 AM on December 17, 2013
Best answer: Just a thought- do you wake up needing to go to the bathroom? Have you had your prostate checked lately? No liquids before bed either.
Also, some people are slow metabolizes of caffeine. Try cutting it out. I know if I have caffeine after noon, I'll have trouble sleeping if I do.
Also cut out bright lights, tv screens, and monitors before bed.
If you google sleep hygiene you'll probably find tips.
Definitely do the study and take the ambien. Maybe even try some benedryl if that makes you drowsy.
posted by lorisr at 10:26 AM on December 17, 2013
Also, some people are slow metabolizes of caffeine. Try cutting it out. I know if I have caffeine after noon, I'll have trouble sleeping if I do.
Also cut out bright lights, tv screens, and monitors before bed.
If you google sleep hygiene you'll probably find tips.
Definitely do the study and take the ambien. Maybe even try some benedryl if that makes you drowsy.
posted by lorisr at 10:26 AM on December 17, 2013
Best answer: For sure, do the sleep study, if for no other reason than to rule out sleep apnea, although a good one will detect other problems.
It is said that the "sleep through the night" thing is not really how we evolved, but an adaption of our sleep to the needs of the factory. Here's an article on Segmented Sleep in Wikipedia. It's perfectly normal to wake early in the morning for a bit, before falling back to sleep.
Because you don't feel rested, this is problematic, but if you could relax about it, knowing that it's perfectly normal, would that help?
Try the Ambien, it may help you.
posted by Ruthless Bunny at 10:27 AM on December 17, 2013
It is said that the "sleep through the night" thing is not really how we evolved, but an adaption of our sleep to the needs of the factory. Here's an article on Segmented Sleep in Wikipedia. It's perfectly normal to wake early in the morning for a bit, before falling back to sleep.
Because you don't feel rested, this is problematic, but if you could relax about it, knowing that it's perfectly normal, would that help?
Try the Ambien, it may help you.
posted by Ruthless Bunny at 10:27 AM on December 17, 2013
Best answer: Apnea patient here. Get a referral to a sleep doctor (er.. sleep medicine specialist), and he/she can decide whether or not to prescribe a sleep study. The doc can also prescribe a home sleep study, where you take home a portable kit with some kind of sensor bonnet to wear overnight; I'm not sure what medical symptoms suggest one over the the other, but your sleep doctor is really the one who'll have final say on whether you get the opportunity of a sleep study of any kind.
One weird thing I learned after I started CPAP therapy is that apnea is what caused me to very reliably have to pee in the middle of the night, every night -- the heart's extra work causes it to produce a hormone that stimulates urine production in your kidneys. Now I sleep through the night; not only do I sleep deeper, but there's no more bladder urgency in the dark of night.
I also sleep less now, and never sleep in anymore-- I was getting lots of head-on-pillow time while my apnea was untreated, but I wasn't sleeping very deeply (brain was waking up on average every 40 seconds) or restfully. I sleep less now because I sleep better than I have in a decade.
Get an appointment today (seriously, I regret the time I lost because I procrastinated on this), and see if you can do some sleep tracking between now and then. Some of the gadgets are nice enough for that sort of thing, but a manually-activated smartphone app will also fit the bill. Show the data to your doctor if you and the doc think it would be helpful.
posted by Sunburnt at 11:38 AM on December 17, 2013
One weird thing I learned after I started CPAP therapy is that apnea is what caused me to very reliably have to pee in the middle of the night, every night -- the heart's extra work causes it to produce a hormone that stimulates urine production in your kidneys. Now I sleep through the night; not only do I sleep deeper, but there's no more bladder urgency in the dark of night.
I also sleep less now, and never sleep in anymore-- I was getting lots of head-on-pillow time while my apnea was untreated, but I wasn't sleeping very deeply (brain was waking up on average every 40 seconds) or restfully. I sleep less now because I sleep better than I have in a decade.
Get an appointment today (seriously, I regret the time I lost because I procrastinated on this), and see if you can do some sleep tracking between now and then. Some of the gadgets are nice enough for that sort of thing, but a manually-activated smartphone app will also fit the bill. Show the data to your doctor if you and the doc think it would be helpful.
posted by Sunburnt at 11:38 AM on December 17, 2013
Best answer: Even when I'm exercising and keeping up good sleep hygiene habits, I'm a very restless sleeper. I'll often wake multiple times per hour, wake up for long periods in the early AM, and so on.
I tried Ambien but the side effects were terrible for me. What's been working for me is trazadone. It's an antidepressant that can be prescribed as a sleep aid. It allows me to stay asleep for longer periods of time, and to quickly go back to sleep when I do wake up.
posted by Squeak Attack at 4:11 PM on December 17, 2013
I tried Ambien but the side effects were terrible for me. What's been working for me is trazadone. It's an antidepressant that can be prescribed as a sleep aid. It allows me to stay asleep for longer periods of time, and to quickly go back to sleep when I do wake up.
posted by Squeak Attack at 4:11 PM on December 17, 2013
Best answer: jessamyn: "Your situation sounds simultaneously confusing but also basically like how my (non live-in) boyfriend sleeps . . . He got a sleep study recently which was ... inconclusive, but its a really [good] idea to go though with it."
Jessamyn's referring to me.
I have a little trouble drifting off to sleep -- I feel most awake at night, I roll over and fidget, and my mind is very active -- but I'm not anxious. In fact, going to sleep for me is kinda cool. My mind will compose its own music, or randomly walk through absurd situations, and I just kinda watch in a non-participatory kinda way, until sooner or later, I hit that sleep boundary. But most of my problem, I am betting, stems from that I wake up lot of times during the night: rolling over from one side to another regularly, which I'm awake enough to be aware of doing; getting up to pee; peeking at the clock; drinking a sip of water. Sleep hygiene helps some of it -- I go to sleep earlier on average if I set a limit on computer-time and read myself to sleep; I feel better during the night if I turn the clockface away from me; I sleep with earplugs -- maybe not wise in a home-safety/smoke-alarm sense, but the sound of only my own breathing and nothing else is kinda soothing. I still drink water before bed because for me waking up to pee is much better than waking up parched. I also exercise regularly, and sleep maybe a little better on the days I do. But I decided I'd like a quantitative look at why I become conscious so many times during the night. So my doc gave me a referral to a pulmonary doc who also does sleep work.
Anyway, this doc said to sign up for an overnight sleep study. Here's my experience, just so you know. It was interesting, to say the least. I arrived at 9PM, they gave me a room (with the best view of Boston EVAH), I was told to hang out, relax, they'd be in 11-11:30 to hook me up. The technician (not the doc) came in around then, set wires on me everywhere -- my legs, my chest, my arms, my face and skull (see picture here), and then they plugged those into something in the wall, and said, stay there, go to sleep, good night, use the buzzer if you have to pee so I can unplug you. He also said that by the next morning, and in some cases, even in the middle of the night, they would know if someone had sleep apnea, and you could take a CPAP machine home with you the next morning, for keeps. If you were diagnosed in the middle of the night, they'd even hook you up with your new CPAP right there, and then and you and your new robot buddy go back to sleep and see what difference it made in the morning.
So, I slept from 1:30ish to 7ish, frequently waking up (I thought) because of the (not so snuggly) tangle of wires I was connected to. The next morning, I was told by the technician that I "probably had mild sleep apnea," and I may have to come in for another test, but no need to take a CPAP home. I was then called less than a day later by a second technician who told me, "You have moderate sleep apnea, would you like to come down for a CPAP machine? Right now?" Well, I'm not ready to sleep with robot darth vader (rowr), though others seem to handle the actual experience fine. I probably could get used to it, but as I'm not ready to hop on board, I told him I'd rather discuss the results with the specialist before I do so, and see if I can come up with alternate solutions. I myself haven't seen the results, not that I would be able to interpret them.
So, that's where I am now. Inconclusive, until I see the pulmonary doc next month. (Who's at least ten years younger than me, OY!) In the meantime, my Wicked Pissah™ insurance recently had a deal on the FitBit Flex™ where they subsidized 80% of the cost for one. So I'm looking forward to all the neat features, seeing graphs or whatever data it spits out -- but particularly the sleep/wake data.
[on edit: I was prescribed trazadone about a decade back for mild depression and insomnia, and it hit me like a zombie pill: yes, I slept fast, deep, and long like I was Sleeping Beauty. When I woke up, I felt like a Romero-film Zombie. YMMV. I haven't tried any other sleep medications besides benadryl (works well for me).]
tl;dr: see your GP and get a referral for a sleep study.
posted by not_on_display at 4:39 PM on December 17, 2013
Jessamyn's referring to me.
I have a little trouble drifting off to sleep -- I feel most awake at night, I roll over and fidget, and my mind is very active -- but I'm not anxious. In fact, going to sleep for me is kinda cool. My mind will compose its own music, or randomly walk through absurd situations, and I just kinda watch in a non-participatory kinda way, until sooner or later, I hit that sleep boundary. But most of my problem, I am betting, stems from that I wake up lot of times during the night: rolling over from one side to another regularly, which I'm awake enough to be aware of doing; getting up to pee; peeking at the clock; drinking a sip of water. Sleep hygiene helps some of it -- I go to sleep earlier on average if I set a limit on computer-time and read myself to sleep; I feel better during the night if I turn the clockface away from me; I sleep with earplugs -- maybe not wise in a home-safety/smoke-alarm sense, but the sound of only my own breathing and nothing else is kinda soothing. I still drink water before bed because for me waking up to pee is much better than waking up parched. I also exercise regularly, and sleep maybe a little better on the days I do. But I decided I'd like a quantitative look at why I become conscious so many times during the night. So my doc gave me a referral to a pulmonary doc who also does sleep work.
Anyway, this doc said to sign up for an overnight sleep study. Here's my experience, just so you know. It was interesting, to say the least. I arrived at 9PM, they gave me a room (with the best view of Boston EVAH), I was told to hang out, relax, they'd be in 11-11:30 to hook me up. The technician (not the doc) came in around then, set wires on me everywhere -- my legs, my chest, my arms, my face and skull (see picture here), and then they plugged those into something in the wall, and said, stay there, go to sleep, good night, use the buzzer if you have to pee so I can unplug you. He also said that by the next morning, and in some cases, even in the middle of the night, they would know if someone had sleep apnea, and you could take a CPAP machine home with you the next morning, for keeps. If you were diagnosed in the middle of the night, they'd even hook you up with your new CPAP right there, and then and you and your new robot buddy go back to sleep and see what difference it made in the morning.
So, I slept from 1:30ish to 7ish, frequently waking up (I thought) because of the (not so snuggly) tangle of wires I was connected to. The next morning, I was told by the technician that I "probably had mild sleep apnea," and I may have to come in for another test, but no need to take a CPAP home. I was then called less than a day later by a second technician who told me, "You have moderate sleep apnea, would you like to come down for a CPAP machine? Right now?" Well, I'm not ready to sleep with robot darth vader (rowr), though others seem to handle the actual experience fine. I probably could get used to it, but as I'm not ready to hop on board, I told him I'd rather discuss the results with the specialist before I do so, and see if I can come up with alternate solutions. I myself haven't seen the results, not that I would be able to interpret them.
So, that's where I am now. Inconclusive, until I see the pulmonary doc next month. (Who's at least ten years younger than me, OY!) In the meantime, my Wicked Pissah™ insurance recently had a deal on the FitBit Flex™ where they subsidized 80% of the cost for one. So I'm looking forward to all the neat features, seeing graphs or whatever data it spits out -- but particularly the sleep/wake data.
[on edit: I was prescribed trazadone about a decade back for mild depression and insomnia, and it hit me like a zombie pill: yes, I slept fast, deep, and long like I was Sleeping Beauty. When I woke up, I felt like a Romero-film Zombie. YMMV. I haven't tried any other sleep medications besides benadryl (works well for me).]
tl;dr: see your GP and get a referral for a sleep study.
posted by not_on_display at 4:39 PM on December 17, 2013
Best answer: I'm still figuring out the sleep issues I've had since I was a child, but things have improved over the years (I sleep well many more nights now). What helps, primarily, is making sure I wake up at the same time every morning. The first several mornings, you feel terrible, but in some time I find the body caves in. It's mostly persistence (not my strong point).
When I have a particularly hard time getting my sleep cycle back to 'normal', I sit out in the sun in the morning. There's something about light in the eyes and how that helps the body's cycles. I take sleep meds only when I'm ill and I really need the sleep to recover — and then it's important to take them at the time you want to regularly sleep, and yes, sleep straight after, and wake up at the right time even if you're groggy.
I think playing around with meal times and exercise times and everything else that might affect the body's cycles helps too. I also find that falling into good sleep at the very beginning, rather than restless sleep, is something I can often control. And it affects the rest of the night. It's amazing how tiny subtle things can have so much impact collectively.
posted by miaow at 7:06 PM on December 19, 2013
When I have a particularly hard time getting my sleep cycle back to 'normal', I sit out in the sun in the morning. There's something about light in the eyes and how that helps the body's cycles. I take sleep meds only when I'm ill and I really need the sleep to recover — and then it's important to take them at the time you want to regularly sleep, and yes, sleep straight after, and wake up at the right time even if you're groggy.
I think playing around with meal times and exercise times and everything else that might affect the body's cycles helps too. I also find that falling into good sleep at the very beginning, rather than restless sleep, is something I can often control. And it affects the rest of the night. It's amazing how tiny subtle things can have so much impact collectively.
posted by miaow at 7:06 PM on December 19, 2013
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Sometime the best course of action is to start eliminating possibilities which may lead to the solution. Short term discomfort can be mitigated by short term solutions while the cause is sought.
I would also eliminate the caffeine. I would also research how the rest of your diet may be affecting your sleep including the times of meals. Finally, I would find a doctor that specializes in sleep disorders rather than use my GP.
posted by JohnnyGunn at 5:13 PM on December 16, 2013 [2 favorites]