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#341 Ferret

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Posted 25 June 2015 - 11:16 PM

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Read this please...http://www.psychiatr...-sleep/page/0/1

The above chart is from the link.

Do NOT feel ashamed! However, your Doctor might want to feel ashamed after she reads the article. Fluoxetine is an SSRI and it most certainly DOES suppress REM and increase REM latency.

The above is just ONE article...google "does Fluoxetine suppress REM" and you'll find pages and pages of information.

Stand firm! Your money, your time and your life...take charge.



#342 everythingthatshimmers

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Posted 26 June 2015 - 12:51 AM

IMO, you are pathologically sleepy or else you wouldn't be able to sleep for four consecutive naps. And six minutes is a fairly short latency. Sounds like IH to me with the sleep latency, no SOREMS, and long naps but I'm certainly no expert.

The main reason I'm replying is because of the visual disturbance you mentioned--my eyes also lose focus at random times. I've mentioned it to two different sleep doctors and they acted like they had never heard of it. Like you, my vision checks out fine during my annual exams. I would think it must be a CNS issue since it's transient. I was advised to get tested for diabetes--been there, done that, blood glucose was fine.

#343 Monstreline

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Posted 26 June 2015 - 07:41 PM


Read this please...http://www.psychiatr...-sleep/page/0/1
The above chart is from the link.
Do NOT feel ashamed! However, your Doctor might want to feel ashamed after she reads the article. Fluoxetine is an SSRI and it most certainly DOES suppress REM and increase REM latency.
The above is just ONE article...google "does Fluoxetine suppress REM" and you'll find pages and pages of information.
Stand firm! Your money, your time and your life...take charge.


Thanks Ferret, for the support AND the great link.

I have a follow-up appointment in a month, for the doc to assess how effective the Ritalin is. I've decided to stop my meds and continue with the sleep diary until my next appointment.

And before everyone gets worried when I talk about stopping meds, the fluoxetine isn't an issue, I've tapered off of it before with my doctor and pharmacist's help, I'll have the pharmacist compound to the same specifications. And as for my chronic pain meds, they don't help as much as they used to anyway. They don't have any withdrawal symptoms so no worries there, and the doc believes that they could be causing the EDS. So I'm going to take a few months to get a baseline.

I'll continue with the sleep diaries and see how it all goes.

Thanks again!

#344 Monstreline

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Posted 26 June 2015 - 07:43 PM

IMO, you are pathologically sleepy or else you wouldn't be able to sleep for four consecutive naps. And six minutes is a fairly short latency. Sounds like IH to me with the sleep latency, no SOREMS, and long naps but I'm certainly no expert.

The main reason I'm replying is because of the visual disturbance you mentioned--my eyes also lose focus at random times. I've mentioned it to two different sleep doctors and they acted like they had never heard of it. Like you, my vision checks out fine during my annual exams. I would think it must be a CNS issue since it's transient. I was advised to get tested for diabetes--been there, done that, blood glucose was fine.


Ha! I can totally relate; some years I've gone back for multiple eye tests because I was certain they missed something.

The eye thing is really weird and frustrating!

#345 Paulette79

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Posted 29 June 2015 - 12:33 PM

If it is possible, you may want to repeat the daytime test without any meds, I know that may mean weaning from the Prozac but it may be worth it to get a reliable and perhaps more definitive result. Also, could the antidepressant be causing the EDS? Just some thoughts...

#346 purpley

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Posted 09 July 2015 - 10:28 AM

Excuse me, I don't often call my colleagues ignorant, but in this case, your doctor's completely ignorant.  Fluoxetine and other SSRIs absolutely, positively suppress REM!  In fact, not only do they decrease the total amount of REM sleep, they increase REM latency -- and rapid-onset REM is very thing you're looking for on an MSLT.

 

There's no way to say that an MSLT rules out narcolepsy while a person is on the maximum dose of fluoxetine.  Fortunately for you, at least she recognizes the EDS and you're going to have a trial of Ritalin.  But really, what is it with these sleep docs???

 

Thanks Sleepingmonkey!

I got my results today. No Dx. My mean sleep latency was 6.77 min and I had no SOREMPs. I asked the doctor if the lack of SOREMPs could be related to my taking a maximum daily dose of fluoxetine for over a year, but she said no. I also asked if my issues focusing my eyes could be related to my sleep issues and she said that I should see an ophthalmologist as it was very unlikely that the trouble that I have with my eyes, going out of focus, could be related to a sleep disorder. That it was more likely caused by my anti-depressant or my meds for chronic pain. My eyes have been sliding out of focus for a lot longer than I have taken any medications, it started before I hit my teens.

The treatment is Ritalin for moderate EDS based on my mean sleep latency. We'll see how it goes. I'd like to be able to have a bit more energy in the afternoons, to get more done, rather than slinking off for two to three hour long naps.

I feel ashamed. I'm young, and I seem to have all these complaints...chronic back pain, with no medically identifiable cause, sleepiness that isn't narcolepsy or anything else. Maybe I'm just a whiner. Whenever I leave a doctor's office I always feel as though they must think that I imagine these things.



#347 Monstreline

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Posted 10 July 2015 - 09:38 PM

If it is possible, you may want to repeat the daytime test without any meds, I know that may mean weaning from the Prozac but it may be worth it to get a reliable and perhaps more definitive result. Also, could the antidepressant be causing the EDS? Just some thoughts...


I'm on the same page; I discontinued my Celebrex and Lyrica (to see if they're causing the EDS) and am tapering off my Fluoxetine in case I get another shot at an MSLT.

It's highly unlikely that another MSLT will be performed however, unless there is a significant change in my symptoms as I live in Ontario where the test is covered by provincial health care.

#348 Monstreline

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Posted 10 July 2015 - 10:11 PM

Excuse me, I don't often call my colleagues ignorant, but in this case, your doctor's completely ignorant. Fluoxetine and other SSRIs absolutely, positively suppress REM! In fact, not only do they decrease the total amount of REM sleep, they increase REM latency -- and rapid-onset REM is very thing you're looking for on an MSLT.

There's no way to say that an MSLT rules out narcolepsy while a person is on the maximum dose of fluoxetine. Fortunately for you, at least she recognizes the EDS and you're going to have a trial of Ritalin. But really, what is it with these sleep docs???


Thanks Purpley,

I'm uncertain if there is any value in spending my time chasing a Dx if I will still be able to get treated for EDS.

So far the Ritalin keeps me awake but also makes my heart POUND! The pounding continues long after the energy has worn of so I end up sleepy, but unable to sleep.

I'm going to try taking some magnesium citrate tomorrow to see if it help with the heart pounding.

#349 purpley

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Posted 13 July 2015 - 09:54 AM

Thanks Purpley,

I'm uncertain if there is any value in spending my time chasing a Dx if I will still be able to get treated for EDS.

So far the Ritalin keeps me awake but also makes my heart POUND! The pounding continues long after the energy has worn of so I end up sleepy, but unable to sleep.

I'm going to try taking some magnesium citrate tomorrow to see if it help with the heart pounding.

 

I agree, chasing the diagnosis isn't too important as long as you're getting treatment.  Meanwhile, try dividing up the Ritalin into smaller doses -- like a half pill every 2-3 hours instead of two full pills 6 hours apart or however you have it scheduled.  Plus avoid caffeine!

 

The real solution will be a longer-acting formula (or a change to a different stimulant, like Adderall), but dividing up the dose like I suggest above will be almost the same, just a lot more work.



#350 sleepingmonkey

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Posted 13 July 2015 - 01:37 PM

So far the Ritalin keeps me awake but also makes my heart POUND! The pounding continues long after the energy has worn of so I end up sleepy, but unable to sleep.

 

Same thing happened to me with Adderall. I currently split my 10mg dose and space them out 2-3 hours like Purpley said. I don't always take the second dose. This eliminates the jitters for me!



#351 Monstreline

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Posted 20 July 2015 - 12:39 PM

Thanks to everyone for all of the great tips and information!

Something occurred to me in my sleep/wake last night;
In my follow-up appointment, while my sleep doc was reviewing my results with me, she noted that I had not experienced any 'microsleeps' between the sanctioned naps.

However, each time the technician came into the room to wake me up, she also disconnected the lead wires from the box on the beside table, that transferred the information to their computers.

Wouldn't that mean that if I had experienced any episodes of microsleep between naps, that they would not appear in the results?

IMO, you are pathologically sleepy or else you wouldn't be able to sleep for four consecutive naps. And six minutes is a fairly short latency. Sounds like IH to me with the sleep latency, no SOREMS, and long naps but I'm certainly no expert.

The main reason I'm replying is because of the visual disturbance you mentioned--my eyes also lose focus at random times. I've mentioned it to two different sleep doctors and they acted like they had never heard of it. Like you, my vision checks out fine during my annual exams. I would think it must be a CNS issue since it's transient. I was advised to get tested for diabetes--been there, done that, blood glucose was fine.

 
 

If it is possible, you may want to repeat the daytime test without any meds, I know that may mean weaning from the Prozac but it may be worth it to get a reliable and perhaps more definitive result. Also, could the antidepressant be causing the EDS? Just some thoughts...

 
 

Excuse me, I don't often call my colleagues ignorant, but in this case, your doctor's completely ignorant.  Fluoxetine and other SSRIs absolutely, positively suppress REM!  In fact, not only do they decrease the total amount of REM sleep, they increase REM latency -- and rapid-onset REM is very thing you're looking for on an MSLT.
 
There's no way to say that an MSLT rules out narcolepsy while a person is on the maximum dose of fluoxetine.  Fortunately for you, at least she recognizes the EDS and you're going to have a trial of Ritalin.  But really, what is it with these sleep docs???

 
 

Same thing happened to me with Adderall. I currently split my 10mg dose and space them out 2-3 hours like Purpley said. I don't always take the second dose. This eliminates the jitters for me!



#352 Jai

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Posted Yesterday, 01:29 AM

If your un hooked how would they know if you had a micro sleep. (I was unhooked between naps too)