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Worsening Nighttime Wake Cycle Eroding Ability Getting To Doc Appts, Why? Advice? Help!


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#1 slo.mo.a.go.go

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Posted 12 November 2013 - 06:46 AM

I'm hoping some w/ sleep cycle wackiness might weigh in/ shed light or advice on my problem. Bf stims I was unable to stay awake for more then 10 hrs a day. But I had some say in my body/mind waking for some daylight hrs. After stims(dx'd & rx'd for adhd 8yrs ago) I could maintain a mind/body normal sleep wake cycle- meaning awake for the day and sleep at night (sleeping 10 hrs reg).  

 

Slowing over the past 1yr, I having been losing any control over getting myself alert during daylight hours   despite maintaining stim and exercise regime. My sleep cycle is of a night owl completely now, regardless of stim vacations. being on stims, I take them early by 10am, feel them wear off, feel tired but stay outta bed until 9pm and fell like i'm going to zonk out ( maybe I do sleep, I can sleep thinking I'm awake) but then -whammy!- I'm alert and awake at midnight and cant fall asleep until 10 in the morning. I cant break out of thiis cycle despite many things tried.

 

So 9 out of 10 days, I face the dilemma do I take my stims to try to get to my doc appts and errands? Taking the stims either leaves me a zombie (duh no sleep, plus I hate this option, I dont want to mess w/ a my already wacky sleep/wake cycle), or I sleep after the stims to wake up around 8pm-ish and miss my appts.

 

Anyone relate?

 

oh the irony-- cant get to a sleep specialist to ask them abt this! I'm pretty amused and laugh at my absurd situation!



#2 Hank

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Posted 12 November 2013 - 10:31 PM

One of the significant pieces of Narcolepsy is fragmented nighttime sleep. I have an inability to maintain sleep. So, I can fall asleep- I just can't stay asleep.

 

The problem with many sleep medications is that they are addictive and intended for short term use only.

 

Psychiatrists routinely use sedating antidepressants for sleep in their patients.

 

For me, Trazadone does the trick. It is very sedating, lasts 8 hours, non-addictive and cheap. I can rely on getting a decent nights sleep. Others my experience side effects like grogginess in the am, but I have not.

 

I think it is very important to treat this symptom of N and take it seriously. A bad night's sleep really screws up the next day. It really brings down morale.

 

I hope you get some relief.



#3 slo.mo.a.go.go

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Posted 13 November 2013 - 04:41 AM

Thank you for your advice. appreciate yr recommendation of trazadone, and the key xtra details of being non-addictive (my preference) and cheap (my preference too!) i'm very glad you have something that works for you and pass along yr exp. I'll let you know if it helps me.

 

I take 100mg zoloft in the evening (so any sedating effects will be felt at night, not the day) and 3x15mg buspar during day for anxiety. I also occasionally take .5mg klonopin 2xday as needed, which i break up into quarters to take as small as dose needed and spread out through the day and evening. the buspar was started abt the same time as this night owlism started and my dosage was increased to current dose 8 months ago, but I cant find good evidence that buspar wld be the culprit.

 

 As this problem is having serious consequences for me, I'm prioritizing it and borrowing $ to get to sleep specialist soon,  i just hope she is a decent & knowledgeable doc.



#4 Ferret

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Posted 13 November 2013 - 06:33 AM

what stims are you taking during the day?

#5 slo.mo.a.go.go

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Posted 13 November 2013 - 06:55 AM

I take at 10 am 20mg adderall IR and at 11am 30mg adderall XR for the past 2 yrs.  For the 6 yrs prior, I took 30mg adderall xr 2xday, one at 9am, 2nd at noon.

 

I take biweekly  "no stim for a day or 2" vacations and every coupla months 4-7 days no stims. for these 8yrs, during stim vacations my bf is vigilant at getting me out and in the sunshine and has me tag-along on errands and our writer/art groups. he's sadden to see this having little effect.



#6 Ferret

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Posted 13 November 2013 - 07:20 AM

I think you've already solved the problem yourself by identifying that the changes in your sleep coincided with the start of taking the Buspar.
That's the joy of only changing one thing at a time. Any chance that you can do without it for a while to see if your sleeping improves? And did you check for interactions at http://www.drugs.com



#7 slo.mo.a.go.go

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Posted 13 November 2013 - 08:45 AM

actually bc I cant get up before 6pm, I havent been able to pick up my buspar refill a the pharm for the past 12 days! no change in sleep cycle but i do need to do more research on buspar interactions, thanks ferret.  



#8 Hank

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Posted 13 November 2013 - 09:04 AM

Thank you for your advice. appreciate yr recommendation of trazadone, and the key xtra details of being non-addictive (my preference) and cheap (my preference too!) i'm very glad you have something that works for you and pass along yr exp. I'll let you know if it helps me.

 

I take 100mg zoloft in the evening (so any sedating effects will be felt at night, not the day) and 3x15mg buspar during day for anxiety. I also occasionally take .5mg klonopin 2xday as needed, which i break up into quarters to take as small as dose needed and spread out through the day and evening. the buspar was started abt the same time as this night owlism started and my dosage was increased to current dose 8 months ago, but I cant find good evidence that buspar wld be the culprit.

 

 As this problem is having serious consequences for me, I'm prioritizing it and borrowing $ to get to sleep specialist soon,  i just hope she is a decent & knowledgeable doc.

Please be very careful with Klonopin. It is a benzodiazepine with a long half life of 24 hrs. It sedates you as much during the day as it does at night. There are safer options for anxiety. It is easy to be on and horrific to get off following regular use



#9 slo.mo.a.go.go

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Posted 13 November 2013 - 03:59 PM

Yes klonopin is a drug with risks and not beneficial for all. However i'm in the 60% of those who tolerate it well and find it immensely useful tool. Its sedating effects lasts only the 1st 2 wks. Bc I take it only as needed I can easily track if it was adding to this problem.  

 

I am well researched on klonopin. I took it for 2yrs previously in '99& '00 as I dealt with PTSD. it really helped me recover as it lowered my anx enough to where I regained some control of my thoughts -allowing me to start using CBT techniques to tackle my ptsd. I've never had any problem stopping it and can't relate at all to those who do have a bad reaction when stopping it.

 

Plus I'm on a much smaller dose this time and take it only at times I have runaway anxiety levels. anxiety completely locks me up bc of my already poor executive functioning and that combo has been very damaging and takes me a long time to repair that damage. 

 

I will post in greater detail to specifics of my sleep wake cycle issues (like even if I sleep at night, I have days when I mentally am asleep during the day and my body shows the symptoms of being in a sleep cycle- slow deep breathing, lower resting heart rate and BP.) But I'm feeling a sleep attack coming one.



#10 Gemma

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Posted 14 November 2013 - 11:34 AM

I'm feeling incredibly stupid today because I only got 6 hours of sleep last night, and I need 10-12 to function semi-normally, so I apologize if I'm missing major points in what you wrote.

Query 1: Have you been diagnosed with narcolepsy? I noticed you said you were on stims for ADHD, at least originally. Were they also intended for narcolepsy?

Query 2: why do stims make u a zombie? Do u still need them for ADHD purposes could you try switching to a different type of wake-up drug, like modafinil? If a different drug had less side-effects, maybe you could take another smaller dose in the afternoon in order to stay awake till nighttime. I'm on modafinil - my doctors say it's generally very well-tolerated compared to traditional stims. Also, I've read that it keeps you awake, but if you WANT to take a nap, you usually can, so if you took it in the afternoon maybe you could still sleep at night.

Query 3: do you find you can't function without the buspar? Because if the buspar could be the issue, perhaps you could substitute a different anti-anxiety drug for a few weeks to see if it makes any difference.

Query 4: do you take any sleep aids at night? I take 200mg zoloft at night (for OCD) and 25mg quetiapine, which is an anti-psychotic that is also often used for anxiety, but which I've been prescribed for sleep. It is very sedating 1-2 hrs after you take it, but wears off by daytime, for the most part (if you're on a low-dose of the type that is shorter-acting). Also, it's not addictive, and it works for sleep long-term, unlike those crappy benzodiazepines and non-benzo hypnotics. I've been on them, and they stopped working after 2-3 weeks, and then all other sleep aids of that type were also useless (cross-tolerance).

Without the modafinil and quetiapine, I would have a sleep-wake cycle much like yours. I was becoming completely nocturnal.

#11 slo.mo.a.go.go

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Posted 20 February 2014 - 09:18 PM

Sorry to those who replied to my post for the utter silence on my part. My health crashed & I have been convalescing myself w/ great help from my boyfriend. My working memory is so impaired that it's not unusual that I can't form my thoughts into written sentences for long periods of time. Knowing this bout myself, I don't post unless I can form sentences or have a crisis. I know people here are a tired bunch & always pushing themselves to just function. And I greatly appreciate when PWN push themselves to reply to help me out!!

 

As it turns out, my sleep/wake cycle prbly slowly became more wacky in conjunction with a coupla colds that worsened into a sinus infection by Thanksgiving. Then I had a coupla more illnesses but after all was said and done, my sleep wake cycle stopped being so oddly nocturnal abt the 1st wk of Dec. I'm on a new preventitive asthma med which has greatly reduced my abuterol use, my steroid inhaler.