Replies to This Discussion

Permalink Reply by susan mccord on August 10, 2009 at 10:54am

Judy--I haven't had any luck with Rx sleeping meds either. Trazadone DID help me but it became less helpful with my depression, so I switched. I'm on Wellbutrin XL now which works great for me. ALL my stupid meds are supposed to make me drowsy. They don't, at least not in a way that helps me sleep. Xanax 1.0 helped me sleep fine till I got on CPAP--not the most I've gotten so far is 5 hours which isn't close to enough. Obviously I have insomnia in conjunction with apnea. Good grief.....getting old, as they say, is not for sissies!!

Susan McCord :-)

Judy said:

Well, I am on Imuran (azathioprine) which is an immunosuppressant. One of the common side effects is sleepiness so it is often recommended that the dose be taken at night. I've never noticed that it affected my sleep or sleepiness one way or the other no matter when I take it: morning, midday or before bed. Another common side effect is nausea, at least at first, and I was fortunate not to experience that unpleasant side effect either. (God looks after fools).

I am also on Pentasa (mesalamine) and have had no problems w/it either. I've been on it so long I don't even remember the most common side effects it can cause.

I know that prednisone can cause sleep and personality problems but have been blessed w/not having had much experience w/it!!!

Trazadone made me higher than a kite! My first and only "out of body" experiences!!! (Can you tell I am not a child of the 60s?)

Valium, years ago, first made me higher than a kite even at 1/2 dose and taken w/food. When the doctors insisted I stay on it to soothe the gut (before the Crohn's disease Dx) I spent one evening laughing hysterically at anything, then getting nastier than a stepped on rattlesnake and then crying hysterically for no reason. Needless to say I refused to continue taking it.

Versed, a relative of valium, given to me for a colonoscopy at first made me agitated, then I got HOSTILE!!

Ambien is good for getting me 4-5 hours of sleep. Have never tired Ambien CR.

Lunesta was good for 7-8 hours of sleep but left such a long-lasting, foul-taste in my mouth I refused to take more than the original one dose. (Too bad too, I really liked their "butterfly" commercial).

Sonata didn't do diddley-squat for me. I might as well have taken a sugar pill.

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Permalink Reply by susan mccord on August 10, 2009 at 10:56am

How do I "pm" you? Susan McCord

susan mccord said:

Rock, I don't mind posting here. Maybe there's something in MY Rx plan that will help you or someone else on here. I take a LOT of meds which include: Vytorin--Plavix--Isosorbide ER--Hyzaar (which is being changed to Lisinipril but I haven't switched yet)--Nitro PRN (rarely anymore)--Celebrex (also being changed to another generic due to cost)--Wellbutrin XL--Xanax 1.0 mg qhs only (never take it at other times)--Estratest--Rx Pepcid bid to (hopefully) prevent stomach bleeding from meds--Ecotrin 81 mg qd--ALSO take the following supplements daily: Centrum Silver--Vitamin E--Glucosamine/Chondroitin--Tylenol PRN--.....I think that's it. I have CAD, dx 10/05, have one stent and another blockage that can't be stented due to location--both blockages were (are) LAD ; also have microvascular spasms, which is the reason for Isosorbide; I rarely, if ever, have angina anymore. However, during my first sleep study, they came in about halfway through to put CPAP on due to sx appearing-within about 20 minutes I started having chest pain which didn't resolve with nitro--I ended up in ER, had gel nitro, and was released about 4-5 hours later. Lab said they had enough info for titration study. I have regular follow-up with cardiologist, PCP, and labs without fail, and always have. My dad (had) and my two sons (47 and 43) have Type II Diabetes. I'm tested for blood sugar everytime I go for labs--sugar's never been out of normal range.

Hope this helps with what you're doing--I'm chemically-altered for life! Oy vey.....

-Susan McCord

Rock Hinkle said:

you can list it here or pm me. If you list here I will answer here. If you PM me I will answer back the same way and post the results at an undetermined date to protect you. up to you.

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Permalink Reply by Judy on August 10, 2009 at 3:00pm

Endothelial dysfunction is a relatively new finding, kind of a buzz word right now, that suggests the cells on the inside of your corornary arteries are not working as they should. These endothelial cells are responsible for releasing local vasodilators and regulationg coronary blood flow.

Endothelial dysfunction is found in some patients with unexplained chest pain symptoms -- without significant coronary artery or valvular disease. A quick literature search did not turn up the incidence of endothelial dysfunction, but my guess is it is underestimated.

Most people with endothelial dysfunction have some form of metabolic syndrome (over weight, glucose intolerance, hypertension, increased triglycerides and low HDL).

INTERESTING! There is a clinical trial Oxidative Stress and Endothelial Dysfunction in Obstructive Sleep Apnea (SOREVAS)

http://clinicaltrials.gov/ct2/show/NCT00646971" target="_blank">

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Permalink Reply by RockRpsgt on August 11, 2009 at 1:08am

prozac/fluoxitine-affects deep sleep by supressing deep sleep and delaying REM onset. This drug can cause insomnia, and can imitate the eye movements of REM on a PSG(As mentioned by Jason). Spriggs Essentials of psg.

That is pretty rough for a drug that is supposed to help level you out. My Dad had some severe medical problems. They put him on this and he became suicidal. Prozac is the 4th most prescribed medication in the world.

Found some great studies

ABSTRACT



This study investigated the effects of open-label fluoxetine (20 mg/d) on the polysomnogram (PSG) in depressed outpatients (n = 58) who were treated for 5 weeks, after which dose escalation was available (40 mg/d), based on clinical judgment. Thirty-six patients completed all 10 weeks of acute phase treatment and responded (HRS-D 10). PSG assessments were conducted and subjective sleep evaluations were gathered at baseline and at weeks 1, 5, and 10. Of the 36 subjects who completed the acute phase, 17 were reevaluated after 30 weeks on continuation phase treatment and 13 after approximately 7 weeks (range 6-8 weeks) following medication discontinuation. Acute phase treatment in responders was associated with significant increases in REM latency, Stage 1 sleep, and REM density, as well as significant decreases in sleep efficiency, total REM sleep, and Stage 2 sleep. Conversely, subjective measures of sleep indicated a steady improvement during acute phase treatment. After fluoxetine was discontinued, total REM sleep and sleep efficiency were found to be increased as compared to baseline.

http://www.nature.com/npp/journal/v20/n5/full/1395314a.html

Effects on EEG sleep in woman.

http://www.nature.com/npp/journal/v21/n2/full/1395349a.html

ABSTRACT



We examined whether fluoxetine treatment has persistent effects on electroencephalographic sleep after drug discontinuation in patients with recurrent major depression. Age-matched groups of 23 women were treated with interpersonal psychotherapy alone (IPT) or fluoxetine plus interpersonal psychotherapy (IPT + FLU). Sleep studies were conducted when patients were depressed, and again at remission, at least four weeks after fluoxetine discontinuation. The groups did not differ in depression ratings pre- to post-treatment. Significant group*time interaction effects were noted for REM sleep (p = .04) and slow wave sleep (p = .02). REM percentage and phasic REM activity increased in the IPT + FLU group but decreased in the IPT group. The effects of fluoxetine treatment on electroencephalographic sleep can be observed for at least four weeks after drug discontinuation and appear to represent both drug discontinuation and neuroadaptation effects.

FDA and Prozac

http://www.drugs.com/pro/fluoxetine.html

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Permalink Reply by RockRpsgt on August 11, 2009 at 2:34am

Ambien or Zolpidem can increase or supress stage 3 depending on the person. Zolpidem is used to treat sleep problems (insomnia). It may help you fall asleep faster, stay asleep longer, and reduce the number of times you awaken during the night. Zolpidem belongs to a class of drugs called sedative/hypnotics. It acts on your brain to produce a calming effect.

This medication is usually limited to short-term treatment periods of 1-2 weeks or less.


i believe for the short term this is the best sleep aid due to it's short shelf life.

http://www.webmd.com/drugs/drug-9690-Ambien+Oral.aspx?drugid=9690&a...

All of the staging information I am getting from "The Essentials Of Polysomnography" by Spriggs.

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Permalink Reply by RockRpsgt on August 11, 2009 at 3:37am

Seroquel/ from binarysleep.com

How does Seroquel work? What will it do for me?
Quetiapine belongs to a class of medications known as antipsychotics. It is used to treat symptoms of schizophrenia, manic episodes associated with bipolar disorder, and depressive episodes associated with bipolar disorder. It works by affecting the actions of certain chemicals in the brain known as neurotransmitters.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

How should I use Seroquel?
The usual recommended starting dose for schizophrenia is 25 mg twice daily. Quetiapine is usually started with a low dose in order to allow the body to get used to it. This dose is increased as tolerated to a target dose of 150 mg twice daily.

For manic episodes associated with bipolar disorder, the recommended starting dose is 50 mg twice daily. This dose is increased up to 400 mg twice daily as tolerated. Most people respond to doses between 200 mg and 400 mg twice daily.

For depressive episodes associated with bipolar disorder, the recommended starting dose is 50 mg once daily. This dose is increased to 300 mg once daily as tolerated.

Different people will need different doses, and your doctor will prescribe the dose for you that best meets your needs. Quetiapine can be taken with or without food.

If you miss a dose of quetiapine, take it as soon as possible and continue on with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue on with your regular dosing schedule. Do not take a double dose to make up for a missed one.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication every day as your doctor told you to ensure that you are getting the maximum benefit from the medication. Do not stop taking this medication or change the time of the day you take it without consulting your doctor.

Store this medication at room temperature, protect it from moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Seroquel for Sleep
Healthcare providers may prescribe Seroquel "for sleep." However, the medication is not approved for this use, nor is it an appropriate use. While it does cause drowsiness and may help with insomnia, it also carries the risk of serious side effects. If your healthcare provider is prescribing Seroquel "for sleep," you may want to have an honest discussion, asking if he or she believes that you may have a mental illness.

http://bipolar-disorder.emedtv.com/seroquel/seroquel-for-sleep.html

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Permalink Reply by Judy on August 11, 2009 at 1:05pm

Rock Hinkle, what about Wellbutrin and Zyban?? Wellbutrin is often used to help w/smoking cessation.

Chantix is yet another used for smoking cessation and is newer than Wellbutrin.

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Permalink Reply by RockRpsgt on August 11, 2009 at 5:28pm

i have a more complete list coming out this week. these are just some of the links that my research has lead me too. i will be putting alot of time into this project and several others this later this week.

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Permalink Reply by susan mccord on August 11, 2009 at 10:10pm

Rock--I forgot to add Levoxyl to my list--have been on it for years.

Susan McCord :-)

susan mccord said:

Rock, I don't mind posting here. Maybe there's something in MY Rx plan that will help you or someone else on here. I take a LOT of meds which include: Vytorin--Plavix--Isosorbide ER--Hyzaar (which is being changed to Lisinipril but I haven't switched yet)--Nitro PRN (rarely anymore)--Celebrex (also being changed to another generic due to cost)--Wellbutrin XL--Xanax 1.0 mg qhs only (never take it at other times)--Estratest--Rx Pepcid bid to (hopefully) prevent stomach bleeding from meds--Ecotrin 81 mg qd--ALSO take the following supplements daily: Centrum Silver--Vitamin E--Glucosamine/Chondroitin--Tylenol PRN--.....I think that's it. I have CAD, dx 10/05, have one stent and another blockage that can't be stented due to location--both blockages were (are) LAD ; also have microvascular spasms, which is the reason for Isosorbide; I rarely, if ever, have angina anymore. However, during my first sleep study, they came in about halfway through to put CPAP on due to sx appearing-within about 20 minutes I started having chest pain which didn't resolve with nitro--I ended up in ER, had gel nitro, and was released about 4-5 hours later. Lab said they had enough info for titration study. I have regular follow-up with cardiologist, PCP, and labs without fail, and always have. My dad (had) and my two sons (47 and 43) have Type II Diabetes. I'm tested for blood sugar everytime I go for labs--sugar's never been out of normal range.

Hope this helps with what you're doing--I'm chemically-altered for life! Oy vey.....

-Susan McCord

Rock Hinkle said:

you can list it here or pm me. If you list here I will answer here. If you PM me I will answer back the same way and post the results at an undetermined date to protect you. up to you.

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Permalink Reply by Laura Hand on August 12, 2009 at 12:34pm

I take Effexor ER, Ditropan XL, Pepcid OTC. After I completed my sleep study, while we were going over the results (yeah I asked him to explain the WHOLE thing to me) he mentioned that the Effexor could decrese REM sleep.

And on a side note, and possibly a rookie mistake, I get Valium for anxiety while I have dental work. I had a diagnosis of sleep apnea, but have not started CPAP yet.....it acts as a respiratory depressant and can make apnea worse (or in my case, crash and get a trip to the ER). Since we are talking about Drugs and apnea...maybe a friendly little warning to be VERY CAREFULL with all meds and how they can relate to apnea.

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Permalink Reply by Awake In America (Dave J.) on August 12, 2009 at 4:16pm

Rock:
Here's a heck of what seems to be a formularly for one person's daily medications. I found the list, broken down by prescribed and OTC, the other day.

Aside from being a doctor's nightmare, at least in terms of tracking interactions, following up on necessary bloodwork for some of the medications, and making sure nothing hits -- or helps something else hit -- a lethal/dangerous dose, it would also likely be a sleep tech's nightmare, especially with all the pain meds. I think at least one of the antibiotics on the list presents a challenge in terms of quality sleep. I think the "drug cocktail effect," hinted about by J. Sazama, may be an understatement for the person who's medication list I posted above.

So, does this list help get you off to a meager start for your studying / project?

-dave

PRESCRIPTION MEDICATIONS
• ACETYLCYSTEINE 10% - USE ONE VIAL THREE (3) TIMES DAILY PRN
• ADVAIR DISKUS (fluticasone & salmeterol) 500/50 MCG - ONE PUFF TWICE DAILY
• ALBUTEROL INHALATION AEROSOL INHALER - 2 PUFFS EVERY FOUR HOURS (RESCUE INHALER)
• ALBUTEROL SULFATE SOLUTION 0.083% MG/ML - USE ONE VIAL VIA NEBULIZER EVERY FOUR HOURS
• ATROVENT (ipratropium) 21 MCG - TWO SPRAYS TWICE DAILY
• BABY ASPIRIN 81 MG - TWO TABLETS DAILY
• CEPHALEXIN 500 MG - ONE CAPSULE EVERY 6 HOURS FOR 10 DAYS
• CIPROFLOXACIN 500 MG - ONE TABLET EVERY 12 HOURS FOR 10 DAYS
• CLINDAMYCIN 300 MG - ONE CAPSULE EVERY 6 HOURS FOR 10 DAYS
• DOCUSATE 100 MG - ONE TABLET TWICE DAILY
• FLUTICASONE NASAL SPRAY (Veramyst) 50 MCG - TWO SPRAYS EACH NOSTRIL TWICE DAILY
• GABAPENTIN (NEURONTIN) 600 MG - 1 TABLET TWICE DAILY MON., WED., FRI., AND 1 TABLET THREE TIMES DAILY TUES., THURS., SAT., SUN.
• HYDROCODONE/APAP (Vicodin) 7.5/750 MG - TWO TABLETS EVERY FOUR HOURS AS NEEDED FOR PAIN
• HYDROMORPHONE (Dilaudid) 2 MG - ONE TABLET EVERY FOUR HOURS FOR PAIN PRN
• K-DUR (potassium) - TWO 10 MEQ TABLETS (total of 20 MEQ) FIVE TIMES DAILY (DAILY TOTAL OF 200 MEQ) 2@ 6 a.m.; 2@ 10 a.m.; 2@ 3 p.m.; 2@ 8 p.m.; 2@ Midnight
• LACHYDRIN 12% CREAM - APPLY TO CRUSTY AREAS ON BOTTOM OF BOTH HEELS DAILY
• LASIX 40 MG - TABLETS TO 60 MG TABLETS BY MOUTH EVERY MORNING and ONE 20MG OR ONE 40 MG TABLET AT BEDTIME
• MIDAMOR (Amiloride) 5 MG - ONE TABLET TWICE DAILY WITH LASIX
• METHADONE 10 MG - FOUR TABLETS (40mg) BY MOUTH THREE TIMES DAILY
• MUCINEX 600 MG - TWO TABLETS (1200 MG) TWICE DAILY
• NAPROXEN 500 MG - ONE TABLET TWICE DAILY
• NOVOLIN N (Humulin N or NPH) (LONG ACTING) - INSULIN 10 UNITS AT BREAKFAST and 10 UNITS AT DINNER
• NOVOLOG (FAST ACTING) - 40 UNITS AT BREAKFAST and 20 UNITS AT DINNER
• OXYCONTIN 60 MG - ONE TABLET BY MOUTH TWICE DAILY FOR PAIN
• PATANOL (olopatadine) - ONE DROP BOTH EYES TWICE DAILY
• PRILOSEC (omeprazole) 20 MG - ONE CAPSULE DAILY
• SPIRONOLACTONE (aldactone) 50 MG - ONE TABLET BY MOUTH TWICE DAILY
• ZYRTEC (cetirizine) 10 MG - ONE TABLET BY MOUTH DAILY


OVER-THE-COUNTER & SUPPLEMENTS
• GLUCOSAMINE/CHONDROITIN 1500 MG TWICE DAILY
• L-LYSINE 500 MG DAILY
• SAW PALMETTO 160 MG TWICE DAILY
• VITAMIN B COMPLEX TWICE DAILY
• VITAMIN C 500 MG DAILY
• VITAMIN D 1000 MCG DAILY
• VITAMIN E 1500 MCG DAILY
• ZINC 50 MG DAILY

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Permalink Reply by RockRpsgt on August 13, 2009 at 8:43am

That is one hell of a cocktail! Thank you all i will be working on and adding the first part of my list sometime today. I got off of work yesterday and was up with my daughter until about noon when the babysitter picked her up. I slept till 6pm, woke up ate dinner with my wife, then was back in bed by 10pm.

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