![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by rodm on July 15, 2002, at 13:25:58
I have sleep apnea, I wear the cpap with no problems, I have changed the pressures with no results, I feel groggy during the day, from Excessive Daytime Sleepiness I have tried the Dr.s ideas, even though I hate meds, he has prescribed Provigal, it didn't help, my only clue to whats wrong was that I had two pleasent experiences 1). One night I used the cpap and the next morning I felt incredable, no EDS, I haven't had this happen since. 2). After hernia surgury they put me out for a couple hours, then I was awakened with oxygen, I felt incredable, SO was it the depth of sleep as I suspect or the oxygen...The dr. says it wasn't the oxygen, as I'm at 91%. SO what med (is best) that will increase stage 4 sleep without messing up my sleep architecture, or being toxic, and habit forming? (restoril, trimipramine, elavil, mirtazapine, ambien?)... I have a Dr. app today so I hope someone can answer soon.
Posted by katekite on July 15, 2002, at 17:11:16
In reply to E.D.S. SleepApnea. Best med, stage4 Sleep., posted by rodm on July 15, 2002, at 13:25:58
Well, I know ambien, sonata and restoril are all enough like benzodiazepines to probably have the effects they do long term: decrease in stage 4. So unfortunately probably best to stay away from them. Interesting as most people report these sleep aids make them 'feel' like they slept really deeply -- but they didn't.
I have been looking into trimipramine. It is supposed to be more sedating than elavil -- ie can use a lower dose. Remeron is very individual -- it may be worth a try but many people get a hangover. For those for whom it works it is great. I think trimipramine shows no effect on sleep architecture. (I do not know about remeron.)
Vistoril is a mild sleep aid that is pretty harmless... similar to benadryl but a little more sedating. A little drying so depends if that is an issue.
Neurontin is sedating and anti-anxiety and few side effects... that could be on the list also.
Take care, hope you sleep better.
kate
Posted by Shawn. T. on July 15, 2002, at 17:27:55
In reply to E.D.S. SleepApnea. Best med, stage4 Sleep., posted by rodm on July 15, 2002, at 13:25:58
Thanks for asking, I can handle this one easily. Remeron (mirtazapine) wins hands down. No questions asked. I suggest that you take 7.5mg/day for the first two weeks and only increase it by 7.5mg every week until you find the optimum dose. Make sure you get the regular form of Remeron so that you can break the pills in half (not the Sol-Tab). While your body is becoming adjusted to the Remeron, take that Provigil (modafinil) every morning to get you up. My old roommate would set a pill on top of his snooze button. I'm going to go out on a limb here and suggest that sleep apnea is causing your E.D.S. (You already knew that though.) I'm only going to provide one link, because providing more than that would only be confusing. Just go to
http://www4.infotrieve.com/search/databases/detailsNew.asp?artID=9322412For anyone unfamiliar with E.D.S, check out
http://www.biopsychiatry.com/sleepy.htmI appreciate someone asking such an easy question for once. I'll provide a more in depth discussion of how Remeron improves sleep architecture sometime else.
Shawn
Posted by Shawn. T. on July 15, 2002, at 20:26:49
In reply to Re: E.D.S. SleepApnea. Best med, stage4 Sleep., posted by Shawn. T. on July 15, 2002, at 17:27:55
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.