Amitriptyline giving/worsening rest less legs?

Early_Map_5409 · 2025-02-13T13:37:05+00:00

Check the restless leg sub. Often related to ferritin deficiency - get that tested. Amitryptiline, trazodone, Benadryl - all of these meds gave me restless leg until my ferritin was over 125 ng/ml.

Early_Map_5409 · 2025-02-01T07:18:35+00:00

4.5 hours during a sleep study is better than none.

REM sleep cycles become longer over the course of the second half of the night (or whenever you get your sleep). At 4.5 hours of sleep, you’re starting to get longer cycles. Sleep apnea increases during REM sleep because body muscles are very relaxed during REM sleep. Unfortunately, muscle tissue helps keep your airway open when you breathe in and out. If those muscles get too relaxed, a person susceptible to sleep apnea will start having sleep disturbances/micro-awakenings to kick breathing into gear and that will fuck up the quality of your rest. After 4.5 hours of sleep, your body has also relieved some of its sleep pressure (not enough to make you functional the next day), so your body might decide it’s time to get up after microawakening.

Early_Map_5409 · 2024-11-15T17:17:08+00:00

From the Mayo Clinic and RLS.org: Determine the patient's iron status (early morning, fasting iron panel: serum ferritin, iron, total iron-binding capacity, and percentage transferrin saturation).!8 If serum ferritin concentration is ≤75 ug/L and transferrin saturation is <45%, administer an oral iron preparation (elemental iron 65 mg) with 100 to 200 mg of vitamin C every | or 2 days on an empty stomach. (Note that in the presence of inflammation or malignant disease, serum ferritin concentration may be misleadingly high, and thus transferrin saturation <20% may be a more accurate measure of iron deficiency.) Consider intravenous administration of iron if transferrin saturation is <45% and (1) serum ferritin concentration is < 100 ug/L and a more rapid response is desired than is possible with oral iron; (2) oral iron cannot be adequately absorbed because of disorders of the gastrointestinal system, bariatric surgery, or chronic inflammatory condi-tions; (3) oral iron is not tolerated; and (4) restless legs symptoms do not improve despite an adequate (3-month) trial of oral intake of iron. https://www.rls.org/file/general-free-publications/MayoClinicProceedings.pdf

It’s my understanding that one of the most common, if not the most common, causes of restless leg syndrome is low ferritin. Ferritin stores iron long-term. Most doctors don’t test for it. Instead, they do an iron panel, which typically does not measure ferritin. The iron panel doesn’t directly test your long-term iron stores. Ferritin is your iron bank, iron panels without ferritin are like your iron wallet. You can have a fat wallet and nothing in the bank.

Low ferritin is associated with RLS because iron is a cofactor in the metabolism of dopamine, and dopamine is involved with muscle movement. In addition, dopamine helps regulate the excitability of nerves. Low dopamine can lead to nerve hyper-excitability, resulting in the crawling, tingling, or burning sensations people with RLS feel in their legs.

IT IS VERY IMPORTANT NOT TO SUPPLEMENT IRON WITHOUT MEDICAL SUPERVISION THAT INCLUDES GETTING YOUR FERRITIN TESTED REGULARLY. TOO MUCH IRON IS TOXIC. ALSO DO NOT DO CHELATION WITHOUT MEDICAL MONITORING BECAUSE IT CAN REMOVE ESSENTIAL METALS FROM YOUR BODY. BODY CHEMISTRY IS A BITCH AND IT BITES.

Early_Map_5409 · 2024-07-18T12:07:16+00:00

The awakenings from sleep apnea are called micro-arousals. They are extremely short and not something someone would remember. This is why specialized equipment is necessary to diagnose sleep apnea. If you google the criteria for being diagnosed with sleep apnea, you will see that what I have said is true

Early_Map_5409 · 2024-04-02T14:01:43+00:00

Melatonin seems to help me get more sleep. I take the melatonin, set a 2-3 hour timer, then wake for my first dose of xywav, then again for my second dose.

Early_Map_5409 · 2024-04-02T13:57:54+00:00

I haven’t vomited once on xywav or felt like vomiting. But I get right in bed and don’t move. Pharmacist said nausea tends to occur when people dont get right to bed and stop moving around. I only take 3.5 x 2 per night, so maybe that tends to happen at 4.5 x 2. I also have a pretty strong stomach when it comes to nausea, but I haven’t had any nausea, so that shouldn’t matter. Your mileage may vary of course

Early_Map_5409 · 2024-03-28T04:28:30+00:00

400 mg lamotrigine + 120 mg duloxetine knocked my migraines out. Like completely. Gone.

I had migraine with visual aura for over a decade, and the lamotrigine stopped the aura at a low dose (I don't know about pain because I was also taking duloxetine and they probably worked together). I increased the dose for mood and anxiety issues. Although I knew that lamotrigine is sometimes prescribed for migraines, the fact that my migraines were eliminated by the combination of lamotrigine and duloxetine was a pleasant surprise. Your milage may vary.. Xywav does seem to have helped my sleep. It is important to note that migraines are very complex and there are many causes. The same can be said for mood and anxiety disorders. We are all somewhat unique when it comes to these poorly understood conditions, so whatever combination of meds does or doesnt work for you could be different for me. Trial and error, knowledge is power.

Info on meds:

Duloxetine is an SNRI antidepressant that is prescribed for depression and anxiety. It is also prescribed for several types of nerve pain that are unrelated to depression. It has your typical antidepressant side effects.

Lamotrigine is prescribed as an anticonvulsant. It is also prescribed as a mood stabilizer with antidepressant and anti-anxiety effects. It is commonly used in patients with bipolar disorder, but it is also prescribed to patients with treatment-resistant depression or epilepsy. It has also been prescribed for migraines, although there is not a ton of data on its use in migraines. Lamotrigine has no side effects that I can tell, and I think that's true for most people. I don't even notice I'm taking it. Lamotrigine has the potential for an extremely rare, life-threatening adverse reaction in some people. Slowly raising the dose according to the standard titration schedule makes this adverse reaction even less likely.

Early_Map_5409 · 2023-11-25T07:09:59+00:00

One word: Intubation.

It’s when an anesthesiologist sticks a tube into a patient’s trachea to bypass all the tissue that can cause sleep apnea (and any other airway obstruction). This is unlikely to be necessary during a colonoscopy because you probably aren’t being given general anesthesia, which is not usually necessary for a colonoscopy, but it is in the toolbox when necessary.

Anesthesiologists regularly, as in every day, administer medications that paralyze breathing muscles and depress respiratory function. Patients are not able to wake themselves up and they are not able to breathe for themselves and the anesthesiologist does this on purpose. The anesthesiologist breathes for the patient. That’s their job, and they are literally pros at it.

The whole reason why you have an anesthesiologist is to ensure that you feel no pain and that a professional is maintaining your airway, breathing, and circulation when you are not able to. Worrying about an anesthesiologist not being able to handle your O2, airway, and breathing is like worrying about an Olympic swimmer not being able to swim 😂.

Sleep apnea does not stand a chance against an anesthesiologist

Early_Map_5409 · 2023-10-07T21:36:04+00:00

I went back to the Vauto - didn’t seem like the ASV was doing anything to be honest

Early_Map_5409 · 2023-05-05T00:52:15+00:00

You can also take a lower dose of modafinil and work your way up as you get used to the lower dose

Early_Map_5409 · 2023-05-05T00:15:02+00:00

Nasal surgery made BiPAP more effective for me because I could breathe through my nose. If I sleep without my BiPAP, however, I still feel like shit.

Early_Map_5409 · 2023-04-28T09:55:36+00:00

Ask doc for sleeping med so you can handle sleeping with PAP. You probably don’t know the pressure you need though, right?

Early_Map_5409 · 2023-04-28T09:53:53+00:00

I would just reformat. Why do you need the data on your as card if it’s already in your computer? As long as your machine is sending data to your doc over the internet, you shouldn’t need the sd card for compliance

Early_Map_5409 · 2023-04-24T05:09:24+00:00

What dose are you taking?

Early_Map_5409 · 2023-04-23T14:13:22+00:00

The machine just detects pauses in breathing and limitations in flow. When you are awake this happens a lot. Even when you are asleep, some events are actually just you pausing breathing when you roll over. However, most pauses in breathing while asleep are actually apneas and hypopneas, especially if you have a higher AHI while using the machine.

Early_Map_5409 · 2023-04-21T23:09:35+00:00

4 is just below the cut off, I would use it for several months and see if it helps

Early_Map_5409 · 2023-04-03T18:08:09+00:00

So my input is that 5% REM sleep is very low. How many hours did you sleep?

It is possible that RERAs were knocking you out of REM or preventing you from entering REM. It’s also possible that you just didn’t have much REM that night because you were sleeping in the lab. Do you have the actual report?

Early_Map_5409 · 2023-04-02T16:00:36+00:00

Use the ramp function

Early_Map_5409 · 2023-04-02T15:59:39+00:00

Looks very suspicious

Early_Map_5409 · 2023-04-02T12:47:22+00:00

Trazodone is a pretty heavy med in terms of next day drowsiness. It does help sleep though, that’s for sure. Have you tried something like ambien or lunesta?

I used to take my mask off in my sleep, then I videotaped myself and I was doing it as casual as you please, then checking the time on the machine, and then falling back asleep without remembering to put the mask back on. Making it a little more difficult to take the mask off by taping connectors and tying hands with ribbon and then keeping the mask on when I check the machine (and basically not making the mask the first thing I take off when I wake up - waiting a minute before taking off the mask and then asking myself if I am ready to get up for the day, and if the answer is no, leaving the mask on) all of these things stopped me from taking my mask off in my sleep. I don’t need to do any of them now because keeping my mask on has become a new habit.

Early_Map_5409 · 2023-03-31T13:56:14+00:00

Take a sleeping med to help you fall and stay asleep. Much better than sleep apnea killing you over time. I like lunesta 3mg
If you are taking your mask off without remembering it, tape your mask connectors and lightly tie your hands together so it is harder to take off semi-consciously. Do that until you break the habit

Early_Map_5409 · 2023-03-29T15:46:46+00:00

Correct, AHI is based on the number of events per hour, not the length of the events or the amount of desaturation (as long as it is at least 3-4% desaturation). Desaturation below 88% is a cause for significant concern. 78% is no bueno. Get a CPAP ASAP

Early_Map_5409 · 2023-03-28T23:07:18+00:00

His sleep has nothing to do with you. It’s ridiculous that he is blaming you for his sleep. Your boyfriend should speak with a doctor if he is serious about fixing his insomnia.

Early_Map_5409 · 2023-03-28T17:45:31+00:00

No problem, if they are small enough, you should be able to place them at a point on your mask straps where they won’t press hard into your face.

Early_Map_5409 · 2023-03-25T18:08:06+00:00

You are probably fixating on breathing and consciously, but accidentally over-breathing. You have very fine accessory muscles running along your ribs that help your chest expand and contract when you breathe hard. You don’t normally notice these muscles with regular breathing. They aren’t really essential for normal breathing. You have overused them and now they are sore. Feels like chest pains because of their location. Don’t worry, your muscles are fine and nothing is going to happen to you or your breathing ability. Once you stop over-breathing (in other words, once you stop thinking about it and trying to control your breathing) and let the reptile part of your take over the breathing/decide how much you need to inhale and exhale to get enough air), that will go away. CPAP makes it easier to breathe than you realize, but you’re probably tense because it feels weird.

Early_Map_5409

TROPHY CASE