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HowlingWolf

Sleeping Problems. pdoc or gp?

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Both my SO and I are having sleeping problems, although both are very different and I'm almost certain they have different causes. Who would we go to for this? Would a general practitioner be able to help or should we go to a pdoc? Does it depend on the type of sleep problems perhaps?

 

My sleeping problem is pretty straight forward. Until the past couple of months, I never had any problems sleeping other than sometimes having trouble falling asleep, which was normally because of my racing thoughts. Now, I'm waking up several times  at night and having even more trouble falling asleep. It takes me an hour to fall asleep. I may wake up 1-4 times through the night, and almost every time I'm waking up from a dream or nightmare and can remember it vividly, indicating I woke up during REM sleep. Nothing woke me up either. I also often feel a lot of pressure on my head from being in a death coma like sleep to wide awake in seconds, that lasts for a minute. The last pdoc I saw was considering diagnosing me with PTSD because of a lot of red flags that i had, but decided I didn't quite meet the criteria. Perhaps this is part of me developing it, or just stress in general.

 

My SO's sleeping problems are quite complicated. My best guess is this is due to him working 3rd shift. However, he has been doing that for several months, and his sleeping problems are newish and getting worse. He typically sleeps about 7-8 hours everyday, around the same time of day. When he firsts wakes up he says he felt like he hasn't slept at all, and he looks like it too, but I know he was because he was snoring for the past 8 hours straight, non-stop. He often falls back asleep instantly, but I'm guessing that's normal? I typically am pretty awake right off the bat so I'm not sure on that one. Also when he is waking up he can have a conversation with me, on topic, making eye contact, and sometimes start talking on a tangent about work. Later he will tell me he has no memory of the conversation even though he looked and acted wide awake. Sometimes he even gets up and goes into the next room and ten minutes later he tells me he doesn't remember walking into the room. Sleep walking?? Often, he falls asleep randomly. Yesterday, we were talking and the next thing I knew he was sitting up with his head completely drooped down, eyes closed, and starting to snore. I wake him up and he tells me he never fell asleep and that he isn't tired at all, nor does he act tired afterward. Pretty much everytime he is idol, he falls asleep. Even if he sleeps for 12 hours or only 4. He claims it to be from relaxation and that he isn't tired. Just randomly falls asleep when he is idol. Who should he see for this? It doesn't seem like he is function right. I read one of the pinned topics that suggested provigil for people who work 3rd shift. Is this over the counter or prescription? Who could prescribe it? Have any of you experienced something similiar? He also does not have any currenlty known MI. He has been diagnosed with insomnia before, but never in the entire time I have known him and lived with him, ever seen any undisturbed sleep, difficulty falling asleep, or difficulty staying asleep. He also says he used to be able to go a couple days with little to no sleep and function fine, then get 8 hours and be completely refreshed. This isn't so anymore.

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I would ask both that way you get a second opinion. It sounds like you might benefit from a sleep aid. Your SO to me sounds like he has sleep apnea. Snoring and being tired during the day is consistent with that.

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When I was first experiencing fatigue, I didn't have a pdco.  I spoke with my gp, and she referred me to a sleep neurologist who referred me to a sleep neurologist who referred me for a sleep study.  I have sleep apnea and sleep with a CPAP.

 

Recently, I was having more trouble wiht sleep and thoughted I might need a med adjustment.  I spoke with my pdoc who suggested I speak with my sleep neurologist to make sure there weren't any problems with my CPAP.  My sleep neurologist referred me for another sleep study, and I am waiting for the results of that right now. 

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I think it is quite common for people to not remember the first few minutes after waking up because it takes a while to become fully conscious. Like how people can wake up for short periods and go back to sleep and not remember being awake afterwards. So, er, having conversations that seem lucid just after waking up and not remembering them is probably not that unusual in itself.

 

I'm not sure who exactly either of you should see, although talking to your gdocs about being referred for a sleep study is probably a good start?

 

If you're going to see your pdoc again soon then I'd definitely ask him/her as well. 

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I would see a neurologist (both of you).  Your primary DR can probably refer you to one.

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I cannot say anything about your SO b/c we are a first-person site.   However, I think anyone having sleep issues can benefit from a sleep study.  The results will show whether you're getting REM sleep, how many (if any) apneas occur, and other relevant data.

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I agree that a sleep study would likely be a useful tool to figure out what's going on with your nightmares and insomnia.

 

I'm the opposite of you, I struggle with hypersomnia (sleeping up to 16 hours a day, unable to wake up without help). I spoke with both my GP and my pdoc about it. I see my GP more often though, so he helped the most. I was never referred for a sleep study because my hypersomnia seems to be caused by medications, even though it continued long after the suspect medication was removed (Abilify). We tried lots of different approaches to address it, mainly changing medications/dosages/times of dosages.

 

The process has been extremely frustrating and disheartening. But, I am very happy to say that we seem to have found a possible solution. *knock on wood* We added 20 mg Ritalin SR in the morning, and I switched to taking my 200 mg Lamictal before bed. In the last 7 days, I've only had 1 day where I slept for 9 hours. All the other days were 5-7 hours. I'd like to sleep at least 7-8 hours, so I need to work on my sleep hygiene, but hey, I'm not complaining!! My pdoc wants me to go back to 150 mg Lamictal, but I'm reluctant to make any changes right now. We'll see. 

 

Sorry for just blabbing about myself, but I hope it helps somewhat. 

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When I had run out of sleeping meds to try my pdoc had me see a sleep doc. He did DX me as having sleep apnea but the Capp didn't help.

We tried Trazadone and Rozerem and I finally got my life back.

After the first script my pdoc took over prescribing it for me. My current pdoc also is the one who prescribes it,

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I think you would benefit from a sleep study and an appointment with a pdoc, get two opinion's.

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Start with the basics : thyroid, basic lab tests, vitamin deficiencies at a GP. Then if nothing shows up go for the sleep study. If that fails then I would go to the psychiatrist. In fact, your psychiatrist can order a sleep study if he wants to.

 

 

Good luck~!

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