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My therapist and I debated having a sleep study done tonight.  Well mostly he argued in favor and I argued against. I guess that's technically a debate.

He sees it as potentially helpful to the sleep problems I'm having now.  I see it as something I should consider if I still have a problem after losing 20-30 pounds.  I feel like even if I have sleep apnea, it's weight-induced and subject to going away on its own.

I also explained that I'd had one previously (about 5 years ago) and they couldn't get valid reading because I couldn't sleep in the lab.  And that I don't think I could wear a CPAP machine because I can't sleep on my back (or still) and I can't handle the mask. HE said that we could do desensitization for that. 

I'm still quite skeptical.  We ended it with I will talk with my pdoc about it.

Any thoughts?

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My mom can't use a mask (claustrophobic and other issues) so she uses the nasal pillow things instead. Also, she sleeps on her side, not her back.

Do you have an approximate self-imposed timeline/deadline on losing the 20-30 lbs, i.e. if I don't lose 20-30 lbs in the next year or in x number of months, I will have a sleep study done? Otherwise, you could theoretically rationalize putting off the sleep study indefinitely if the weight loss thing doesn't happen or goes slowly. And I think (obstructive) sleep apnea is bad for your heart and other stuff, so might be important to eventually treat in the meantime until you meet your weight loss goal?

I think I remember someone recently on CB talking about at-home sleep studies being possible?

I had a sleep study done 5+ years ago. No apnea or other issues except once and for all confirming I move a lot in my sleep (but it doesn't apparently affect the quality of my sleep so not a disorder). I've gained more weight since then and remain almost as tired and still sleep more than most but (thankfully) no one has pushed for a 2nd sleep study. The worst part of the sleep study for me was having to have my perfectly good sleep/dreams interrupted and have to get up so early because they wake you up at an ungodly hour and send you home. I know it sounds silly but I've lived my entire life going to bed somewhat late and getting up somewhat late. Even when I've worked jobs (or had classes) that required me to conform to a different (more traditional) sleep/wake cycle or a super early morning schedule, it never became or felt natural to me and was always like wearing an ill-fitting shoe. Also, at this point if a doctor told me I had obstructive sleep apnea, I'd probably resist treatment and want to wait to lose weight first to see if that solved the issue, even though I do realize that just a few sentences ago I said, "And I think (obstructive) sleep apnea is bad for your heart and other stuff, so might be important to eventually treat if the weight loss goes slower than expected?" (I apparently like to ignore the same advice I freely dispense to others.)

Mainly I wanted to speak up and let you know nasal pillows are an option vs. a mask and sleeping on your side is okay (I think). I slept on my side during my sleep study and my mom sleeps on her side with her nasal pillows thing strapped to her head/face and she gets excellent "scores" from her cpap device. 

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You'd be surprised how much advancement has been made in CPAP technology, even in just the past five years. My ex's mask barely covered any part of his face, and it was practically silent and I couldn't hear it running (no Darth Vader effect or humming whatsoever). I was actually surprised to be awoken by his dog's snoring instead of his... lol.

Just for the sake of the sleep study, you could do a low dose of instant-release Seroquel (25-50 mg) (I know Seroquel XR did bad things for you). I would've said Belsomra but that did even worse things to you. There's another sleep drug Rozerem that works on melatonin receptors, but it may be just the same as taking a heavy dose of melatonin, just exponentially more expensive. I'd say also lemon balm might help with sleep for the sleep study, possibly ashwagandha too. Check with the sleep study technicians about those supplements though because they're GABAergic and may alter your EEG reading.

I do believe trying to lose the weight first would be a good idea like you said, and if you still have problems with sleep apnea, then getting the sleep study done and using a CPAP at night would be a good idea.

 

 

 

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Insurance companies generally like you to try an at-home study first, which will pick up apnea (though not all sleep issues) and is fairly easy to deal with. I have a CPAP, and as others have said, it's mostly quiet, I can sleep on my side, and the "nose pillow" type is a significant improvement over the earlier masks (though not everyone can use the nose pillows). Attacking your weight is probably a good idea, though as others have said, apnea is really not good for you, so depending on how slowly you intend to lose weight it wouldn't be the worst idea to see to any apnea now. Also, as explained to me by my sleep doctor, independent from weight, our tissues slacken as we go through life, so depending on the size of your jaw and airway, it's not a guarantee that losing weight will make any. apnea go away. That being said, waiting six months to lose twenty pounds first probably won't kill you.

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thank you all for the insight.  lots of good information.  and many things I didn't know because my experience was a good five years ago (with the study--I didn't show apneas).

I think I'm going to try to bargain with my therapist for 4-6 months to try the weight loss approach and then see if I still need a study.  It seems reasonable. 

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I meant to say thank you for the med ideas @mikl_pls .  It unfortunately takes 100mg of seroquel to knock me out, so I'm not sure it's feasible as it could throw off the results.  You have a good memory of me with belsomra.  I didn't know it was possible to have that bad nightmares while still on prazosin.

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20 minutes ago, dancesintherain said:

I didn't know it was possible to have that bad nightmares while still on prazosin.

Oh yeah, sleep paralysis and subsequent frightening nightmares are a rather common side effect of Belsomra. I think I experienced sleep paralysis a couple of times on it, but no nightmares (hypnopompic hallucinations, etc.).

I wish there was an easy solution for you for sleep. :( 

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