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Fatigue

A friendly ear
AsleepInYorkshire
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Fatigue

#456048

Postby AsleepInYorkshire » November 6th, 2021, 12:37 pm

I wasn't sure if this should be posted on the Health & Wellbeing board. Just a note for anyone looking in I decided it was probably more appropriate here.

In January or February of 2000 I was diagnosed with clinical depression. It had gone undiagnosed for over twenty years. I hadn't got a clue what the diagnosis meant. I took my anti-depressants and hoped they would have me on my feet within a few days.

In October 2014 my GP referred me to single point access. I was at my lowest and had personal timelines and plans in place which would end my mental health problems once and for all. I muddled my way through and was once again refused a referral to a sleep clinic by the various clinicians who saw me.

In February 2016 I self referred to a private sleep specialist. He wrote to my GP suggesting I should be given a polysomnography. In June 2016 I was diagnosed with severe obstructive sleep apnea.

I still have some issues with excessive daytime sleepiness, even though I am receiving treatment for my apnea.

About three months ago I decided it was time, once again, to help myself as the NHS appear to be floundering with this excessive sleepiness.

I've started to take Modafinil again. It worked in 2015 and I am alive today because of it. The NHS will not allow my GP to prescribe it. It's a job for secondary care consultants.

The results have been game changing. I am alert, no sleepiness and I feel very calm and happy within.

It's a personal story I know.

But one that I suspect is repeated by others in far greater numbers than ever I would want.

I've made it this far and will do what I can to make it to my retirement in 4 1/2 years time.

It's been an interesting journey, as I tell others - but not one I could ever recommend to others.

I know we all have health issues to deal with. We all have burdens to suffer.

Sometimes thought the kind words of another, even a stranger on a bulletin board, can change someone's feelings.

And sometimes it helps just to know that you are not alone

AiY

88V8
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Re: Fatigue

#456101

Postby 88V8 » November 6th, 2021, 5:09 pm

Sleep deprivation is insidiously damaging.

Before I injured myself during the summer, I had been in the habit of going to bed around midnight. To help recovery, I began going to bed at 2230h or earlier, and even though I have to get up in the night - it's me age, guv - I am amazed how much better I feel for that extra sleep.

You may have heard R3's Private Passions last week, the guest was Matthew Walker, a sleep expert, https://www.bbc.co.uk/sounds/play/m001147q worth a listen for anyone with general sleep disorders. He had interesting things to say about heart attacks and road accidents at the time of year when the clocks change.

Sleep apnea is probably more common that one would think, judging by the number of gadgets offered in the newspapers to counter it. Not a problem I've ever had although my wife complains that I make huffing noises if I sleep on my back.

Being familiar with Modafinil - what I believe is sometimes referred to as as an 'upper' - you'll be aware of its potential to sabotage sleep patterns and do long-term harm. I guess you must be rather desperate to have resorted to it and I hope you won't need to continue.

AsleepInYorkshire wrote:In January or February of 2000 I was diagnosed with clinical depression. It had gone undiagnosed for over twenty years. ..... I was at my lowest and had personal timelines and plans in place which would end my mental health problems once and for all.

One can make such plans so coldly and 'logically'. Whether it would be kinder to my wife for the train to run over my neck or my middle, which would make less mess... or whether I should lie in the ditch and freeze. It all seems logical at the time, and during 48 years of intermittent depression I have made many such 'plans'.
One just has to hope that one will get through the episodes of depression and come out the other side.

I hope you get a fix for your sleeping problems. It will make such a difference.

V8

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Re: Fatigue

#457154

Postby Clariman » November 10th, 2021, 7:37 pm

AiY and 88V8

Sleep, indeed, is very important. We tend to go to bed around 11.30pm and then read, but when staying with family and grandkids last month, we were all in bed by 10.30 and I felt much better for it.

Hope you are both in a good place just now and are in positive frames of mind.

Take care
Clariman

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Re: Fatigue

#457225

Postby bungeejumper » November 11th, 2021, 8:57 am

Clariman wrote:Sleep, indeed, is very important. We tend to go to bed around 11.30pm and then read, but when staying with family and grandkids last month, we were all in bed by 10.30 and I felt much better for it.

One of the things we really enjoy about camping in rural France is that you go to bed pretty soon after it gets dark (well, once your wine glass is empty), and then you're up and about bright and early. Or at least, when the morning church bells start drumming up business in the villages. There's something about aligning your diurnal rhythms with the daylight that seems to do you a power of good. Of course, the fresh air might also help. Not to mention the absence of a mobile phone signal. ;)

Interesting piece in the grauniad the other day (https://www.theguardian.com/lifeandstyl ... tudy-finds) about a Biobank survey that found that people who normally hit the hay between 10pm and 11pm had significantly fewer heart attacks than those who choose a later or earlier hour. I could understand the risk for later sleepers, because that would include all the evening boozers etc, but it's a mystery to me why an earlier hour should be so risky?
More specifically, those who fell asleep at midnight or later had a 25% higher risk of going on to develop cardiovascular disease, while those who fell asleep before 10pm had a 24% increased risk.

There are plenty of holes in the data from this survey, and alternative explanations galore, but the numbers are still striking.

BJ

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Re: Fatigue

#457418

Postby Sunnypad » November 11th, 2021, 8:15 pm

AiY
Interestingly it has been suggested to me in the past for insomnia - seems odd to some until you try it - and depression.

One of the reasons my health is so much better, touch wood, these days, is I have learned a lot more about all this stuff and deal with my NHS GPs a lot less. They are all nice at my local surgery - bar one - but they do get very specific protocols going, usually based on big data and taking no account of the individual.

Bungee - I love the idea of camping in rural France or similar but the reality is I have only camped in the Australian Outback in summer. I am not sure what cold camping would be like for me! :lol:

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Re: Fatigue

#457430

Postby AleisterCrowley » November 11th, 2021, 9:47 pm

I've camped in Devon in mid August for many years - that can be pretty cold :-)
A few pints of Otter bitter help.

On the subject of sleep, I am suffering quite badly from disturbed sleep at the moment. Not so much waking up during the night*, but it takes me ages to drop off even if I dose myself with diphenhydramine
I have got into the habit of watching YouTube on my Fire tablet in bed, and I'm told the light can affect one's ability to drop off to sleep.

I'm quite interested in the 'two sleeps' theory - if I didn't have to fit my life around work I'd give it a go. Basically you go to bed relatively early, sleep for 'several hours', then get up and do stuff. Then you head back to bed for your second sleep and get up when you feel like it. Apparently this was quite common until industrialisation/factory hours, and the dreaded electric light.

I've found the Hobbit-style 'second breakfast' quite easy to adopt though

AC

*well, I'm getting up a bit more often for the loo, but that's a bloke/age thing...I think

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Re: Fatigue

#457463

Postby servodude » November 12th, 2021, 12:41 am

bungeejumper wrote:There's something about aligning your diurnal rhythms with the daylight that seems to do you a power of good


True in most parts of the world; but a bit of a bugger if you live in Kiruna or even Inverness :)
I'm acutely aware of just how much light affects my sleeping: and resort to a mask when the sunrise is going to be a problem

AsleepInYorkshire wrote:About three months ago I decided it was time, once again, to help myself as the NHS appear to be floundering with this excessive sleepiness


How's the new CPAP going? Have you managed to get it working well for you?

-sd

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Re: Fatigue

#457493

Postby bungeejumper » November 12th, 2021, 8:29 am

AleisterCrowley wrote:I'm quite interested in the 'two sleeps' theory - if I didn't have to fit my life around work I'd give it a go. Basically you go to bed relatively early, sleep for 'several hours', then get up and do stuff. Then you head back to bed for your second sleep and get up when you feel like it. Apparently this was quite common until industrialisation/factory hours, and the dreaded electric light.

Absolutely. Until the mid-eighteenth century (in towns, anyway), it was perfectly normal to think of the night as two sleeps with a one-hour interlude in the middle. People would get up, move around, pour themselves a drink, have sex, or go next door to visit the neighbours. I daresay some of them did all those things. ;)

BJ

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Re: Fatigue

#457499

Postby Watis » November 12th, 2021, 8:43 am

bungeejumper wrote:
AleisterCrowley wrote:I'm quite interested in the 'two sleeps' theory - if I didn't have to fit my life around work I'd give it a go. Basically you go to bed relatively early, sleep for 'several hours', then get up and do stuff. Then you head back to bed for your second sleep and get up when you feel like it. Apparently this was quite common until industrialisation/factory hours, and the dreaded electric light.

Absolutely. Until the mid-eighteenth century (in towns, anyway), it was perfectly normal to think of the night as two sleeps with a one-hour interlude in the middle. People would get up, move around, pour themselves a drink, have sex, or go next door to visit the neighbours. I daresay some of them did all those things. ;)

BJ


How much documentary evidence do we have for this 'two sleeps' lark?

I ask because I've read the unabridged diaries of Samuel Pepys. I'm pretty sure he never mentions doing this despite providing detailed information regarding his daily personal activity throughout the diary over a continuous period of nearly ten years.

Watis

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Re: Fatigue

#457504

Postby bungeejumper » November 12th, 2021, 9:07 am

Watis wrote:How much documentary evidence do we have for this 'two sleeps' lark?

I ask because I've read the unabridged diaries of Samuel Pepys. I'm pretty sure he never mentions doing this despite providing detailed information regarding his daily personal activity throughout the diary over a continuous period of nearly ten years.

Easily explained, my dear 'Astings. The neighbours had sworn him to secrecy. :|

BJ

(Actually, I think John Evelyn was probably a better source of low gossip?)

AsleepInYorkshire
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Re: Fatigue

#457506

Postby AsleepInYorkshire » November 12th, 2021, 9:13 am

servodude wrote:
AsleepInYorkshire wrote:About three months ago I decided it was time, once again, to help myself as the NHS appear to be floundering with this excessive sleepiness

How's the new CPAP going? Have you managed to get it working well for you?
-sd

Thank you for asking. I've spent the last two days reflecting deeply about my latest sleep test results. I've taken some time out of work to spend more time with my Mum. She's deteriorating rapidly now and is very confused and extremely tired. I've also been trying to come to terms with my sleep test results. My previous diagnosis was severe obstructive sleep apnea. On Wednesday evening I was informed that I have mild obstructive sleep apnea. I was also told that the hospital wouldn't normally issue a CPAP device for this diagnosis. My sleep apnea hasn't improved. The original diagnosis was flawed as I was taking mirtazapine at the time, which is a known sedative. My sleep apnea was, therefore, medically increased in severity by the sedative.

It's not good news though. Because that doesn't explain why I have "excessive daytime sleepiness". However, and I am quoting from Spock himself - when you eliminate the impossible, whatever remains, however improbable, must be the truth :) .

There aren't many options left to explain my symptoms. The one that is the most probable is non cataplectic narcolepsy. I have come off my APAP machine last night. I am taking Modafinil which is a recognised medication for narcolepsy. I suppose at some point the NHS will get around to sending me to see a neurologist. But in the meantime I am feeling no symptoms of tiredness whatsoever. The Modafinil is clearly a game changer.

I'm going to spend the morning sat with Mum. She is sleeping most of the time now and when she isn't she's very confused and part of her has already gone.

Thank you for asking about my progress. Your kindness has lifted my spirits a little and I'm genuinely grateful

AiY

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Re: Fatigue

#457508

Postby AleisterCrowley » November 12th, 2021, 9:18 am

Watis wrote:
How much documentary evidence do we have for this 'two sleeps' lark?

I ask because I've read the unabridged diaries of Samuel Pepys. I'm pretty sure he never mentions doing this despite providing detailed information regarding his daily personal activity throughout the diary over a continuous period of nearly ten years.

Watis



Well, Pepys had an 'office job' with the 1600s equivalent of the MOD - not sure what his hours were ?!

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Re: Fatigue

#457536

Postby servodude » November 12th, 2021, 10:56 am

AsleepInYorkshire wrote:
servodude wrote:
AsleepInYorkshire wrote:About three months ago I decided it was time, once again, to help myself as the NHS appear to be floundering with this excessive sleepiness

How's the new CPAP going? Have you managed to get it working well for you?
-sd

Thank you for asking. I've spent the last two days reflecting deeply about my latest sleep test results. I've taken some time out of work to spend more time with my Mum. She's deteriorating rapidly now and is very confused and extremely tired. I've also been trying to come to terms with my sleep test results. My previous diagnosis was severe obstructive sleep apnea. On Wednesday evening I was informed that I have mild obstructive sleep apnea. I was also told that the hospital wouldn't normally issue a CPAP device for this diagnosis. My sleep apnea hasn't improved. The original diagnosis was flawed as I was taking mirtazapine at the time, which is a known sedative. My sleep apnea was, therefore, medically increased in severity by the sedative.

It's not good news though. Because that doesn't explain why I have "excessive daytime sleepiness". However, and I am quoting from Spock himself - when you eliminate the impossible, whatever remains, however improbable, must be the truth :) .

There aren't many options left to explain my symptoms. The one that is the most probable is non cataplectic narcolepsy. I have come off my APAP machine last night. I am taking Modafinil which is a recognised medication for narcolepsy. I suppose at some point the NHS will get around to sending me to see a neurologist. But in the meantime I am feeling no symptoms of tiredness whatsoever. The Modafinil is clearly a game changer.

I'm going to spend the morning sat with Mum. She is sleeping most of the time now and when she isn't she's very confused and part of her has already gone.

Thank you for asking about my progress. Your kindness has lifted my spirits a little and I'm genuinely grateful

AiY


It sounds like you're making the most of the time with your mum; that's really all that matters at the moment.
We lost my father-in-law a week ago to dementia; we lost most of him about three weeks previously when it took a drastic down turn.
If the Modafinil is working for you just now that's a success.

Sleep apnea is a very tricky business to diagnose and manage. Some folk with severe apnea (as measured by the AHI score) hardly feel tired in the day at all - others with mild/moderate OSA can barely get anything done because they're that fatigued.

Now's probably not the time but if they've decided that your apnea is mild because of a sleep study (polysomnograph) the same study would probably show if you were a candidate for narcolepsy.

- sd

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Re: Fatigue

#457550

Postby 88V8 » November 12th, 2021, 11:40 am

AleisterCrowley wrote:I have got into the habit of watching YouTube on my Fire tablet in bed, and I'm told the light can affect one's ability to drop off to sleep.

Yes.
If you listen to that R3 programme I linked above, that was one of the negatives he mentioned.
No tablets, phones, TVs, bright lights, in the bedroom.

The brain should associate the bedroom exclusively with sleep.
OKOK there may be an exception.

Not that I'm on the PC late any more nowadays, but I installed f.lux which redshifts the screen in the evening to help with sleep.
https://justgetflux.com/

V8

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Re: Fatigue

#457555

Postby Sunnypad » November 12th, 2021, 11:53 am

AiY, are any of these readings from when your mum has been ill? Not to be patronisong but it all has an effect.

I read some history and was surprised to come across the two sleeps thing. I first heard it on social media. Not convinced it was a major thing tbh. I think sometimes these stories evolve from a tiny inconsequential remark.

Obviously pre Industrial Revolution, people had much more freedom, but it seems unlikely that we are designed to sleep that way. I smell urban myth.

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Re: Fatigue

#457564

Postby AleisterCrowley » November 12th, 2021, 12:16 pm


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Re: Fatigue

#457607

Postby Sunnypad » November 12th, 2021, 2:13 pm

AleisterCrowley wrote:https://www.bbc.co.uk/news/magazine-16964783

BBC article with more info


This sounds like an early evening nap. Which I've done after coming home from work, especially in my 20s when I'd be out the night before! :lol:

But if it's dusk - nap - dinner - sleep, I don't think of that a split night sleep.

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Re: Fatigue

#457612

Postby AleisterCrowley » November 12th, 2021, 2:39 pm

Well, I think if you actually disrobe and go to bed it's a sleep. Passing out on the sofa is 'a nap'....
I don't count falling asleep in meetings as my 'first sleep' :)

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Re: Fatigue

#457630

Postby Watis » November 12th, 2021, 3:11 pm

AleisterCrowley wrote:Well, I think if you actually disrobe and go to bed it's a sleep. Passing out on the sofa is 'a nap'....
I don't count falling asleep in meetings as my 'first sleep' :)


If Management catch you, it may be your 'last sleep', as far as they are concerned!

Watis

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Re: Fatigue

#457632

Postby AleisterCrowley » November 12th, 2021, 3:15 pm

Ah, working from home so - 'sorry, broadband problems' or 'couldn't get off mute'


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