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Seasonal Affective Disorder (SAD) - Circadian Rhythm/Sleep Disruption

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AsleepInYorkshire
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Seasonal Affective Disorder (SAD) - Circadian Rhythm/Sleep Disruption

#372699

Postby AsleepInYorkshire » January 3rd, 2021, 3:07 pm

Caveat
I am currently well and not suffering with any mental health issues. I do need some help though.

The Back Story
In February 2000 I was diagnosed with clinical depression. At the time I'd taken the decision to see a different GP within the practice who I had not seen before. I was prescribed with an antidepressant called Venlafaxine Effexor. The diagnosis was 21 years late. I had been complaining of my symptoms to several different GP's over that time with no diagnosis whatsoever.

For the next 16 years I battled with my depression. Soon after diagnosis I determined I was suffering with SAD (Seasonal Affective Disorder). However, I couldn't get on top of my symptoms despite a huge amount of self help. My GP stayed with me until she retired in late 2015. At which time I was in an extremely dark and vulnerable place.

In a final redoubt, in February 2016, I self referred and paid privately to see a doctor at a specialist sleep disorder hospital. I was ultimately diagnosed with Severe Obstructive Sleep Apnea (OSA) and treatment began in June that year.

Since then I've not been "quite right". I've struggled with a residual tiredness and some other unwelcome symptoms.

Where Am I Now
When I was diagnosed with OSA I was told that my depression would abate. However, and now with the benefit of 4 years of treatment of the OSA I am absolutely sure I have Seasonal Affective Disorder too. I am also extremely confident that my SAD occurs in summer too.

An Analogy to Explain
The brains default setting is sleep. It needs a switch to wake it. And that switch is light sensitive. If the "light sensor" is faulty then the switch cannot turn the brain on. My light sensor is faulty :roll: The result is that in the summer my brain is woken quite early in the morning as sunrise is both early and strong. In winter my brain wakes much later in the day. Currently it's waking between 12.30pm and 2.00pm.

Overall the symptoms abate in spring and autumn as we move towards 12hrs of daylight.

A Plan
I'm currently not "fighting" my "natural" winter sleep pattern. I go to bed and fall asleep between 4.00 and 6.00am. I wake 8hrs later. I use my CPAP to sleep which is the gold standard for treating OSA and I have no symptoms. When I try to squeeze into a 9-5 society my symptoms recur. Until recently I've simply not understood that my OSA wasn't the only health problem. I'm planning to commence operation lifestyle this week :lol:
  1. Dawn simulation - reinstated
  2. Bright light therapy - new light box ordered
  3. Vitamin D3 - continue to take 3,000 iu's per day
  4. Vitamin B12 - reinstated 6,000 mcg's per day (sublingually)
  5. Other Vitamin B's - daily vitamin tablet tablet introduced
  6. GP - ask GP to refer me to a circadian sleep disorder specialist
  7. Antidepressant - discuss modest increase with GP (reinstate Cipralex?)
  8. Modafinil - a back stop medication that I can obtain to use a chemical "switch". Comes with issues and not a simple solution.
At some point in the next 2 weeks I need to try and return to "early waking" at say 7.00-7.30am. I can't imagine it will be easy. I know the easy answer is to find some form of income that works around my sleep issues. However, before I accept that I want to spend this year making a final effort. After which I have a follow up plan. I was hoping that the diagnosis of OSA would bring closure to my health problems. Not to be. My good lady and my 13 year old daughter are both very supportive and I hope that over the coming year I can find the means and methods to put my symptoms behind me. My dream is to be able to work in a 9-5 society, earn a few quid and build up my pension funds. To do that I need to have control over my "very awkward" symptoms.

I doubt that anyone reading will have any direct experience of this kind of joint condition. However, I'd welcome any thoughts which could help please.

Thank you for listening

AiY

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Re: Seasonal Affective Disorder (SAD) - Circadian Rhythm/Sleep Disruption

#372758

Postby johnhemming » January 3rd, 2021, 5:19 pm

With Vitamin D3 you need to be sensitive to your weight. If you are obese (as I was until recently) then 3,000 iu is reasonable, but as your weight comes more into the normal range that can be too much and it can cause sleep problems. I am currently taking 1,000 iu, but also taking about 800iu as the second metabolite, but you may wish to run that as an option past your GP. Also the time you take Vitamin D can have an effect. On waking is probably best. (because it metabolises into calcifediol and that takes a certain amount of time.)

There are sensitivities about the metabolism pathway of vitamin D, but it is complicated and definitely not something to try to advise via a forum.

You may also find it worth looking at whether you could do with some Melatonin at some point in the daily cycle. That may be worth talking about with your GP.

You don't list Vitamin A or Vitamin E whether that would make any difference I don't know.


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