How Sleep Apnea Changed my Mental Health Outlook

Sleep and I never got along. I am not sure exactly when it started to affect my life, but since my childhood, I have never put much stock into the idea that sleep is possible in my life. Sleep is very important to mental health.

In 2016, my diagnosis became mild sleep apnea, and I was told it was affecting my mental health. My anxiety at the time was at an all-time high, but trouble with the CPAP machine, mainly that it was causing severe dry mouth that was keeping me from using the machine, made my insurance take back the machine before I could get the right mask. It sucked because I needed it, but I decided that it was too much trouble to keep dealing with the insurance and the machine.

Fast forward to 2019, where I began to once again get very little sleep, little did I know that it was worse than I believed. In the first sleep study, I found out some troubling news. One, I was not getting any REM sleep. That is bad for anyone wondering. The worst part? My sleep apnea was now severe to the point that, as an average, I stopped breathing around 87 times an hour. If you do the math, in eight hours, I was not breathing half the time. One of the worst was when I stopped breathing for approximately 57 seconds. That scared me to death. It meant I was waking up so many times a night it was borderline that I could die in my sleep.

In the second sleep study, about a month later, I got sick in-between studies, they added the mask and the CPAP machine this time around. I saw better improvement. It was interesting how advanced the devices had gotten since 2016. I still had sleep apnea events about 32 times an hour, but that was a significant improvement. Things could realistically look up in my life.

In September, I got my CPAP machine. I was hopeful that I could finally start conquering this sleep issue and at the same time, improve my mental health. What amazed me about the machine was that it starts out at a low level of air pressure. As you begin to sleep, it increases to the number that they found during the second sleep study as the best pressure for me to sleep. It starts out at a four, and increases all the way to 15, which is very high but necessary.

Nothing happens overnight, but I could tell in the first week that I was sleeping more through the night and waking up less. The dry mouth was no longer an issue as my new machine had a better dehumidifier. It was gradual, but within a month, I was sleeping around seven hours without waking, which for me, is out of this world. The best part? My sleep apnea events went all the way down to less than one event per hour. I don’t have to tell you how amazing that is, and since I have bought into the idea.

It is not a perfect world. I still have some issues getting to sleep, and the mask is cumbersome. But it works. Slowly the dark circles are disappearing. Its December and I am getting seven hours of sleep. I feel rested. I am more productive and alert. It was something I needed to commit to, and I have more than fulfilled the goals I set this time around. It is amazing what sleep can do for a person.

My point is that in this mental illness life, find things that will help you. I feel as if my anxiety is something I can work on, and my panic attacks will become less of an issue the more rested I am to start the day. I can finally start immersion therapy for my panic disorder. On occasion, I oversleep something I never did before, and it feels good! I will continue to stay committed and who knows where I will come in December 2020.

If you have any questions about sleep studies, sleep apnea, and CPAP machines please leave a comment and I will share my wisdom further.

Always Keep Fighting

James

P.S. If you have time, please purchase my book. You can find it on Amazon by looking up my pen name James Edgar Skye. The name of the book is The Bipolar Writer: A Memoir. It is available in print and Kindle edition. Thank you for your support. I will also link my Amazon page below.

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My Insomniac Life

Deep into that darkness peering, long I stood there, wondering, fearing, doubting,

dreaming dreams no mortal ever dared to dream before.

I became insane, with long intervals of horrible sanity.

We loved with a love that was more than love.

Quoth the raven, “Nevermore!”

Those who dream by day are cognizant of many things which escape those who dream  

only by night.

All that we see or seem is but a dream within a dream.

The boundaries which divide Life from Death are at best shadowy and vague. Who shall

say where the one ends, and where the other begins?

Ah, distinctly I remember it was in the bleak December; And each separate dying ember

wrought its ghost upon the floor.

 All religion, my friend, is simply evolved out of fraud, fear, greed, imagination, and

poetry.

 And my soul from out that shadow that lies floating on the floor Shall be lifted—

nevermore!

– Edgar Allan Poe

My Insomniac Life

* This is a long chapter but an important one as it is a major part of my own mental health– sleep is always an issue in my life.

This is a long chapter, and I apologize for it being so. This might become a series as I start to work on my insomnia again.

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Insomnia has been a part of my life for as long as I can remember. I like to joke to people that “it’s in my blood to not sleep.” But, it is a severe issue in my life. You ask any professional they will tell you that good sleep is key to your mental health.

Unlike most of the things wrong with my life, like living with Bipolar disorder or my social anxiety, I have never felt in control of being an insomniac. I have been through several sleep studies in my life, but they never amount to actually helping me. I have worked on my sleep hygiene but, to no avail, it doesn’t really help me get to sleep. My biggest problem is the actual getting to sleep.

I can remember growing up eight or nine and not being able to sleep. Over the years it has become impossible to get to sleep without medication. I can’t remember the last time I could lay down and go to sleep without medication. I sometimes joke about this because I feel insecure about my rest. If I really think about it, I spend more time at night trying to shut my brain off enough to get sleep, than actually getting to sleep. I have tried every sleeping medication on the market, both prescription and not, and at best they’re a temporary fix.

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What has gotten me through the last few years is that I take the antipsychotic Seroquel to help with my Bipolar disorder and it is one medicine that can sleep. It’s the one medication that has been consistent in my life because it does a great job at shutting my brain down (although the side effects of having trouble getting out of bed as well as being in a constant haze have always been the worst.) Over the years my dosage of Seroquel has changed.

At one point in my life, I took that max dosage of Seroquel allowed for a patient at 600mg every night. This was early in my diagnoses in 2007, and it went like that for years. Most days that dosage got me to sleep, but the problem was that oversleeping became an issue. When I would oversleep, it would make it harder to sleep the next day. I grew wildly inconsistent with my sleep, and sometimes I would go days without sleep even with the high dose of Seroquel. My days were spent mostly in a haze, at least a few hours after waking. The drug is potent, and I felt that sleep would be impossible without it.

Around 2012 when I was starting to get back to normal, and going back to school was on the horizon, my doctor and I came up with a plan to find a workable dosage where I could still function. Eventually, we settled on a 300mg dose. It worked for three or four years and while I even got less than five hours of sleep, but at least it was something.

I should have realized last year that my sleep was starting to become a major issue again. There would be spurts of time over the previous year where sleep was impossible at 300mg. My doctor at the time made a choice to give me options. I would get 100mg tablets and continue to take the 300mg dose with the opportunity to go up to 600mg if needed.

It was slow, but the dosage over the last year has steadily increased. It started with 400mg to get me to sleep, and I would raise it to 500mg if needed. Sometimes it took that much more, but 400mg was enough.

Then this weekend happened. If I had known on Friday that my sleep would take a wrong turn, I might have worked harder to get back down to my 300mg dosage in the weeks prior. By I digress.

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It started on Saturday. I knew I had to wake up around 5am over the next couple days, so I figured why not go to sleep at a decent time? It usually takes me two hours from the time I take my Seroquel, to the time my mind shuts down so I can sleep. I took my usual 400mg and went to bed— early. I honestly tried to sleep. I was in total darkness, and I just laid there not feeling even a little tired.

I figured it was a night for another single dose, so I did that, and still sleep escaped me. Hours had started to pass, and I began to panic that I wouldn’t get enough sleep, it turns out that was the least of my worries. Around 2 am, I decided I had to get some sleep before waking up and did the unthinkable. For the first time in five years, I took a max dosage.

This story doesn’t get better. I didn’t sleep that night/morning and still had to get up to be normal. I had to do the things that were planned. I was exhausted. I felt heavy. The worst part is, it was about to get worse. By the time the evening rolled around, I could barely keep myself upright, and I figured why not try and sleep? My anxiety was at a very high level, and it was already in my head things were only going to get worse.

I tried to go long into the night before taking my medication, but I finally had enough around 6pm. I received my regular dose, and I was barely aware of my surroundings. I laid down with the hope of falling asleep, and for some reason that woke me up. I lay there in my bed once again my thoughts racing faster than the day before. It had been close to 36 hours since I last slept. After an hour, I upped my dosage to 500mg. After two more hours of lying there, I took one more dose. After 40 hours, sleep finally consumed me.

This is where I find myself today. I am depressed about this because of it such a significant deal and its finals this week. I am worried that tonight will be another step in the wrong direction with my sleep. I have no choice but to really work on my CBT today so that there is a hope to get my mind right. I have to get my mind right.

Insomnia like depression never comes when life is good, and nothing can bring you down. It happens when your mental health has taken a beating you are failing to recognize the symptoms and even the triggers. When I am overworked, I tend to forgo the things that help me get by. CBT, meditation, or using my heat lamp in the mornings. When my routine starts to change like waking up later and later each day.

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Your body always gives you signs. It does that to protect itself from total collapse. Considering what I have put my body through over the last ten years, my body is well versed in what is wrong. I implore you in this mental illness life to take a moment each day and assess where you at with your health. How many hours did you sleep? There is often a correlation between sleeping less and less each night and when my social anxiety starts to spiral.

Sometimes in this life, all three hit me at once. My social anxiety, depression, and anxiety. This is what I call my worst-case scenario because it takes its toll. For me, it starts with sleep. The less I get, the more issues I have in my day. I still don’t have it exactly right. I am weary that Insomnia will always be a part of my life.

Many of the conversations that I have with my therapist when my social anxiety is spiraling is how your sleep is? Insomnia can be a dangerous thing. I remember before all my sleeping medications and Seroquel that I would go days without real sleep. I once almost made it to six days before exhaustion caught up.

In those times my thoughts would race for days. I couldn’t tell you how I functioned and in a way, I didn’t function at all. I would do what I could to occupy my time. Playing video games often helped me. Watching DVD’s for hours on end (this was before the whole Netflix thing.) I would lay there in the darkness for hours until the morning light reached through my window to tell me it was another day. The worse my sleep got, the worse my other things like depression got.

In my chapters about my suicides, you find that insomnia is tied into each one. My sleep was so bad at one point that I took a sleeping aid on top of the Seroquel. The thing is, medication only works for so long. In about seven years I went through every sleep aid my psychiatrist could give me. Eventually, they stopped helping.

My battle with insomnia has been a really long one, and it seems one that I will bring with me for the rest of my life. One day I will find a better way of managing those two-three hours it takes me each night to get to sleep. My point is rest is the most essential part of the mental health recovery process. If you struggle with it and haven’t sought help, there are many resources available to you.

Always Keep Fighting (AKF)

James

Photo Credit:
Quin Stevenson

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Annie Spratt

Rafael Barquero

JD Mason

I need my Sleep

My husband and I enjoy old movies.  My favorite movies of all time are Casablanca and It’s a Wonderful Life.  In fact, we have a jumbo canvas print of an original movie poster from It’s a Wonderful Life hanging in our kitchen–it’s my husband’s favorite movie as well.  Over the past week or so, my husband and I have been watching snatches of a classic movie we hadn’t seen before, Citizen Kane.  Desperate to understand the meaning of Charles Foster Kane’s dying words, “rosebud,” we stayed up much later than usual to watch the conclusion of this film.

It was almost 11:30 when we turned off the blu-ray player and tv and started heading upstairs to bed.  I could feel right away that staying up so late had not been a wise choice, on my part.  I didn’t feel great emotionally.  I could feel some mental pain creeping in at that point.

I have learned, over the years, that no matter how good I feel during the day, sleep is not something I can compromise on.

Sleep disruptions, such as having trouble falling and staying asleep, were the hallmark of my child and teen years.  And even then, I can remember my mom remarking on my excessive “grumpiness” after a poor sleep.  In the home video made at my wedding reception, my mom and sister both made sure to record for all of my posterity (and my new husband, Ryan), that I should never be allowed to get tired or hungry, (or stressed) because each of these states would cause me to be “very grumpy.”  I was, of course, annoyed at this reference to my moodiness, but they were right.  This has been true for me throughout my entire life.

The effects of fatigue have been most pronounced when my thyroid was also out of wack.  I can remember after the birth of my first son, before I was diagnosed with hypothyroidism, I was in a constant state of emotional distress from being so tired and never being able to recover.  I asked my mother in law at that time, with exasperated and exhausted tears, “Will I ever feel better?”  Some months later, after breaking down emotionally in the doctor’s office, a doctor finally thought to check my thyroid and after getting proper treatment, I was able to feel relief from the constant, plaguing fatigue.

Throughout my most recent episode of depression, falling asleep was extremely difficult due to the persistent, agonizing mental pain I was experiencing.  Thankfully, over time, things got better and now, as long as I get to bed at a decent hour, I can sleep without problem.

Last night, however, I pushed myself too hard.  When I lay down on my pillow to sleep, my mind was exploding with pain.  I squeezed my eyes shut and tried to remember how I had gotten through it before.  I attempted to relax and clear my mind, but it was to no avail.  I finally prayed for help, and before I knew it, I was waking in the morning.  I was tired from a late night but extremely grateful that I had fallen asleep so quickly.  It was a good reminder for me that I can’t be careless about my approach to getting enough sleep.

Submitting to the fact that I need my sleep, and not compromising in this area, is one thing I have had to come to terms with when managing the symptoms of my bipolar depression.

There are other things I have come to terms with, and I will cover these topics in future posts.  Because Bipolar Disorder is a chronic health condition, I have learned I have to make lifestyle choices that support me in feeling my best–just like any other chronic health problem.

What are your experiences with sleep and mental illness?  What struggles have you had?  How have you dealt with them?

As always, I love to hear from you!  Comment to share your experiences.