Suggest Treatment For Obstructive Sleep Apnea

Posted on Wed, 1 Mar 2017

Question: just never seem to wake up refreshed .. I sleep for more then 10 hours at night and still takes naps during the day . I stay in bed for 1 to 2 hours after I wake up just to be able to get uo and go about my day .sometimes I have to relieve my self sexually in order to go back and sleep when I wake up not refreshed .

Answered by Dr. Alexander H. Sheppe (1 hour later)

Brief Answer:
Consultation

Detailed Answer:
Hello, and thanks for your question.

There are a few different possibilities diagnostically. The first and most likely is obstructive sleep apnea. Other options include narcolepsy and depression. The first step to diagnosis is to get a sleep study (polysomnogram). This will diagnose the problem and tell your doctors how to fix it. I recommend a polysomnogram.

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In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Alexander H. Sheppe (2 hours later)

I had PSG and MSLT tests done and it did not show any apnea catalepsy or narcolepsy . I have beeen diagnosed with cfs before and while working 3 jobs and going to school I took supplement like creatine, soy protein ... then I crashed , I was sleeping for 14 to 16 hours a day and when I wake up i never feel refreshed ,always exhausted . how can it be depression and i m not sad or anything ? those supplements didnt make me depressed just exhausted and willing to sleep.

Answered by Dr. Alexander H. Sheppe (23 hours later)

Brief Answer:
Followup

Detailed Answer:
Welcome back,

PSG+MSLT examines whether the sleep architecture of your brain is abnormal -- in your case, it must not be. This means the cause of the sleep disturbance is not a sleep disorder, but rather secondary to something else.

By far the most common cause of hypersomnia like this is depression. Sometimes, depression can be a constellation of neurobiological symptoms rather than a mood state such as feeling sad. I would at least try an antidepressant medication to see if this improves things for you. I'd recommend Lexapro or Zoloft, both of which are safe and effective.

Please remember to rate and close this answer thread when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Alexander H. Sheppe (22 minutes later)

thanks for your reply. I tried lexapro , xanax when i first took those supplements and crashed me .My primary doctor prescribed them to me and they didn't help. they actually gave me a bad sides affect like shaking sometimes ... following my primary orders i left the country and went back home to rest .at home I was put on several anti depressant prozac was one of them . no good results . one day I withdraw after almost 2 years on them coz they didn't do anything for me . its been several years without them but I don't wanna go back to feeling the way they made me feel . what you suggest ?

Answered by Dr. Alexander H. Sheppe (30 hours later)

Brief Answer:
Followup

Detailed Answer:
I suggest trying an SNRI antidepressant, which is a little bit different than Lexapro or Prozac. Sometimes people who try this newer drug class have better results. Examples include venlafaxine, desvenlafaxine, or duloxetine.

Please remember to rate and close this answer thread when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Alexander H. Sheppe (11 minutes later)

So you think it s in my brain !!! but I don t feel sad depressed or anything like that ...just constantly tired willing to take naps during the day and feeling cold. how is that related to my brain?

Answered by Dr. Alexander H. Sheppe (55 minutes later)

Brief Answer:
Followup

Detailed Answer:
Depression can affect the hypothalamus and reticular activating system, a neural network in the brain that regulates sleep and temperature. This can result in fatigue, oversleeping, and feeling cold. This is directly caused by your brain.

Please remember to rate and close this answer thread when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Alexander H. Sheppe (13 minutes later)

K how about Trazodone ? I read it a a good Antidepressng for sleeep . What you think ?

Answered by Dr. Alexander H. Sheppe (5 hours later)

Brief Answer:
Followup

Detailed Answer:
Trazodone actually makes people SLEEPIER. I would recommend a wakefulness-promoting antidepressant like venlafaxine, desvenlafaxine, or duloxetine.

Please remember to rate and close this answer thread when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Alexander H. Sheppe (11 hours later)

That s why I asked I don't get a restful sleep and I go to bad every late sometime at 5 am ... but you consider those three antidepressant the best for my case ? Will they make me go to sleep on time wake up refreshed with energy and take away my bad habit or self fulfillment ?

Answered by Dr. Alexander H. Sheppe (3 hours later)

Brief Answer:
Followup

Detailed Answer:
I think they have the best chance of helping you, yes.

Please rate and close this answer thread.

Above answer was peer-reviewed by : Dr. Nagamani Ng