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Promoting NREM Stage 3 Sleep (or in this case, getting any at all)

J

Jktm

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May 19, 2012
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I recently had a sleep study done because of my treatment resistant insomnia, and lack of restful sleep.

My results were as followed (abridged):

Pt took 26.5 minutes to fall asleep after taking medications (Amitriptyline - 200mg, Gabapentin - 300mg, Hydrocodone/APAP - 22.5mg/975mg, Promethazine - 50mg, Estazolam - 4mg, Tizanidine - 4mg, Alprazolam - 2mg, Simvastatin - 20mg (Estazolam and Xanax were taken sublingually with 20-30 units of isopropanol for increased rate of absorption)


Sleep Architecture:

Stage N1: 4.5% (15.0 min)
Stage N2: 83.4% (276.0 min)
Stage N3: 0.0% (0.0 min)
Stage REM: 12.1% (40.0 min)

PLM index: 1.1/h

No significant cardiac arrhythmia noted.

So, my problem is I'm not getting any deep sleep which is where you get your restful sleep.

I realize this thread is geared to me, however I assumed this information could be useful to others as well.
 
Maybe don't take 9 separate drugs before you go to sleep?

Cannabis is known to decrease REM and increase NREM sleep. But I'm pretty sure your fucked sleep architecture is caused by the huge cocktail of sedatives you're taking...
 
Yeah, as sekio pointed out, taking multiple drugs that 'pervert' sleep architecture, spanning multiple classess and mechanisms of influence, will make it very easy to promote stage 4 sleep....and out of curiosity, what proportion of those are prescribed? I can't really imagine a physician so reckless as to prescribe most, let alone all of them, concurrently.

sekio said:
Cannabis is known to decrease REM and increase NREM sleep.
Click to expand...

Yeah, but would the trade off for decreased time spent in REM be evenly distributed among other stages of sleep (or even selective for deep sleep)?

ebola
 
I'm prescribed all of them. My pcp is the one currently rxing the elavil xanax and prosom (the antidelressant and benzos), my spine doc does the norco and zanaflex, and my neurologist is rxing the zocor and propranolol.

Edit: oh, and the phenergan is by my gi doc and I'm no longer on the neurontin.
 
Have you tried melatonin? That probably won't be enough to overpower that cocktail you're taking, but anything else you could add would interact badly with at least one of those drugs.
 
Well, the only thing I can think of to help produce Stage 3N sleep (formerly stage 3/4) are gaba-ergics, and the only benzo that can sedate me at all at clinical dosing is estazolam (and I'm pushing it at 4mg). Dropping the elavil might help, but no psych will take me w/o some form of SSRI (and they don't like that being my Antidepressant), I wouldn't be able to afford sodium oxybate if I could even get an rx w/o my psych thinking I'm a date rapist, and I honestly doubt I can get an Rx for nembutal or seconal.

My benzo tolerance is my own fault and I realize that, but 6mg of alprazolam yesterday +60% nitrous/local anesthetics wasn't really enough for the work I had done yesterday (albeit I had 7 fillings and a temp crown put in), however after a discogram with 3mg of Versed and no fentanyl I got through it.
 
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