Joined: 24 Mar 2005 Posts: 3 Location: Northern Canada
Sleep State Misperception Posted: 03-25-05 14:13pm
Hi everybody
i'm wondering if anyone has had any
experience with sleep state misperception.
I have struggled with insomnia for the
better of 25 years now, and was out to a
sleep disorders clinic a couple of years
ago for a two night study. As far as I
was concerned I stayed wide awake for the
two nights I was being tested, and got up
each morning absolutely exhausted and
looking like hell. But my testing
results came back that I had slept a total
of 6 hours each night, and they diagnosed
me with sleep state misperception. :?:
i have just recently gone through a
withdrawal process from ativan, a
benzodiazapine and trazadone an
antidepressent. I have been some sort
of medication to sleep for years now, but
ran into the problem where they just were
not working at all for me. I used to
get a little relief from them. But what
happened is that I hit tolerance
withdrawal with the ativan and became very
ill, and thus did the slow taper off both
meds. The trazadone
was not giving me any relief anymore
either.
What happens with me is that I go to bed
every night at 10:00 p.M. And I lay
there for hours, I seem to go into this
trance like state where I can actually
dream, but I am also wide awake, and this
goes on until the wee hours of the
morning, until I finally just get up. I
am very tired when I get up, and I look
like I haven't slept in weeks, and as far
as I am concerned I haven't.
I am just wondering if anyone has been
diagnosed with sleep state misperception,
and what your experience with your sleep
pattern is.
Deb
|
bkdaniels
New User, Becoming EHEALTHy
Joined: 13 Mar 2005 Posts: 48 Location: Little Rock, Arkansas
Sleep State Misperception Posted: 03-25-05 15:20pm
Hey marshlakemom, how are you doing?
Hypnotics and benzodiazepines (bzds) are
the mainstays of short-term treatment of
primary insomnia. Basic principles for
rational treatment of insomnia are to use
the lowest effective dose, use
intermittent dosing (2-3 nights per wk),
use for short term (2-3 wk at a time),
discontinue after slow taper if the
patient has been taking it regularly, and
use agents with short and/or intermediate
half-life to minimize daytime sedation.
Primary insomnia (sleep state
misperception) is sleeplessness that is
not attributable to a medical,
psychiatric, or environmental cause. Bad
sleep habits such as those naturally
acquired during periods of stress are
occasionally reinforced and, therefore,
are not resolved and become persistent.
Primary insomnia is diagnosed in
approximately 15% of patients with
insomnia who are referred to sleep
disorder centers following exclusion of
other predisposing conditions. However,
true incidence is not known. Primary
insomnia is estimated to occur in 25% of
all patients with chronic insomnia.
The active agent in many of these
over-the-counter medications are generally
safe but have anticholinergic adverse
effects such as dry mouth, blurred vision,
urinary retention, and confusion in older
patients, which can be potentially more
serious in patients with dental caries,
glaucoma, prostatic enlargement, and
dementia (or delirium), respectively.
They are also minimally effective in
inducing sleep and may reduce sleep
quality and thereby should not be used on
a routine basis.
Use of a variety of herbal preparations
(eg, herbal tea) and so-called nutritional
substances should not be used, also,
because of the lack of evidence in their
support. A recent study showed that
melatonin did not produce any sleep
benefit in patients with primary
insomnia.
The primary indication is for short-term
management of insomnia, either as the sole
treatment modality or as adjunctive
therapy until the underlying problem is
controlled. An occasional hypnotic
(flurazepam (dalmane), quazepam (doral),
or estazolam (prosom) can be used for
sleep state misperception when the patient
becomes extremely worried about perceived
lack of sleep for several nights.
For excellent patient education resources,
visit emedicine's sleep disorders center
and mental health and behavior center.
Also, see emedicine's patient education
articles primary insomnia, insomnia,
disorders that disrupt sleep
(parasomnias), and understanding insomnia
medications.
