Inconsistent Sleep Quality

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Oozz
Posts: 217
Joined: Wed Oct 11, 2017 8:09 pm

Inconsistent Sleep Quality

Post by Oozz »

It seems like my sleep quality is always inconsistent. The medications are handling my urge to move pretty well; however, no matter how consistent my life is (stress, diet, exercise), it seems like every night I’m rolling the dice on how restful the sleep will be.

Does anyone else have this problem? One would think that a consistent medication regimen would manage this, but that doesn’t seem to be the case and has never really been the case.

The only forward predictor of my sleep quality is how little sleep I’ve gotten the past two nights. If I have really bad sleep 2 nights in a row, I’ll typically have a really strong catch up night.

I’m currently in Mirapex and Gabapentin 600mg. The mirapex has also fluctuated in how effective it is night to night. Some days I only need .125, some days I need to redose in the middle of the night. I don’t think I’ve augmented because this has been the case since my first week.

Rustsmith
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Re: Inconsistent Sleep Quality

Post by Rustsmith »

This is just my experience, but I will have good nights and bad nights when it comes to being able to fall asleep. In some cases I know what triggered it, such as forgetting to take my meds at the right time, but often I have no idea what triggered a bad night. And like you, a bad night often (but not always) results in a better night the next night.

Since you are taking gabapentin, you need to be aware that the adsorption of gabapentin can be inconsistent. Sometimes your body will pick of most of the medication and sometimes you only get part. That is why they developed Horizant, but you pay a very hefty price (in dollars) with Horizant to get more consistency.
Steve

https://www.mayoclinicproceedings.org/a ... 0/fulltext
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

ViewsAskew
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Location: Los Angeles

Re: Inconsistent Sleep Quality

Post by ViewsAskew »

I wish I could say I had no idea what you were talking about. Alas, I know all too well.

I have no clue what causes my inconsistent sleep quality. My urge to move is 95% controlled most times (occasionally some worse periods). but sleep? I have no idea if it is PLMS that may be uncontrolled, the effect of the medications, or some underlying issue that is part of the whole thing and as yet not identified. My best guess is that it is mostly the medications. We know that medications can change our sleep architecture and pramipexole absolutely does for me.
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

stjohnh
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Joined: Sun Feb 14, 2016 3:13 pm
Location: Palo Alto, California

Re: Inconsistent Sleep Quality

Post by stjohnh »

Oozz,
RLS actually has two main symptom groups, urge-to-move (restless legs) and sleep disorder. They appear to be mediated by different pathways (dopaminergic and glutamaturgic). In the mild phases of RLS the urge to move is the only apparent problem, and controlling urge-to-move usually results in satisfactory sleep. As the disease progresses, sleep problems become much more apparent, with many people reporting continued sleep problems even though the urge-to-move is controlled.

Meds that help the most consistently in RLS insomnia are gabapentin and medical marijuana (THC).

Since you are already on gabapentin, perhaps increasing the dose, likely splitting it as well (1/2 2 hours before bed and the other 1/2 4 hours later).

Most of us with moderate and severe RLS have sleeping issues.

RLS is caused by BID (Brain Iron Deficiency). Many people with RLS can have their symptoms markedly reduced or even eliminated with IV Iron treatments. This is the only treatment that gets at the basis for RLS (low brain iron). It has almost no side effects. The International Restless Legs Syndrome Study Group has elevated IV Iron treatment to first line therapy. This means that IV Iron is one of the first treatments doctors should try, not one of the last (as has been done for many years). If you can get your doc to prescribe IV Iron treatment, that is the way you should go. Unfortunately this is fairly new information and most docs, even those that frequently treat RLS, are not aware of it. Note that the blood test doctors usually do to check for low iron (ferritin test) only checks for low BLOOD iron, there is no test available for checking for low BRAIN iron. Oral iron usually doesn't provide a high enough blood level increase to help, folks need IV Iron infusions. Here is a link to the recommendations:
https://www.sciencedirect.com/science/a ... via%3Dihub
Blessings,
Holland

Polar Bear
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Re: Inconsistent Sleep Quality

Post by Polar Bear »

The title refers to inconsistent sleep quality.
Mine isn't exactly inconsistent, the pattern is quite consistent, just inconsistently bad in the same general pattern.
I sleep for an hour or so around 1am. Then I'm up until 6am or 7. Often I don't go back to sleep at all.
Recently I've been napping during the day and today just seems to have disappeared amongst naps.

Last week I was diagnosed with moderate sleep apnea following an overnight sleep test. The result was 20 apneas/hypoapneas per hour. That was done privately and I have been referred to the NHS for treatment. Heaven only knows how long that will take.
Betty
https://www.mayoclinicproceedings.org/a ... 0/fulltext
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation

debbluebird
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Re: Inconsistent Sleep Quality

Post by debbluebird »

I have had several bad nights lately. Having a hard time going to sleep. Then sleeping only a couple of hours. Leg has been pretty good, just awake. I am so tired. I hope I sleep some tonight.
What I hate about this is, I don't feel like doing anything. Just too tired. Only 2 hours last night. Luckily 2 hours this afternoon.

Polar Bear
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Re: Inconsistent Sleep Quality

Post by Polar Bear »

debbluebird - So tired but not sleepy.
I could have that tattood across my forehead.
I hate it when someone says to me..... Just go and have a wee rest !!
Betty
https://www.mayoclinicproceedings.org/a ... 0/fulltext
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation

ViewsAskew
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Re: Inconsistent Sleep Quality

Post by ViewsAskew »

Polar Bear wrote:
Thu Jun 25, 2020 7:30 pm
debbluebird - So tired but not sleepy.
I could have that tattood across my forehead.
I hate it when someone says to me..... Just go and have a wee rest !!

:cry: :cry: :cry:
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

Yankiwi
Posts: 548
Joined: Wed Sep 10, 2014 7:20 am
Location: West Coast, South Island, New Zealand

Re: Inconsistent Sleep Quality

Post by Yankiwi »

Polar Bear wrote: ↑
Fri Jun 26, 2020 7:30 am
debbluebird - So tired but not sleepy.
I could have that tattood across my forehead.
I hate it when someone says to me..... Just go and have a wee rest !!
Also, after a really long hike with friends when they say "we'll sleep well tonight!"

debbluebird
Posts: 2386
Joined: Mon May 21, 2012 3:27 pm

Re: Inconsistent Sleep Quality

Post by debbluebird »

I'd like to add to my post to better answer your question. I've had a little more sleep the last 2 nights. Ha !
Yes every night is a crap shoot. I hate that that is the case. I take methadone 5 mg every 8 hours. Gabapentine 600 mg every 8 hours. Both at 10pm, 6am, 2pm. I recently added CBD/TCH 1:1 .5 ml at 10 pm. That helped a lot in the beginning. Then the insomnia returned. Then last night leg spasms returned. Dang. So tonight, who knows what will happen.
I'll sleep in heaven.

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