Sleep deprivation and Higher Order Thinking - Just Don't Mix

[Cort]

I wouldn't be surprised if this wasn't on the Japanese CFS groups. They got alot of hoo hoo but unfortunately they seem to be doing alot of very basic (ie simple) studies. Still they do highlight some interesting things.

This one shows that healthy people who are deprived of sleep can do the simple things afterwards but ask them to do some high level thinking and they are in trouble. Just think of what years of poor sleep can do to your cognitive centers if one bad night can cause healthy people to blow it on higher cognitive tests not for one but for two days afterwards.

Recovery of Cognitive Performance and Fatigue after One Night of Sleep Deprivation.

Ikegami K, Ogyu S, Arakomo Y, Suzuki K, Mafune K, Hiro H, Nagata S.
Department of Mental Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan.

The aim of this study was to investigate how subjective sleepiness, mood states, simple and high-order cognitive performance change after one night of sleep deprivation (SD) and recover to after 7 hours normal recovery sleep opportunity during three recovery days. Methods: Ten healthy subjects participated in this study. We measured their subjective sleepiness, mood states and their performances of 2 simple tasks and 4 high-order cognitive tasks twice a day for 5 days, on the baseline day, post-vigil day and 3 recovery days after SD.

The performances of simple tasks such as addition or short-term memory were not reduced after SD and were the poorest on the baseline day, and improved gradually; however the high-order cognitive performances were at their lowest on the post-vigil day and needed 2 recovery sleep opportunities to return to the baseline level. Fatigue and confusion in mood states and subjective sleepiness were also at their lowest after SD. Subjective sleepiness nearly recovered to the baseline level on the 1st recovery day, but fatigue and confusion reached the baseline levels on the 2nd recovery day.

Conclusion: These results suggest that cognitive deterioration and the recovery process may differ between simple task performance and high-order cognitive task performance, which needed 2 ordinary sleep opportunities to recover to the baseline level, and the change of subjective mood states were also different for each mood.

 

[Michelle]

When I had my sleep study, I only slept 5 hours that night. The doctor was going to simply have me redo it, but decided to see how I responded to the nap test. When I didn't fall asleep right away during the nap tests, he concluded that sleep wasn't my problem. But he never tested how well I could accomplish cognitive tasks with only 5 hours of sleep.

Since starting morphine sulfate a year and a half ago, I absolutely have to sleep 12 hours. Yes, morphine is notorious for somnolence, but once I wake up, I'm awake and even more coherent than prior to starting morphine when I only averaged about 5-6 hours a night. I probably averaged that for two decades. Pain has been such a problem for me for so long. I find sleeping so much annoying as hell, but figure it's my body trying to compensate for so many years of bad sleep. Though I still never wake up feeling very refreshed. :-(

 

[Cort]

That's one way to get better sleep! It is so rare that I get more than six hours of sleep a night and I think average between 5 and 6. This has been consistent for decades. I don't know if sleep meds would help me or not but every now and t hen getting that extra hour sure makes a difference. All I want is another hour!

 

[Tony]

Ever thought of trying a sleep med? I know of someone who was similar in getting 5-6 hrs per night, working 30 hours a week with nothing in the tank after that. No social life etc.
They went to the doc and got low dose amitriptyline. Changed their life. I guess we have to weigh these things up like always.

 

[Cort]

I think its definitely worth a try even if I just used it occassionally. No doctor, however. I may get to see one if I get in the low-income program here though. It would be something I'd give a shot.

I'm going to focus more on meditating before sleep, getting to bed at the right hour and continuing to do Gupta and such things. Oddly enough just in the last couple of weeks I've slept into daylight a couple of times.

 

[Jody]

I wouldn't be surprised if this wasn't on the Japanese CFS groups. They got alot of hoo hoo but unfortunately they seem to be doing alot of very basic (ie simple) studies.

Pardon, sir.

What is this .. "hoo hoo"?

 

[Jody]

This study does seem to be stating the obvious.

But the importance of sleep for the chronic, and for healing, probably can't be emphasized enough. When my son Jesse's sleep was so dysregulated, and he'd be exhausted and gray looking but unable to sleep for 2 days at a time, he looked like death warmed over. When he did sleep we'd been following somebody's advice, and were waking him up by noon or so everyday. Idea being, to try to get his body adjusted to being awake during the day and sleeping at night (his body was doing the reverse when he did sleep).

Read a book called My Stroke of Insight (can't remember author's name but can dig it up if anyone wants it) that basically gave me permission to do what I wanted to do. Let him sleep as long as he could, whenever he could. My motto was, Any sleep is a good sleep.

He began to sleep 12 hours at a stretch -- still very erratic but he was getting the longer sleep periods he needed. And he would feel -- not revitalized, but more human after, and his colour was better, his eyes didn't look dead, he felt better and it showed. Mentally more with it ... everything would improve, just from getting a great big ol' sleep.

I have had the habit of napping, off and on through this illness. I have had occasions where I was feeling tired, with fragmented thinking, body stone, and ... chose to go to sleep for awhile. When I'd awake, an hour or two hrs later, sometimes (not always) I would feel much more alert, quieter nervous system ... just from sleep. It is the pause that refreshes.

 

[Lisa]

I have a heck of a time sleeping unless it is after 11 pm most nights though if I have had short sleep a few nights in a row I can pass out as early as 10:30 pm! weee! Pass out is probably a very good description of most times I fall asleep, the chatter in my body is just too high to let me sleep any other time.

Once asleep, I am usually good till about 7 ish with only a few wake ups to turn over or such. After 7 I am still too zonked to wake up yet the chatter is going enough that what sleep I do get is only marginally more restful than if I actually just got up at 7. If I do just get up at 7ish for too many days though I end up feeling very sleep deprived but can not get to sleep significantly earlier to help.

Over the years I learned how to tell when I pass the point of getting that slightly restful sleep and when to wake up or feel even worse because something about that chatter while trying to sleep can just wreck me in the morning if it gets too high before I am up.

Naps. I would love to be able to nap! The chatter just won't allow it other than 2-3 times a year. When I do manage a nap on those few days I sleep like a log for anywhere between 2-4 hours and usually at 4 hours I could even sleep more but Jeremy gets me up so that I'm not awake all night. After a nap I just can't shake this kinda odd grogginess that seems to leave me less mentally able to do most things and physically less stamina. More rested feeling and calmer though so it is an odd trade off.

Lisa

 

[Frankie Dene]

Sleep and amytrip

Ever thought of trying a sleep med? I know of someone who was similar in getting 5-6 hrs per night, working 30 hours a week with nothing in the tank after that. No social life etc.
They went to the doc and got low dose amitriptyline. Changed their life. I guess we have to weigh these things up like always.

When I was incredibly sick and only able to get 3 hours sleep a night - the worst symptom you can have, insomnia, I was put on 10mg of amytrip and slowly went up to 30mg. It was the best thing - started to wake only once and then slept all night. Stayed on it for 11 years at 10mg. When I became well I had no trouble. Stopping it - it was not addictive at all - a worry for lots - but it is a very small dose (45mg is the normal for depression.) In Nz we use it for sleep, some can't take it, it makes them feel awful - but for most of us it has been a life saver. Now I'm sick again and having sleep problems I'm back on it and will have to lift my 15mg I think to get back to a good sleep. I've been fine up to a week agaon but just starting with the sleep problems.

It has been interesting getting sick again and finding the symptoms wax and wane - now I know so much more - it is like a scientific experiment - I just wish it wasn't me housbound and on the bed all day.

 

[Cort]

That's great to hear about Amytriptyline - it's yet another drug that I've little about. Definitely got to get a page on it up on my website. These 'antidepressants' can be versatile - I looked it up in Wikepedia - it being explored with regard to these diseases:

PTSD[4], migraine,rebound headache, chronic pain, tinnitus, chronic cough, postherpetic neuralgia (persistent pain following a shingles attack), carpal tunnel syndrome, fibromyalgia, vulvodynia, interstitial cystitis,male chronic pelvic pain syndrome, irritable bowel syndrome, diabetic peripheral neuropathy,neurological pain, and painful paresthesias related to multiple sclerosis

There certainly is something of a common thread here; many of these are the so-called 'sensitivity syndromes' - mysterious pain (and some fatigue) disorders. Thanks!

 

[Lisa]

Does anyone have any experience with Amytriptyline and sun exposure? The first summer I was in a tent, a doctor prescribed it for me to help with depression. When I filled the prescription it came with a very large warning label to stay out of the sun - something that is nearly impossible to do when living in a tent!

I asked the pharmacist about it but they only knew what the label said so I opted to skip it figuring that the depression wasn't very bad and I had not really wanted to use antidepressants anyways.

But now I have to wonder... would it have helped? doh!

Lisa

 

[Jody]

Lisa,

As with so many things, amytriptylene may help or it may not. Or it may make you feel worse.

And it will take I think a month or thereabouts to see if it works.

 

[Lisa]

Feel worse!

Considering the competency of the doctor.. wait, amend that to nurse practitioner if I remember right, she wasn't someone who would instill a sense of confidence in her care. Sounds like a good type of prescription to make sure the physician prescribing it is very solid and caring.

I'll put it on the list of things to possibly try after all the much safer things have been done and if there is healing left to do.

Lisa

 

[Jody]

Well it MIGHT not make you feel worse.

From what I understand (which isn't much I'm afraid) amytriptylene is one of the milder ones, and may have less chance therefore of having a bad reaction. (This is NOT my area, you'd want to check with some other source on this.)

I do know that for whatever reason one of the side effects of many of these types of drugs, is an increase of the symptoms you are trying to get rid of. Sometimes. They'll work for some people. And if one doesn't work for you another one might. But there is by no means any guarantees no matter what the doctor implies.

 

[Sushi]

I've taken this one low dose--prescribed by a sleep doctor and yes it did help sleep. But having learned more in the years since, there are some cautions on this one. This class of drugs can be dangerous if you have a long cardiac QT interval. It is also one you have to be very careful with what other drugs you take at the same time. For me the only problem, and it was a problem, was urine retention--hard to pee!

Sushi

 

[meandthecat]

In the early days I slept, was unconcious, for 16 hrs a day. Could fall asleep in a second almost anywhere but I always woke up for 6am, years of work!

Gradually I moved back to a more usual sleep pattern which then began to break up into shorter chunks, waking at 3am and taking hours to doze off again. The world seems really bleak at 3am.

I tried citalipram as a way of toning down the anxiety but it was of little use. I am now using melatonin and it seems promising; giving me a subtly different, better, quality of sleep.

I wonder how others have found this?

 

[annunziata]

The sleep disorder that I have with CFS has changed over the years. It's much better than it was at one time, but I still tend to wake up during the night. This is true even if I've felt well enough for moderate activity. I remember being given amitriptyline long ago, when Doctor #1 thought I had masked depression. I don't recall that it had much affect at all. Eventually, after trying quite a few meds, including Klonopin which did NOT agree with my system, my doctor and I settled on Dalmane. It works pretty well for me when I'm in a cycle of severe insomnia -- I take 15 mg. I used to have to take it every night to sleep, but for the past decade or so, I just use it occasionally.

No matter what, I never wake up feeling well. Even when I seem to have slept pretty solidly, I wake up feeling just ghastly. There hasn't been a single morning since I became ill 23 years ago that has been an exception to this. When I first wake up, I feel as if I have been bludgeoned, half-bled to death, and am badly hung over ('unrefreshing sleep', right!). It usually takes about three hours for this to sort of 'burn off', and then I generally feel a little better, for a while.

Meandthecat, I also had the impression that melatonin gave me a slightly different, and better, quality of sleep when I tried it -- but it wasn't lasting. I might try it again, though.

 

[Sunday]

linden, melatonin, acupuncture, and marijuana

Lisa, I don't know if this will work for you, but it does work for many. Linden flower tea has a longstanding reputation of stopping chatter; it worked for me when I was healthy (and for many I recommended it to), and it often but not always works for me with CFS. It's nice-tasting, too. Steep one teaspoon in a cup of boiling water, covered, for ten minutes at least for full medicinal effect. You can find it in tea shops that carry European herb teas, but the cheapest way is to get it in bulk at an herb or health food store. It's fluffy and light so an ounce goes a long way.

Another thing that I find gives me more refreshing sleep, and makes it easier to get to sleep, is acupuncture.

If melatonin works for people who can't get sleep otherwise, go for it, but you might want to be aware that it messes with your hormonal system when used long-term. Since our hormonal systems are already messed with, this is a consideration.

I do use melatonin when I travel because my usual sleeping dose is marijuana oil, legal in my state with prescription. Honi soit qui mal y pense; it's the only reliable sleeping potion I've found that won't give me liver damage with long-term use (like Ambien) and doesn't mess with my hormones. It also relaxes me emotionally, by helping me gradually unravel my day and get a new perspective; for me the psychoactive effects are spiritually and emotionally refreshing, get me out of my bad grooves. My sleep with it is usually good and I don't wake any groggier than usual (I'm now putting my active b12 lozenges by my bedside so I can start up even before I get out of bed. My cells start perking up and getting out of bed and facing my day is much easier). Klutzo did alert me to the fact that I might be in danger of overeating! But since I have pretty constant nausea, the nausea relief is very welcome. I may eat some junk food along with the good but it is heaven to really enjoy my food. The partial nerve pain relief is welcome also.

This may not work for everybody, but it has been a godsend to me. I'll keep reading this thread with interest, to see what works for others. Sleep is really key and I never knew how important it was until I could no longer get it when I wanted.