Methadone Rehabilitation

Question by Our Family Online: Is there a way to get REM Sleep with Severe Sleep Apnea & Narcolepsy/Cataplexy?
My husband has SEVERE Sleep Apnea and Narcolepsy. In his sleep studies, he wasn’t having any REM sleep at all until his third sleep machine – the VPAP. Now, he gets about 20 minutes of REM in a 5 1/2 hour night sleep and no REM during his naps. He sleeps 5 1/2 hours at night like clockwork, wakes up, takes his 3 Provigil, eats toast and 1/2 hour later can’t stay awake for anything. He’s out cold for 3 hours (with no REM). His daytime sleep test for Narcolepsy show that he falls asleep within the first 2 minutes of a “nap” and cannot stay awake in-between “naps”. It is dangerous. He has fallen asleep in the kitchen standing up and fallen completely over before – hitting his head on the granite counter and hitting the floor.

He has been told of a “miracle” Narcolepsy medication to bring him to a deep sleep but he can’t take it because he takes pain medication and the two combined could be lethal. We’ve been trying for 3 years to get his Sleep Apnea and Narcolepsy, Hypopneas, Hypoxia, blood disorder caused by Hypoxia, and other life threatening conditions treated. The blood disorder has cleared up, the chronic hypoxia has reversed with oxygen and VPAP, the Obstructive Sleep Apnea is gone with the Gastric Bypass, we’re now left with Central Apnea/Hypopnea, No Rem/almost No Rem and Narcolepsy/Extreme sleepiness all the time.

He is only 43 – with a 7 year old son. My husband is the kindest – most loving, most compassionate man I have ever met and I will spend my life caring for him – loving him and fighting for health care for him. I just want to see him get rest and his doctors aren’t helping him stay awake. I have heard that there are other medications that he can take other than Provigil / Nuvagil to stay awake during the day so that he can enjoy his family, but his doctor has never prescribed them . (not board certified in sleep medicine.. actually, a pulmunologist, but not board certified in that either.) We went to a certified sleep doctor/psychiatrist who mentioned that there were many options for medication treatment, but when we moved just after his first sleep test, we had to start all over and find new doctors. We went to the “sleep center” here in our town right next to and affiliated with our local hospital…. unfortunately, the doctor is not board certified and the “technicians” talk about marjuana and have only a high school education. They have the study results sent to a board certified doctor to read them and send back a report that the “sleep doctor” reads and treats my husband based on what he reads in books. I can’t believe we just wasted a year of our lives with this group of “doctors”.

Anyway……my questions are:

1. Can someone help my husband or a person get more REM Sleep – is it even Possible?
2. Are there other medications than Provigil for staying awake during the day for Narcoleptics?

3. Shouldn’t the fact that he takes 3 or 4 200mg Provigil and then taking a 3 hour nap 30 minutes after taking the Provigil say something to even a non-sleep doctor – that this drug isn’t working? It has been a year like this.

4. Is it time to see a Neurologist? Are we looking in the wrong place or did we just come in contact with one of the lesser skilled sleep doctors?

5. Has anyone taken Xyrem with Methadone 10mg before – is it lethal? This was the drug he said could make my husband sleep.

Best answer:

Answer by Kiki
Hi there,
I am sorry to hear about your husband’s (and your) situation. Sleep apnea can often prevent you from living your life like you wish you could.
What my friend uses for sleep apnea is “positional therapy.” Basically, the idea is that by sleeping on his side, your husband’s airway won’t collapse onto itself, and he will breathe better. It’s so much cheaper than the CPAP, and so much less intrusive. My good friend with sleep apnea uses a bumper belt from a company called Rematee. The belt will keep your husband sleeping on his side, because it has inflatable bumpers on the back of it. I think it works best for people with mild to moderate sleep apnea, but it’s worth a shot eventhough your husband as severe sleep apnea!
You can check out their products on their website at www.rematee.com.
I hope this helps and I wish you good luck!

Answer by koogy
I honestly don’t know why your husband hasn’t seen a neurologist before now! Not only that, but the methadone may be a big part of the problem. A quick search online and I found a few articles in legitmate medical publications that showed methdone and other narcotics significantly lessen REM sleep. The methadone could conceivable be “undoing” any possible benefits of the Provigil!

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