Doctors Answers (3)
Often, patients suffer from a multitude of sleep disorders which makes us wonder if there is a common cause. Obviously, sleep apnea often causes sleep deprivation and the daytime sleepiness seen with sleep apnea is as severe as we see in patients with narcolepsy. We know that obstructive sleep apnea is more common in narcolepsy patients so you may have all the disorders you mention. Treatment is available for most all sleep disorders but, in your case, a board certified sleep specialist will be your best choice. This sounds too complicated for most physicians who do not treat sleep disorders on a daily basis.
You will need testing and will need to be placed on medication and possibly taken off some medication. This will also require some work on your part and serious personal involvement such as adhering to schedules and staying in touch with your physician regarding the efficacy of treatment. Due to the multiple issues, I would not expect immediate results so patience on your part will be necessary. You sound motivated to correct these problems. You should do well as everything you mention is treatable.
It sounds like you may have several sleep disorders in addition to sleep apnea including a chronic insomnia or a circadian rhythms disorder like Delayed-sleep phase syndrome. In the latter syndorme the circadian rhytyms that help regualte sleep are shifted to a later than normal clock time. A chronic insomnia primarily of the sleep onset type suggests the possibility of the this diagnosis as well. Chronotherapy (progessive phase delay of bedtimes over several days to resync to a normal bedtime) and bright light therapy in the early morning to help phase advance the sleep cycle are the usualy methods of treatment. The other psychosocial complaints you mention are likely due to insufficient sleep and once this is corrected they should improve as well. You also need follow up to help monitor and optimize the use of the CPAP device for sleep disordered breathing.
Your sleep history is very complicated compounded by several factors. I would strongly recommend you see a Board Certified Sleep PHysician. In addition to diagnosing and treating any underlying sleep disorder, chances are you may also have underlying mood disorder. Consulting a psychiatrist may also not be a bad idea, but definitely see a sleep physician.