Sleep issues

[Unregistered]

Since childhood, I have had trouble sleeping. I can miss a night's sleep, be dead tired, then at 10 pm the next night its like a sudden jolt wakes me up. I can dig post holes all day and still be wide awake until 4am, sleep well until 10am. Mind seems overactive, some important, most not. I must however conform to the 8-5 business cycle.

I am on CPAP for obsructive apnea. Never had and problem nodding off except occasionaly after being severely sleep deprived.

I was on Ambien, now Lunesta. I see Ambien is on the approved list, I don't see Lunesta.
For me, Lunesta lacks the knock out punch of Ambien, but is vastly superior for the morning after effects-virtually no grogginess or hangover. I have never had any sleepwalking or other side effects of either.

Melaton, valroot, and some other non-prescriptions help.

I have made changes in last 10 years, lost 100 lbs., quit drinking, no smoking, and still working to further simplify life. But I don't forsee giving up the CPAP or some form of sleep aid. I hope to get my 3d class medical back in a year.

So, my question is, what can I do to get my sleep issues within FAA guidelines?

 

[dtuuri]

Since childhood, I have had trouble sleeping.

I hope this helps. Two days ago I had a cup of coffee at my cousin's house at noon. I was still wide awake at 3:00 AM. So, I went to the fridge and chugged a delicious 8 oz Lime-A-Rita. Next thing I knew, it was after 9:00 AM.

dtuuri

 

[asgcpa]

Dr Bruce had commented previously about Ambien and Lunesta. For me it's no caffeine after 3pm, then some exercise if possible late afternoon. I will have a herbal or decaf tea at night.

 

[Papa Foxtrot]

Obstructive Sleep Apnea(OSA) is a Special Issuance(SI). You can do this on your own, but it's much easier to use Dr. Bruce Chien's services(www.aeromedicaldoc.com). I've got an OSA SI and Bruce's help was invaluable. He may still be on vacation, but you can email him from the web site above.

From my notes from Bruce, you'll need:

1. Copy of sleep study; original if available - definitely most recent.
2. A CPAP compliance report showing 30 days more than 75% of nights with >=6 hours
   usage
3. Letter from your doc, stating the four items: (1) appears
   well rested, (2)no excess tendency to fall asleep, (3)compliant with CPAP,
   (4)no findings of gross right heart failure.

I don't know about the pharmas, but Dr. Bruce will.

BTW, use the search function for OSA or apnea in this forum. It's been discussed a lot.

 

[AggieMike88]

A visit to a board certified sleep doc might be worth the trip and cost. Tell him of your plans to return to aviation and that you wish to find a solution that doesn't require medication. Once all the data about your situation has been gathered, he might be able to identify the cause and suggest a course of action.

For the moment, you can try what I do when I find that I am not able to doze off within 5-10 minutes of turning out the light because my mind is still in "random active" mode. I fire up my Kindle with a good novel (currently reading the Jack Reacher series), set the display for black background, white text, and low brightness. Freqently within 10-15 minutes of reading, I'm noticing that I'm dropping out and ready for sleep. So I shut off the device, turn to a comfortable position, and I'm out.

Other areas to explore is sleeping environment. It might be time for a new (and better) matresss. Consider temperature of bedroom. Banish the TV. Perhaps aromatherapy (I've set a cloth soaked with lavender oil near the air inlet on my CPAP once or twice and it helped.

How about routine? Are you going to bed at same time each night? Exercise? Relaxing and "wind down" activities? How about what you are eating and drinking in the afternoons/evenings as Matthew and Dtuuri speak of?

Ask your significant other to rub your tummy or head. I know it sounds silly, but somehting about that simple gesture activates the lizard part of your brain and brings relaxation. Once in college, I was very anxious about an exam and couldn't drop out. GF started stroking my chest and stomach and later said that within 7-8 minuutes of that, I was in dreamland. I recall getting one of the best round of sleep ever from that.

Hopefully something we share and offer helps you out!!

 

[Unregistered]

My sleep issues

Already no coffee after 10 am, no more than one soda before 4 pm, no caffeine after 4

can't don't want to drink any more

surgery doesn't seem a permanent OSA fix

until I can become Zen I expect to need a sleep aid

So, (assuming I get my other issues fixed), can I get me 3d class if I am on CPAP and Lunesta?

Should I be documenting anything? "last night I didn't sleepdrive" or such?

Will I have to go back to Ambien since its on the approved list?

Thanks

 

[AggieMike88]

Re: My sleep issues

Already no coffee after 10 am, no more than one soda before 4 pm, no caffeine after 4

can't don't want to drink any more

surgery doesn't seem a permanent OSA fix

until I can become Zen I expect to need a sleep aid

So, (assuming I get my other issues fixed), can I get me 3d class if I am on CPAP and Lunesta?

Should I be documenting anything? "last night I didn't sleepdrive" or such?

Will I have to go back to Ambien since its on the approved list?

Thanks

Dr. Bruce will be along with what public guidance he can give. He usually logs on around 2130-2230 central time.

But for direct contact, consider emailing him at aeromedicaldoc@comcast.net

 

[Unregistered]

Ever tried Melatonin supplements?

I've had trouble falling asleep at what most people call a reasonable hour all my life.

Melatonin is a natural hormone and you can get it over the counter just about anywhere. Works as good as any sleeping pill I ever tried and doesn't have as much of an after effect in the morning(you're still groggy/drowsy but it's not AS bad).

OTC = no need to tell the FAA anything. Just a thought. Good luck to you!

 

[asgcpa]

I have OSA. Had to get a usage compliance report for Dr. Bruce. Don't know about Lunesta, but I believe Dr. Bruce has commented in the past. My advice would be to contact him directly. Bbchien@comcast.net. Good luck.

 

[bbchien]

Ambien has DEMONSTRATED cognitive after effects until 48 hours so now the agency says, 60 hours down after a dose.

Now for so "how does this look" stuff:

Say you have 60 pills Rx'd in a year. That means you're down for 2 1/2 x 60 days, or 150 days of 365 days. At the 61st pill in a year, the FAA says, "Hey no dice. you have a sleep disorder. Get that fixed". Ambien they actually say they are unhappy at more than once per week, and that's only 53 pills per year.

Lunesta has a 30 hour wait. Same deal, similar calculation

If you don't get REM sleep, narcolepsy is a presumed problem. You end up doing sleep latency studies, and Mandatory Watchfullness tests, even to fly in the periods you are OUT from behind the meds.

 

[airguy]

Ambien has DEMONSTRATED cognitive after effects until 48 hours so now the agency says, 60 hours down after a dose.

Now for so "how does this look" stuff:

Say you have 60 pills Rx'd in a year. That means you're down for 2 1/2 x 60 days, or 150 days of 365 days. At the 61st pill in a year, the FAA says, "Hey no dice. you have a sleep disorder. Get that fixed". Ambien they actually say they are unhappy at more than once per week, and that's only 53 pills per year.

Lunesta has a 30 hour wait. Same deal, similar calculation

If you don't get REM sleep, narcolepsy is a presumed problem. You end up doing sleep latency studies, and Mandatory Watchfullness tests, even to fly in the periods you are OUT from behind the meds.

That makes EtOH start to sound like a viable sleep aid alternative!

 

[bbchien]

That makes EtOH start to sound like a viable sleep aid alternative!

How do you thing airline alcohol started? It used to be 8 ours bottle to throttle.

Captain takes a cordial from the first class galley, put it in his pocket. Steps down to the curb but on the way downs the scotch.

Arrives at holiday inn, takes shower and goes to sleep.

Then we had abuse. Then we had 0.04. Then we have 0.00.

Airguy-san, destined to re-live history yet again....

 

[airguy]

Airguy-san, destined to re-live history yet again....

"Not I", said the Little Red Hen...

I've seen it hit close to home in my family and more than a few of my friends, I do like a little whisky during a family get-together or holiday celebrations, but that's about it. You won't see me on your client list, I'm afraid.

 

[kgruber]

Can't sleep? That's a good thing. Learn to enjoy that time. Get on the net, read a book, go outside and watch the army shooting up the Yakima Firing Range.

To me, it is the best time of the day.

 

[bbchien]

"Not I", said the Little Red Hen...

I've seen it hit close to home in my family and more than a few of my friends, I do like a little whisky during a family get-together or holiday celebrations, but that's about it. You won't see me on your client list, I'm afraid.

...and that's about right. :wink2:

 

[flyingron]

The studies show while EtOH can help you fall asleep initially, it's not conducive to remaining asleep. As the doc says, chronic bedtime alcohol ingestion messes up the sleep maintenance and leads to fatigue and more alcohol consumption.

 

[airguy]

The studies show while EtOH can help you fall asleep initially, it's not conducive to remaining asleep. As the doc says, chronic bedtime alcohol ingestion messes up the sleep maintenance and leads to fatigue and more alcohol consumption.

I don't doubt the part about screwing up the sleep cycle - but it's lack of willpower and misguided escapism that drive the future alcohol consumption. It's a crutch - not a fix.

 

[flyingron]

I don't doubt the part about screwing up the sleep cycle - but it's lack of willpower and misguided escapism that drive the future alcohol consumption. It's a crutch - not a fix.

Your first part is clearly wrong. Ingestion of the alcohol (and it's metabolism) has definitely been shown to disrupt the long term sleep leading to fatigue. You are right, that the further attempt to recover from those effects with more alcohol starts with misguided (call it lack of willpower, or just an uninformed shortcut) application of more alcohol to recover.

 

[airguy]

Your first part is clearly wrong. Ingestion of the alcohol (and it's metabolism) has definitely been shown to disrupt the long term sleep leading to fatigue.

?? I think that's exactly what I was saying?