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> Sleep Apnea and cognitive enhancers, Is there a relation?
Braintease
post Feb 14, 2012, 04:41 PM
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Hello, this is my first post here. Pleased to meet everyone.

I am having trouble finding help for this and thought that maybe this was a good forum to visit for some insight.

Long story short. A series of anxiety/panic symptoms which started late november (right after thanksgiving) and pretty much culminated around late january.

To ensure I did not have any heart problems I had several EKG tests, a stress echo, a holter monitor. All of which came back normal or unrevealing of anything dangerous. Blood flow between chambers, normal. Heart Rhythm, normal (with common premature beats, very rarely, possibly caused by anxiety). Also had an MRI which came back normal, thyroid test which came back normal, allergy tests, all came back normal. Electrolytes normal. Glucose normal, A1C, perfect.

I have been experimenting with several supplements, including nootropics, for the past 3-4 years.

At first I was doing GNC's focus formula, then I tried huperzine on its own for a while, then ginko on its own along with some mood enhancers such as saint john's wort and 5htp (I never took the last two at the same time, because of the SSRI potentiality when mixed). I also took melatonin, valerian root and now experimenting with L-theanine for sleep and mood enhancement.

Anyway, my primarily question is related to my latest bout of symptoms, which include:

1-Extreme fatigue within an hour or two after waking (after waking I feel alright, but within one to two hours my energy levels plummet, and I experience muscle aches and general physical weakness)

2-Brain fog (this is the best way I can describe this symptom, it is very unpleasant and unnerving)

3-Short term memory loss (I was talking to a friend about movies earlier, and couldn't remember the name of an actor who's films I have all seen, namely Will Smith. Also been having trouble remembering what I did 30 seconds prior, or what I was about to search for in a google search, what I read one paragraph earlier, etc).

Here is my primary question:

Could any supplemental mood enhancers or sedatives, like Valerian (which i am not currently taking), melatonin (which I am only taking once or twice a weak at a very low dose), and L-theanine (which I am currently taking, but not every day) cause the throat and tongue to relax to such a degree that they can cause or worsen OSA (Obstructive sleep Apnea)?

Furthermore, and this is kind of scaring me half to death, I heard that untreated sleep Apnea can lead to heart attacks after a while, but there is conflicting information on the internet about this. Is it only in CAD patients that this can happen, or can it happen in anyone, even people with otherwise healthy hearts who just recently had a battery of tests to confirm that their hearts are in perfect working order?

The other half of this question is this. I just recently had an MRI done which revealed nothing wrong with my brain. But I read that OSA can cause tissue damage to the hypothalamus area and as a result can effect memory badly. And since I have symptoms of short term memory loss, could I be suffering from tissue damage to this region of my brain? Is it possible the MRI was not a deep enough scan or was it adequate enough to show any possible problems associated with the above symptoms?

Thank you in advance for your responses good people.
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JsMill
post Feb 19, 2012, 08:21 PM
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QUOTE(Braintease @ Feb 14, 2012, 04:41 PM) *

Hello, this is my first post here. Pleased to meet everyone.

I am having trouble finding help for this and thought that maybe this was a good forum to visit for some insight.

Long story short. A series of anxiety/panic symptoms which started late november (right after thanksgiving) and pretty much culminated around late january.

To ensure I did not have any heart problems I had several EKG tests, a stress echo, a holter monitor. All of which came back normal or unrevealing of anything dangerous. Blood flow between chambers, normal. Heart Rhythm, normal (with common premature beats, very rarely, possibly caused by anxiety). Also had an MRI which came back normal, thyroid test which came back normal, allergy tests, all came back normal. Electrolytes normal. Glucose normal, A1C, perfect.

I have been experimenting with several supplements, including nootropics, for the past 3-4 years.

At first I was doing GNC's focus formula, then I tried huperzine on its own for a while, then ginko on its own along with some mood enhancers such as saint john's wort and 5htp (I never took the last two at the same time, because of the SSRI potentiality when mixed). I also took melatonin, valerian root and now experimenting with L-theanine for sleep and mood enhancement.

Anyway, my primarily question is related to my latest bout of symptoms, which include:

1-Extreme fatigue within an hour or two after waking (after waking I feel alright, but within one to two hours my energy levels plummet, and I experience muscle aches and general physical weakness)

2-Brain fog (this is the best way I can describe this symptom, it is very unpleasant and unnerving)

3-Short term memory loss (I was talking to a friend about movies earlier, and couldn't remember the name of an actor who's films I have all seen, namely Will Smith. Also been having trouble remembering what I did 30 seconds prior, or what I was about to search for in a google search, what I read one paragraph earlier, etc).

Here is my primary question:

Could any supplemental mood enhancers or sedatives, like Valerian (which i am not currently taking), melatonin (which I am only taking once or twice a weak at a very low dose), and L-theanine (which I am currently taking, but not every day) cause the throat and tongue to relax to such a degree that they can cause or worsen OSA (Obstructive sleep Apnea)?

Furthermore, and this is kind of scaring me half to death, I heard that untreated sleep Apnea can lead to heart attacks after a while, but there is conflicting information on the internet about this. Is it only in CAD patients that this can happen, or can it happen in anyone, even people with otherwise healthy hearts who just recently had a battery of tests to confirm that their hearts are in perfect working order?

The other half of this question is this. I just recently had an MRI done which revealed nothing wrong with my brain. But I read that OSA can cause tissue damage to the hypothalamus area and as a result can effect memory badly. And since I have symptoms of short term memory loss, could I be suffering from tissue damage to this region of my brain? Is it possible the MRI was not a deep enough scan or was it adequate enough to show any possible problems associated with the above symptoms?

Thank you in advance for your responses good people.




Hi. I may be able to help you with this. I run sleep studies at night and am a pre-med student with extensive reading in psychopharmacology and sleep medicine.

First, you asked about whether the supplements you are taking could possibly be causing any of your symptoms. The answer is that it is unlikely. There may be some interaction with substances that affect serotonin reuptake (St. John's wort)-- "brain fog" and fatigue are commonly reported symptoms during SSRI use. The rest of the substances you list-- 5-htp, melatonin, l-theanine, and valerian root, when taken in normal dosages, are unlikely to result in fatigue or cognitive decline.

Your symptoms are classic, however, for both anxiety and unresolved OSA. Your nocturnal panic attacks are common as a symptom of either generalized anxiety or OSA that is inadequately treated (OSA patients often report drowning dreams or feeling as if they have woken in a panic).

Both anxiety and OSA can cause morning and daytime fatigue, "brain fog" and memory problems, particularly short-term memory problems.

Are you being treated for sleep apnea? If not, you should be. Please take comfort in the fact that sleep apnea is not going to kill you in your sleep. However, left untreated, it DOES roughly double your risk of heart attack, stroke, and diabetes. Moreover, it can cause your quality of life to plummet-- increasing fatigue, anxiety, ect.

One caveat to what I said earlier regarding your supplements-- OSA is often worse during the REM portion of your sleep cycle. Melatonin tends to increase the frequency and length of your REM periods, and so it may be that melatonin is indirectly worsening your sleep apnea.

You also seemed somewhat concerned about premature beats on your heart monitor. You should know that your doctor was correct in telling you that these are normal and can occur in very healthy adults. They are generally known as either PVCs (pre-ventricular contractions) or PACs (premature atrial contractions). Their incidence can be increased by anxiety, strenuous exercise, smoking, and caffeine or other stimulant use. They are nothing to worry about. In the absence of severe heart disease or other real heart abnormalities (which would have been picked up on your heart tests), they will not kill you or cause adverse cardiac events.

Hope this was helpful to you. smile.gif


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Braintease
post Feb 21, 2012, 12:33 AM
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QUOTE(JsMill @ Feb 19, 2012, 08:21 PM) *

QUOTE(Braintease @ Feb 14, 2012, 04:41 PM) *

Hello, this is my first post here. Pleased to meet everyone.

I am having trouble finding help for this and thought that maybe this was a good forum to visit for some insight.

Long story short. A series of anxiety/panic symptoms which started late november (right after thanksgiving) and pretty much culminated around late january.

To ensure I did not have any heart problems I had several EKG tests, a stress echo, a holter monitor. All of which came back normal or unrevealing of anything dangerous. Blood flow between chambers, normal. Heart Rhythm, normal (with common premature beats, very rarely, possibly caused by anxiety). Also had an MRI which came back normal, thyroid test which came back normal, allergy tests, all came back normal. Electrolytes normal. Glucose normal, A1C, perfect.

I have been experimenting with several supplements, including nootropics, for the past 3-4 years.

At first I was doing GNC's focus formula, then I tried huperzine on its own for a while, then ginko on its own along with some mood enhancers such as saint john's wort and 5htp (I never took the last two at the same time, because of the SSRI potentiality when mixed). I also took melatonin, valerian root and now experimenting with L-theanine for sleep and mood enhancement.

Anyway, my primarily question is related to my latest bout of symptoms, which include:

1-Extreme fatigue within an hour or two after waking (after waking I feel alright, but within one to two hours my energy levels plummet, and I experience muscle aches and general physical weakness)

2-Brain fog (this is the best way I can describe this symptom, it is very unpleasant and unnerving)

3-Short term memory loss (I was talking to a friend about movies earlier, and couldn't remember the name of an actor who's films I have all seen, namely Will Smith. Also been having trouble remembering what I did 30 seconds prior, or what I was about to search for in a google search, what I read one paragraph earlier, etc).

Here is my primary question:

Could any supplemental mood enhancers or sedatives, like Valerian (which i am not currently taking), melatonin (which I am only taking once or twice a weak at a very low dose), and L-theanine (which I am currently taking, but not every day) cause the throat and tongue to relax to such a degree that they can cause or worsen OSA (Obstructive sleep Apnea)?

Furthermore, and this is kind of scaring me half to death, I heard that untreated sleep Apnea can lead to heart attacks after a while, but there is conflicting information on the internet about this. Is it only in CAD patients that this can happen, or can it happen in anyone, even people with otherwise healthy hearts who just recently had a battery of tests to confirm that their hearts are in perfect working order?

The other half of this question is this. I just recently had an MRI done which revealed nothing wrong with my brain. But I read that OSA can cause tissue damage to the hypothalamus area and as a result can effect memory badly. And since I have symptoms of short term memory loss, could I be suffering from tissue damage to this region of my brain? Is it possible the MRI was not a deep enough scan or was it adequate enough to show any possible problems associated with the above symptoms?

Thank you in advance for your responses good people.




Hi. I may be able to help you with this. I run sleep studies at night and am a pre-med student with extensive reading in psychopharmacology and sleep medicine.

First, you asked about whether the supplements you are taking could possibly be causing any of your symptoms. The answer is that it is unlikely. There may be some interaction with substances that affect serotonin reuptake (St. John's wort)-- "brain fog" and fatigue are commonly reported symptoms during SSRI use. The rest of the substances you list-- 5-htp, melatonin, l-theanine, and valerian root, when taken in normal dosages, are unlikely to result in fatigue or cognitive decline.

Your symptoms are classic, however, for both anxiety and unresolved OSA. Your nocturnal panic attacks are common as a symptom of either generalized anxiety or OSA that is inadequately treated (OSA patients often report drowning dreams or feeling as if they have woken in a panic).

Both anxiety and OSA can cause morning and daytime fatigue, "brain fog" and memory problems, particularly short-term memory problems.

Are you being treated for sleep apnea? If not, you should be. Please take comfort in the fact that sleep apnea is not going to kill you in your sleep. However, left untreated, it DOES roughly double your risk of heart attack, stroke, and diabetes. Moreover, it can cause your quality of life to plummet-- increasing fatigue, anxiety, ect.

One caveat to what I said earlier regarding your supplements-- OSA is often worse during the REM portion of your sleep cycle. Melatonin tends to increase the frequency and length of your REM periods, and so it may be that melatonin is indirectly worsening your sleep apnea.

You also seemed somewhat concerned about premature beats on your heart monitor. You should know that your doctor was correct in telling you that these are normal and can occur in very healthy adults. They are generally known as either PVCs (pre-ventricular contractions) or PACs (premature atrial contractions). Their incidence can be increased by anxiety, strenuous exercise, smoking, and caffeine or other stimulant use. They are nothing to worry about. In the absence of severe heart disease or other real heart abnormalities (which would have been picked up on your heart tests), they will not kill you or cause adverse cardiac events.

Hope this was helpful to you. smile.gif



Thank you very much for your responses. It is much appreciated.

I do have a couple of follow up questions/comments however.

1-Because supplemental sedatives, such as L-theanine, melatonin and valerian root increase the level of undisturbed deep sleep, is it possible they may have an effect on the relaxation of the throat muscles and tongue, which may contribute more than an average risk toward OSA? I really would like your speculative insight here. Because for some reason, the better I sleep, the more I wake up feeling like I am not breathing right. I know that on average humans only breathe 10 times a minute during periods of deep sleep, but I sometimes feel as if my breathing is less than this.

2-Could supplements like l-theanine effect the center of the brain associated with respiratory regulation while in an unconscious state, independent of relaxation of the throat and/or tongue?

3-You say that untreated sleep apnea can double ones risk of heart attack, but you did not specify further circumstances or why this is. Could you clarify that? For example, how would sleep apnea double the chances of heart attack in someone who has been thoroughly tested for various heart conditions and has been given the seal of good health by both cardiologists and physicians and who is under 40 years of age? This is very important to me because hearing things like 'it doubles your chances of heart attack' without any further explanation of the statement really invokes terrible anxiety in me.

4-I am stuck between a rock and a hard place because on the one hand these supplemental sedatives help me sleep better, as long as my mind is relaxed. On the other hand the following day I experience problems with fatigue, respiration, cognition, etc. I wonder if this has something to do with synaptic misfiring and pretty much shot neural receptors due to years of supplementing melatonin and valerian root?

On the other hand, if I do not take these sedatives/sleep aids for a while, my sleep becomes very sporadic, disrupted and the former symptoms return.

To respond to your inquiry about being treated for sleep apnea. Not at this time, because I have not actually been diagnosed with it. I have an upcoming sleep study in the first weeks of march which will determine whether or not I suffer from either form. I might get in sooner if there is an opening.

In terms of what my holter monitor said, there were 7 ventricular ectopies, which is less common than what many people experience actually and the doctor seems almost positive that they were triggered by anxiety, which makes sense, since I was going through a lot of stressful moments at that time.

Of note is the fact that I have a somewhat small neck for a man, which my doctor thinks makes me an unlikely candidate for sleep apnea, considering my low BMI along with it (145 LBS at 5'9 and a half).

But he ordered the sleep study in any event, at my request just to 'ease my mind' apparently.

What I am concerned with is that, if the sedatives I am taking are somehow affecting my respiration during sleep, it will be very difficult to rule this out because the sleep study requires that I take no sedatives for the study. Can you enlighten me as to why this is so?

Thank you in advance for your further responses.
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