wake-sleep transition disorder?

[rockybed]

I am aware of what hypnic jerks are but I seem to have something more severe. I am unable to sleep without the use of a benzo which affords me 4 or 5hrs maximum. As I'm about to fall asleep, I will get a jolt/shock in the trunk area. Sometimes it happens in my head, neck, shoulders, but mostly in the chest. ocassionally, arms, hands. Also after I've slept about 4hrs(benzo), there seems to be some kind of myoclonus in the throat area- like an involuntary swallowing reflex. I will be drowsy from the med and want to sleep more but the throat jerks keep me awake, completely disabling me from sleeping. I've layed in bed an entire night, and EVERYTIME I start to drift off, I get these jolts and/or throat jerks completely preventing me from sleeping. They are unrelenting but only happen at sleep onset. It doesn't happen if just laying there relaxing and mentally alert. I was diagnosed with OBSA in 2006 and this was confirmed with annual PSGs. However a recent PSG revealed I no longer had OBSA, to the astonishment of the sleep specialist, as I had not lost any weight etc..The difference between this test and all other tests was I had recently come off an SSRI and used lorazepam for the sleep study. Unfortunately the lorazepam masked this other condition that has been getting progressively worse. Do you have any insight into this? I'm thinking it's neurological, as even with the sleep apnea, I was not a typical candidate, fit, athletic,non-smoker/drinker etc...How does apnea just disappear? Why are the jolts persisting?

[essexorcist]

I am suffering with the same wake-sleep issue, for the last year - did you ever get a diagnosis or solution to your issue? Its so debilatating I have never suffered so much, as constantly falling asleep 30 times a night, but getting shocked awake at the transition. truly horrendous!

[rockybed]

Thank you for responding. The sleep specialist said I had plenty of deep sleep, REM, etc...,but I am skeptical, so another sleep study is scheduled. There is also something called UARS that I'm suspecting might not have been picked up, however the lab assured me they had proper equipment to detect that as well. The specialist argued that if I had sleep apnea, the lorazepam would worsen it and make me feel worse, however, paradoxically, I feel better(particularly before jerks started). I believe the SSRI caused the sleep apnea, and these jerkings, arousals, are part of SSRI withdrawl. I also contacted another sleep institute for another opinion/explanation. I'm waiting for appt there as well.

[KatEyes]

No answers, but some thoughts... I have RLS & PLMD and when I'm on a med and end up with augmentation, my movements become odd and contradictory to any expectations. You might want to ask your pharmacist if any of your meds are known to possibly cause movement issues.

About the sleep apnea - unless you had substantial good sleep in all stages and some time in REM while supine, a sleep study negative for obstructive sleep apnea may not be conclusive. Look at your copy of the report and see what it says about arousals, especially any associated with limb movements. Maybe you didn't sleep enough to exhibit the apneas on this particular night.

Some meds can make one more prone to obstructive sleep apnea by relaxing the throat muscles, or by making one too sedated to respond promptly to reduced or stopped breathing. Some meds can make one at risk for central sleep apnea. So a change in medications between the two studies could theoretically affect the outcomes. Maybe a talk with your doctor could clarify some things for you in view of your case and study details.