DSPS, Lack of deep sleep, Mild Sleep Aponea and Melatonin usage - What dosage?

[silent_one]

So I've been diagnosed with a few things over the past few years, in particular sleep aponea, which I have under control with a splint / a Somnomed device.

I also have a mild delayed sleep phase syndrome, my bodyclock is off by approximately 2hours.

I use bright light, in particular the Phillips Golite Blu every morning after waking up.

Sleep studies also showed little time spent in REM sleep, which the doctor mentioned as nighttime hyper vigilance.

I've been advised to use melatonin and I started on a 3mg dose. The 3mg does help but I still find myself tired during the day, the occasional headache especially if the sleeping pattern is not consistent for 1-2 weeks at at time.

I've gone all the way to 12mg to see if the higher dosage will help.
I'm currently taking the medication about 3.25 hours before bed time, and the melatonin is sustained release.

I sleep from approximately 10:30PM to 7AM most nights.

I'm looking for idea's / help on what could be wrong. Or how much melatonin I should be taking.
When I suggested a dosage smaller than 3mg, the doctor did not agree.

[silent_one]

The other problem is that I never recall waking up. So if anything I'm waking up but not knowing about it so its hard to tell if its happening at all :(

I just feel tired.

Thanks for the info.

[silent_one]

I've done 3 sleep studies in total, the last one was maybe 6-9months ago.
No aponeas, hypopneas were below the normal range I believe.

I cannot afford another study at a private hospital for another 9months.

Nightime hyper vigilance is a term I can find no information on. I think it might be a nickname for a high level of alertness at night. The doctor advised melatonin is the best way to deal with this.

I'll have to dig through my files to double check the report itself, it has been a while since I last looked at it.

[KatEyes]

Ok, sorry to be a stickler for details, but did the test with the device say you had no more hypopneas as well as no more apneas? I'm not sure if you are relaying what you read in the report or what you were told, just want to be sure all bases are covered. Also, things can change, so it still wouldn't hurt to reconfirm the device's effectiveness at this point. I know my OSA was first diagnosed as mild, later moderate, even later moderate to severe. Also, that nighttime hyper vigilance thing, I would want to see in black and white that there was nothing identifiable and treatable going on. How long has it been since you were studied with the device in place?

[silent_one]

I think we may have spoken 1-2 years ago.

Apnea is within the normal range. The apnea was only during REM previously but now it is completely eliminated.
However the tiredness persists, often with eyestrain / headaches and the slightest change to my sleeping pattern can have a side-effect for weeks.

Blood tests have been done a few times.
I have seen a cardiologist because my heart pattern was slightly abnormal but that is all fine as well.

My lung capacity is fine.

I don't have pain, only eyestrain / headaches and some other strange side effects as I become more fatigued. Although I am heavily fatigued I do nearly fall asleep and have difficulty remembering things after a poor nights sleep.

I take no medication besides melatonin.

It has been a few years now so there are not many tests I can think of that are left
I do not have any movement disorders.

[KatEyes]

So often there are exceptions to the rules. Research can show what usually happens, but we each have to be in tune to if we could be an exception, and not do something just because it worked for others if it doesn't work for us.

You say with the device you have less issues - are those issues less enough to assure your sleep is not affected? Is your event index with the device less than 5 per hour, putting you in the "normal" range?  Are any of your remaining events of long duration or causing desats? Did any of the remaining events cause arousal?

I have a personal thing about medicating for a symptom without being absolutely certain it's not just like putting a bandaid on a cancer, or allowing us to ignore something that shouldn't be ignored. So many things can contribute to poor sleep, like medication side effects, mood disorders, thyroid dysfunction, movement disorders, pain... just to start the list. I'm just thinking that if increasing amounts of Melatonin isn't working, your efforts might be better utilized going back to the basics and methodically ruling out possible root causes.

[silent_one]

I have done a sleep study (split) with and without the device. With the device I had less issues.

Every suggestion of a decreased melatonin dose is always met with the doctor advising they would only give less than 3mg to a child.

3mg is better than no melatonin at all. I haven't found 3-15mg to be more effective. I'm back to 9mg again now to see if that will work this time.

[KatEyes]

Melatonin can be particularly helpful to those whose have decreased amounts, but if that is not your issue, adding Melatonin is less likely to be helpful. I am one who cannot even take 3 mg or my sleep will get worse instead of better. Were you tested with your dental device in place to confirm its effective in treating your apnea?

[silent_one]

Thanks I've been seeing a sleep specialist for about 3 years now. I'm looking for any more advice on dosage levels.

I'll see if I can try 500micrograms. I'll need a new prescription for that.

[Dr Rajput]

Hi, welcome to the forum, a Melatonin preparation belongs to class of neutraceuticals and appears to be the primary sleep-regulating hormone of the body. It is secreted in relation with normal day/night cycles.

The dosage range varies from 0.5 mg to 10 mg/ day depending upon the requirement and severity of the sleep disorder. Further increase in dose will not benefit you much but increases drowsiness. You need to continue with the phototherapy. You need to go for morning exercises and work out which will make you fresh and active all day and tiredness at the end of day will help you to induce sleep naturally.

I suggest you to consult sleep specialist for appropriate dosage and prescription. Take care and regards.