Several of my sleep lab titrations show 0% REM, where can I find guidance?????

[The_Dude01]

Hi there!  I've been on an exhaustive list of psych and sleep meds, in excessive amounts and combinations over the past decade for several psych disorders.  All physical symptoms were dismissed as "side effects," until Nov 2015 when I started going into multiple organ failure.  My mind was already completely gone, but the physical could no longer be ignored.  The psychiatrist Ive been working with for two years now, lowered my medications and doses so that I no longer lived in a pharmaceutical coma, so the medication has been constant, but I was still suffering.

In Nov 2015 she sent me for a sleep study. Results? Scary.  Insomnia, OSA, RLS, PLMD.  I have now had SIX sleep studies!  Sleep doc is absolutely useless, so psych is no helping me to address these issues to the best of her ability. She tested my thyroid (good shape), and I did get a CPAP (AutoASV) in November, and I am no longer rock bottom.  I tried ativan, gabapentin to help the pre-sleep anxiety and the PLMD, but had bad reactions to both.  Now I am taking Klonopin (2mg) (for a month before final study) and I fall right asleep and my LMI has gone from the 50s to below 10.

This last study showed 0% REM.  The problem is, the previous five studies REM% were between 0% and 6% at the highest.  Sleep doc wants me to stay on the Klonopin, but has told me the cause of my lack of REM is due to my medications.  Discussed with psych, she feels the only medication that would be an issue is the Klonopin! We have decided to stay with the Klonopin due to the benefits and the fact that the REM was not present prior to taking the klonopin, and start reducing my other medications. (My mood has been stable with addition of CPAP)

Here is the kicker.  All of my apneas were Obstructive for the first 5 studies. This final study, I had 2 apneas and they were both CENTRAL.

Here are my symptoms and current meds.  I absolutely do not know where to turn with this.  Have an appt. with ENT and new sleep doc, but those are several months out.

Symptoms: mainly OCD/Anxiety stuff (lack of concentration, no short term memory, fixating on things, grinding teeth all day, irritability, etc.) Also the physical and mental exhaustion is overwhelming.  I need to get out the emotions, but I dont do any REM emotional processing, and now I'm so tired, any type of physical activity puts me in bed for several days.  Physical activity was my coping mechanism for years!  I cant get anything done, I cant think straight and I cant just sit around for months waiting to see a doctor for 15 minutes.  

Meds: Lithium 425mg (labs show 0.2, therapuetic  level is 0.7??, so im not taking much), Lamictal 200mg 2x/day, pristiq 100mg (cutting down to 50mg tomorrow), and now at night 2mg Klonopin.  Psych has me on strict gluten free/dairy free diet, tests my nutrient levels regularly, and anything I'm not getting from food, I take supplements.  I also take 5HTP at night and several brain support supplements during the day, EPA (1000) DHA(500) from fish oil, NAC, selenium, magnesium, vitD.

If anyone has ANY suggestions, please please let me know. Ive considered nuero, but I cant go on a blind spending spree. I havent been able to work in over a year, my funds are running very low, but more importantly, this is NOT a quality of life that is up to my standards, so we are going to have to get this fixed up :-)  I'm ready to start a new decade!  I truly do appreciate any advice.  and as my sleep doc keeps referring to me as, Im a "complex patient" grrrr I just want to smack him