Addison's disease and insomnia

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Addison's disease and insomnia

Postby andyheckford » Mon Feb 25, 2013 11:32 pm

Hi all,

I haven't been on this board for awhile.

For the last couple of years I've been doing well and was probably the fittest I've been for a few years. Then last year I had an emotional upset (which due to my own lack of confidence did drag on for a few months) followed by a stomach bug and then flu. My sleep was a bit disrupted (waking early in the morning ~4am). Having had experience of depression about 5 years ago, I assumed my poor sleep was just down to recent life events. I assumed this was a spell of mild depression with anxiety and that with a bit of help (I've been doing cognitive behavioural therapy) I could break out of it.

However, in the last few months the sleep has got a lot worse. I was managing no more than a couple of hours sleep and becoming very sleep deprived. I did the usual lifestyle things to combat it, cut out caffeine, alcohol, avoided eating late but it didn't have much affect. My GP prescribed zopiclone as a short term fix. I took one 3.75mg tablet each night for a week and was sleeping well. I tapered to every other night the following week and felt worse. By the end of the week, I felt dreadful and had severe fatigue. The same day the hospital got in touch with the results of my recent day curve test. My 9am cortisol was too high 746 nmol/l, my 12.30am was also a little high 347 nmol/l but my 4pm was fine at 132 nmol/l. I take 30mg hydrocortisone a day, 20mg on waking, 5mg at 1pm, 5mg at 5.30pm. I've been on that dose since I was diagnosed over 20 years ago. I've known for a while that the dose is at the high end of the recommended amount but I take calcium carbonate supplements, my bone density is checked periodically and my endo was satisfied there wasn't an undue risk of osteoporosis. Based on this most recent day curve test they strongly advised dropping the morning dose to 15mg. Over the next two weeks I had a phased return to work whilst I recovered and adjusted to the new dose. My sleep got better and I didn't need the zopiclone.

However, the sleep has got worse again the last few weeks. I had another fatigue crash a fortnight ago all the reduced cortisone seems to do is make me feel tired and shorten the cycle of sleep debt. Other symptoms are low libido, my pulse is up between 80-110, occasionally food tastes bland without salt and I feel quite emotionally numb. I'm very groggy in the mornings, perk up after lunch and then feel bolt wide awake in the evenings. I feel like I have sugar crashes when I get hungry (trying to eat fruit like bananas between meals). I've lost a lot of self confidence. However, my CBT counselor says I'm not depressed and that there's something else affecting my well-being. On her recommendation I do mindfulness meditation and I'm confident my mind is clear and I'm not thinking about things when I go to bed. I've been in regular contact with the nurses at the endo unit of my hospital. Last week they said the sleep issue was not Addisons related and the brain fog was just down to sleep deprivation. That landed me back at square 1. Now my GP has prescribed a low dose of citalopram which I've had before when I had depression. Thing is, I don't feel depressed, my mood is low sometimes but that's mostly because I feel ill all the time.

I was wondering if anyone had any thoughts or similar experiences? I haven't started the anti-depressents yet and I know it'll take about a month before they will have any affect for better or worse. At the moment I don't know whether this is Addisons related, some form of depression I've not experienced before or something else. My recent blood test showed no evidence of diabetes but when I eat seems to have an impact on my sleep. If I eat my dinner early ~6pm I usually can get a couple of hours sleep, any later and I don't sleep at all even with the zopiclone.

Any info would be very much appreciated,

Many thanks,

Andrew.
andyheckford
 
Posts: 13
Joined: Sun Feb 15, 2004 3:48 am
Location: Cambridge, UK

Re: Addison's disease and insomnia

Postby Wanda » Thu Feb 28, 2013 3:25 pm

Andrew,

Has your thyroid been checked lately? Free T3, Free T4 and TSH. Have you had your DHEA-s and testosterone checked? Do you supplement either of them?

Have you tried taking 2.5mg HC at bedtime? Taking it from your a.m. dose might work. You could try moving your 5:30 dose to 4pm to see if your sleep improves.

Wanda
Wanda
 
Posts: 180
Joined: Tue Dec 23, 2003 9:09 am
Location: Oregon


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