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Sleep disorders and Fitbit?

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Hey all!

 

I just saw a neurologist for the first time for excessive daytime sleepiness for the past 5 years. I've actually fallen asleep at the wheel, in class, in meetings, in theaters, recently at the dentist, while in an MRI machine, while standing up during my surgery rotation and scrubbed in (I'm now a physician assistant) and at the hairdresser. I'm 30 years old, no medical conditions, I run 5 miles or more per day and I'm a very healthy eater. My neurologist scheduled me for a sleep study to formally diagnose narcolepsy. I've had several confirmed cases of cataplexy and hypnogogic hallucinations. I frequently have vivid dreams while napping for 10 minutes. I'm weaning myself off of Effexor (venlafaxine) because the neurologist said that this drug suppresses REM sleep and will create a false negative sleep study. It is also prescribed to suppress cataplexy. 

 

My question is, how accurately does the Fitbit charge 2 detect awakenings and R.E.M. Sleep? I have several nights where I've gone from being awake straight into R.E.M. Sleep which is the hallmark of narcolepsy. I know this cannot replace a formal sleep study but I'm just very curious! 

 

Here are a few examples of going straight into R.E.M. Sleep. And this is on Effexor which has helped me immensely with my symptoms! 

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I can't figure out how to post a screenshot sorry! Anyway you all get the point. I'm interested to hear everyone's experiences!!

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17 REPLIES 17

I can't figure out how to post a screenshot sorry! Anyway you all get the point. I'm interested to hear everyone's experiences!!

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@destca01 Good luck with the sleep study, hope they can resolve this for you. 

 

Wearable trackers are usually pretty good at getting a close estimate of your sleep stages. The problems are we are all individuals and are all a bit different. Most of the more accurate trackers take data from heart rate and movement sensors and extrapolate your sleep stages from that. The math involved is designed to give reasonable results for an average person. Also, things like your device loosing heart rate data because it slipped on your arm will throw off the estimates. 

 

Wear your device during the sleep study and you can then compare it's estimates against the gold standard used by the clinic. If you think of it, then share your findings with us. I would love to know.

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@craigk4 thanks for the input! I was just curious as to how accurate they were, and I'll definitely wear it during my sleep study in 2 weeks. I'll keep you posted on the results and their comparison to the Fitbit Charge 2! I find it fascinating that these little devices can track things like our sleep and even when I'm napping during the day! One thing I've noticed is that it seems to recognize when I've been in more actual light and deep sleep - I tend to spend a lot of time in REM sleep (sometimes up to 50% of my sleep time) and when it says I've spent more time in light and deep sleep I tend to feel more rested. Very interesting. Love these things! 

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Super interesting! I wonder if they will let you compare your data to the lab results. I was diagnosed with narcolepsy without cataplexy about a year ago with the MSLT. I actually went in hoping I had OSA so I could just wear a cpap and hope I could stay awake all day.  Unfortunately not.  I’m 37 and also a PA and it can really be a struggle to stay awake charting, etc at work. I use my Fitbit but really am not too sure what an abnormal one would look like specific to narcolepsy. Anyways good luck and give an update 🙂

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@Elizabetta I just had my sleep study and MSLT a few days ago! (Had to reschedule due to work). I have preliminary results of "pathological daytime sleepiness" but they won't give me the full results until I see the neurologist which isn't for a while, October 30th 😞. Hoping they call me with more information sooner. I am fascinated that you're a PA too and were able to get through school because I always doubted my symptoms thinking I'd never get through school if I was really that sleepy! I was actually originally given thyroid medicine for a NORMAL T4 and a TSH of like 5.9 when I was in school and complaining of sleepiness, hallucinations and specifically falling asleep during rotations, even while scrubbed in during surgery! Thankfully I recognized this and stopped taking the levothyroxine.  I'd love to hear more about your experiences and how you deal with work. I find myself becoming drowsy while talking to patients... it's so bad! Anyway I bet they would let me compare my sleep graphs so I will keep you posted! 

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This is such an interesting thread. I have struggled with sleep attacks since my middle teen years.  I too work as an advanced provider (NP) and have fallen asleep while scrubbed in to assist in surgery, and during more school exams than I care to remember.  Staying awake through an entire lecture was never even considered in the realm of possibility. Many years ago I started taking Nuvigil 150 mg tablets, 1/2 tab 1-2 times a day, which has basically changed my life. I still have occasional episodes, but am doing much better. I also take fluoxetine 20 mg daily which has all but eliminated my previously mild episodes of cataplexy.  I have learned to be extremely careful about the amount of carbohydrates I eat, timing of meals, and eating small meals to decrease postprandial somnolence.

My sleep patterns recorded on my Fitbit Charge 2 seem inconsistent.  I haven't seen any sort of persistent pattern.

Good luck with finding effective treatment.  My experience is not something I share very often, but behind the anonymity of the internet, it is nice to be able to interact with others that have similar struggles.  I hope you get some helpful answers!

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So conclusion - I'm not so sure the sleep tracking is as accurate as people claim. I did test positive for narcolepsy and my tracker didn't really pick up REM sleep in the beginning of the night. 🤷‍:female_sign: But I'm now treated with Adderall which i don't necessarily like the idea but it's helped. It's not fool proof because I can still get sleep attacks and cataplexy even with taking the Adderall and Effexor. I couldn't tolerate Provigil. But overall much better! As for the Fitbit, I think it's overall okay at detecting an elevated heart rate and estimating REM based on that - but that's only if it's reading your pulse rate accurately.

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I have my 2nd Sleep Study coming up on March 26th and I’m nervous about being off my meds two weeks prior. My sleep specialist thinks that my original diagnoses of Idiopathic Hypersomnia was just the beginning stages of what now looks like early Narcolepsy with Cataplexy. I got the Fitbit Versa a few days ago and my sleep just seems too ‘normal’ haha! I hope they let me wear mine during the sleep test so I can also contribute to this comparison. I am wondering if I’d be better off tracking sleep with a non wearable device. It’s the only real reason why I got this, but I do love it so far.

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I've been a narcoleptic with hypnogogic sleep, collapse when I get emotional since I was a kid. Back then, I was considered lazy.About 20 years ago I found out I actually was bipolar as well.

I think society has gotten beyond the lazy label, but I believe it's unrealistic to expect any device to simulate a sleep study which involves all the electrodes to monitor your sleep. We are not like most people and products are designed for the rest of the population.

The bright side is, having my fidbit does record my steps and as I endeavor to get in better shape; it gives me a rough idea how my resting heart beat is affected.

Finally, I don't think fidbit will begin measuring sleep cycles until you have slept for more than 4? Hours which of course, doesn't work for a narcoleptic who can literally sleep at anytime. Nsrcolepsy is not that common and narcolepsy with cataplexy is even rarer. Add bipolar disorder to that, well for me, I think I might as well be from another planet.smile.

Living with a disability where it's not self evident, like you're blind or your a free bleeder and people can see blood isn't an easy hurdle to negotiate but it can never become an excuse. When I was a kid I was lazy, now I am old and have Provigil and Xyrem. I already kniw I am narcoleptic. Who cares if my Fidbit don't?

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I’ve had narcolepsy since I was 12 but wasn’t diagnosed until 18, and I’m now 23. I’ve had FitBit watches for years and I really don’t think they’re accurate either. I take nuvigil 250 mg and Effexor 150 mg during the day and Xyrem at night. I take the Xyrem in 3 doses so I wake up twice in the night to take the next dose. My tracker seems to think I don’t sleep enough since I also toss and turn in my sleep. Like today, it says I only slept 3 hours 13 minutes last night, when I know for a fact I slept way more than that. It’s too bad these trackers don’t account for sleep disorders.

On another note, to those who are PAs, how did you get through school? Do you have any study tips? I’m studying neuroscience and hoping to become a PA (since my dream of becoming a doctor was crushed by narcolepsy, considering I can’t stay awake overnight). Studying is nearly impossible for me since I fall asleep while reading. I have to listen to books to comprehend them, but since no one pre-records textbook audiobooks, that’s not an option. I’ve asked my sleep doctor, but she told me to just choose a major that requires less reading. Which, unless you’re artistically gifted, is kind of impossible.

I don’t actually know anyone else with narcolepsy so I’m kinda excited to find people in the same boat as me!

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Having Narcolepsy is a disability but it doesn't mean you can't have a life. It means the time you are awake, has to be compacted to fit your whole life into.
What people normally do is go through a 14-16 hr. day; we have to compact our life into just a few hours.
It requires a lot of planning. I have been on 1 Nuvigil daily that I cut in half, and 2 provigil in my morning and 2 in my afternoon.I have been on that regimen for years.
I am also cataplectic like you are which explains the Xyrem. But I stopped the Xryem a long time ago.
I am aware of my emotions and try to avoid any extremes which bring on the the onset of cataplexia.
The best dosage for me was 4 provigil in the morning and 4 in the evening which worked, But the insurance company would no longer insure it. They felt I didn't need it.
I continue my life not knowing what it is to feel truly rested and most of the time like someone has put some clothes pins on my eyelids and pinned them open.😃
In society, if you don't bleed, the consensus is you are not sick.
So you won't get any sympathy, you will as always have to struggle.
School is a struggle. You have to walk and read, you can't lie down and read or sit in a chair and read, you won't last long before your friend,sleep comes to visit you or before your attention span gets shorter and shorter. As far as audio lessons, as long as the reader is not monotoned and boring which will put anyone to sleep.
Narcoleptics have to be more disciplined than the average person because of our time constraints.
I am also bi-polar so that brings in another problem that has to be resolved.
You can resign yourself a life of sleep but how would you live? One thing I do is I don't excuse myself to anyone, I used to feel guilty when I was tired and just went to bed to sleep.
My doctor put me on naps during the day but you have to be careful the naps don't turn into hours instead of just an hour or less. Two naps a day.
I think you can learn about anything and be about anything, but any job requiring long hours will not work for you.I don't drive because I don't want to kill anybody.
You can do a job like real estate where you will be moving and if you do drive; it'll be short distances.
You have to move when you're a narcoleptic, because sitting down or lying down will lead to excess sleepiness.
Nurses require long hours, so do PA' s for the most part.
It's hard to find a profession you can really enjoy that is cut into small sections, but it's something you will have to do otherwise your disability will become overwhelming.
You can't pretend your nervous system and glandular system works like everybody else's; it doesn't. You have to discover how to work within your disability LIKE a normal person.
It's tough.
You can do it. You must.
Take care.
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Hey! So I actually started showing symptoms while in college. It was very gradual for me. I fall asleep after about 10 minutes of reading. Honestly it is possible to get through PA school. I scheduled naps. I put a half hour alarm every time I had to study and it woke me up whenever I fell asleep. I practiced good sleep hygiene, I did not pull all nighters, ate a healthy diet, exercised daily and kept myself healthy. In the end it worked. I graduated and I’m doing very well. Currently I’ve been in family practice for almost 6 years now and I have a great patient panel. Right now I’m in a COVID19 testing tent which sucks. But my point is, it is possible to control your symptoms. I’m currently taking Effexor 150, Wellbutrin 150 and adderall 20 daily. I find with that I can for the most part function. Good luck to you! And wherever you are, stay safe. 

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I am a RN, just dx with narcolepsy with cataplexy and mild OSA. School was rough, but I denied I was narcoleptic, although I started symptoms at 5 years of age. It took crashing my car while pregnant to get a diagnosis. 

I find work has become harder over the years.  I am 43. I also have a toddler and preschooler.  I have such a time staying awake. I take Effexor 150 mg and Sunosi 150 mg daily.

Anyone else think it is harder as we get older?

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Do you take a couple naps a day? I HAVE been on 400mg of provigil and 200mg
of nuvigil per day 4 years, Zyrem for Cataplexia and use a dipap machine,
had corrective surgery on my nose(boxing), and it's been rough.
Recently started Sinosil and believe me, it's better.
But unlike you, I am 69 and don't have the responsibilities to keep me from
sleeping if I feel the need. So I think, first you can't drive a car more
than you are able to resist sleep; it's like driving drunk.
Even if the law forgives you, you will never be able to escape yourself
should you kill someone asleep behind the wheel.
I think once your children are grown, you will have gained more experience
of how to live with your disability, life will not get harder.
For me, I was diagnosed when I was 19( I have had narcolepsy with cataplexy
at a very early age), I was not medicated. Years later when I was 38, I was
diagnosed again and it was determined I was bi-polar,too.
The only medicine at the time was Ritalin, and what a nightmare that was.I
felt like my eyes were opened with clothespins and my moods, let me just
say, I feel so bad and sorry for the people around me.I was like a tornado
wrecking everything in my path, whether manic or depressed.
Like I said, experience and the luxury of having time unallocated to other
responsibilities gave me an opportunity to sleep when I needed to and when
I noticed the onset of the bipolar symptoms which are like a broken
record,always the same, I would do likewise, retire and sleep it off.
What helped me the most was the bipsp machine, you see that's the irony of
narcolepsy- more sleep doesn't lead to a feeling of being rested and that's
because the very nature of narcolepsy involves what they call arousal and I
had about 67-78 arousal per hour which means you just never get any sleep.
It's a good thing REM happens almost immediately otherwise I don't think I
could have made it.
But getting back to the Dipap machine, my hourly arousal are now about 17.
Yes, I still feel tired but at least I don't feel like I am fighting sleep
from the minute I wake up and the misery that accompanies that struggle
anymore.
Hope this can lead you to an answer!
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I’m only 24 but I’ve had narcolepsy symptoms since I was 12, and I can honestly say it can get harder as you get older. If you don’t use a cpap or bipap, I’d recommend it, since even mild OSA can really exacerbate narcolepsy symptoms. I have mild OSA too and I’ve noticed a pretty big difference since I started using my cpap a few months ago. I don’t know what it’s like to work long hours like nurses do, but I do work long-ish hours and they wipe me out. If you haven’t tried Nuvigil, you should. It’s been a miracle worker for me. As for kids, I don’t have any, so I can’t speak to that.

Also, as an update to my last post (if anyone cares), I was re-diagnosed with ADHD a few months ago. So my studying issues really had nothing to do with narcolepsy. I was diagnosed with ADD when I was in middle school and put on Concerta, which is a stimulant, and which is probably why it took so long for me to be diagnosed with narcolepsy. But when I was finally diagnosed with narcolepsy, they took me off concerta and put me on provigil and later nuvigil, so my ADD symptoms were left untreated.

Now I’m wondering if there’s some sort of connection between narcolepsy, adhd, and high-functioning autism (which I also have)? They all seem to go hand-in-hand. I know autism and narcolepsy are both linked to the neurotransmitter GABA. I’m sure there are connections to other mental illnesses too. 

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But a dysfunctional neurotransmitter in this case GABA is not a mental
illness. It's a problem with how your body transmits signals.
For instance I have a condition in which I can lie in bed, be wide awake
but have no motor skills, it's called hypnogogic or something like that,
just like I can drive while asleep, my mental ability is just fine,
although I feel tired; the problem is turns, stops, things which require
your body to be completely awake.
As far as provigil and nuvigil are concerned, when NORD was paying for my
drugs I was getting 800 mg of provigil per day, 200 mg of nuvigil and I was
fine but always felt like someone was lifting my eyelids, in other words
never really rested.
To make matters worst, I had a deviated septum. Bruxism and restless leg
syndrome as well, because of being bipolar , lithium was prescribed and I
gained weight like crazy, from 218 to 318# and that acerbated my breathing.
Event hough I was prescribed at the time a cpap machine it hurt my head and
was so noisy, I didn't use it. I didn't care if I looked like an alien or
Jason in Friday 13th. But that noise, I couldn't tolerate.
I don't understand AD except I know I started on Ritalin and for kids with
it. It slows them down but for an adult,Ritalin speeds you up(keeps you
awake).Of course, for me it was a curse because I had bipolar disorder and
my moods would be mercurial.

So if you mean mental disorders, like bipolar who knows? But I honestly
don't think many narcoleptic with cataplexy are bipolar and if they are
then it becomes very difficult to identify.
Whereas Although all cataplectics have narcolepsy, the opposite is not
true, most narcoleptic do not have cataplexia which is easy to identify
since it's identifier resides in a patient's spinal fluid.
Narcolepsy is diagnosed when in a sleep clinic in a series of 5 fifteen
minutes naps, you go into REM sleep.
I never had to take more than two naps, I go into REM sleep almost
immediately,

It's hard to compare anything to narcolepsy and conjecture without reliable
data, Thankfully I am in the care of one of the country's leading Pulmonary
Specialists, Dr. Frank Hull who is an expert in sleep related medical
issues. And he is constantly updating me and keeping me informed on ongoing
research and advances in medicine related to narcolepsy.

But the question of whether it gets easier or harder can't be answered by a
20 year old, experience and learning to listen to your body and becoming
flexible will lead to an acceptable middle road. The only thing that will
change it is a major break through and I don't see it happening. THERE IS
TOO MUCH MONEYBAND PROFIT SELLING THE DRUGS FOR US TO BE ABLE TO LIVE OUR
LIVES BEST AS POSSIBLE.
I have often wondered what it would be like to wake up in the morning or
whenever and feel fully rested?

People who have disabilities don't overcome them.But by listening to their
body. Listening to your doctor. Understanding what it is you can do and
what you can't, coming to an acceptance, you learn to quit feeling sorry
for yourself, count your blessings and then you are living with a
disability.
Isn't it like sometimes you feel terrible but not sick enough to skip work.
You go anyway because you have to without too much thought,
And it's tough. But when you get your paycheck you forget all about that,
We weren't promised a perfect life, so we have to make due and acceptance
begins the end to that suffering accepting there's not anything you can do
but move forward. Live your life and just be glad that you are alive.
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I mean, yes. Narcolepsy is a neurological disorder, not a mental illness. But dysfunctional neurotransmitters cause both mental illnesses and [some] neurological disorders. While autism is thought to be caused by an imbalance in the synaptic excitation and inhibition of neurons, depression is thought to be caused by low serotonin levels. ADHD is caused by low dopamine and/or norepinephrine levels (mine is dopamine). And narcolepsy is thought to be caused mainly by low hypocretin levels. So it can be both. Autism isn’t directly caused by GABA, but GABA is the primary inhibitory neurotransmitter in our brains, so because autism has an imbalance in synaptic inhibition, GABA is thought to be a neurotransmitter that is affected. Hopefully that makes sense.. (sorry for all the medical jargon...)

And I may be 24, but I’ve had narcolepsy symptoms for 12 years, which to me has been long enough to know it gets harder as I get older... I was diagnosed at 18 and had my license suspended until I was on treatment and could prove I could stay awake. This involved a sleep study and then a day study where I had to stay awake while sitting in bed in a very dark room for 50 minutes without anything to do but just sit there. I had to do that 4 times throughout the day. Having narcolepsy, you know how difficult it is to stay awake even in daylight. Somehow, I managed to stay awake each time... I did drift off a few times, but because I managed to snap out of it within 30 seconds each time, I passed. So my license is hard-earned.

And while you can’t always overcome the physical aspects of a disability, you can overcome the mental obstacles that come with living with one. It’s a lot easier to live with narcolepsy if you focus on what you can do instead of what you can’t.

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