Lunesta for sleep?

August 2, 2007

Hi all,

My Dad is a medically complicated guy. He has at least 12 meds.

We added #13 today because of an infection/pneumonia, Levaquin.

Dad also complained today (for the 2nd time) of sleep problems. He sleeps

when he goes to bed, until about 2 a.m. then is awake.

(This is Dad's old pattern, head nodding all day, fall asleep easy, go to

bed at 9 p.m. up 2-3 a.m. on. Dad stopped this for a while after starting

Namenda & Zyprexa, not sure how long the sleep pattern has been back.) He

also has Obstructive Sleep Apnea and uses a CPAP. Dad used to walk around

when he had this sleep pattern before - get a drink, watch tv, etc. My DH

and I are not aware that he is getting up now - he may just be staying in

bed - or maybe we are too exhausted to hear him get up, not sure. but I

think I'd hear the tv via the baby monitor.

So today Dr. gives us samples of Lunesta. (This makes me nervous.)

We had BAD problems with sleep meds last fall, and (now) I think one of the

meds damaged him last fall and accelerated Dad's dementia.

(One was a carzemambepine. NO CLUE if I spelled it correctly & too exhausted

to care.)

Dad has a 30+ year history of familial tremor, which was always manageable.

Since we started the Namenda and Zyprexa, the tremor has increased in

amplitude. They say he has Parkinsonism, but I think it's familial tremor

amplified by the drugs.

Any thoughts about Lunesta? Any ideas for a better approach than another

med?

Thanks!

Debbie in SoCal

August 2, 2007

Debbie,

Have you checked out Lunesta on rxlist.com or a similar site? There

are some wacked-out #s for neurological side-effects of Lunesta

compared to placebos in trials.

What about trying melatonin? What about insisting on better sleep

hygiene, which means keeping him awake during the daytime? What

about a psychostimulant to keep him awake during the daytime? Or

Klonopin, the go-to drug for sleep disorders? Have you discussed

your fears about the previous sleep med with the MD? (No clue what

carzemambepine could refer to.)

I'd get him back into the sleep specialist for a sleep study as it

doesn't sound like the CPAP is giving him efficient sleep during the

night because he needs to sleep during the day. Shouldn't he be

exhausted from fighting pneumonia?

You mentioned 13 drugs. Is he on an AChEI for the dementia?

Good luck,

Robin

Hi all,

My Dad is a medically complicated guy. He has at least 12 meds.

We added #13 today because of an infection/pneumonia, Levaquin.

Dad also complained today (for the 2nd time) of sleep problems. He

sleeps when he goes to bed, until about 2 a.m. then is awake.

(This is Dad's old pattern, head nodding all day, fall asleep easy,

go to bed at 9 p.m. up 2-3 a.m. on. Dad stopped this for a while

after starting Namenda & Zyprexa, not sure how long the sleep pattern

has been back.) He also has Obstructive Sleep Apnea and uses a CPAP.

Dad used to walk around when he had this sleep pattern before - get a

drink, watch tv, etc. My DH and I are not aware that he is getting up

now - he may just be staying in bed - or maybe we are too exhausted

to hear him get up, not sure. but I think I'd hear the tv via the

baby monitor.

So today Dr. gives us samples of Lunesta. (This makes me nervous.)

We had BAD problems with sleep meds last fall, and (now) I think one

of the meds damaged him last fall and accelerated Dad's dementia.

(One was a carzemambepine. NO CLUE if I spelled it correctly & too

exhausted to care.)

Dad has a 30+ year history of familial tremor, which was always

manageable.

Since we started the Namenda and Zyprexa, the tremor has increased in

amplitude. They say he has Parkinsonism, but I think it's familial

tremor amplified by the drugs.

Any thoughts about Lunesta? Any ideas for a better approach than

another med?

Thanks!

Debbie in SoCal

August 2, 2007

The published research on treating sleep disorders in DLB hasn't kept

pace with the arrival of the new options.

Lunesta is a " patent-buster " tweak of an older drug called Imovane

that was never terribly popular in the United States, for a variety of

reasons, mostly legal. The fact that it's sampled indicates that it

makes a lot of money for the manufacturer. But there are no specific

trials that I can find that study it in the sleep disturbances of PDD

or DLB.

It's probably not a *bad* choice - the structure of the drug makes it

somewhat different than many of the other sleep drugs, and it's known

to clear the system pretty quickly. It's expensive - that's probably

the worst side effect - wallet lightening. A month of Lunesta is

about $135.

The most-studied agent for improving sleep in people with PDD and DLB

is Klonopin (clonazepam). It is proven to create good, restful sleep

in sleep studies, it's dirt-cheap ($10/month) and it doesn't generally

cause hangovers. There's tons of research out there, but the

freely-available Boeve _Continuum_ paper is a good place to start,

found at:

http://www.lewybodydementia.org/Boevelink.php

It's also important to consider good sleep hygiene - dark room, comfy

bed, voiding before bed (huge potential issue in DLB - it's possible

that six hours is ambitious for people with DLB because of a defect in

the urine concentration systems, so they're constantly waking up

because they need to urinate), no daytime naps longer than an hour, etc.

If your dad's been diagnosed with OSA, it sounds like he's got a

relationship with a sleep specialist. I wouldn't hesitate to get in

touch with them, and make them aware of the DLB diagnosis if they

weren't aware at the time of testing - some features of DLB show up on

sleep study, and can help to explain unusual findings.

Finally, in our case, use of the psychostimulants in the morning has

been associated with better sleep at night.

August 3, 2007

Hi Debbie,

In reading your post, two things come to mind.

The first is regarding the fact that he has an infection/pneumonia.

Any time my Dad has an infection (of any type) there is a significant

reduction in his cognitive functioning. So if you are seeing a

decline right now, my guess is that it is due to infection. For my

Dad, it takes a little while after the antibiotics have been

completed for him to come back.

Second, is regarding Zyprexa. I know everyone reacts differently to

meds and Zyprexa has helped some. In our case however, Zyprexa

resulted in severe Parkinsonism in my Dad. Before adding any more

meds to " treat " Parkinson issues, I personally would consider

discontinuing the Zyprexa to see if things improve. There are

tradeoffs with the meds so only you will be able to decide if the

benefits/side effects are worth it.

Good luck.

Daughter of Bill, 92

>

> Hi all,

>

> My Dad is a medically complicated guy. He has at least 12 meds.

>

> We added #13 today because of an infection/pneumonia, Levaquin.

>

> Dad also complained today (for the 2nd time) of sleep problems. He

sleeps

> when he goes to bed, until about 2 a.m. then is awake.

>

> (This is Dad's old pattern, head nodding all day, fall asleep easy,

go to

> bed at 9 p.m. up 2-3 a.m. on. Dad stopped this for a while after

starting

> Namenda & Zyprexa, not sure how long the sleep pattern has been

back.) He

> also has Obstructive Sleep Apnea and uses a CPAP. Dad used to

walk around

> when he had this sleep pattern before - get a drink, watch tv, etc.

My DH

> and I are not aware that he is getting up now - he may just be

staying in

> bed - or maybe we are too exhausted to hear him get up, not sure.

but I

> think I'd hear the tv via the baby monitor.

>

> So today Dr. gives us samples of Lunesta. (This makes me nervous.)

>

> We had BAD problems with sleep meds last fall, and (now) I think

one of the

> meds damaged him last fall and accelerated Dad's dementia.

>

> (One was a carzemambepine. NO CLUE if I spelled it correctly & too

exhausted

> to care.)

>

> Dad has a 30+ year history of familial tremor, which was always

manageable.

>

> Since we started the Namenda and Zyprexa, the tremor has increased

in

> amplitude. They say he has Parkinsonism, but I think it's familial

tremor

> amplified by the drugs.

>

> Any thoughts about Lunesta? Any ideas for a better approach than

another

> med?

>

> Thanks!

>

> Debbie in SoCal

>

August 3, 2007

I tried to get the NH to use Rozarem (sp) for my

husband, which has melatonin in it, but they wouldn't

do it until they tried everything else. By then, it

was too late. His medical doctor recommended it, but

his care was with the NH physician. It is not

supposed to be habit-forming.

Also, earlier, had tried to get them to use Melatonin

but that got nowhere. It was too cheap, I suppose.

-- rriddle_travel wrote:

> Debbie,

>

> Have you checked out Lunesta on rxlist.com or a

> similar site? There

> are some wacked-out #s for neurological side-effects

> of Lunesta

> compared to placebos in trials.

>

> What about trying melatonin? What about insisting

> on better sleep

> hygiene, which means keeping him awake during the

> daytime? What

> about a psychostimulant to keep him awake during the

> daytime? Or

> Klonopin, the go-to drug for sleep disorders? Have

> you discussed

> your fears about the previous sleep med with the MD?

> (No clue what

> carzemambepine could refer to.)

>

> I'd get him back into the sleep specialist for a

> sleep study as it

> doesn't sound like the CPAP is giving him efficient

> sleep during the

> night because he needs to sleep during the day.

> Shouldn't he be

> exhausted from fighting pneumonia?

>

> You mentioned 13 drugs. Is he on an AChEI for the

> dementia?

>

> Good luck,

> Robin

>

> Hi all,

>

> My Dad is a medically complicated guy. He has at

> least 12 meds.

>

> We added #13 today because of an

> infection/pneumonia, Levaquin.

>

> Dad also complained today (for the 2nd time) of

> sleep problems. He

> sleeps when he goes to bed, until about 2 a.m. then

> is awake.

>

> (This is Dad's old pattern, head nodding all day,

> fall asleep easy,

> go to bed at 9 p.m. up 2-3 a.m. on. Dad stopped

> this for a while

> after starting Namenda & Zyprexa, not sure how long

> the sleep pattern

> has been back.) He also has Obstructive Sleep Apnea

> and uses a CPAP.

> Dad used to walk around when he had this sleep

> pattern before - get a

> drink, watch tv, etc. My DH and I are not aware that

> he is getting up

> now - he may just be staying in bed - or maybe we

> are too exhausted

> to hear him get up, not sure. but I think I'd hear

> the tv via the

> baby monitor.

>

> So today Dr. gives us samples of Lunesta. (This

> makes me nervous.)

>

> We had BAD problems with sleep meds last fall, and

> (now) I think one

> of the meds damaged him last fall and accelerated

> Dad's dementia.

>

> (One was a carzemambepine. NO CLUE if I spelled it

> correctly & too

> exhausted to care.)

>

> Dad has a 30+ year history of familial tremor, which

> was always

> manageable.

>

> Since we started the Namenda and Zyprexa, the tremor

> has increased in

> amplitude. They say he has Parkinsonism, but I think

> it's familial

> tremor amplified by the drugs.

>

> Any thoughts about Lunesta? Any ideas for a better

> approach than

> another med?

>

> Thanks!

> Debbie in SoCal

>

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August 5, 2007

Deb,

I think Melatonin was mentioned to you. It is Over-the-counter and I have

personally used it. Might help and is more natural!

Just a thought.