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I Have Had Sleep Issues And Other Things Happening To
Question: I have had sleep issues and other things happening to me for about a year now. I haven't tried taking any medications for these issues as I was planning on joining the Military. All the doctors I have seen told me they can't find anything wrong and suggest trying medication. It all first started when I took Accutane (Isotretinoin) for acne in XXXXXXX of 2018, only took it for a month then stopped. A month later in July I developed a sort of "brain fog", I would forget certain words and occasionally stutter. Another month passes and the "brain fog" reduced but a new problem arose, I felt like I needed to urinate constantly, this issue still plagues me. I got blood tests done and a cystoscope but they couldn't find ANYTHING. Then a few months pass and it is mid December, I developed some sort of sleep issue, I would wake up every two hours every night. Now I wake up every three hours, this is an issue I've had for a long time and I REALLY want to know what you think it can be and what can help. Also for the past year I have had hair shedding issues alongside these other symptoms, this problem also remains today.
Brief Answer:
If tests come out normal, thyroid tests included, then anxiety/depression is possible- details below
Detailed Answer:
Hello and welcome to "Ask a Doctor" service,
I carefully read your query and understand your concern.
I saw you mentioned several tests that came out normal. It is not mentioned if you had a thyroid check as well. The reason for this is because the thyroid gland may affect the way we handle stress and it may also affect the hair follicles and cause hair shedding.
The tests to check for the thyroid function are TSH and FT4. If these tests are normal and all the rest of the examinations come out normal then very likely the symptoms you explain are due to anxiety.
Anxiety may cause a wide range of symptoms, including frequent urination, sleep issues, problems with concentration, and even hair loss.
To better help with your symptoms, I would recommend you to take SSRI drugs. These do not cause addiction, they are well tolerated by most patients and are quite effective in treating anxiety and sleep problems related to anxiety/depression.
Sleep hygiene is very important for better sleep and also Zolpidem can be taken to treat insomnia (sleep issues). This is a drug that is well tolerated as well and does not cause addiction.
To conclude:
- I would recommend you to have TSH and FT4 check if you have not had a thyroid check already
- if all the tests and examinations are normal than anxiety/depression may be the cause of your symptoms (frequent urination, sleep issues, brain fog, hair loss, etc)
- I would recommend you to take SSRI drugs (escitalopram or sertraline) to help with insomnia in the terrain of anxiety/depression, this is especially the case if you score high in GAD 7 and PHQ 9 questionnaire (for anxiety and depression). These are questionaries the doctor may conduct in the office.
- If you do not score high in GAD7 and PHQ9 questionnaire then you may just treat insomnia with good sleep hygiene and also Zolpidem.
- sleep hygiene consists on going to bed and leaving the bed at the same time each day; avoiding daytime naps; avoid caffeine and other energy drinks or nicotine in the last part of the day; being active and doing sports (but not close to bedtime); good exposure to sunlight during the day; the room you sleep should be pleasant, quiet, dark and cool; avoid being in bed other than when you want to sleep, etc.
- finally, any drug or alcohol can affect sleep and may make these problems worse, so it is important to let us know if you use any.
I hope this answers your query.
I remain at your disposal for further medical assistance.
Regards,
Dr. Antoneta Zotaj
General and Family Physician
If tests come out normal, thyroid tests included, then anxiety/depression is possible- details below
Detailed Answer:
Hello and welcome to "Ask a Doctor" service,
I carefully read your query and understand your concern.
I saw you mentioned several tests that came out normal. It is not mentioned if you had a thyroid check as well. The reason for this is because the thyroid gland may affect the way we handle stress and it may also affect the hair follicles and cause hair shedding.
The tests to check for the thyroid function are TSH and FT4. If these tests are normal and all the rest of the examinations come out normal then very likely the symptoms you explain are due to anxiety.
Anxiety may cause a wide range of symptoms, including frequent urination, sleep issues, problems with concentration, and even hair loss.
To better help with your symptoms, I would recommend you to take SSRI drugs. These do not cause addiction, they are well tolerated by most patients and are quite effective in treating anxiety and sleep problems related to anxiety/depression.
Sleep hygiene is very important for better sleep and also Zolpidem can be taken to treat insomnia (sleep issues). This is a drug that is well tolerated as well and does not cause addiction.
To conclude:
- I would recommend you to have TSH and FT4 check if you have not had a thyroid check already
- if all the tests and examinations are normal than anxiety/depression may be the cause of your symptoms (frequent urination, sleep issues, brain fog, hair loss, etc)
- I would recommend you to take SSRI drugs (escitalopram or sertraline) to help with insomnia in the terrain of anxiety/depression, this is especially the case if you score high in GAD 7 and PHQ 9 questionnaire (for anxiety and depression). These are questionaries the doctor may conduct in the office.
- If you do not score high in GAD7 and PHQ9 questionnaire then you may just treat insomnia with good sleep hygiene and also Zolpidem.
- sleep hygiene consists on going to bed and leaving the bed at the same time each day; avoiding daytime naps; avoid caffeine and other energy drinks or nicotine in the last part of the day; being active and doing sports (but not close to bedtime); good exposure to sunlight during the day; the room you sleep should be pleasant, quiet, dark and cool; avoid being in bed other than when you want to sleep, etc.
- finally, any drug or alcohol can affect sleep and may make these problems worse, so it is important to let us know if you use any.
I hope this answers your query.
I remain at your disposal for further medical assistance.
Regards,
Dr. Antoneta Zotaj
General and Family Physician
Above answer was peer-reviewed by :
Dr. Raju A.T
I took a Thyroid test and it was normal. I will ask my Doctor about the medications you mentioned. Also a person can have these symptoms for a year due to anxiety/depression? Also thanks for your answer and time.
Brief Answer:
Symptoms due to anxiety or depression may last for years
Detailed Answer:
Hello and welcome back,
Anxiety symptoms may last for years.So, it is not unusual to have such symptoms for a year.
It is good your thyroid function is normal. It is best to discuss the treatment with the doctor and decide together on best treatment and follow up plan in your case.
It is my pleasure to assist you. I remain at your disposal in case further medical assistance is needed.
Regards,
Dr. Antoneta Zotaj
General and Family Physician
Symptoms due to anxiety or depression may last for years
Detailed Answer:
Hello and welcome back,
Anxiety symptoms may last for years.So, it is not unusual to have such symptoms for a year.
It is good your thyroid function is normal. It is best to discuss the treatment with the doctor and decide together on best treatment and follow up plan in your case.
It is my pleasure to assist you. I remain at your disposal in case further medical assistance is needed.
Regards,
Dr. Antoneta Zotaj
General and Family Physician
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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