I've been having nightmares on a daily basis for the past 8 years. I also yell out profanities and act out my nightmares while asleep. I toss a lot in bed and wake up several times per night. Due to the bad sleep quality, I've also been experiencing excessive daytime drowsiness, severe depression, anhedonia, fatigue, brain fog and significant cognitive deterioration. Sleep disorders are not recognized where I live. There are no centers for sleep study, so I'm on my own to deal with this thing through trial and error.
Right off the bat, I did not experience anything psychological that could cause this disorder. No psychological trauma or mental disorder and my nightmares don't revolve around a certain subject. It's always random. It started quite abruptly with no trigger; I believe something is up with my brain but it's too early to detect on MRI/EEG. I also have symptoms that resemble autoimmunity such as chronic joint and muscle pain, but blood tests for CRP/ESR and ANA are slightly elevated and normal, respectively.
On very rare occasions (~once a year), I get a random night of super refreshing sleep and for a day all my symptoms improve significantly, so I've come to the conclusion that my symptoms are caused by chronic sleep deprivation-like effect due to chronic, very poor sleep quality.
Rheumatoid arthritis and Alzheimer's disease run in the family, but I'm, perhaps, too young to show overt symptoms if I have any of those. REM sleep behavior disorder (RBD) is an early sign for several neurodegenerative disorders but it can also be idiopathic (60%), so I don't want to jump to conclusions.
Medications that I tried (some with my pdoc, some on my own):
Ineffective or made it worse: Prazosin, Melatonin, Mirtazapine, Trazodone, SSRIs, Alprazolam/Bromazepam. Z-drugs. Carbamazepine. Saint John's Wort. Baclofen. Several antipsychotics. TCAs (Amitriptyline, Clomipramine).
Only 3 medications that worked somewhat are:
1- Pregabalin: Improved sleep quality moderately but I needed 450 mg of it. I'm now down to 150 mg to reduce the severity of the cognitive side effects. Keep in mind that it doesn't improve the nightmares, only the subjective sleep quality or feeling refreshed upon waking up.
2- Venlafaxine: The only medication to block my dreams out entirely. Either I don't get them on it or I fail to remember them upon waking up. Other SSRIs/SNRIs never had this effect on me.
3- Metformin: i don't have diabetes but for some reason it improves most of my symptoms. I've been taking it for weight loss following Olanzapine and I discovered its beneficial effects on my other symptoms by accident. I believe it alters the core underlying pathological cause perhaps via interaction with AMPK or something.
My sleep quality is only a fraction of what it used to be a decade ago, and I'm at my wit's end.
EDIT: Forgot to mention that all blood tests and hormone profiles are normal.
Edited by Diesel, 19 December 2017 - 03:07 AM.