Chronic Disease Group discussion

Why Can't I Get Better? Solving the Mystery of Lyme and Chronic Disease
Dr. Horowitz's Wisdom > Chapter 13: Discussion and Summary

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message 1: by Rebecca (last edited Oct 24, 2014 03:18PM) (new) - added it

Rebecca Guglielmo | 50 comments Mod
Chapter 13: Lyme and Sleep Disorders

Discussion Questions:

1. How well do you sleep? Is it restorative?

2. Have you ever considered a sleep study?

3. What steps have you taken to increase the quality of your sleep?


• Oh, glorious sleep. Lyme patients often have problems getting enough sleep which is essential to healing. Severe insomnia is by far one of the most common complaints according to Dr. Horowitz. Patients can also get plenty of sleep but it is not restorative. This is called hypersomnolence.

• Standard sleep aids are often ineffective. It is important to get to the root cause of sleep problems and Dr. H proposes looking at Borrelia, co-infections and/or overlapping medical problems (like sleep apnea, restless leg syndrome, mood disorders, diet, medications, nocturia (getting up to urinate), or hormonal dysregulation.

• Impaired sleep directly correlates with impaired immune function.

• The longer a patient is infected and untreated the harder it is to get better. Dr. H refers to a study that shows the longer lymphocytes are in contact with Borrelia in a lab setting, the stronger their effect on immune suppression.

• Symptoms of sleep deprivation include: fatigue, daytime sleepiness, increased pain perception, as well as irritability, memory and concentration problems.

• Lack of sleep can cause an increased production in inflammatory cytokines.

• Dr. Horowitz lists medical conditions associated with insomnia on p. 337.

• Medications (especially stimulants), and certain foods (like caffeine and chocolate) can also interfere with sleep.

• Sleep studies may be important in determining the cause of a patients sleep issues. Sleep Apnea is particularly important to test for along with looking for restless leg.

• Understanding why a patient is not getting proper sleep is an important part of the puzzle. The circadian rhythms of MSIDS patients is often problematic.
o It is important to sleep long enough for a patient to get though all the stages of sleep. It is also important to stay in each phase for long enough and deep enough.

• Inadequate sleep has a direct effect on chronic age – and stress-related disorders and increased cytokine levels, worsening of chronic inflammatory diseases such as rheumatoid arthritis, FM and chronic fatigue syndrome.

• Cytokines are a particularly important factor effecting sleep quality. “If we have a running faucet (the ongoing production of cytokines) as well as a clogged drain (poor detoxification pathways), we’re going to accumulate abnormal levels of these inflammatory molecules in our body.” P. 343

• Sleep Medications for MSIDS patients as recommended by Dr. H can often interfere with each other so it is important to check for drug interactions. Refer to pages 343-348 for specific drug options.

message 2: by Vicki (new) - added it

Vicki (vicki46) | 52 comments I was a bit confused as to whether phosphatidylserine had soy. I seem to remember it being related to soy lecithin. I could be wrong. The neuro Lyme chapter is me all over!

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