Dr. Saraswat Kumarshri Shriniwas
Psychiatry
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Patient's Query
Hello doctor,
I am 34 years male. I take Ramipril 5 mg and Insulin. I have asthma, and I am allergic to dust, mites, and grass. I get brain fog with sudden cognitive deficits at night for six years. I am unable to memorize or remember things. My vision has reduced, and I feel like I am drunk as I do not have concentration or resilience. Since the day I developed a problem with my left TMJ, my muscle spasms and pain are constant. Later, I noticed that I was tired all the time, even during the day, and one month after the result, I had light attacks of falling asleep. Six months after the impact, I suddenly got high blood pressure connected with anxiety disorder and panic attacks.
Recently I was diagnosed with type 1 diabetes and my blood report shows CRP between 6 to 12, TSH is 4.5, CT and MRI of brain are normal.
Today I have hardly any resilience, and it is often difficult for me to do work like household chores.
Kindly help.
Hello,
Welcome to icliniq.com.
A couple of differential diagnoses could be causing your problems of low resilience, brain fog, and tiredness.
1) Depression can present with symptoms such as low energy, motivation, and cognitive dulling.
Besides, it is often co-morbid with anxiety and panic disorder and physical conditions like diabetes, hypertension, and asthma. These symptoms respond more to certain antidepressants like Sertraline, Desvenlafaxine, and Venlafaxine.
2) You need to get a sleep study done to rule out obstructive sleep apnea. It also presents with the same symptoms and is frequently connected with obesity, diabetes, and hypertension.
If it is severe, the treatment involves positive pressure ventilation at night with a CPAP (continuous positive airway pressure) machine.
I suggest you consult a physician or an immunologist or a rheumatologist to rule out any autoimmune or connective tissue disorder which could be causing all your illnesses like diabetes, asthma, cognitive dulling, and hypertension.
Regards.
Patient's Query
Hello,
Thanks for replying.
I might have severe sleep apnea and must get a sleep study as soon as possible. Is the damage by sleep apnea reversible with CPAP or APAP therapy? I got this issue when I was 28 years old, and my dad also has the same problem.
Kind regards.
Hello,
Welcome back to icliniq.com.
Most of the issues caused by sleep apnea are reversible. Treatment for sleep apnea will make you more active in the day. Being more active will cause weight loss, and that will indirectly reduce your diabetes and fear. However, let your doctor confirm sleep apnea by a sleep study and decide the right course of treatment for you.
Regards.
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Psychiatry
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