Q. : I woke up a little after 4AM having feelings of anxiety from conditions caused by sinusitus/cold. Often one area of my airways is almost closed if not totally. When other complications exacerbate this condition, I have dreams or feelings of tedium and claustrophic content that wake me up, or keep me from sleeping. The feelings of tedium are like not being able to solve a tedious puzzle or something of great detail, but a VERY compelling feeling to do so, or else (whatever else means). Often the terrible feelings come from not being able to solve the puzzle or situation. It almost feels like I will go insane if it isn’t figured out. I try to dismiss the feelings with emphasizing that the puzzle is not real or necessary to any real life issue. I can’t really say that it is a puzzle or a particular situation, but it is something that needs to be fixed, repaired, or resolved. I thought it might stem from my past profession in the technology industry and unfortunate personal career due to a downturn in the economy, but had these episodes prior to economic issues. I conduct dispute mediations, and have a history of helping others resolve issues through discussion. I don’t get much exercise, and work on the computer constantly. I also thought it might be related to my hypertension medications (Atenolol, Hydrocholorothiazide) and temp medications for physical conditions (Sudafed, Aceteminophen, Oxymetazoline HCL). This problem has occurred 80% of the time when I’ve had sinus infections and experiencing severe congestion where I can’t breath through my nose over a period of days. It is infrequent, but occurs in dreams when I’m not experiencing those medical problems. This morning, it came to critical mass where I had these feelings, as though the walls were caving in and I was going crazy. I had to get out of the house, left a note for my wife and went for a walk. I know people have those times when they have to get away or get out and get some air, but my episodes have been rather intense. What can I do to keep these from happening?
A. I am not a physician but I have encountered this problem with clients many times. I would be willing to bet that it is due to the medications that you are taking, most likely the decongestants, like Sudafed. Notice the warnings on the packaging that these drugs can cause excitability. When trying to fall asleep, you will fall into a light stage of sleep but the medication will not allow you to enter into a deep stage of sleep. Many antihistamines and decongestants create a psychological effect. I have heard many people describe, exactly the ruminating behavior that you mention is occurring in your mind as you try to sleep. Many do exactly as you have, get up and do something physical for relief of these “racing” feelings. Check with your doctor. There are other ways to open up your sinus passages. Many of my clients have switched to benedryl and a mucus thinner (Mucinex). They are both over the counter medications but they did not make the switch until talking with their physician and neither should you. Good luck.
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