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jewelsav

jewelsav
Joined Feb 2022
Bio

San Francisco Bay Area

jewelsav
Joined Feb 2022
Bio

San Francisco Bay Area

Thank you @RayRBD for your thoughtful response. I was originally going to wait until I had 2 months of data, but will post my very preliminary results now.

I started taking ashwaghanda 2 weeks ago. [Douglas Laboratories, Ayur-Ashwagandha, 300 mg, 1 capsule/night, 1-2 hrs before bedtime, $20.80 for 60 capsules.]. It can take up to 2 months to see the full effect. So far...

• AHI ~ 3.0

• 8/14 nights slept >7 hrs vs avg 5-6 hrs

• 12/14 nights woke up 2x/night vs 3-7x/night

• 14/14 nights longest period of sleep >2 hrs (average: 2.66 hrs) vs avg 1-2 hrs

• Time to fall asleep ~ 7 min vs avg 8 min (about the same as before)

• 0/14 nights RBD behaviors, movement or vocalizations, vs ~2-3 significant events/week (screaming, hurling self out of bed)

• Waking up relatively refreshed vs feeling run over by a truck

• No side effects

CAVEAT 1

There’s no way to separate the effects of ashwaghanda from the cumulative effect of being on correct CPAP therapy for one month. I may be predisposed to wanting ashwaghanda to work. But my skeptical husband noticed a difference immediately, and my sleep doctor did not believe the results were solely due to CPAP therapy.

It's possible that I had/have pseudo RBD due to long term sleep deprivation. It's also possible getting more REM sleep as a result of starting CPAP was responsible for the recent greater violence and greater frequency of RBD type behaviors I experienced before I started taking ashwaghanda. Time will tell.

CAVEAT 2

My highly trusted integrative physician recommended ashwaghanda for my sleep disturbances. This is a supplement which you don't need a prescription for. Supplements are not regulated, so quality can vary wildly. Douglas Laboratories is a very high quality firm, and it has the highest percentage of the active ingredient (7% withanolides vs 1.0-1.5% in other brands) of the ashwaghanda supplements I've seen. As with any therapy suggestion, please do your own research if you are considering taking this supplement. I'm not a medical professional, and I have only presented the experience of 1 patient (me).

@MattK, I'm no expert, and I'm only 1/2 step ahead of you, asking the same questions about how to find and secure an appointment with an RBD specialist. Here's how I'm approaching it.

  1. US News and World Reports annually publishes hospital rankings. Here are the top hospitals in neurology. I live in the San Francisco Bay Area, so I was lucky that UCSF was #1. If I wasn't, I would have seriously considered a trip to Johns Hopkins, the Mayo Clinic or a few others that specialize in out-of-town consults.

  2. I looked up the credentials and specialties of all 120 UCSF neurologists. I found Dr Rafael Zuzuarregui, who practices medicine at the intersection of sleep disorders and RBD.

  3. I emailed my sleep doctor at Stanford to refer me to Dr Z. If all had gone smoothly, my sleep doctor would have reached out to Dr Z, with whom he did his sleep Fellowship, and whom he highly recommended. But my sleep dr's admin assistant didn't even show him my request and said Stanford doesn't make referrals outside their system. (Turns out Stanford has no such policy.) So, I asked my primary care dr to make the referral. I supplied my PCP with case notes from my last 2 visits to the sleep doctor, and the results of 2 sleep studies, which she then faxed to UCSF along with their referral form.

  4. There's an unpleasant gate keeper, the "patient coordinator" at UCSF who rudely turned down my request for an appointment with Dr Z. When I asked why, and what the criteria for being accepted were, she hung up on me. But, before she hung up, she said she had referred me to another neurologist, though did not specify a name. This seems to be her modus operandi, as she is cited by name in Yelp and Healthgrade reviews as being quite rude to other prospective patients. Throughout the process of getting a referral, I have kept the end goal in mind and "not stopped for every barking dog".

  5. I heard back within 1 business day from Dr Liza Ashbrook's office, the neurologist I was referred to. This 2nd patient coordinator was incredibly professional, efficient, pleasant and empathetic. Dr. Ashbrook will perform whatever tests are necessary to determine if I have RBD. Dr Ashbrook also was in the same fellowship class as my sleep doctor, and he highly recommended her. My appointment is in Sept (6-month wait), but am on the cancellation waiting list and may get an earlier appointment.

There's probably a long wait time everywhere to see a specialist. I was originally referred to the Stanford neurology dept (from the Stanford sleep department), but they were even ruder, took 3 weeks to completely reject my sleep doctor's referral, and said to call back in Dec, 2022 to see if there might be appointments in 2023.

So, you might have some luck finding an RBD expert at a hospital with an excellent neurology department, located close to you.

Wishing you good luck!