1 hour ago, Pokey449 said:

Ugghh! Sunday night was a good nights sleep. I felt close to normal yesterday. Last nights sleep was terrible. I woke up twice in great discomfort feeling sick. Especially so my final wake up. I could barely get up and walk to the bathroom this morning. I think WD is compromising my cpap therapy and vise versa. I don’t know what all is physically happening to me, why I feel so ill upon awakening. Some system, some bodily process(es) is/are being negatively affected. It’s not healthy for sure and perhaps life threatening given enough time if it chronically continues. The way I felt this morning dying would almost be a blessing 😩😢

@Pokey449 . You are doing great. Always remember that the healing process is non-linear. You will always gets the ups and down. It is harder in the mornings because of the cortisol, which it's what helps us be ready to wake up. It is higher in the mornings and as day goes by, it starts to reduce during afternoon hours. This is the reason, you might feel awful more in the mornings than afternoons. It's feels like a life threatening, but it's just that it affects our psychological aspects. But the true is that if you go to doctor, they will not find anything because you are fine. Your brain is just getting wrong signals from your body.

I am 21 months journey and I am still in my ups and down as well. I did my yearly check up and I'm healthy thanks God even though this makes me feel I'm dying or something....I have learned in time not to listen to your mind...

Take care. Few bad nights won't take the fact that you are healing. It's actually when your body is healing...

@Raymond i hope you are correct. I felt pretty awful this morning. I think my taper and the struggles I’m having with cpap therapy are complicating each other. One exacerbating the other. I’m having some central apneas which is when your brain tells your body to not breathe. I think my respiratory center is being suppressed by the drugs. But I don’t know what I can do about it. Can’t just stop. One of the most frustrating aspects of all this is I have no life. It’s turned me in essence into an agoraphobic. I don’t go anywhere or do anything cause I just don’t feel like it. It’s not living. It’s surviving!! And it’s keeping me away from the ones I love most. 🫩🥲

1 hour ago, Pokey449 said:

agoraphobic

Very common during the first months on this journey. I can go places now, but I can't go and visit my father. Crazy because I talk to him all the time over the phone, and I still can't figure out why my body feels like not visit him. It's just a fear that still there. In the beginning, I couldn't see anybody. It got a lot better now, but still struggling with few situations. .

Hang in there...

@Pokey449, you are not alone. What a suffering, what a Hell... I start soon my month 6 after the last pill of Mirtazapine, and I haven't have a second of relief, all the time terror and nightmare. But as Raymond says, hang in there, we don't have any other choice. Any.

Svetla

@Pokey449 Hey mate, I am sorry about your bad day yesterday. I am really hoping today is better for you.

@Raymond@skamen @Chippy I looked at my dosing log. I don’t have the first couple pages showing the exact date I started my taper but pretty sure it was March 2025. If you recall I’m also on 7.5mg of mirtazapine but not tapering it. Ive tapered the doxepin from 50mg down to 29mg by January 2026. So I reduced from 50mg to 29mg, or 42% over the course of 9months. That averages out to about 5%/month. So it wasn’t a rapid taper. But in review of my daily log WD sxs started pretty early into the taper. Kindling is likely an issue though. I’ve been at 29-29.6mg now since January 2026. I’m 18months into my taper, and 8 months basically at the same dose and sxs seem to have gotten progressively worse, not better. I feel like I’m getting sicker & sicker by the day/week.

I know this is not a linear process but I really think what is going on is more than just WD. Possibly some sort of negative idiosyncratic affect of the doxepin & mirtazapine combination that has developed over time. They are two meds not commonly given together so I’m not sure anyone knows what they might do to a person. I’m not sure even Horowitz knows what’s happening. I have another email/voice message session with him next week, not that he can “fix it”. But hope he can give me some sense of hope.

I just don’t know if I can take much more of this.

Hey @Pokey449 sorry to hear you are feeling so frustrated still. It is great you have a email from Dr H coming, always good to get some reassurance from him.

I think you summed a lot of what happened up quite well with your taper. 5% can often be too much. I think the biggest thing wasn't the speed of the taper, it was tapering whilst destablised that was the issue here ontop of some big moves at the start of the year which kicked off alot if this for you imo.

Another day closer mate, hope you have a good rest tonight.

@Chippy sounds like you are of the mind that my malaise is all taper/WD related?? I can’t negate that for sure but I still think it’s more complicated than that. And then there’s my struggles with CPAP on top of all this Talk about a pain in the butt. I hate it. Ready to throw the damn thing in the trash.

17 hours ago, Pokey449 said:

@Chippy sounds like you are of the mind that my malaise is all taper/WD related?? I can’t negate that for sure but I still think it’s more complicated than that. And then there’s my struggles with CPAP on top of all this Talk about a pain in the butt. I hate it. Ready to throw the damn thing in the trash.

I don't deny everything potentially plays a role mate we don't experience WD in a vacuum, I do think the bigger issue here is WD though.

@Chippy its so hard to tell what’s causing what. WD v back pain V cpap struggles. It’s all tied together in one big ugly convoluted knot. Thursday night was a much better night, last night was terrible. Awoke 2-3x in great discomfort along with nausea. I get good cpap #s one night, poor the next. A relatively ok sleep one night, terrible the next. I’m just surviving, not living. I look at myself in the mirror and don’t recognize who I’m looking at. The tired eyes, the bags under them are telltale of my nights. I ask myself when will it end? How will it end? Will I stabilize or die 🫩🥲

19 hours ago, Pokey449 said:

@Chippy its so hard to tell what’s causing what. WD v back pain V cpap struggles. It’s all tied together in one big ugly convoluted knot. Thursday night was a much better night, last night was terrible. Awoke 2-3x in great discomfort along with nausea. I get good cpap #s one night, poor the next. A relatively ok sleep one night, terrible the next. I’m just surviving, not living. I look at myself in the mirror and don’t recognize who I’m looking at. The tired eyes, the bags under them are telltale of my nights. I ask myself when will it end? How will it end? Will I stabilize or die 🫩🥲

Pokey I feel the same. One night better, one night not good, no reason for it. Just how it is. I empathise, my eyes are very dark too. I often feel sleep deprived in the day, sometimes not, I feel often like I am just trying to live while suffering rather than actually live. I don't ask questions like how and when and all of that, just accept, and move forwards, it is all we can do mate.

Hi @Chippy Its been a couple days. I've been dealing with other issues which diverted my attention away from here. The last two nights have been lousy for sleep. The first night I was highly stressed over something I don't need to discuss here. Last night I fell asleep right away to awaken at 4am due to nasal congestion preventing me from being able to breathe adequately through my CPAP mask. I had no other symptoms which I hope is a sign I am becoming stabilized. Thinking it was a CPAP complication alone that boogered up my sleep. Not a good night for sleep but maybe a good sign otherwise?????

I have a 10 minute email/voice message session with Dr. H this Friday. I have a couple questions for him about possible affects from the doxepin/mirt combo. Especially on my respiration, if any. I'm really struggling with my PAP therapy. This will likely be the last time I seek his council as I don't know what else I can ask & he can tell me.

35 minutes ago, Pokey449 said:

awaken at 4am due to nasal congestion preventing me from being able to breathe adequately through my CPAP mask

I also have a CPAP and this also happens to me once in a while. I just loose the CPAP mask a little bit..... it doesn't happens every night. It could be weather or something. I still can't figure out.

Hi @Raymond I can't figure it out either. I've tried multiple humidity & temp settings on my BIPAP machine. Ill get a good night or two and then get all plugged up the next night. I've tried full face hybrid masks to alleviate the issue but I can't seem to tolerate any of them. They ALL leak eventually in the night either blowing air in my face or shuddering against my cheek waking me up. Ive been on PAP, first APAP now BIPAP therapy for 18 months and its been a total pain in the ass. I'm ready to chuck it!!

50 minutes ago, Pokey449 said:

Hi @Raymond I can't figure it out either. I've tried multiple humidity & temp settings on my BIPAP machine. Ill get a good night or two and then get all plugged up the next night. I've tried full face hybrid masks to alleviate the issue but I can't seem to tolerate any of them. They ALL leak eventually in the night either blowing air in my face or shuddering against my cheek waking me up. Ive been on PAP, first APAP now BIPAP therapy for 18 months and its been a total pain in the ass. I'm ready to chuck it!!

I totally understand. I only use the nose pillows. The other day, I just took it out and slept body down as my problem is that if I sleep body up, intend to hold my breath. My issue is the muscle on my throat that when relaxed, it obstruct the air... This is the reason, I'm trying to loose weight and see if it helps. I have been with this cpap since i was 35.....

@Raymond Have you tried a mandibular advancement device ( MAD) to hold your tongue forward. I wear mine when using my BIPAP.

17 hours ago, Pokey449 said:

Hi @Chippy Its been a couple days. I've been dealing with other issues which diverted my attention away from here. The last two nights have been lousy for sleep. The first night I was highly stressed over something I don't need to discuss here. Last night I fell asleep right away to awaken at 4am due to nasal congestion preventing me from being able to breathe adequately through my CPAP mask. I had no other symptoms which I hope is a sign I am becoming stabilized. Thinking it was a CPAP complication alone that boogered up my sleep. Not a good night for sleep but maybe a good sign otherwise?????

Well this sounds like some positive news, although I am sorry about the recent stress Pokey and the not so good sleep. Having the CPAP complications to add to your situation doesn't help matters I am sure.

17 hours ago, Pokey449 said:

I have a 10 minute email/voice message session with Dr. H this Friday. I have a couple questions for him about possible affects from the doxepin/mirt combo. Especially on my respiration, if any. I'm really struggling with my PAP therapy. This will likely be the last time I seek his council as I don't know what else I can ask & he can tell me.

I hope Dr H has something useful to add to the mix for you, I can understand why you may choose to not consult with him for the moment at least, there comes a point where there is nothing more to do other than be patient and let the body work things out.

Hope tonight is a much more restful night my friend.

After your appointment, can you please summarize, what it worth to pay dr. H for his help? Was there any meaningful "outcomes"? What, specifically, you got from him? Sorry for asking skeptically, but you sound far from excited when you mentioned him...

Edited August 26Aug 26 by The Dust

@The Dust It’s not that I’m skeptical about his.advice. I think he’s probably the best professional medical advice one can get regarding getting off these damned drugs. If I’m sounding unenthusiastic it’s because getting off this **** is exhausting, worrisome, problematic, difficult and lonnnggg despite Horowitz’s counsel. Plus I have other complicating stressors going in my life and I’m just plain exhausted and about done in. It’s not Horowitz!!

I thought skeptical about your personal consultation with him, not about him as professional, or his knowledge. If it was even helpful for you...

I’ll let you know more after my email/voice message on Friday.

Thanks. Because maybe it will be good to hear your summary about your consultation with him - what's his professional opinion about your situation in general...

Edited August 26Aug 26 by The Dust

@Chippy @skamen @The Dust I received my voice message from Horowitz this morning with his response to the questions I sent him. He seemed to think my sleep issues are still mostly protracted withdrawal related. I had asked if he thought the Doxepin + the mirtazapine was possibly causing the central apneas that I have been having in my sleep. He did not think so, but admitted he was no expert on sleep breathing issues. I'm worried about over sedation, but as I told him my night time sxs wear off pretty quick after I get up. I asked when he thought I might be able to resume my taper given my sxs. He suggested either waiting longer to start or go ahead but make very SMALL cuts such as 1-2% at a time. I also shared with him that my sleep medicine doctor wanted to repeat a sleep study on me but give me Ambien this time to help guarantee I sleep through the night since the sleep study I did in June I only slept 3 hours. I can barely sleep in a damned sleep lab. To unnatural!! He rambled around that question a bit but I got the primary impression that it was not the best of ideas and that it could even lead to a "false study result" which I thought of that as well. So I think I am going to tell my sleep doctor, no Ambien........I am at the point I don't know what else to do but to struggle and live through this like so many here do. I'll either survive or I wont, but its robbing me of my life, again like so many others here. I'm not really that afraid of dying from it, its the misery beforehand that is so exhausting. I hope you all are doing OK today

Pokey

Thank for sharing!

I don't know what so say, but it sounds a bit strange that dr. H think it's related to your protracted WD. But you are still on meds. He knows that small dosage doesn't necessary mean no effect or weak effect... Probably he didn't know how to comment your sleep issues in terms of psych meds and finish by speculation...

Taking Ambien and expecting reliable resulted when they are testing your sleep, sounds like giving an amphetamine pill to an athlete and excepting to see objective results about his (real) performance same time...

Edited August 28Aug 28 by The Dust

Thank you, @Pokey449, for sharing this information. Yes, don't take any other drug. Indeed, living Hell, Pokey. What do you decide, hold or decrease with small amount?

Svetla