← Return to Quality of sleep: Is it better without the aid of medication?

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I suppose it depends on the nature of the sleep disturbance. I've dealt with Restless Leg Syndrome and the accompanying Organic Leg Movement during sleep for nearly 40 years. RLS delays sleep onset, and OLMDS results in hundreds of micro-awakenings; resulting in failure to reach the rejuvenation level of sleep, and thus, fragmentation. After trying 27 medications and remedies, I saw Dr. Ehrinberg (who was, at the time, the Chairman of the Restless Leg Foundation) at Tuft's New England in Boston. Given the lack of efficacy of the medications most often prescribed for the disorder, he recommended the opioid hydrocodone (this was in 1988). By 2002 I and my wife were desperate for a solution, and I opted to try this approach (despite my fear of sidelong looks from pharmacists, and all that implies). The dosage that my physician and I ultimately discovered effective/optimal, was 30mg of hydrocodone before bed. Literally, overnight it was as though the disorder had never existed. within 4 years, any euphoria faded, and the medication simply worked. In 2014, due to CMS guidelines on insurance reimbursement for physicians that prescribed opioids, and numerous red flags the physician had to explain, and reports he had to generate, he discontinued the treatment. The RLS/OLMDS returned. To date, the only sleep disorder Medical Centers that continue to push back against the CMS and continue to recommend the opioid treatment, are Mayo, Tuft's New England, and Mass General. In the past six months, the CMS altered it's wording to say this was only a recommendation and not a guideline, but the damage had been done. Physicians are now fearful of doing what is best for the patient. Granted, there may be an opioid epidemic in this nation, but the CMS' blanket approach has altered the narrative for those who do need this treatment. It would be unkind and unethical to say, "let natural selection fix the problem by weeding out the abusers," but surely a compromise could be negotiated. I would think the CMS, of all organizations, would know that in medicine there are no absolutes, and no two patients respond the same way. Surely Hippocrates would hesitate to write his famous oath if he could only have seen the future of medicine. When reimbursement trumps what is best for the patient, I think the meme' would be, "there is a glitch in the Matrix."

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Replies to "I suppose it depends on the nature of the sleep disturbance. I've dealt with Restless Leg..."

Hello David @davidlyle7, Thanks for sharing your experience and knowledge about Restless Leg Syndrome and Organic Leg Movement. There are a couple of other discussions that you may find interesting and like reading the experience of other members and sharing your experience.

– Restless Leg Syndrome (RLS) and Opioids: https://connect.mayoclinic.org/discussion/rls-and-opioids/
– Restless leg symdrome affecting my sleep: https://connect.mayoclinic.org/discussion/restless-leg-symdrome/

I see that you shared your story with RLS/OLMDS in the Restless Leg Syndrome discussion here in case other members missed it. I thought it might really be helpful for some – https://connect.mayoclinic.org/discussion/restless-leg-syndrome-2a74e5/?pg=15#comment-403710

How are you doing now?

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