Managing the Sleepiness

[DownUnder91]

Hi everyone,

I have postpartum psychosis after my second daughter, and after spending 6 weeks in the mother baby unit have been at home now for 2 weeks. I'm currently taking Quetiapine, which has made the psychotic symptoms and mania disappear but leaves me really drowsy and forgetful. With 3 month old and 20 month old daughters I feel like I need to be on top of things and am finding the drowsiness/sleepiness and general feeling of being out of it problematic as it usually lasts most of the day. I am just wondering if anyone has any strategies that helped them to manage these symptoms?

[Cicerenella]

I've found a couple of ways to manage drowsiness and other side effects from medication, but I have to acknowledge that I don't have two young children, so they may not be as useful or achievable for you. But, anyway, here we go, one's with ** are particularly helpful.

- Basic sleep hygiene: no coffee before bed; room comfortable temperature; dark room

- If I can't get to sleep at night I don't stay in bed waiting to fall asleep; get out of bed until I feel tired.

- **Wake up at the same time every day no matter how tired you feel.

- ** Take medication at the same time every day. I take my olanzapine at about 8pm every night, I'll start to feel drowsy by 9, and then in bed at 10pm. By the time I've woken the next morning I don't feel as drowsy.

- **Don't nap for more than one hour during the middle of the day. Try to avoid napping after 5pm.

- Try not to have disrupted sleep over night (Maybe your partner can get up for night feeds, or if you're breastfeeding, keep baby in a bassinet close to your bed so you don't have to get up completely to feed)

- Have a daily schedule that has clear achievable goals for each day (i.e. out of bed by 8, breakfast for you and your daughter by 9, lunch by 1, shower while kids nap, whatever.) this kind of helps with the out of it feeling, because it's grounding to have a physical thing to look at, and it reminds you about what needs to be done even if you do feel like you're on autopilot - plus there's a sense of achievement at the end of the day that "oh, even though I perceived my day to have been bad I got things done, and I cared for myself and my children"

- Have a friend or family member call you during the day to check on how you're doing. I find that talking to other people can help to ground me if I feel groggy and out of it because they're normally at a normal energy level!!

[JaneHW Volunteer]

Hello downunder91, if you have only been on quetiapine a matter of weeks then it will still be feeling like a very 'heavy' drug in your system. I remember once describing it as like carrying a physical weight. Things that can make it worse: grapefruit and Seville oranges, bizarrely enough. I promise, you'll find them in the smallest print!! I have been on and off quetiapine since my pp 5 years ago now, and in general I would say benefits outweigh problems, although the initial period of your system getting used to it is not fun. Also, keep an eye on your weight with this one, not because the drug itself has an effect, but in some people it can have an effect on appetite whereby you kind of lose track of when you've had enough, and you crave sugar. I wish someone had let me know and I'd have been more proactive with the fruit bowl. All the best Jhw

[TabithaSparkle]

Hi, I was the same but was then put on Modified Release Quitapine which helped a lot - could you ask your doctor for that? I'm sure you're doing brilliantly.

[Hannah_at_APP Administrator]

Hello downunder91 and welcome to the forum.

You have already had some great replies, but to add my experience and strategies too, I think that trying to achieve something (no matter how small) was important to me. Some days after being home, I would get cross with myself and the foggy/ sleepy feeling you describe. I think I thought that being home I should somehow be "better" but recovery can be a long process and for some Mums can take longer than others. Please don't be too hard on yourself, you have come through an awful lot. Perhaps writing things down to remember them, and also recognise the achievement, could be helpful to you. I also kept a diary and would enjoy looking back a week, month or longer, and seeing the improvement in myself, as well as having an outlet for my frustrations.

I had PP in 2009 and it helped me to try and get out of the house a little too, even if it was just once a week, or occasionally more if my CPN would visit and take me somewhere (as I couldn't drive). I particularly enjoyed going for coffee and cake (although fruit or something healthier would work too) - this also helped my confidence, to be seen as a Mum out with her baby, as nobody knew the other person was a MH professional!

I don't have experience of Quetiapine, but the suggestion of a modified release version could be something to bring up at your next meds review. I took Olanzapine and found that very sedating, but know that it also helped me to get better (with the benefit of hindsight). I had regular reviews of my medication and each time it reduced, and then stopped, I could feel the improvement in my concentration and feeling of being more alert and less tired. My Dr described it as being "chemically restrained" which really resonated with me too.

The Recovery Guide that APP has produced might also give you some more info, here is the link: app-network.org/what-is-pp/... There is also one for Partners if that would also be helpful.

All the best with your continued recovery, you are doing really well and should be proud of yourself! Take care, xx

[DownUnder91]

Thanks everyone for the helpful suggestions. Some of them I'm doing already, but I really like the ideas of having a daily routine or a goal and trying to get out of the house. The feeling of being "chemicallyb restrained" really resonates with me too, it does literally feel like being weighed down sometimes!