Q: I am 29 years old. I started having the problem of headaches and disturbed sleep six years ago due to some extreme exam pressure and personality problems. My blood pressure shot up to 160/90. I had no headache problems before it. I started taking Clofranil 75 mg along with some other medicines after which the conditions improved. I occasionally tried meditation, which brought my blood pressure down to 120-130 / 80-85. However, headaches in milder form persisted. I also started feeling very sleepy and found it hard to concentrate well at work. Since I relocated to another city after three years of medication, I lost touch with the doctor. I continued taking the medicine and brought it down to 10 mg as suggested by the doctor in the last visit (though was very uncomfortable). But I have recently stopped taking it when an eye doctor suggested that it had many side effects, and actually increases the headache and makes one get addicted to it. After stopping the medicine, my condition has worsened with increased headaches in the morning. I also feel that I am suffering from depression. I have a doubt that my blood pressure has again increased. Is this because I have become addicted to the drug? I have also consulted an ENT recently and reports have shown a bone in the nose has bent causing nasal blockage. The doctor has suggested a surgery after medicines and sprays offered only temporary relief. Please suggest what I should do to improve my health. Has the nasal problem aggravated my condition? Are Ayurvedic remedies and breathing exercises helpful?

A:Both sleep disturbances and depression can lead to excessive daytime sleepiness and headaches. To tease these disorders out, you need to have a comprehensive examination by a professional who is trained in both psychiatric disorders and sleep disorders. As you describe some deformity with your nose, it is possible that you might have sleep apnoea, a type of sleep disorder with obstruction to airway during sleep - sleep apnoea is more likely if you snore loudly and either you have been seen stopping breathing or you gasp for air in your sleep and you are overweight / obese and have daytime sleepiness / tiredness. The best way to rule out or rule in sleep apnoea is to get an overnight sleep study done. The treatment should be dictated once the diagnosis is clarified. Clofranil is not addictive; however, it could cause some daytime sleepiness if you are taking it during the day. I suggest that you see physician trained in psychiatry and is familiar with sleep disorders for proper diagnosis and treatment. Another alternative strategy that might work is exercise. We do not have any scientific evidence for treatment modalities like Ayurveda and breathing at this time.