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I have been having trouble with the need to sleep almost ...

Sent to Health Experts February 17 12:55 AM

I have been having trouble with the need to sleep almost all the time, especially during the day, for several years. It just keeps getting worse! I feel good but then I eat or drive or relax and I have to sleep. Then when Im sleeping I won''t get up most of the time unless I have to. I take lithium, Effexor and Zanax for Bipolar disease but I think there is something else going on than just feeling a little tired from those meds. Please help! I don''t know where to turn. I had a sleep study for apnea but I don''t have that. I have young children who need my attention during the day and I can''t give it to them because I feel like I have no control over my need to sleep all of a sudden off and on throughout the day. I need help.

 

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Female, Age: 36, Massachusetts

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February 17 1:15 AM (2 minutes and 57 seconds later)
         
Reply to Dr. Cawlfield's Post: I just started taking the Zanax about 1 year ago on a regular basis. Before that I would take it if I woke up in the middle of the night with an anxiety attack. I have RLS and some muscle weakness but not much. I have had hallucinations if I'm asleep and then wake up suddenly but I don't get those all the time. Maybe once a year at most.

I hope this helps.
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February 17 1:32 AM (17 minutes and 2 seconds later)
         
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Thanks for that additional information.

What you are describing is a condition called excessive daytime sleepiness (very creative name, don't you think?) This is a condition with multiple causes. The most common cause is from a primary sleep disorder followed by medications and then medical problems.

Primary sleep disorders are problems like obstructive sleep apnea, narcolepsy, RLS with periodic limb movements, and insomnia. Sleep studies are very helpful in diagnosing these problems. Although you do not have sleep apnea, you do have RLS/PLM. RLS makes can make it difficult to fall asleep, the PLM's will often wake the individual, although they frequently don't remember this. Insomnia and narcolepsy can be diagnosed with the time that it takes to fall asleep. I would pay careful attention to the sleep study report for sleep latency and the index of awakening (forgot the name). A short sleep latency supports narcolepsy, a high awakening index would suggest that the limb movements are disrupting your sleep.

Medications could also be a cause. Studies have shown that after about 4 months, benzodiazepines (like Xanax) alter the sleep architecture. Normal sleep has 4 stages of sleep followed by a REM cycle. After time, benzodiazepine use eliminates stage 3 and 4 sleep. These are the stages responsible for resting the mind. Even though your body is rested, your mind is not. I would re-evaluate your need for Xanax with your psychiatrist.

Not a definitive answer here, but as you can see, there is a wide variety of possible causes. Let me know if you need any clarification.




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Thank you,
Dr. Cawlfield
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February 17 1:39 AM (6 minutes and 28 seconds later)
         
Thank you so very much!!! I will take this information to my primary doctor and I believe that it will help us a lot in the final outcome. Thank God for doctors like you! You may have just put me on the track to finding my cure... finally, someone who may have pointed me in a direction that will lead to answers not empty questions!
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February 17 1:48 AM (8 minutes and 56 seconds later)
         
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