increasing temazepam after eight years of treatment?

[anne816]

I have had a sleep disorder for over twenty years, that started with a very severe head injury where I was hit as a pedestrian by a car going 40 mph. I had surgery to fix my forehead but shortly afterwards began to have extreme personality changes, and increasing hypersomnia.

This hypersomnia continued increasing for the next 12 years, but nobody believed me that it was real. They dismissed it as 'in my head'.

Finally about eight years ago my sleep cycles had deteriorated to the point where I was sleeping about 20 hours a day, and throwing up repeatedly whenever awake.  I was so desperate and sick that finally I was able to be referred to a neurologist of some sort. My insurance wouldn't cover a sleep study, but I was given temazepam. (15 mg a night) this worked dramatically -- and the very next day my symptoms of excessive sleep were literally gone.

Over the past eight years I have slowly regained most of my functioning although I had to go on disabililty.  However recently, the hypersomnia is beginning to creep back again. I am now sleeping again 13 - 14 hrs a day, and again craving sleep the entire day. I cannot function or think.  I want to increase the dose of temazepam. I am usually very intuitive about what I need medically..  but I have a new dr since then and am petrified they will disbelieve me or dismiss it as ' in my head' which happened so often before.  

I dont want to take drugs unecessarily, etc, but, its been eight years since the dose was looked at.. and, my quality of life is going rapidly back to zero.  I do nothing but sleep and want to sleep.  Is it reasonable to ask about increasing the dose at this point??  I see my dr on Nov. 5th. I want to know what I can do to help myself. I dont know if my insurance will cover actually seeing a sleep specialist.

Thanks so much for any thoughts.

[anne816]

Well, I appreciate your quick answer.  The difficulty is that I live well below the poverty level and have no sleep doctor.  I am lucky to have a GP.  My insurance is a govt. medical card.

I will likely have to fight very hard and make a very compelling case for a referral, if I can get one at all. The referral I got before took me four years to get.  There was no question I could not see a real sleep specialist or have any sleep study --- they essentially just gave me temazepam on a guess.  

I am praying that I will somehow be able to convince someone to send me to an actual sleep specialist this time.  

Thanks for your help.

[Steven Y Park, MD]

Sounds like a complicated situation. This is a question that you have to have with your sleep doctor. It's reasonable to bring up the possibility of increasing the medication dosage, but again, that a discussion that you need to have with your doctor. Call your insurance company and find out if a sleep consultation and a sleep study are covered. They should be able to tell you.