Is this narcolepsy...or a symptom of another condition?

[sunbeamin]

When I was in my teens and twenties I would occasionally become extremely sleepy.  Since I have allergies, it seemed that it often coincided with when I would take an antihistamine/decongestant, so I attributed it to that.

Now that I'm in my 40's, I get regular allergy injections and rarely, if ever take any antihistamine/decongestants.  However, it is now these bouts of extreme sleepiness seem to be a regular occurrence.  While I do fall asleep very quickly at night, I am a light sleeper.  These episodes of sleepiness are often so extreme I am unable to keep my eyes open and often better off if I can just lie down and try to sleep it off, however this sleep is often restless.

What could be the underlying cause?  I have a recurring pituitary tumor (1.4 cm prolactinoma) and the most recent MRI findings read "Scattered foci of T2 hyperintensity are seen in the periventricular and subcortical white matter which may represent small vessel ischemic disease versus a demyelinating process or post vasculitic changes."  I have been recommended to a neurologist, however the earliest available appointment is December 2nd.

Any insight is greatly appreciated.

[Curtis1960]

Good afternoon, Sunbeamin!

Your fatigue issues could have many possible causes - vitamin or hormone deficiencies, sleep disorders, stress, disease, etc.  It is a common symptom for so many diseases.  The best thing to do is to talk with your doctor about your fatigue.  First, he can prescribe something to help with the fatigue while he determines a cause.  Secondly, he can run all sorts of tests to rule out the most obvious things.  Lastly, if an answer doesn't become readily apparant, he can request an overnight polysomnogram (sleep study).  A sleep study will show if you have sleep apnea, narcolepsy, catapexy and other sleep disorders.  

I had terrible fatigue which I thought was related to depression.  After three psychiatrists and numerous medications, my last shrink asked me about my sleep.  I had known for over 20 years that I have apnea just from my own observation.  Well, apnea side effects include fatigue and depression.  A sleep study proved apnea and I've been on CPAP ever since.  My fatigue has not resolved, but my MD recently ran tests that show a vitamin B-12 and testosterone deficiency.  Once I begin getting my injections, I hope the fatigue will resolve.

Good luck and I hope it's something simple.

Curt

[Curtis1960]

One other possibility is the small vessel ischemic disease - which may be indicated from your MRI result.

[KatEyes]

My MRI also showed possible small vessel ischemic disease that showed more and larger lesions over time. I can't help but wonder if mine is due to years of untreated sleep apnea and oxygen desaturations. Have been successfully on cpap for a couple years, so I'm curious if that has stopped their progression.

Because circulation and thus oxygen to your brain is so important, anything that could compromise it should be ruled out. Add to that your reported light sleep and daytime sleepiness, and I would think you would be a candidate for a sleep study sooner than later. There are other sleep disorders that can also be picked up by a sleep study. Your general practitioner can order you a sleep study, but be sure it is at a reputable  accredited sleep lab. If they are scheduling far out, ask them to call you if they have a cancellation and can get you in sooner. Diagnosing and treating a sleep disorder could fix all, most, or some of your symptoms. Still need to work with your docs to pinpoint any other contributing factors to how you feel.

[sunbeamin]

Thank you both.  I am actually going to be able to see the neurologist on Tuesday.  I have done a little research on him and believe he does sleep studies as well.  I will be discussing things with him at length and see where we go from there.

Thanks again for your replies!

[scarlet37]

I just wanted to chime in on this post because I have Narcolepsy. While your symptoms seem similar  to many with N ; without ruling out apnea first it's hard to say which it could be-  the symptoms can be extremely similar. I would make sure to ask about the pituitary causing sleep issues - the hypothalamus & pituitary are responsible for so many things including sleep.

Good Luck with the Neuro and please let us know how it went.

[sunbeamin]

I have the results back from the sleep study and nap assessment.  All came back normal...no apnea (which I didn't think there was) and no narcolepsy.  I am now waiting on blood test results for vitamin B12, to see if there is a deficiency there.  I will also be looking into the pituitary side of things.  I know it can affect a great many things, so that is a real possibility as well.