Over sleepiness

[helkaissy]

Hi Doctor
i have been suffering a slowly increasing symtom over the past few years of my life and it has reached a stage where i think it could be a medical state.
Every day when i wake up, it feels that i need to sleep more, regardless of how many hours i sleep, i tried sleeping up to 12 hours and my body just doesnt mind sleeping that long and i still wake up with the feeling of having slept for just 4-5 hours, i then feel sleepy all day long and any time of the day if i close my eyes i find myself about to dose off to sleep, it can happen in the elevator at work or whenever i am alone. i dont actually fall asleep in these cases so i can still control myself, but this constant feeling of need for speep has been increasing over the years, in addition to a general fatigue and loss of concentration at work and during any conversation in my daily life.
I have met with several doctors in a hospital in paris, they made sleep tests to see if i have respiratory problems at night and they found that i didnt, i did all kind of blood and urine tests looking for any anormalities which i didnt, i havent been taking any medication when these symtoms appeared. after the visits in Paris the doctor informed me that they see no physical reason for my case and that it might be a case of general sleepliness (a degree of narcolepsie) or a general depression.
They prescribed to me to take one of the two medicines (Modiodal or Ritaline LP) i tried modiodal but i still feel the same sleepliness symptoms. i am also not convinced about this beeing a depession, i have no reasons in my life for depression and on the best days of my holidays when i am in the best mood i still feel the same symptoms.
i made CAT scans, abdominal scans and chest scans and all turned out to be normal.
I made a heart test on the monitor machine and all came our fine.
I am really lost behind the reason for what i feel and i need to be directed to how i could further investigate possible reasons for this condition which is deeply affecting both my work and private life.
Thanks in advance for taking the time to read this and for ypur help
Best Regards

Hussein El Kaissy

[Paderla Anitha, DNB]

Hello and hope you are doing well.

Understand your predicament.
Excessive daytime sleepiness can occur, due to inadequate sleep at night due to sleep disorders like obstructive sleep apnea. Other sleep disorders like narcolepsy can also cause excessive sleepiness. You will need to consult your primary care physician, who may schedule you for a polysomnogram (sleep test) to rule out sleep disorders and initiate appropriate therapy. Narcolepsy is diagnosed by the sleep onset REM episodes (SOREMs), wherein the person goes into the dream phase or REM cycle soon after sleep onset. This is evident in the Multiple Sleep Latency Test (MSLT). So, have yourself evaluated for sleep disorders and then take therapy after a confirmatory diagnosis. So, don't worry and discuss these options with your doctor.

Hope this helped and do keep us posted.

[helkaissy]

Dear DrAnitha
First of all thank you very much for your reply to my post.
Indeed it was the conclusion of the hospital in france that i suffer either from narcolepsy or idiopathic hypersomnia exactly as you mentioned.
Yet i was not subject to MSLT so i am not sure which i suffer from.
Maybe my symptoms details can clarify more, i do not actually fall asleep at all during the day, i never go to sleep against my will or suddenly so i am in full control of my sleep, i dont do naps in afternooni i only sleep at night normally.
What i suffer from is a very strong desire to sleep during the day and a very big difficulty to wake up and leave bed in the morning, whenever i am alone (in an elevator for example) i feel like closing my eyes and sleeping and if i do close my eyes, i feel my eyes rolling up and my mouth open and feel as if im about to go into deep sleep, but i still am in control and never sleep against my will. This is also added to a general loss of energy and concentration during work. As long as i am talking or with people i am alert but as soon as i am alone i start getting the urge to close my eyes and sleep.
I tried to challenge my body and give it as much sleep as it needs but i ended up sleeping 11 or 12 hrs continuesly for several days and  still i wake up tired as if i only slept 4 or 5 hours. I cant wake up on time to go to work, i am too tired to do anythjng with my family after work and this is affecting my whole life as i feel i am going through the days as if im dreaming and not fully aware of my surroundings.
I tried both medicines they gave me for the narcolepsy but they both dont seem to have any effect on my case, i am even surprised that they dont wake me up at all or improve my allertness.
Im really lost and appreciate your help a lot

[Paderla Anitha, DNB]

Hello and hope you are doing well.

As you have been investigated extensively, your symptoms of excessive sleepiness could be due to either narcolepsy or idiopathic hypersomnia. Narcolepsy is diagnosed by the sleep onset REM episodes (SOREMs), wherein the person goes into the dream phase or REM cycle soon after sleep onset. This is evident in the Multiple Sleep Latency Test (MSLT).  And idiopathic hypersomnia is diagnosed by exclusion. Treatment is based on the cause.

Hope this helped and do keep us posted.