Fatigue and daytime sleepiness

[MR]

I have been experiencing an issue for about seven years that I am looking for help with. I experience times of extreme fatigue during the daytime. These periods of fatigue come when I "settle down" for a minute. I have lots of trouble almost anytime I drive for more than twenty minutes. My drive home from work in the afternoon seems to be the worst. I also get drowsy and often fall asleep when reading or watching T.V.

My doctor has taken blood tests, etc. and nothing stands out as a possible physiological causes. He has asked me some basic questions about snoring, etc., but I don't seem to exhibit the symptoms of sleep apnea or really any other of the more common sleep disorders.

On average, I sleep about 7 to 8 hours per night. I seem to sleep peacefully, but I don't necessarily wake up refreshed. I often have trouble getting out of bed in the morning.

I am not sure what to do. The almost daily drowsiness while driving concerns me the most. My doctor didn't refer me to a sleep center because he said I don't exhibit any signs of a sleep disorder (e.g. snoring). He suggested drinking coffee in the afternoon, but that just seems like a bandaid.

I am not sure what else could be causing the fatigue. I do have a stressful job, which could sap my energy, but I am also often very tired on the weekends. This is again especially true when I am driving. I also take a medication that could make me tired, but I have been taking it a long time and it doesn't seem to be the cause. There are periods when I haven't taken it, but have still had problems with fatigue.

Has anyone experienced similar issues or does anyone have any ideas of possible causes?

Thanks for any help.

[JudiElise]

Hi MR,

I think it would have still been a good thing to go to the sleep center for a test. There are over 80 sleep disorders and not all the them begin and end with snoring. For example, my son has symptoms, which mimicked insomnia and narcolepsy, but it wasn't any of those two. It took a trip to an ENT and two sleep studies to rule those out. His symptoms? Daytime sleepiness (he could fall asleep at the drop of a dime!) and fatigue. In the end, he has two sleep disorders - Obstructive Sleep Apnea and Delayed Sleep Phase Syndrome.

So, my advice to you (just a layperson with three people in my life-hubby, son and sister-with sleep disorders) is to go back to your doctor, and ask for a referral to a sleep specialist or an ENT or both. It can't hurt, and coffee is not enough for the rest of your life.

Let us know what happens.


Take care,


Judi

[MR]

Thank you very much for the feedback. It is helpful. It seems like the next step is to do a sleep study. I guess I just need to talk my doctor into it.

MR

[Charlie]

MR,

Do you have a headache when you wake up? Just because you don't exhibit the classic symptoms of sleep apnea, doesn't mean you don't have it; and just because a person snores doesn't mean he does, you know? It sounds as if your doctor isn't completely up to date on sleep apnea. And it sounds like you suffer from excessive daytime sleepiness and that most definitely a symptom of sleep apnea. As is waking up not refreshed after a seeming 7-8 hours of "rest." I agree with what JudiElise said; I would go back to your Dr. and request a sleep study and referrals to an ENT or sleep specialist. Not to scare you, but I speak from personal experience when I say it very well could be a matter of life or death, especially when you drive.

Now, while this is a great board, I recommend going to http://www.talkaboutsleep.com/ . It is a sleep disorder board message board owned and run by patients who live with a variety of sleep disorders, including sleep apnea, RLS and narcolepsy. There are message forums for many different sleep disorders and some of them even host a chat during the week. Feel free to ask any questions you may have. Many of the long time posters are very knowledgeable and will try to steer you in the right direction. Please, don't feel as though you are bothering them or that your question is dumb. The only dumb question is the one you don't ask. As Judi said, there are many different sleep disorders and unfortunately for us, many of them share symptoms. That, and many who suffer don't exhibit symptoms or don't fit the "typical profile" for some of the disorders. So get as much info as you can lay your hands and see your Dr. Remember, forewarned is forearmed!!

Take care!

Charlie
p.s. Oh, and if you do check it out TAS and you end up in the sleep apnea forum, tell them Tex-Mex Dad sent you. ;)

[MR]

Charlie,

Thanks very much. I am concerned. It seems like it is hard to pinpoint sleep problems. The best thing to do is rule out potential causes. It seems like a sleep study would be the next logical step.

MR

[NS]

Hi MR, i have experienced similar symptoms, specifically sleepiness during the daytime and during long drives. so here are some suggestions:

1. The official term you should use Excessive Daytime Sleepiness (EDS).
2. Evaluate the quality of your sleep at night. Ultimately, we as humans recharge our batteries at night. The simplest solution may be to ensure your nighttime sleep is restful and rejuvenating. Sometimes little things can make a big difference: dark lighting, temperature, even having a bed-time "routine" for a half hour allowing your body and mind to relax and unwind in preparation for sleep. I personally find having a fan on as "white-noise" is very relaxing.
3. If you know you are tired during afternoon driving, take a quick cat nap before you drive. You could even put a small pillow in the trunk just in case. Airlines and trains actually have really nice small pillows.
4. Make sure you are getting enough exercise. It will help you sleep better at night and is great at stress relief (just don't do it immediately before bedtime.)
hope this helps!
-N

[Sharron]

I too have suffered from daytime sleepiness. Someone has recenetly told me that there is a clinical trail that is for this. Please check this link for more information.. it might be helpful!
http://clinicaltrials.gov/ct2/show/NCT00711516?term=sleep+apnea+bos...

[NS]

Sharron,

Note: that drug under clincical trial is for sleep apnea.

[Hee]

Try Provigil.

[Susan]

I'm on 400 mgs. of Provigil a day & I can still sleep right through it. I'm so frusturated!
Hopefully when I go back to see my Sleep Dr. in March he'll put me on something else. My sleep study shows that I don't have narcolepsy but I do suffer greatly from EDS. I do have Obstructive Sleep Apnea & severe RLS.
According to the sleep study,I'm not really doing alot of sleeping.

[NS]

Susan.
me too. lol. Maybe we can share some tips with each other.
First, what do you take at night?
Second, do you take the Provigil all at once?
Third, what times of day are you most sleepy?
NS

[Susan]

I take 1 klonipin at night for the RLS.
Then in the morning,I take both of the Provigils.
It's hard to say what time i get sleepy,it's pretty random.Sometimes after not being up but for about 1-2 I'll become so sleepy that i can't keep my eyes open. Or,I can be cooking or cleaning dishes,at the computer & I'll just have to go to sleep cause I really can't keep my eyes open anymore.
There are also times in the evenings where I do the same thing. I usually take about 1-2 hr nap.
I'm so frustrated!!!! Grrrrrr!
I even did a lil experiment on my own to see if the Klonipin was having some side effects. Well I didn't take it for 2 wks-my legs weren't happy-but I still felt the same way.

[Susan]

Hi NS,I'm sorry i just saw this.
I take the provigil all at once.
At night i take the green colored Klonopin
It's really hard to say when I'm sleepy. See I don't have a problem waking up,but instead have a problem staying awake after I've been awake for 30min. -3 hrs. after i awaken. It's really crazy. LOL!