Friday, February 29, 2008

Idiopathic hypersomnia (IS)

Think perpetual teenager. As in back in the days when you were one or parented one, holding mirror to Rip Van Winkle Jr.'s nose at 2 p.m. to see if you/he could still be counted among the living. Only this Sleeping Beauty is no longer a teen, and snoozes on even if it means losing a job or failing a course while remaining oblivious to the wake-up bells and whistles going off around him.

I hate these idiopathic diagnoses. This one is basically a fancy way of saying the patient sleeps too much and we don't know why. Now how is that going to make a person feel better about not only sleeping too much, but once up, being so out of it that he or she can't even remember what was said or done in those first few hours of the day? Well, if misery loves company, this diagnosis says you sleep too much, we don't know why, AND there are other people just like you sleep too much in the same way so it's a syndrome and not just you.

The symptoms of IS include excessive daytime sleepiness, tendency to nap, long nighttime sleep durations, difficulty awakening, and confusion on finally getting up which is also known as 'sleep drunkenness.' And don't mistake these people for healthy hypersomniacs or those people who thrive on a long night's sleep and then function perfectly well by day.

So what do you do with a drunken sleeper who's had no drinks at all but just seems that way? Per Medscape author Muhammed Faisal Hafeez Khan, MD of Duke University, you ply them with the same sort of stimulant medication that persons with ADD use. In addition to Dexedrine, he recommends a trial of Provigil (modafanil) which, if used at bedtime, promotes morning wakefulness. This drug was originally developed for narcolepsy and is now approved to rally shift workers and persons with sleep apnea to full alertness.

5 comments:

JeanMac said...

I haven't experienced day time sleepiness with our family - but, years ago our younger son (and my Dad) would sleep so soundly that they didn't wake up even when you rocked them by grabbing their shoulders. Doorbells, clock alarms, nothing would do the trick. ??

Cilicious said...

Perpetual teenager is a good description; I remember those days. What a problem, I feel sorry for the guy and wish I could share some of my wakefulness with him (and receive some of his sleepiness in return.)

dorsey said...

provigil is alertec in canada, half the price (still too expensive for what it does, my opinion, but I hope it's useful in these cases)

Mauigirl said...

Interesting, didn't know there was a syndrome like this. I knew about nacolepsy but don't think this is the same, right? Isn't narcolepsy related to epilepsy in some way? And it's sudden "sleep attacks," not prolonged sleeping.

Meri said...

Having nursed my younger brother who is a victim of idiopathic hypersomnia from a very young age, I know that there are several alternate therapy options for improving the condition which do not need any drug assistance. They involve making some lifestyle changes as well as deploying several self-help strategies. Let me give some examples of both:

•Maintain regular sleep hours.
•Avoid socializing that entail keeping late hours.
•Stop rushing through sleep.
•Quit alcohol and smoking.
•Do some kind of physical exercise for about 20 minutes every day.
•Do not have foods or drinks that contain stimulants like coffee, soft drinks, chocolate, etc.
•Do some pre-bedtime activity that relaxes both mind and body like a warm shower, etc.
•Improve bedroom ambience and make it more sleep-friendly.

Please visit this site that I helped conceptualized -- my own efforts to raise awareness:

http://www.hypersomnolence.org/