Before I Embarass Myself At A Doctor's Office...
Posted 08 September 2008 - 11:57 AM
Ever since I was little and as far as I can remember, I have ALWAYS been falling asleep. Especially in high school, I was the one that fell asleep in every single class, and every single seminar. It got to the point where I was well known for it, and still fell asleep even though I would be sitting front and center with my professor standing over me. I had problems also falling asleep while driving. Nothing usually dangerous, as it would almost always be at a stoplight (very embarrassing...) There was once though where I drove over a curb onto the sidewalk of a street behind a bus stop and I was able to get back on the road safely. Thank god no one was in the way! That was one of the scariest moments of my life, and it still haunts me. I fell asleep in classes and seminars and in speakers, no matter how important they were. It seemed like everyone else could at least MAKE themselves stay awake if something was important enough. However, even if it is my boss or coworker that is presenting something to other people that is very important, I still will doze off. once again very embarrassing.
I don't know if this is significant, but when I was little (like under 14) I would sometimes (maybe once every few months) get up in the middle of the night and have very drawn out and detailed episodes where I would be still in a dream, but interacting with others. Like I would walk into my parents room and start crying, or yelling nonsense (words, but they didn't make sense). It doesn't really happen anymore, although I did wake up in the middle of the night recently yelling at the top of my lungs, scared the crap out of my wife, and then didn't remember it at all when I "woke up"
Now one of the most prominant, and distracting things is that I will doze off when trying to read anything. It doesn't matter what it is, after a few minutes I will start nodding off uncontrolably until I get up, do something, and then sit back down again. I will have to get up every 5 minutes or so, in order to focus, and that alone disturbes my focus and is very distracting. I can drink a gallon of coffee and it still has no effect. Now a weird thing about these dozes, is that I will have a "mini-dream" as I like to call it. Something completely random will occur in the 1-5 seconds that I nod off, and it has NOTHING to do with what I might be reading/doing, and it could be completely off the wall. Sometimes I guess I will be laughing in this mini-dream and I will wake up with a chuckle. I even started recording some of these dreams, and showed them to my wife, and SHE suggested I go get help.
Now some of the things that are NOT a problem are: I have never fallen asleep while walking, or when actively moving my body (although I do feel myself falling asleep while standing, yet I can typically snap out of it before falling asleep). Also I haven't fallen asleep when talking either, but I HAVE fallen asleep when having a conversation in a group, and I wasn't the one speaking, despite how interested in the conversation I was.
All these things I have mentioned have happened both sleep deprived and with plenty of sleep. This past summer I had off completely and I seriously got 8-10 hours of sleep per night. This really didn't matter, and these signs still showed their heads.
I never really thought I had a medical condition or looked for medical treatment until now because typically I found ways to deal with it. I started chewing sunflower seeds while driving to keep me awake, which worked. I just accepted my sleepy-head title in high school and college. High school was easy enough that I could study enough to do fine. College was harder, but I was still able to manage by putting in lots of hours. But now I just started medical school, and everything is 2x worse. Information is flying at me in very concentrated amounts during lecture. Dozing off now sets me back a TON and loses my focus, and I struggle the entire class, always looking at friends notes next to me to try and catch up. When I go home I have a gazillion things to do and read, and I have fallen far behind. Like I said, I started out with plenty of sleep, but I have recently started to fall behind on sleep too, and that is causing even more problems. It is impacting my life pretty seriously now. My profession in the future will require me to work long hours with even less sleep then I am getting now. I need to fix this now, IF IT IS A MEDICAL PROBLEM.
From just what I have said, what do you all think?
Posted 08 September 2008 - 02:53 PM
Narcolepsy Symptoms manifest differently in different people, but here are the biggies:
Excessive Daytime Sleepiness - inability to stay awake during the day, even when active
Fragmented Nighttime Sleep - could be insomnia, or could be sleeping long hours without refreshing
Hypnagogic/Hypnopompic Hallucinations - dreams that seem real
Sleep Paralysis - inability to move when waking
Automatic Behavior - perfoming mundane tasks (writing, driving) while "microsleeping"
some people will have Cataplexy too - momentary loss of muscle control due to emotional stimuli
Your description seems to include EDS, FNS, and HH -- potentially AB with the driving thing. I have all of the symptoms except SP. The two biggies for Narcolepsy are the EDS and FNS.
Second, I will warn you that I saw doctors for 15 years and described my symptoms, and none of them suggested Narcolepsy or any type of sleep disorder!
So -- I suggest that you use one of most the common diagnostic screening tools as a talking point with your physician.
First, take the Epworth Sleepiness Scale. This will give a score for how sleepy you feel during the day. This is a good measurement to tell your doctor how tired you are, and gives real situations in which you may be feeling drowsy. I like the one on http://www.sleepdiso...m/epworth.shtml because it can be printed out and indicates potential sleep disorders based on your score. This should be enough to get your PCP to refer you to a sleep specialist, who can then dig deeper with you.
The reason I recommend taking and bringing in this test is because not a lot of physicians are educated about sleep disorders. I kept telling my physicians I was TIRED, and they'd always correct me and say I was FATIGUED and order bloodwork. Granted, it is important to check for iron deficiencies, thyroid problems, and other potential causes of fatigue.. but after 15 years of complaining, testing, and re-testing, no one ever thought to suggest a sleep disorder. If I would have known about this scale and would have brought it in, would have saved me a lot of headache and heartache.
I hope this suggestion helps.
Posted 08 September 2008 - 05:55 PM
As Kimberly said, only a sleep professional can diagnose you, but she is right on the mark in terms of her comments. What your describing certainly would make me think that you have some type of sleep disorder. Definitely follow Kimberly's advice. I would also add that if you can with your health insurance, try to get in to see a sleep doctor (usually a pulmonary specialist or a neurologist). You will have a much better chance with one of those than with a GP. Good luck, and I hope you get a diagnosis quickly.
Posted 08 September 2008 - 07:44 PM
A good approach is looking up a sleep lab at http://www.sleepcenters.org/ (American Academy of Sleep Medicine's website). Each lab will have the name of a Medical Director. This is the doctor in charge of the sleep center. Use those names to see if any of them are on your insurance.
Mike M is right -- they are normally either Pulmonologists or Neurologists. Pulmonologists obviously focus on Sleep Apnea whereas Neurologists would have more to do with Narcolepsy, BUT -- if they are a Diplomate of the American Board of Sleep Medicine, it doesn't matter what their specialty is as they will have completed education about all sleep disorders. I saw a Pulmonologist at first because he is the doctor I was referred to -- once I learned of a Neurologist in my area I switched to him and am happier with my care.