Hypersomnia

[evbirch]

. . .

[katcw]

I have no idea, but thought I'd answer to bump this up toward the top. Good luck with this!

[JohnBFisher]

... The study shows that I entered REM sleep within one minute of laying down for these naps - which the Doc said is typically thought of as "impossible." ... The report lists "severe objective hypersomnia." ... My doctor seemed really pleased to have made this diagnosis, but doesn't seem to be very interested in doing anything about it.

I don't have hypersomnia, but I wonder ... Mind if I ask some questions?

• Do you sometimes feel physically weak when confronted with strong emotions?
• Do you sometimes feel physically weak when someone or something surprises / startles you?
• Do you sometimes feel paralyzed when you fall asleep or wake up?
• Do you sometimes briefly dream even while awake, such as when things are quiet and you blink and briefly dream?

You've allready mentioned the Excessive Daytime Sleepiness (EDS). So, if any of the others are true, you might want to look at the following information on narcolepsy:

http://www.webmd.com/sleep-disorders/guide/narcolepsy
http://med.stanford.edu/school/Psychiat ... ptoms.html
http://www.nhlbi.nih.gov/health/dci/Dis ... _what.html

EDS and going into REM state upon faling asleep (rather than the normal sleep cycle) are indications of narcolepsy. You might want to discuss this with your doctor. Or you might want to find a board certified sleep specialist who is also a neurologist.

Hope that helps.

[old64mb]

Two things.

I'd point out this quote:

I occasionally take "breaks" on the weekends if my skin is bothering me

You can't, simply can't, take breaks. Your CNS doesn't know that you're on a weekend. It only knows that you're being stressed to the point of causing massive disruption elsewhere in your body, and by continuing to take breaks you never allow it the time to finally recover.

Second, based on your posts you have a very, very complex set of sleep disorders between restless legs and hitting REM within a minute of falling asleep. You've already gone through one set of surgeries and started taking some very strong stuff for the RL. It is zero surprise that you have EDS, since your sleep is ineffective in actually restoring your body for the day.

I strongly suspect your doctor is out of their league on this one, and the next step will be Provigil or Nuvigil, which will almost certainly help the symptoms but won't do a thing for the causes. I'd also point out that you're using about as basic a model of CPAP there is out there (along with only a nasal mask), which may be part of it.

I'll trump the suggestion for finding a new sleep doctor. If you're in the Northwest, find out if your insurance will cover you in coming down the coast to Stanford. Not that long or expensive a trip, and you've got enough things wrong with you that if they can't figure out what's the underlying issue, no one can.

[evbirch]

Thanks for the responses.

old64mb - I've actually quit doing the "breaks" from CPAP. This board has been really helpful for me, especially in helping reinforce the importance of wearing CPAP every night. I think that you could be right about my doc being out of his league. He is very focused on apneas, and I think that anything else is at the very least, less interesting to him. I'm going to see if there are any specialists in my area.

JohnBFisher - I've read through the info on narcolepsy and some, but not all applies to me. I'm going to keep looking into this.

Thanks again.

[yasulh]

The study shows that I entered REM sleep within one minute of laying down for these naps - which the Doc said is typically thought of as "impossible." The report lists "severe objective hypersomnia."

Your doc is a bit off in terms of what he thinks is impossible. In studies where participants were deprived of REM sleep for a long period of time, the participants later entered REM sleep almost immediately after falling asleep. It is research that has shown us that our body actually needs REM sleep, but may also help explain what is happening to you. It may be that when you sleep your apnea is keeping you from getting REM sleep for long periods, causing your body to try to recover those needed episodes of REM.

[Muse-Inc]

...participants...deprived of REM sleep for a long period of time...later entered REM sleep almost immediately after falling asleep...

The articles I've read say that for us hoseheads, this is a likely scenario. When our sleep has been poor and we miss regular REM, esp in the early part of sleep, if we wake up later and then fall asleep we almost invariable immediately enter REM. Sounds like your therapy needs ajustment of some sort to enable you to start getting restful sleep. With so many things going on, it sounds like a visit to a large sleep research center might be order to discover what's really going on and charting a course forward tackling each separate issue.

[kteague]

I'd consider what the study results were the night preceding the naps test (MSLT). Some of the MSLT results' legitimacy hinges on it following a reasonably decent night's sleep. Ideally the MSLT is not done on one who is sleep deprived, but on one who gets good sleep but is still sleepy during the day.