Hello,
Thank you for choosing DoctorSpring.
I have sought the opinion of a Sleep consultant Dr.Vivek Verma. ( We do not have full time on board Sleep Medicine Specialists )
As a first step, we would like to know some additional information from you :
1. I understand that this is a long term habit and concern. Recently was it like a recurrence ? Or has it been continuous from childhood ? Was there a break period without this compulsive sleeping habit ?
2. If you had to resists this sleep for a reason (for a social function as example ) do you feel sleepy ? Do you fall asleep in between ?
3. Do you wake up refreshed or tired in morning ? Do you snore ?
4. Are you excessively worried about anything at work / personally ? Is your mind pre occupied ?
5. Do you often feel depressed / blues ?
6. Do you find it hard to find pleasure in day to day activities and life in general ?
7. On normal work days you feel sleepy ? or compelled to sleep ?
You can reply as a follwoup
Thank you
Patient replied :
1) I have always slept a lot when circumstances allow - but it my adult years I would usually get up by noon - now it seems I can sleep all day.
2) If I have other things to do and I get up at like 7:00 a.m. I can go all day without being overly tired - I do not fall asleep during these occasions.
3)I never feel refreshed from my sleep - it's always tough to get out of bed - still feel tired/sleepy. I believe I do snore a lot.
4)I am under stress from a boss who bully's his staff - partially why I am on leave.
5) I do suffer from depression.
6) when and if I get out of bed a spend time with family there is great joy in it but generally I find these moments passing me by while I lay in bed.
7) on normal work days I perform my job and have no desire to have a nap or anything.
One other point is when I am sleeping all the time my body does get achy and I find my hands get tingly or like pins and needles as they call it.
Hello,
Thank you for the additional details.
We have analysed your medical history and your symptoms are NOT suggestive of any major sleep disorder. While the reason for prolonged sleep cycles in your younger age remains unclear, the current prolonged sleeps during break and holidays stem out as a manifestation of depression.
There are many characteristic signs which suggest your depressed mood as the cause for this sleep pattern. And you should address this seriously. As the first measure you need to bring up your spirits - yoga, music, exercise whatever works for you should be taken up.
This might not be enough unfortunately . A Behavioural therapy and anti depressant medication (like SSRI) has to be considered in consult with your Doctor. Do not bother about the sleep habits now. With medications and behavioural therapy you will feel improvement in 2-4 weeks. Once you start feeling better you should schedule activities for your break days (even household activities will do). This will keep you awake. And once the depressed mood is releived you will not find it hard at all.
Also a baseline blood tests, liver and kidney function test and a Thyroid function test is indicated if not done recently.
Hoper this helps
Feel free to ask followup / clarifications
Thank you
Patient replied :
Would a medication which I found called Armodafinil be appropriate for my situation?
Armodafinil in unlikely to work in your scenario. This is because your depressed mood will be masking any sleep disorder you are having. So it has to be unmasked to asses whether there is any sleep pattern disturbance. And most likely if your depressed mood is addressed you will not need any further benefit.
Armodafinil might give you a short term benefit, but the effects wont be long lasting or reproducible.
Hope this helps
Thank you