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Excessive day time sleepiness - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Excellent Posted in: Sleep Disorders
Answered by

General & Family Physician
Practicing since : 2009
Answered : 593 Questions
Doctor :   Hi,x
User :   Hi
User :   I am suffering from excessive daytime sleepiness
User :   20yr old male otherwise fit and well
User :   dont smoke or drink
Doctor :   Ok , since when do you have this problem ?
User :   6 months
Doctor :   Do you have adequate sleep in the night ?
User :   Yes 8 hours
User :   However I awake unrefreshed and drowsy - Althrough I never actually fall asleep
User :   It gets better throughout the evening
Doctor :   Did you mean that you get good 8 hour sleep in the night ?
User :   Yes I fall asleep straight away and do not wake up at all
User :   during the night
Doctor :   ok, Do you have any other symptom associated with drowsiness in the day time ?
User :   Breathlessness but this is minor
Doctor :   like fever , headache sweating
Doctor :   swollen lymph nodes anywhere in the body ?
User :   I sweat profusely and have done for a few years, this is treated with anyhydrol forte
User :   I also suffer from painless throbbing in the head
User :   No swollen lymph nodes at the moment
Doctor :   Well there are two main causes of somnolences
Doctor :   one commonest would be sleep deprivation in the night
Doctor :   and the second common is infection ( trypanosomiasis )
User :   I have seen an ENT surgeon who requested a home sleep study for sleep apnea
User :   however i wore this for three hours but took it off as it was uncomfortable
Doctor :   but you say you have good sleep in the nights ?
User :   The surgeon stated that it is unlikely that i have OSA but wished to rule it out anyway
User :   how likely is it that i have OSA considering I am fit and healthy and not everweight and have neck size of 13 inches?
Doctor :   then i do not think the home sleep study will pick any apnea
Doctor :   i would not consider a need to rule it out too
User :   I see - what other causes should I be looking at? Could an infection really last for six months?
User :   As I have no sleep deprivation at all
Doctor :   yes, there are fair chances for it to be an infection ,
Doctor :   i would consider to rule it out , as most of times the infection run chronically without much severity in symptoms
Doctor :   a simple blood smear test will help here
User :   Ok, most of my blood tests and biochemistry is normal.
User :   I have had two blood smear tests...
User :   The first showed atypical lymphocytes, target cells and stomatocytes, however this has since returned to normal with a clear second blood smear
User :   Everything else is normal except high unconjugated bilirubin
Doctor :   lymphocytes are characteristics of a chronic infection
Doctor :   it would be advisable for the smear test to be repeated again
Doctor :   if the second test too turns negative then the increased sleep in day can be attributed to low energy levels or other simpler causes like stress
User :   Ok should i be worried about more sinister causes
User :   And if it is an infection, will it go on its own eventually?
Doctor :   well if its an infection , cure is much available
Doctor :   there are medications which combat the infection
User :   How are infections normally diagnosed because as i said my blood tests have all been normal
Doctor :   the atypical lymphocytosis is one indirect sign of a chronic infection
Doctor :   a better or repeat smear study may pick the parasite
User :   Parasite?
Doctor :   the infective agent
User :   I see - I do not think that the doctors will do a repeat smear as my last one was clear
User :   I live in england and we are unable to request such tests
Doctor :   i agree , but try with another / new doctor
User :   Ok, otherwise will it go away on its own?
Doctor :   yes, it does some times but will take time
Doctor :   also other causes which affect the energy levels are also to be considered
User :   I don't really struggle with lack of energy, I can run for miles it's just a physical sense of drowsiness and a desire to sleep but if I tried to sleep I would be unable to in the daytime.
Doctor :   ok, try to get indulged in any physical activity
Doctor :   do not give it a chance to worsen by trying to sleep
User :   Ok, i try to excercise everyday but this is extremely difficult as it exacerbates the sensation.
User :   Should i be worried about more sinister causes
Doctor :   no , more sinster the cause more deprived of sleep you will be in nights
Doctor :   only cause you have to be concerned about is infection , rule it out
User :   I see - Since I didnt make it through the sleep study would it be appropriate to repeat it, or do you feel this is unnecessary?
Doctor :   i think its unnecessary
Doctor :   you would surely have felt the distorted sleep or any other symptom associated with nights sleep
User :   I see
Doctor :   only then the sleep study is conducted to outline the cause for it
User :   Ok, thankyou very much for your time
User :   It is much appreciated
Doctor :   You are welcome
Doctor :   Thanks for consulting me
Doctor :   Kindly provide your feedback
Doctor :   Bye for now
User :   Ok thankyou bye
Doctor :   take care
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