Do I have narcolepsy, insomnia, both or neither?
October 26, 2006 2:06 PM   Subscribe

Can I have narcolepsy and insomnia, or am I just another cad with cyberchondria?

Ever since I can remember, at least as far back as when I was 7 years old (now 25), I've had trouble with sleep.

In college I talked to psychology professors, a counselor and had a session with a clinical psychiatrist at the hospital. The answers were across the board. Here are the symptoms I have:

1. When I do sleep I immediately begin dreaming, even if I only doze off for a minute. Often I can have a dream that seems to take hours within a 30-second nod-off.

2. My dreams are extremely vivid and easily remembered. I can read and feel pain in my dreams. They are in color and have tastes and smells (not sure about proprioception). They range from surreal (experiencing sensory input from two people at once, dying multiple times) to so mundane yet believable that I confuse them with memories of what happened the day before.

3. I almost never feel "tired", but I also rarely feel rested. I have accidentally stayed up through the night on various occasions when I get involved with a book, project or interesting train of thought. I seem to either be awake or exhausted to the point of passing out.

4. When I was younger I was unable to quiet my mind enough to fall asleep and would stay up for multiple days, sometimes experiencing blackouts/sleepwalking/fugues or mild hallucinations. These are less common now.

5. I don't often get cataplexy, but sometimes I do feel weak and it is difficult to move. These are very rare (half dozen times a year), however, which makes me question the narcolepsy angle.

6. My friends have always found in funny how the more stressful the situation, the calmer I seem. Even though I can be extremely anxious, the more agitated I get the more I slouch move slower, etc. The first time I got pulled over for speeding I inexplicably fell asleep as the cop was checking my license and registration in his car (this looked bad). It has not happened before or since, and I have been in various high-stress situations.

7. I only sleep 4-6 hours a night, not because I wake up repeatedly, but because I have difficulty falling asleep. Once asleep, however, I am dead to the world.

8. I often have trouble remembering the first half-hour after waking. I can get ready for work and talk to my wife in this time, but an hour later I can recall none of it.

9. I rarely take naps because when I do I almost alway experience sleep paralysis, which is very unpleasant.

10. I feel like I am going to pass out shortly after lunch. I do not have this feeling at any other time of the day. I worked second shift for a while, thinking I was merely a night owl, but my symptoms were the same.

11. The only time I feel really rested an aware for a full day is when I have drank large amounts of alcohol the previous night. I do not get hangovers, or, if I do, I sleep through them. My non-medical opinion is that the alcohol suppresses my REM sleep, but I don't know if this is true.

12. I do not have micro-sleep or pass out for no reason many times a day, as is illustrated by Hollywood versions of narcolepsy.

13. Finally, the reason the various "experts" were confused is because I may or may not have bipolar disorder. My mother has it, and I seemed to have symptoms, but neither I nor the psychiatrist were able to decide if the mania caused the insomnia or vice-versa. I do have bouts of depression, but again cannot figure out if it is cause or effect.

Am I crazy? Or just crazy for thinking I am?
posted by JeremiahBritt to Health & Fitness (8 answers total) 1 user marked this as a favorite
You say you've been to a psychiatrist, but have you had a sleep study done? They'll monitor your brainwaves in your sleep to see if you're really hitting REM in the first few minutes (which I think means you're sleep deprived, although the narcolepsy guy's gone for the day and I can't ask him to confirm that.) There's a lot of varieties of disorganized sleep and they might be able to help diagnose you. It can't hurt, after all.
posted by cobaltnine at 2:37 PM on October 26, 2006

I was just diagnosed with narcolepsy based only on a sleep study's findings that I also go into REM immediately after falling asleep.

I don't know whether you can mix insomnia with narcolepsy, and I don't know what causes all of your symptoms, but according to my doctor, if you've had a sleep study that shows you're in REM just minutes after falling asleep, you qualify as narcoleptic.
posted by booksandlibretti at 2:46 PM on October 26, 2006

Could your after-lunch feelings just be the afternoon slump? Always hits me around 2 or so.

About the dreaming... there's a video floating around from either the Air Force or NASA. If I remember correctly, it's an astronaut-in-training (or perhaps a test pilot) in a centrifuge. They spun him up so fast he blacked out. He was out for 15 seconds, tops, and he had a full dream during that time. So I don't think that's terribly unusual, either.

There's also been some studies done (no sources, unfortunately) that indicate the amount of sleep people need varies from person to person. I really need about 9 hours to feel rested; I had a professor who told me he slept 4 hours a night, tops.

I think you're right about the alcohol suppressing your REM sleep (another study I can't find the source to). However, suppressing REM usually causes people to feel more tired the next morning - it's the REM sleep that really rests you up.

Don't some people with sleeping problems get prescribed antidepressants? Have you tried that?

There's my Jeopardy education at work.
posted by backseatpilot at 4:07 PM on October 26, 2006

Some of your symptoms sound like narcolepsy to me - the lucid dreams, potential cataplexy attacks, trouble falling asleep... Get tested at a sleep clinic. They are the only ones who can confirm this or another sleep disorder. It's what they do.
posted by caution live frogs at 9:30 PM on October 26, 2006

Thanks. I have thought about a sleep clinic, but I wanted to make sure I just wasn't one of the millions of Americans who have run-of the mill trouble sleeping before I wasted my money and their time.

And no, I haven't tried antidepressants.
posted by JeremiahBritt at 9:41 PM on October 26, 2006

I can't offer help with the sleep issues, I just want to urge you to try your damndest to avoid a bipolar diagnosis. It's a label you certainly don't want to be stuck with for the rest of your life. I'm just a random guy on the Internets, but I don't see anything in what you've said that would indicate such a disorder.
posted by sgass at 5:10 AM on October 27, 2006

Sleep deprivation can cause behaviors that look like a whole range of mental illnesses. Definitely start with a sleep study and physical to look at the medical issues before you pursue psychiatric diagnoses. In fact, start with the physical, because diabetes is just one of the many things that could be causing all the symptoms you list. Sleep apnea could as well, so do both soon.
posted by Lyn Never at 6:24 AM on October 27, 2006

I don't have diabetes. I know this because I have to get regular full-blood work-up for Gilbert's Syndrome.

And yes, I know "meal related fatigue" is a symptom, but I do not get tired around breakfast or dinner, and can become drowsy in the afternoon even if I skipped lunch.

Looks like I'll have to see if my insurance covers a sleep study.
posted by JeremiahBritt at 8:23 AM on October 27, 2006

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