Psychiatry & Psychology--General/hypersomnia


Thanks for taking your valuable time to help on this board.

I'm a 56-yo, with a diagnosed anxiety disorder for eight years, Rx's fluoxetine 40 mg/day and it is working well for anxiety. Because of issues with trouble falling asleep, he also Dx'd zaleplon 10 mg, which I usually take each night. I am careful not to over do any drugs-- I try to go without zaleplon if at all possible. I am at my internist's idea of optimal weight, and I work out regularly. In short, I'm pretty healthy overall. Nor do I drink more than one bottle of wine per week if at all, or smoke.

The problem is that I seem to go through periods of hypersomnia. Last night and today were somewhat typical: Fall asleep at 11 or so, wake up around 4:30, unable to sleep, get up, do some work, and then have to go back to sleep at 6:30 (no zaleplon needed). Sleep til 9:30, difficulty waking. Force myself to get up, do some work, then need to take a two hour nap (no zaleplon), waking again with difficulty, feel a bit headachey for the rest of the day.

This sleepiness can make driving dangerous for me. If I feel it coming on, I need to stop driving, but it is not sudden.

I do use a CPAP (Dx'd with apnea two years ago), but it does not seem to help. Eventually the problem seems to peter out, and I go along fairly well without all this daytime sleepiness. This takes about a month or six weeks.

All that having been said, my question is: Could this hypersomnia simply be an aspect of my diagnosed depression?

Thanks again for your expertise.

Yes, it is probably a type of cycle your depressive disorder goes through. Depressions tend to cycle.  My suggestion is that you simply set a specific sleep cycle: go to bed at 11pm (or whatever) and stay in bed for eight hours.  Do not get up if you wake; just close your eyes and stay there.  Get out of bed eight hours after you got into bed, no more, no less, and then do not go back to be until the next night (no naps).  That should shorten the problem.

Psychiatry & Psychology--General

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Daniel S. Harrop, M.D.


Dr. Daniel S. Harrop received his B.A. and his M.D., both from Brown, and his M.B.A. from the Edinburgh Business School, Scotland. Board-certified in adult and geriatric psychiatry, he is a past president of the R.I. Psychiatric Society and a member of the Committee on Medical Quality of the American Psychiatric Association and the Committee on Continuing Medical Education of the R.I Medical Society. He serves as a consultant to four of the top five major medical management companies, including OptumHealth/United Healthcare, Magellan Behavioral Health Services, ValueOptions and APS Healthcare, and maintains a private practice in Providence, R.I. He also serves as chief psychiatric consultant on the Medical Advisory Board at the R.I. Workers Compensation Court. He was formerly on the faculty at the medical schools at both Brown University and Harvard University.

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