Neurologist: Daytime Sleep Disorder Disrupts Lives

Jan. 2, 2013

David RyeEmory researchers have discovered that many adults with an elevated need for sleep have a substance in their cerebrospinal fluid that acts like a sleeping pill and leads to a condition called primary hypersomnia (also referred to as hypersomonolence). David Rye, professor of neurology at and director of research for Emory Healthcare’s Program in Sleep, published the results of a study evaluating a promising drug therapy for hypersomnolent patients in the journal Science Translational Medicine.

Individuals with the condition may sleep more than seventy hours a week yet still have difficulty awakening and staying alert. Their condition often interferes with work or school attendance. Conventional treatments, such as stimulants, rarely help, according to an Emory News Center article.

“These individuals report feeling as if they’re walking around in a fog — physically, but not mentally awake," Rye said. “When encountering excessive sleepiness in a patient, we typically think it’s caused by an impairment in the brain’s wake systems and treat it with stimulant medications. However, in these patients, the situation is more akin to attempting to drive a car with the parking brake engaged. Our thinking needs to shift from pushing the accelerator harder, to releasing the brake.”

The work of Rye and his colleagues is also the focus of a December 11 Wall Street Journal article, where Rye said in an interview that the condition “tends to hit people in their young, formative years when they are trying to get started in a profession or having a family. A lot of them get dismissed as lazy, or as drug seekers.”

Study co-author Andrew Jenkins, assistant professor of anesthesiology, told the WSJ that researchers now understand that the condition “is something real. We know why you’re sleepy—your brain is sedating itself.”

In their study of seven hypersomnolent patients, the researchers found that treatment with the drug flumazenil can restore alertness, although the agent’s efficacy was not uniform for all seven subjects.

“Previous studies with flumazenil indicate that it does not have a wake-promoting effect on most people, so its ability to normalize vigilance in this subpopulation of extremely sleepy patients appears genuinely novel,” Rye told the Emory News Center. 

To read the article on the Emory News Center, click here.

To read the Wall Street Journal article, click here.

To read study abstract, click here.

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