Know How Our iCliniq Doctor Helped a Patient Who Used to Doze Off While Driving

A 27-year-old female sought consultation from our iCliniq doctor, reporting a concerning issue of randomly falling asleep during the day in the past month. She mentioned having no trouble sleeping at night but struggled to stay awake during the day. She expressed concern about her driver's license being seized as she dozed off multiple times while driving, and this even happened while showering. She disclosed that she had visited the emergency room where some tests were conducted. Additionally, she informed the doctor that she was currently taking antidepressants and wanted the doctor's opinion.

Upon analyzing the patient's symptoms, our iCliniq doctor suspected that she might be suffering from narcolepsy, a neurological disorder that affects the ability to stay awake and fall asleep. The doctor enlightened the patient that narcolepsy often presents with excessive daytime sleepiness, leading to sudden and uncontrollable sleep episodes in various situations. The exact cause of narcolepsy is not fully understood, but it is believed to involve a deficiency in the brain chemical hypocretin, likely due to an autoimmune reaction. There are several potential triggers for narcolepsy, including depression, thyroid hormone dysfunction, past infections like the swine flu, hormonal changes, sleep disorders (sleep apnea or restless leg syndrome), certain medications, and a history of drug abuse. To explore potential underlying causes, the doctor recommended investigations such as a polysomnogram, multiple sleep latency tests, thyroid function tests, a complete blood count (CBC), and random blood sugar (RBS) test.

The doctor emphasized that while there is no cure for narcolepsy, lifestyle modifications could help manage its symptoms. These modifications included scheduling brief daytime naps of 10 to 15 minutes, consuming smaller meals more frequently, maintaining a consistent exercise routine, adhering strictly to a sleep schedule, avoiding smoking and alcohol consumption, and considering certain medications like stimulants, antidepressants, and wakefulness-promoting agents to alleviate the symptoms of narcolepsy. He also advised the patient to consult a neurologist for further evaluation and management.

The patient reverted and expressed concern about her ADHD (attention-deficit or hyperactivity disorder) diagnosis and wondered if it could be related to her current issue.

In response, the doctor informed her that there is a significant association between narcolepsy and ADHD, with evidence suggesting shared genetic links between the two conditions. Individuals with ADHD may experience daytime sleepiness due to poor sleep, which overlaps with the clinical features of excessive daytime sleepiness and sleep disturbances in narcolepsy patients. Moreover, narcolepsy is more commonly found in individuals with ADHD (15 to 30 percent) than in the general population. Consequently, the treatment approach for both conditions may overlap, and medications commonly used for treating excessive daytime sleepiness in narcolepsy, are also utilized for managing ADHD.

The patient expressed gratitude and satisfaction with the doctor's prompt and comprehensive response. She assured the doctor that she would diligently follow the suggested lifestyle modifications and seek further consultation with a neurologist as advised.