Sleepiness in daytime

Chief Complaint A 67 yo female came with the complaint of the feeling of sleepiness in daytime and fell asleep 6-7 times a day due to which she is not able to sleep properly at night. She also had involuntary arm movements in sleep. History She is diabetic and has h/o Htn and scatica. She has h/o backache. She also complaints of weakness in his legs and arms. Examination She is a lean female and physical examination was normal. Treatment What is your opinion on the case?


Investigation ruteen with b12 d3.. Control dm HTN and back pain Then Bramhi vati Sarasvatarishta Shirodhara and katibasti

Hypersomnolence/Narcolepsy Dd. Hyponatremia Hypothyroidism Chronic debilitating diseases.. diabetes.. renal impairment... IHD Cortical atrophy. Sug. Serum sodium.. potassium.. bicarb... chloride Tfts Glycemic status Ecg Urine re.. acr.. BUN.. s. Creat. Ct. Brain.

Here are differentials DM with DKA Hypothyrodism Hyponatremia Narcolepsy Alzemers diease

Hypersomnia in this case may be due to chronic hypoglycemia . Need to check BSF and PP and HbA1c. Other general causes are Hypothyroidism OSA Chronic nocturnal insomnia,and hypnotic drug abuse . Narcolepsy 3red ventricle tumour , pituitary tumors Need investigations, including polysomnography.

Rule out organic disorders like Electrolyte disturbances Hypothyroidism Alzheimer's disease Uncontrolled DM and Hypertension. Auto- brewery syndrome If above disorders are ruled out It is a case of NARCOLEPSY without catapexy . Treatment is CNS stimulants like Amphetamine Dextroamphetamine Modafinil A newer drug - Solriamfetol is promising


Tnx Dr Shivraj Agarwal sir

Diabetic PT with sleep apnea. At night time, sarpghanda vati,Brahmi vati, tab mentaid, saraswatarisht, helpful. In daytime, medication,yoga, Pranayam helpful.with a control at Diabetes and other ailments..

Diabetic pt c/o sleepiness Hyperkalemia/hyponatremia Electrolyte imbalance need to r/o DKA Secondaly hypothyroidism Yes sleep apnoea also to be r/o just check sp02 pt may be hypoxic

Thanx dr Kute Ankush

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Sleep Apnea I think shirodhara is best for this condition. And avoiding vatakar ahar vihar. Pranayama and asana like sarvangasan, halasan are good.

Thyroid function hb electrolytes and blood sugar

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