Help for Chronic Sleepiness
Judging by the number of coffee cafes lining the streets in cities everywhere, it appears most people crave stimulation. They want a caffeine kick to wake them up. For the average person, a grandé latte will do the job, but there are some who can't wake up no matter how much caffeine they imbibe, no matter how much sleep they get at night, no matter what they eat or do.
There are many possible reasons for chronic sleepiness, ranging from Lyme Disease to narcolepsy to something called "hypersomnia." Hypersomnia differs from narcolepsy in that those who have the condition don't necessarily fall into deep sleep in the middle of conversation, as narcoleptics typically do, but rather, the hypersomniac stays half asleep all day. Those with hypersomnia tend to snooze for excessive hours--at least 70 hours a week and often far more--and then when they wake up, they feel like they haven't slept at all.1 Unlike Lyme Disease or Chronic Fatigue, hypersomnia doesn't necessarily involve other symptoms. Still, the condition is debilitating enough to prevent victims from holding down jobs or even enjoying normal relationships.2
Until now, nothing has been particularly helpful to people suffering from chronic sleepiness. The usual anti-sleep drugs and cures simply don't work, but a breakthrough just published in the journal Science Translational Medicine presents a possible fix. It turns out that a neurotransmitter called GABA, which tamps down brain activity, has an exaggerated effect in people who have hypersomnia. We all need GABA to keep us from being hyperactive, and in fact, some people take GABA supplements to help them sleep or to control anxiety. GABA supplements also may help control epileptic seizures and hypertension.3 But all things in moderation. It turns out that those suffering from hypersomnia have an abnormal protein in their cerebrospinal fluid that enhances the effects of GABA to double its influence. The scientists haven't yet figured out exactly what that protein is.
What the scientist do know is that the protein amps up GABA to cause the stupor-like state described above. "In some of the more severely affected patients, we estimated the magnitude of the GABA-enhancing effect as nearly equivalent to that expected for someone receiving sedation for outpatient colonoscopy," said study director Dr. David Rye of Emory University Medical School. "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."
To "release the brake," Dr. Rye's research team chose to forego the traditional method of stimulating the hypersomniac patients, which never works anyway, and instead provided the subjects with a drug called flumazenil, known to combat the effects of benzodiazepines. Benzodiazepines are a class of sedative drugs that includes Valium and Ambien. Flumazenil isn't a stimulant and has no stimulant effect on normal people--but apparently, it sure has an antidote effect on GABA. All but one of the patients said they felt better after getting treated with flumazenil. They also performed perfectly on psychomotor responsiveness tests.
"I feel alive," one of the patients apparently remarked in tears after receiving the drug.
The researchers subsequently withheld the drug from the subjects and the Rip Van Winkle effect returned. When the drug was re-administered, the patients again felt alert.
Unfortunately, though, as with most things pharmaceutical, there's a dark side to this sunny success story. Flumazenil has side effects ranging from the merely annoying to the disturbingly serious.4 In 11 percent of patients, the drug causes nausea and vomiting. Up to nine percent suffer from dizziness, sweating, headache, and visual disturbances. Others report nervousness, palpitations, insomnia, vertigo, confusion, arrhythmias, cardiovascular events, and panic attacks. The drug may induce seizures, psychosis, respiratory depression and even lead to the not so minor side effect--death. Also, as of now, flumazenil has to be administered intravenously and some experience pain at the injection site.
But in spite of the risks it brings, the drug may seem like a lifeboat for those who haven't felt awake for years. On the other hand, how much better it would be to find a more natural way to help your body rebalance itself-- that can do the same thing as flumazenil, without all the health-compromising effects. It's also probably worth noting that the although whole tea is a GABA enhancer, the primary antioxidant in green tea, EGCG, is a GABA inhibitor5 -- as is coffee extract.6 If you're one of the rare individuals who suffers from hypersomnia, it just may be worth a trip to the naturopath armed with this research. The same thing applies if you suffer from other conditions that also cause constant sleepiness--like chronic fatigue and Lyme's Disease. Theoretically, it's possible that the abnormal, GABA-enhancing protein also contributes to the exhaustion you can't shake. You also might want to check out things like making sure your room is completely dark when you sleep and make sure you don't watch TV or work on the computer just before bed as both activities disrupt sleep. For more on sleep disorders and natural remedies, click here.
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- 1. "Spinal Fluid Substance May Help Drive Sleep Disorder: Study" 21 November 2012. Health Day News. 21 November 2012. http://health.usnews.com/health-news/news/articles/2012/11/21/spinal-fluid-substance-may-help-drive-sleep-disorder-study
- 2. Gever, John. "Cause, Tx Found for Excessive Sleepiness."21 November 2012. Med Page Today. 21 November 2012. http://www.medpagetoday.com/PrimaryCare/SleepDisorders/36063
- 3. "Gaba." Health Vitamins Guide.com. 20 November 2012. http://www.healthvitaminsguide.com/aminoacids/gaba.htm
- 4. "Flumazenil Side Effects" Drugs.com. 21 November 2012. http://www.drugs.com/sfx/flumazenil-side-effects.html
- 5. Hossain SJ, Hamamoto K, Aoshima H, Hara Y. "Effects of tea components on the response of GABA(A) receptors expressed in Xenopus Oocytes."J Agric Food Chem. 2002 Jul 3;50(14):3954-60. http://www.ncbi.nlm.nih.gov/pubmed/12083865
- 6. Hossain SJ, Aoshima H, Koda H, Kiso Y. "Effects of coffee components on the response of GABA(A) receptors expressed in Xenopus oocytes." J Agric Food Chem. 2003 Dec 17;51(26):7568-75. http://www.ncbi.nlm.nih.gov/pubmed/14664509