Q:  Hypersomnia & Bipolar Disorder

I am 32 years old and I have been diagnosed with Adult ADD & Bipolar Disorder.  Not so much the manic depression, I simply never have the "highs".  I have a terrible time with wanting to sleep all of the time (the term I was given hypersomnia).  I take Trileptal 300mg, Zoloft 50mg and was changed from Adderal XR 30mg to Provigil 200mg.  I do feel awake until late in the afternoon but I still lack a major energy so to speak to do my everyday house hold chores.  I don't feel as "flat" as before but I still feel that this has to get better eventually?  Any helpful hints? 
 

Dear Melissa -- 
Hypersomnia is an unusual finding, in my experience -- unless a person is in a relatively "pure" bipolar depression.  That kind of depression is very often accompanied by a person's wanting to sleep all the time:  12, 14, 16 hours in every 24.  If there is a depression, quite severe, that goes with this, then I recognize it, and would focus on treating the depression expecting the sleep part to resolve as the depression improved.  

But if there is no depression to go with the sleep problem you describe, that seems a bit odd to me.  Without knowing anything else about you, I'd be wondering what else might be going on that might relate to this sleep thing.  (For example, does this warrant a sleep specialist evaluation -- which you may already have had -- and possibly a sleep-lab evaluation? Don't go telling your doc' that an internet source said you should have a sleep study now; I know you wouldn't do that.  But if you haven't had that, you could gently wonder aloud if that might be warranted.  There could be good reasons not to go that route, though.)  

Dr. Phelps

Published September, 2005