Re-Awakenings
November 22, 2012 10:38 AM Subscribe
Anna Sumner’s craving for sleep began when she was an 18-year-old high school senior. She thought nothing of it.
When it followed her to college, she blamed it on stress. She was working so hard, she told herself, her body just needed the extra rest. But it was more than that. She would chose naps over eating lunch, working out, or being with friends. Every night after dinner, she came back to her dorm room to sleep. If her parents called on those evenings, her roommate would cover for her, telling them she had gone to the library.
Really interesting, thanks.
I could certainly believe that there's an endogenous benzodiazepine or other sleep enhancer. The fatigue that follows surgery and is typical of certain chronic diseases doesn't make much sense otherwise.
posted by Orange Pamplemousse at 11:17 AM on November 22, 2012 [1 favorite]
I could certainly believe that there's an endogenous benzodiazepine or other sleep enhancer. The fatigue that follows surgery and is typical of certain chronic diseases doesn't make much sense otherwise.
posted by Orange Pamplemousse at 11:17 AM on November 22, 2012 [1 favorite]
Yeah, definitely read the comments for once. What a great article, thank you so much for posting it.
posted by KathrynT at 11:35 AM on November 22, 2012
posted by KathrynT at 11:35 AM on November 22, 2012
Wow--this is one of those links that makes MeFi one of the reasons I read it every day.
posted by rmhsinc at 12:27 PM on November 22, 2012 [2 favorites]
posted by rmhsinc at 12:27 PM on November 22, 2012 [2 favorites]
What is impressive is that she still managed to become a lawyer and get a job at a prestigious law firm.
posted by Ad hominem at 12:44 PM on November 22, 2012 [9 favorites]
posted by Ad hominem at 12:44 PM on November 22, 2012 [9 favorites]
I read this while thinking about taking a nap. Maybe I should sit up instead! I was plagued by sleep disorder most of my life (non 24-hour sleep wake disorder, finally pretty much fixed just a few years ago when I got treatment for bipolar disorder), so I know how much having wack sleep can interrupt your life. Really interesting read!
posted by whitneyarner at 12:46 PM on November 22, 2012
posted by whitneyarner at 12:46 PM on November 22, 2012
At first I thought this post was going to be about Klein-Levin syndrome, which was just in the news the other day. During a KLS episode patients sleep for 16+ hours a day for weeks at a time, and even their waking periods are basically in a fugue/sleepwalking state.
posted by sevenyearlurk at 1:00 PM on November 22, 2012
posted by sevenyearlurk at 1:00 PM on November 22, 2012
I made similar rationalizations about being stressed out in my second year of grad school causing me to be exhausted. It turned out I had recurring acute phases of Infectious Mononucleosis (the stress likely kept me from getting enough rest and shaking the virus like a normal and healthier person would have). I only got the correct diagnosis from the University Medical Clinic when the throat infection got so bad I needed steroids to be able to breath and swallow (Note to others: It turns out continuity of care would have helped - the clinic had rotating doctors and I never saw the same doc twice. In the end I did however become an interesting teaching case as they brought every training doctor in the clinic in to see my clinically interesting manifestation of a severe I.M. throat infection).
posted by srboisvert at 1:04 PM on November 22, 2012 [1 favorite]
posted by srboisvert at 1:04 PM on November 22, 2012 [1 favorite]
This research has great personal interest for me. I've been disabled by profound fatigue associated with various autoimmune diseases for almost 20 years. I've tried so many different medical and other approaches to find some relief, with no result that could be called success. Then I had my gallbladder out a few moths ago, and starting later on the day of the surgery WOW I felt AWAKE in my head for the first time in longer than I could remember. (Previously.) It lasted for a good (very good) 6 - 8 weeks, then faded away. It had to have been an effect of some medication they gave me during the surgery (I'm pretty sure they gave me some sort of benzo -- maybe followed by flumazenil to reverse it?). I'm waiting to get my medical records to find out exactly what they used, and I'm desperately hoping that it's something I can get more of. The improvement in my quality of life was astounding, and I want it back.
The more these "anecdotes" get discussed, the greater the chance that serious research will follow. Drug companies could be making big money, and people like me could be earning a salary instead of collecting disability. Go, science!
posted by Corvid at 1:10 PM on November 22, 2012 [11 favorites]
The more these "anecdotes" get discussed, the greater the chance that serious research will follow. Drug companies could be making big money, and people like me could be earning a salary instead of collecting disability. Go, science!
posted by Corvid at 1:10 PM on November 22, 2012 [11 favorites]
Great article. I did take a nap after reading it.
Most adolescents go through a phase of needing more sleep don't they?
In Sumner's case it's almost as if the negative feedback signal saying 'OK that's enough with all the sleeping already!' was never given or never received and she just continued to sleep more and more.
Benzodiazipenes are taken to control seizures, and flumazenil, a benzodiazipene receptor blocker and the drug that woke Sumner up, has seizures as a side effect, so it's tempting to guess that she may have had an underlying seizure disorder, and that the extra sleep needs of adolescents in general have to do with controlling a greater tendency to have seizures then-- and it is the time many people with seizure disorder experience the onset.
posted by jamjam at 1:19 PM on November 22, 2012 [3 favorites]
Most adolescents go through a phase of needing more sleep don't they?
In Sumner's case it's almost as if the negative feedback signal saying 'OK that's enough with all the sleeping already!' was never given or never received and she just continued to sleep more and more.
Benzodiazipenes are taken to control seizures, and flumazenil, a benzodiazipene receptor blocker and the drug that woke Sumner up, has seizures as a side effect, so it's tempting to guess that she may have had an underlying seizure disorder, and that the extra sleep needs of adolescents in general have to do with controlling a greater tendency to have seizures then-- and it is the time many people with seizure disorder experience the onset.
posted by jamjam at 1:19 PM on November 22, 2012 [3 favorites]
Fascinating article. Thanks, latkes!
posted by Sidhedevil at 2:52 PM on November 22, 2012 [1 favorite]
posted by Sidhedevil at 2:52 PM on November 22, 2012 [1 favorite]
Good post.
posted by Pruitt-Igoe at 4:00 PM on November 22, 2012
posted by Pruitt-Igoe at 4:00 PM on November 22, 2012
Huh, this is actually relevant to me. I'm sleeping 10-12 hours a day minimum and in trying to reset my sleep schedule yesterday just slept 15 hours instead. I'm pretty constantly tired to the point where they've thought I had mono a few times, but nope, just 'probably a virus or two making you tired.'
I hope they do more research on this.
posted by OnTheLastCastle at 7:23 PM on November 22, 2012
I hope they do more research on this.
posted by OnTheLastCastle at 7:23 PM on November 22, 2012
interesting... full disclosure I work for a site that is a former subsidiary of Roche and this particular episode was an item of minor interest awhile back before we were divested. Of course it was not subject for public discourse until this study was published owing to legal / confidentiality issues.
I do wish there were better background data / more support for this research because until/unless a specific molecule is isolated and more robust proof is demonstrated for whatever peptide causes this effect, I just don't know that there will be much interest or support in producing the antidote. The site I work for is a manufacturing site in fact, and while it sounds mercenary and uncharitable (and it is) it is simply cost prohibitive to put a major manufacturing train the size of ours into production for something that has little to no effective market value.
posted by lonefrontranger at 7:43 AM on November 23, 2012 [1 favorite]
I do wish there were better background data / more support for this research because until/unless a specific molecule is isolated and more robust proof is demonstrated for whatever peptide causes this effect, I just don't know that there will be much interest or support in producing the antidote. The site I work for is a manufacturing site in fact, and while it sounds mercenary and uncharitable (and it is) it is simply cost prohibitive to put a major manufacturing train the size of ours into production for something that has little to no effective market value.
posted by lonefrontranger at 7:43 AM on November 23, 2012 [1 favorite]
Thank you for sharing. I've passed it onto a friend who suffers from this.
posted by photojlisa at 7:50 AM on November 23, 2012
posted by photojlisa at 7:50 AM on November 23, 2012
This is relevant to me, too. I also have the agony of insomnia, partially resulting for worrying about the fact that once I do fall asleep, I'll then sleep for about eight hours.
Unfortunately, there's very little sympathy amongst friends and co-workers, who all assume that it's just laziness on my part.
posted by The Sprout Queen at 12:41 PM on November 23, 2012
Unfortunately, there's very little sympathy amongst friends and co-workers, who all assume that it's just laziness on my part.
posted by The Sprout Queen at 12:41 PM on November 23, 2012
Just signed up for an account to thank you for posting this. Sumner's problems sound eerily familiar for someone close to me, and it's good to have something other than "It's narcolepsy, take Ritalin" that I can research about it.
posted by markslack at 7:41 AM on November 26, 2012 [1 favorite]
posted by markslack at 7:41 AM on November 26, 2012 [1 favorite]
Modulation of Vigilance in the Primary Hypersomnias by Endogenous Enhancement of GABAA Receptors
The biology underlying excessive daytime sleepiness (hypersomnolence) is incompletely understood. After excluding known causes of sleepiness in 32 hypersomnolent patients, we showed that, in the presence of 10 μM γ-aminobutyric acid (GABA), cerebrospinal fluid (CSF) from these subjects stimulated GABAA receptor function in vitro by 84.0 ± 40.7% (SD) relative to the 35.8 ± 7.5% (SD) stimulation obtained with CSF from control subjects (Student’s t test, t = 6.47, P < 0.0001); CSF alone had no effect on GABAA signaling. The bioactive CSF component had a mass of 500 to 3000 daltons and was neutralized by trypsin. Enhancement was greater for α2 subunit– versus α1 subunit–containing GABAA receptors and negligible for α4 subunit–containing ones. CSF samples from hypersomnolent patients also modestly enhanced benzodiazepine (BZD)–insensitive GABAA receptors and did not competitively displace BZDs from human brain tissue. Flumazenil—a drug that is generally believed to antagonize the sedative-hypnotic actions of BZDs only at the classical BZD-binding domain in GABAA receptors and to lack intrinsic activity—nevertheless reversed enhancement of GABAA signaling by hypersomnolent CSF in vitro. Furthermore, flumazenil normalized vigilance in seven hypersomnolent patients. We conclude that a naturally occurring substance in CSF augments inhibitory GABA signaling, thus revealing a new pathophysiology associated with excessive daytime sleepiness.
Here is the actual paper, if anyone would like a copy feel free to MeMail me with an email address I can send a PDF to and a promise not to distribute it. For the purposes of this academic discussion we are having of course.
posted by Blasdelb at 5:52 AM on November 27, 2012 [1 favorite]
The biology underlying excessive daytime sleepiness (hypersomnolence) is incompletely understood. After excluding known causes of sleepiness in 32 hypersomnolent patients, we showed that, in the presence of 10 μM γ-aminobutyric acid (GABA), cerebrospinal fluid (CSF) from these subjects stimulated GABAA receptor function in vitro by 84.0 ± 40.7% (SD) relative to the 35.8 ± 7.5% (SD) stimulation obtained with CSF from control subjects (Student’s t test, t = 6.47, P < 0.0001); CSF alone had no effect on GABAA signaling. The bioactive CSF component had a mass of 500 to 3000 daltons and was neutralized by trypsin. Enhancement was greater for α2 subunit– versus α1 subunit–containing GABAA receptors and negligible for α4 subunit–containing ones. CSF samples from hypersomnolent patients also modestly enhanced benzodiazepine (BZD)–insensitive GABAA receptors and did not competitively displace BZDs from human brain tissue. Flumazenil—a drug that is generally believed to antagonize the sedative-hypnotic actions of BZDs only at the classical BZD-binding domain in GABAA receptors and to lack intrinsic activity—nevertheless reversed enhancement of GABAA signaling by hypersomnolent CSF in vitro. Furthermore, flumazenil normalized vigilance in seven hypersomnolent patients. We conclude that a naturally occurring substance in CSF augments inhibitory GABA signaling, thus revealing a new pathophysiology associated with excessive daytime sleepiness.
Here is the actual paper, if anyone would like a copy feel free to MeMail me with an email address I can send a PDF to and a promise not to distribute it. For the purposes of this academic discussion we are having of course.
posted by Blasdelb at 5:52 AM on November 27, 2012 [1 favorite]
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