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What Causes Excessive Sleepiness And Tiredness?
Question: Hi Doctor
My mom is 90. 5 feet, 111 pounds. She has one kidney (works well.) Has CHF but controlled. Has a-fib (controlled). Daily--->She takes 12.5 mg of hydrochlorothiazide; 100 mg of metoprolol; 30 mg of nefidipine; 160 mg of Diovan (spread out during the day). her BP runs 140-160 over 49-55. She seems to be sleeping a lot (often after dinner but not necessarily then.)Im concerned that her diastolic number is too low and might be causing the sleepiness or lack of energy. She took Tenormin for years and the doc changed her to 50 metoprolol....then to 100 mg of metoprolol...... other wise she feels pretty good. Uses a walker. IF her BP rises, it is always the top number that might go up.What could be causing to the wanting to sleep a lot.
My mom is 90. 5 feet, 111 pounds. She has one kidney (works well.) Has CHF but controlled. Has a-fib (controlled). Daily--->She takes 12.5 mg of hydrochlorothiazide; 100 mg of metoprolol; 30 mg of nefidipine; 160 mg of Diovan (spread out during the day). her BP runs 140-160 over 49-55. She seems to be sleeping a lot (often after dinner but not necessarily then.)Im concerned that her diastolic number is too low and might be causing the sleepiness or lack of energy. She took Tenormin for years and the doc changed her to 50 metoprolol....then to 100 mg of metoprolol...... other wise she feels pretty good. Uses a walker. IF her BP rises, it is always the top number that might go up.What could be causing to the wanting to sleep a lot.
Brief Answer:
I would advise as follows :
Detailed Answer:
Hello!
Thank you for your question on HCM!
I passed carefully through your mother's medical history and I would explain as follows :
Increased sleepiness is normally associated with advanced age as the whole body systems go through a physiological functional aging and derangement.
From the other hand, heart failure syndrome though medically controlled has been shown to be associated with increased sleepiness and damaged sleeping quality.
Another cause of increased sleepiness is chronic dehydration status(which may be compatible with her medical condition and therapy).
I would also advise her thyroid function level as it may be responsible for the lower diastolic pressure, together with a possible dehydration and possible heart valve regurgitations.
At the end I would recommend you to consult with a neurologist for a possible sleep apnea syndrome, to perform thyroid hormone levels and blood electrolytes levels.
A Holter monitoring is advisable as sometimes episodic lowered atrial fibrillation rates may be responsible for increased sleepiness.
In such case a metoprolol increase should be done.
Hope to have been helpful!
Greetings! Dr. Iliri
I would advise as follows :
Detailed Answer:
Hello!
Thank you for your question on HCM!
I passed carefully through your mother's medical history and I would explain as follows :
Increased sleepiness is normally associated with advanced age as the whole body systems go through a physiological functional aging and derangement.
From the other hand, heart failure syndrome though medically controlled has been shown to be associated with increased sleepiness and damaged sleeping quality.
Another cause of increased sleepiness is chronic dehydration status(which may be compatible with her medical condition and therapy).
I would also advise her thyroid function level as it may be responsible for the lower diastolic pressure, together with a possible dehydration and possible heart valve regurgitations.
At the end I would recommend you to consult with a neurologist for a possible sleep apnea syndrome, to perform thyroid hormone levels and blood electrolytes levels.
A Holter monitoring is advisable as sometimes episodic lowered atrial fibrillation rates may be responsible for increased sleepiness.
In such case a metoprolol increase should be done.
Hope to have been helpful!
Greetings! Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you doctor. I was thinking the lower diastolic was due maybe to the 100mg metoprolol, but I guess it's not that simple. We like her cardiologist and he has been ours since 2001.Should I just go back and ask him to do these other tests...How do you get it done? We saw him last week. Do you have suggestions on how do talk to him.
Brief Answer:
You should primarily follow her doctor advices.
Detailed Answer:
Hello again!
As long as she has a stable heart condition (controlled heart failure and atrial fibrillation), there is no need to consult again her cardiologist out of the programmed schedule.
If increased sleepiness is disturbing, then a visit to her neurologist would be advisable.
Remember that the above mentioned recommendations are general opinions and could not substitute her attending doctor's decisions.
Best regards! Dr. Iliri
You should primarily follow her doctor advices.
Detailed Answer:
Hello again!
As long as she has a stable heart condition (controlled heart failure and atrial fibrillation), there is no need to consult again her cardiologist out of the programmed schedule.
If increased sleepiness is disturbing, then a visit to her neurologist would be advisable.
Remember that the above mentioned recommendations are general opinions and could not substitute her attending doctor's decisions.
Best regards! Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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