RLS, Sleep Deprivation, and Driving

I have been sleep-deprived for as long as I remember.

Not sure if that is saying a whole lot, since sleep deprivation impairs memory. But it is certainly timely, given that Drowsy Driving Prevention Week is November 6-13.

Issues with energy and falling asleep uncontrollably

I don’t recall being sleep-deprived ever being a problem when it came to driving or anything else, mostly because it was my normal state of existence. It affected me, of course, causing concentration issues, impaired focus and poor memory, and a crappy immune system. But no one says anything about that. People just expect you to function and plow on through it.

After developing a vestibular condition that affects my energy levels during the day, and then not quite recovering from COVID, I have a lot of problems with energy. There's a whole lot of just falling asleep whether I like it or not. I have really struggled to stay awake in the weirdest places — getting my hair cut, or with the dentist working in my mouth.

I often will start to fall asleep upright, start to fall into my laptop, and jerk awake over and over again. So I need to take naps, and my neurologist set me up with an appointment with a sleep specialist.

A conversation with the sleep specialist

The sleep specialist talked with me over the phone. Basically, since the sleep clinic is privately owned, it would be 800 bucks for a sleep study; no way my insurance company will fork that out, so I am not going to find out what the cause of this issue actually is.

The sleep specialist told me she believes it is severe sleep deprivation. But I have had severe sleep deprivation before, and often. It causes sleep paralysis, hypnic jerks, and hypnagogic hallucinations (those sort of weird wake-like dreams between wake and sleep) — all at extreme frequency. Like, a "several bouts of sleep paralysis a night" sort of thing.

A constellation of sleep-related symptoms

I also have many other symptoms, as you might imagine, that could be associated with sleep deprivation — all due to severe, chronic, unmanaged migraine attacks. But I didn’t previously fall asleep spontaneously at home, and I sure didn’t do so in public. I didn’t have this severe daytime sleepiness before, either. If anything, I ride an adrenaline high for half the day, then crash really hard for the rest.

I'm not saying the sleep specialist is right or wrong; only that since my vertigo started, I have actually been able to fall asleep (which used to be a real problem for me) and get more sleep than I ever used to at night. However, I also get up insanely early, so it is still classified as insomnia.

Add in my unintentional crash naps, and technically I am getting a decent amount of sleep — just not an average amount. More than my normal amount, though.

Both specialists told me I cannot drive

The sleep specialist doesn’t think I have narcolepsy from COVID, but maybe some other issue as a result of COVID. She doesn’t know. But since she is sure it isn’t narcolepsy, I asked her if she thought I could drive. My neurologist said I couldn’t until I had the sleep study, which now I am not having.

Well, she adamantly said I definitely could not, since I had explained to her that I randomly fall asleep all over the place, and that I definitely could not until it is resolved.

Well, I had just wanted it to be clear. It makes sense given the high risk to myself and others.

Unclear advice and prognosis from doctors

However, I need someone to be specific when they say this, one way or the other. Regarding my migraine attacks, no one is clear on these limitations at all — doctors might advise that you can drive with a migraine attack, but not while taking the medication to treat the attack, or vice versa.

However, the sleep specialist adding "until it is resolved" is not cool, since it isn’t going to be "resolved" when they are not going to do anything to find out what "it" is.

Meanwhile, I am extremely tired all the time. And if I am even slightly comfortable? Out like a light. Anywhere.

So, obviously, driving is out of the question. I get that. But I sort of would like them to figure out a timeline for when it could be an option.