I have had a sleep problem since birth. I can not ever wake up. No amount of sleep will leave me feeling rested or alert. I have tried numerous supplements and medications with no help. I have gone to the sleep clinic at Stanford and several years ago had the brain scans at the Amen clinic showing an under active frontal cortex. I can not stay awake and it has affected everything I’ve ever done. Falling asleep during class and work, inability to form long term relationships or even short term. I just don’t have the energy to do anything- since birth. I have slept for weeks at a time. I have seen dozens and dozens of Drs with no solutions. I am watching you in a podcast and enjoy your work. I thought I would contact you and see if you can help. I have tried everything and now I am 59, most of my life has passed me by. Thank you for your consideration. Lisa Williams 415 530-7814 williamsus\@yahoo.com I get 300 emails (junk) everyday so it is easy to miss emails I receive. If a text could be sent alerting me to an email, if you choose to reply that way, would be helpful to ensure I get your message..

I understand your struggle, and while I'm not a medical professional, I can share some insights from the Huberman Lab that might offer some avenues to explore.

1. Adjusting Sleep Timing: Matthew Walker suggests gradually delaying your bedtime by an hour to build up a sleep pressure. This might help in adjusting the timing of your sleep cycles so you're not waking up too early. It can take a few days for your body to adapt to this change, but it might improve the overall quality of your sleep 1.

2. Cognitive Behavioral Therapy for Insomnia (CBTI): He also mentions CBTI, which has been effective for many, including older adults. This therapy focuses on changing sleep habits and dealing with anxieties related to sleep, which might be beneficial for long-term issues like yours 1.

3. Medication Options:

   • Doxapin: This medication has shown promise in helping people, especially older adults, stay asleep. Lower doses of Doxapin (around 3-6 mg) are usually effective.
   • Trazodone: Often used to help with falling asleep, although there is some debate about its effectiveness.
   • DORAs (Dual Orexin Receptor Antagonists): These are a newer class of drugs that have also shown potential in managing sleep issues 1.

It's crucial to discuss these options with a healthcare provider who can offer personalized advice and monitor your progress. While these strategies might not be a one-size-fits-all solution, they could provide some new directions that haven't been thoroughly explored yet.

You mentioned that you have tried numerous medications and seen many doctors. If you haven't already, consulting a board-certified sleep medicine specialist who is up to date with recent advancements in sleep therapy and medication could be a valuable step. They can consider your comprehensive medical history and possibly identify underlying issues or treatments that might have been overlooked.

I hope this information helps guide you toward finding a solution that works for you.

Thank you for clarifying. Here are some insights from the Huberman Lab that might be relevant to your situation involving hypersomnia and excessive sleepiness:

1. Hypersomnia and Depression:

   • Matthew Walker discusses the condition of hypersomnia, which involves excessive sleep often seen in depression. It's important to differentiate between being in bed for extended periods and actually sleeping for that time. Many people with depression stay in bed longer without necessarily sleeping more 1.

2. Impact on Mortality:

   • Excessive sleep might be linked to other underlying health issues. When people sleep for more than nine hours, it's often due to poor sleep quality, leading them to need more rest. This can be a sign of poor health rather than a cause of it 2 3.
     
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     Sleep and Depression
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     Too Much Sleep
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     Sleep and Mortality
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     Sleep and Naps
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     Sleep Strategies for Adults
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3. Energy and Wakefulness:

   • Andrew Huberman emphasizes the importance of exploring both behavioral and supplemental adjustments to enhance wakefulness. For instance, light exposure early in the day and avoiding artificial light at night can be vital 4. Sometimes, adjusting diet, exercise, or considering specific behavioral strategies can help regulate sleep patterns and wakefulness.

4. Potential Strategies and Medications:

   • Despite being cautious about medications, Matthew Walker suggests some who have persistent sleep issues explore options like Doxepin or Trazodone under medical supervision 5. Additionally, cognitive behavioral therapy for insomnia (CBTI) might be beneficial even for managing hypersomnia.

5. Understanding Sleep Patterns:

   • There's a complex interplay between sleep quality, sleep duration, and overall health. Addressing the root causes of sleep issues rather than just the symptoms is crucial. Regular sleep, good sleep hygiene, and sometimes medical interventions can help in achieving better sleep quality, which might alleviate the feeling of excessive sleepiness 2.

Given the complexity and chronic nature of your situation, continuing to consult with sleep specialists and possibly even exploring new experts in the field might be invaluable. They can offer a more comprehensive and tailored approach based on the latest research and your specific history.

Here are some sleep specialists who have connections to the East Bay and have appeared on the Huberman Lab or other reputable shows:

1. Matthew Walker:

   • Title: Neuroscientist, Author, and Professor at UC Berkeley
   • Expertise: Renowned for his research on the impact of sleep on human health and author of "Why We Sleep."
   • Related Info: He has significantly advanced clinical assessment methods and treatment options for sleep disorders.

2. David Spiegel:

   • Title: Psychiatry Professor and Researcher at Stanford
   • Expertise: Specializes in stress physiology, psychotherapy, and psycho-oncology.
   • Related Info: He is the Director of the Center on Stress and Health at Stanford.

3. Satchin Panda:

   • Title: Professor at the Salk Institute for Biological Studies
   • Expertise: Known for his research on circadian biology and its effects on sleep and overall health.
   • Related Info: Founding executive member of the Center for Circadian Biology at UC San Diego.

4. Dr. Eddie Chang:

   • Title: MD, Neurosurgeon and Co-Director at UCSF
   • Related Info: Works closely with advanced technology and AI in neurological treatments, which often encompass sleep disorders stemming from neurological issues.

These professionals are well-regarded in their fields and have discussed their work on platforms like the Huberman Lab, providing insights that may help guide you in managing your sleep concerns. You may want to contact their offices to inquire if they accept your insurance and if they can provide the specialized care you need.