I constantly sleep. i self medicate with caffeine and nicotine. i'm always tired have been for years. i have periodic episodes of sleep paralysis. i've had blood work and a cat scan which came back normal. what could it be?

You need to visit: a sleep specialist (board certified in Sleep Medicine either pulmonologist or neurologist) to help you diagnose your problem. Sleep paralysis is usually only a phase and you should "grow out" of it, however I had it for 10+ years and still occasionally get that. Thanks for trusting in HealthTap.

Sleep Study: Being tired all the time from poor sleep is an issue. The quality of your sleep is likely contributing. You really need a sleep evaluation including a sleep study. This will help get your sleep figured out. You might also need some additional testing depending on what the sleep study shows like a multiple sleep latency test. Could be sleep apnea or narcolepsy or some other sleep disorder.

Have you had a...: ...sleep study? The amount of time you get restorative sleep may be much less than the amount of time you spend in bed.. Periodic episodes of sleep paralysis aren't necessarily abnormal, but, in the context of an abnormal sleep pattern, could be significant. Depression, lack of exercise & self-medication can contribute to chronic fatigue. Best wishes. Dr. Anne.

Narcolepsy-Cataplexy: You need two types of sleep study, at a sleep disorders center NOW. The diagnosis of narcolepsy is difficult to reach, but the risk of early and sudden death is too high to let it pass. Fatigue, sleepiness, somnolence, and sudden attacks of sleep with muscle paralysis are very dangerous, particularly if you drive. Xyrem is the best drug for that condition. Google Narcolepsy, see your MD in am.

Sub specialist : You need a full workup for this before it ruins your life. A focused sleep specialist is the best route.

Sleep Study Needed: Obstructive sleep apnea, major depression with vegetative symptoms, hypothyroidism and low testosterone are all in the differential diagnosis of hypersomnolence...along with medication side effects. If you were my patient I would order a sleep study. Do you have shift work disorder or a circadian rhythm disorder from overnight work or travel? Stop smoking and caffeine use late at night!