Excessive Sleepiness: Symptoms, Causes, Diagnosis, and Treatments Update 10/2022

In the United States, between 10 and 20 percent of the population suffers from excessive daytime sleepiness. According to the 2020 Sleep in America Poll, the average number of days per week that Americans feel drowsy has a substantial impact on their mood and physical health.

Excessive daytime sleepiness should be taken seriously, even if it is not a problem in and of itself. Symptoms of sleep deprivation or other health problems may be your body’s way of alerting you to the fact that you need more sleep. It is critical to recognize the symptoms of excessive daytime sleepiness in order to identify and correct the underlying problem.

What Is Excessive Daytime Sleepiness?

The inability to stay awake or attentive throughout the day, or an increased urge to sleep during the day, are both considered symptoms of excessive daytime drowsiness. You may feel more tired if you are unable to move much, such as while driving or working. A little tiredness on occasion is to be expected; however, excessive daytime sleepiness is when this occurs virtually daily for a period of three months or more.
Excessive sleepiness: Causes, symptoms, and treatment

When you’ve been awake for an extended period of time, it’s simple to mistakenly believe that you’re tired when you’re actually sleepy. As a result, they may not be able to sleep even though they are exhausted and sluggish. Sleepiness and exhaustion might occur at the same time.

Symptoms

Sleep is critical to memory consolidation, immune system restoration, and other crucial functions. There are a variety of symptoms that might arise as a result of poor quality sleep that you may not be able to immediately link to it.

Excessive sleepiness can occur even when you don’t consciously feel drowsy. If you experience any of the following:

  • A hard time keeping my eyes open.
  • Displeasure and annoyance.
  • Memory lapses are a concern.
  • I’m having a hard time concentrating.
  • Having trouble remembering fresh ideas.
  • Making decisions is difficult for me.
  • Reduced speed of response.
  • a tendency to take risks.

Consequences of Excessive Daytime Sleepiness

Sleep deprivation can have a wide range of health and daily life consequences. Daytime drowsiness has a number of negative effects, such as:

  • Auto and workplace accidents are more likely to occur.
  • a decrease in productivity at work or in school
  • Declining standard of living
  • Regulating emotions and moods
  • Problems in personal and professional relationships

Sleep deprivation can be problematic for young individuals, shift workers, medical professionals, and those who frequently drive.

Several chronic diseases, including diabetes, obesity, and heart disease, have been related to persistent sleep deprivation. Children’s daytime sleepiness may have an impact on their development, while daytime sleepiness in older individuals raises their risk of falling and may contribute to cognitive decline, memory loss, and an earlier death.

Causes of Excessive Sleepiness

Daytime tiredness can be caused by a variety of things. Insomnia, shift work, and other factors all contribute to sleep deprivation, which is one of the most common causes of chronic fatigue syndrome.

Getting a bad night’s sleep can also lead to excessive drowsiness. Disrupting the natural flow of sleep stages, such as getting up numerous times a night to use the bathroom, may lower the amount of slow-wave sleep. Tobacco use, a lack of physical activity, and a variety of other lifestyle behaviors can all disrupt sleep and induce daytime sleepiness.

The majority of people who are constantly tired during the day appear to be getting adequate rest. An underlying health problem or sleep disorder can show up as excessive drowsiness in these people.
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Sleep-Wake Disorders

Several sleep disorders, including obstructive sleep apnea, restless legs syndrome, and periodic limb movement disorder, are recognized for disrupting sleep and creating sleep fragmentation. Patients may not realize they have these issues until they see a sleep doctor, causing micro-awakenings that interrupt sleep.

Another type of sleep disorder targets the brain’s neural processes for regulating the sleep cycle directly. People with narcolepsy and idiopathic hypersomnia, both of which cause excessive daytime sleepiness, have hypotheses that the hormones responsible for boosting alertness are disrupted.

For those with circadian rhythm problems, their internal body clock is out of sync with the times they need to be awake. Insomnia while trying to sleep or excessive tiredness while awake can both be caused by this disconnect.

Other Health Conditions

Sleepiness during the day is common in those with long-term medical illnesses or mental health issues. Depression, anxiety, schizophrenia, lupus, Parkinson’s disease, multiple sclerosis, cancer, chronic pain, obesity, and hypothyroidism are among the most common causes of mental illness.

It’s common for health ailments and sleep issues to have an impact on one other. Parkinson’s disease and other health conditions may be diagnosed later in life if people don’t get enough sleep now. Recent studies reveal that the tendency to be drowsy during the day may be hereditary.

Daytime sleepiness can occur as a side effect of medications used to treat health disorders, as can drugs such as alcohol and opioids.

Diagnosis of Excessive Daytime Sleepiness

Because of the difficulty in distinguishing it from other health issues including weariness, which the NSF defines as a sensation of low energy and a need to rest but not necessarily sleep, excessive daytime sleepiness can be difficult to diagnose. According to the NSF, it can be misinterpreted for depression if you find yourself losing interest in once-enjoyable “regular activities.”

To treat sleep apnea, your first stop should be your health care physician, but you may require an evaluation from a sleep expert to identify the main cause and discuss treatment options, says Kapur. According to Kapur, a sleep specialist may often establish the source of your extreme daytime sleepiness simply by acquiring a complete “sleep history” and completing a regular physical exam. The Epworth Drowsiness Scale (ESS), a standardized questionnaire used to assess sleepiness during the day, may be administered to you as part of the interview process.

You may be advised to conduct an overnight sleep study at home by your doctor if the results of your physical examination suggest that you may be suffering from sleep apnea. Heart rate, blood oxygen, and breathing patterns are commonly measured in these examinations.

A sleep expert may propose that you do a polysomnography, or a thorough sleep study, in a laboratory based on the results of your assessment (and, if applicable, your home sleep test). Doctors can keep close tabs on you while you sleep with a sleep study, which is a noninvasive overnight test (keeping track of things such as your stage of sleep, your airflow, oxygen levels, heart rhythm, and limb movements). In order to detect sleep disorders, such as narcolepsy, restless legs syndrome and insomnia, sleep specialists employ these tests. They also use them to diagnose nighttime behaviors such as REM sleep behavior disorder.

Your sleep specialist may offer the multiple sleep latency test if they feel that narcolepsy is to blame for your insomnia (MSLT). Using an MSLT, the American Academy of Sleep Medicine reports that it measures how soon you can fall asleep in a quiet atmosphere throughout the day.

Five scheduled naps, separated by two-hour breaks, are part of the MSLT. Each nap, you will lie down in your bed and try to fall asleep as softly as possible. The test will track how long it takes you to drift off to sleep once the lights are turned out. Excessive sleepiness is defined by Kapur as falling asleep within eight minutes. “So, we need to figure out what’s going on here. If you don’t fix the problem of excessive sleepiness, it can lead to major health concerns.”

Working with your doctor to identify the proper treatment and make changes can help you reduce your excessive daytime drowsiness and achieve better sleep, better daily performance, and a more rested, healthier, and safer you.

When to Talk To Your Doctor

If you’re constantly exhausted, if excessive daytime sleepiness is interfering with your daily routine, or if you suspect an underlying disorder, you should consult a doctor.

In order to determine the cause of your tiredness, your doctor will conduct tests and inquire about your sleep patterns. Alternatively, they may inquire as to whether you gasp, snore, or move your legs while sleeping. A sleep specialist may be called in if they feel that you have a sleep disorder and want to do additional tests.

Daytime sleepiness can have a variety of causes. The doctor would most likely begin by offering sleep hygiene tips and encouraging you to get more sleep. They will work with you to build a treatment plan for underlying issues that need to be treated independently of any medication adjustments.

How is excessive sleepiness treated?

It is possible to cure excessive sleepiness in a variety of ways based on the underlying cause.

Obstructive sleep apnea

Continuous positive airway pressure (CPAP) is one of the most common therapies (CPAP). You wear a mask over your nose and mouth, and a little bedside machine pushes air into it via a flexible tube.

There are newer, slimmer CPAP masks on the latest devices. CPAP may be too noisy or uncomfortable for some people, yet it is still the most effective treatment for OSA. It’s the most common treatment for OSA that a doctor recommends.

Restless legs syndrome

With minor lifestyle changes, RLS can be managed. It’s possible that giving your legs a massage or taking a warm bath before you go to bed will assist. It’s possible that exercising first thing in the morning will help alleviate RLS and improve your ability to drift off to sleep.

If your iron levels are low, your doctor may advise you to take iron supplements. As a last resort, your doctor may prescribe medication to treat RLS. If so, be careful to talk to your doctor or pharmacist about any possible side effects.
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Narcolepsy

Symptoms of narcolepsy can be alleviated by making lifestyle changes. Short, timed naps may be beneficial. It’s also a good idea to keep a consistent sleep-wake routine every night and morning. The following are some further hints:

  • exercising on a regular basis.
  • Before going to bed, stay away from anything with caffeine or alcohol in it.
  • halting the habit.
  • unwinding before retiring for the night.

A combination of these things can help you get to sleep and stay asleep more easily at night. There is a possibility that this will assist alleviate daytime sleepiness.

Depression

Psychotherapy, medicine, and a change in one’s way of life can all be used to combat depression. Not everyone needs antidepressant medication. You may need to use them for a short time if your doctor advises them.

Talk therapy and certain lifestyle modifications, such as increasing physical activity, limiting alcohol use, eating a healthy diet, and managing stress, may help alleviate depression.

Age-related sleep problems

People who are suffering sleep problems as they become older can benefit from the same dietary and lifestyle adjustments that are effective in treating narcolepsy and insomnia. Talk to your doctor if lifestyle modifications aren’t enough. They can prescribe medication to help you get a better night’s rest.

Idiopathic hypersomnia

Treatments for idiopathic hypersomnia focus on relieving symptoms and may involve stimulants, dietary changes, or lifestyle changes because the origin of the condition is unknown at this time.

The bottom line

The importance of getting adequate sleep cannot be overstated for the sake of one’s health. Identifying and treating the underlying reason of your excessive sleepiness will help you feel more awake and focused during the day.

Even if your doctor doesn’t inquire about your sleep habits, you can bring up the topic of excessive daytime sleepiness and come up with a plan to combat it. Why put up with feeling tired all the time when you could be suffering from something treatable?

Using the Healthline FindCare service, you can look up local doctors if you don’t already have one.

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