Sleep Care

The Struggle To Stay Awake: Excessive Daytime Sleepiness

Sometimes it’s normal to feel sleepy during the day, especially after a night out or during cold and flu season. But if you find yourself regularly wanting to sleep at the most inopportune times, such as while driving, sitting in a meeting or holding a conversation, then you may have a more serious condition.

Excessive Daytime Sleepiness (EDS) is a pronounced urge to sleep that is almost impossible to resist. It’s also one of the most common sleep-related issues affecting an estimated 20 percent of the population.

Those who experience daytime sleepiness may struggle to remember things, have difficulty concentrating and trouble getting up in the morning. It also may impact their overall health and their day-to-day life leading to problems at work, at school and even in their relationships. In severe cases, sufferers even have trouble operating a car or other machinery and are at risk for serious injury. In fact, according to the American Academy of Family Physicians (AAFP), sleep problems contribute to more than 70,000 injuries and 1,500 caused by motor vehicle incidents each year.

The key to treating EDS is to uncover the root cause.  The most common cause of EDS is self-imposed sleep deprivation. With today’s busy schedules, sleep is often pushed to the back burner. People push themselves to stay awake longer in hopes of getting more done. Widespread access to technology is another contributing factor because people can stay busy at the computer around the clock and often forgo sleep in favor of Facebook, gaming and other activities. And this trend is only getting worse. Numerous studies have shown that people now sleep about 20 percent less than they did a century ago.

In addition to self-imposed sleep loss, EDS also has been a linked to a number of sleep disorders that prevent deep, restful sleep. These disorders are not always easily identifiable as their symptoms are present during sleep. Obstructive Sleep Apnea (OSA) is a sleep disorder caused by blockage of the upper airway. As a result, a person with OSA often experiences a cessation of breathing or a reduction in airflow while sleeping. And according to the AAFP, 23 percent of women and 16 percent of men with OSA experience daytime sleepiness.

Snoring, which affects approximately 90 million Americans, also can cause daytime sleepiness because it creates disruptions in sleep – both for the person snoring and his or her bed-partner. About half of all people who snore also have OSA.

Neurological disorders are another common factor in EDS. For instance, narcolepsy and restless leg syndrome (RLS) both have been linked to daytime sleepiness. Narcolepsy is a neurological disorder that causes individuals to develop sudden overwhelming urges to sleep during the day. It affects one in every 2000 Americans according to the National Institute of Neurological Disorders and Stroke (NINDS). Meanwhile, RLS is a neurological disorder characterized by sensations in the legs and urges to move and stretch them, especially at night. People who suffer from RLS often mistake these sensations for insomnia.

Finally, medications and other health problems also contribute to EDS. For instance, a number of medications cause drowsiness including some tranquilizers, muscle relaxers, pain pills and allergy medications. When taken during the day or too late at night, they can cause sleepiness during the day.

Meanwhile, recent studies have found that people suffering from depression are often sleepy during the day too. In fact, a study conducted by a Pennsylvania State University research team found that people whose sleepiness was not caused by other factors often were depressed. Today, depression is thought to be a high risk factor for daytime sleepiness.

Other medical conditions that may cause EDS include Parkinson’s disease and thyroid problems. According to the Mayo Clinic and the NINDS, sleep problems including trouble falling asleep and waking up throughout the night are common problems for sufferers of Parkinson’s. Likewise, people who have hypothyroidism often feel fatigued, worn down and sleepy during the day.

Typically, your health care provider can help you determine the root cause of your daytime sleepiness. Once the cause has been determined, there are tools and medicines to help curb the sleepiness. For instance, if EDS is caused by OSA, a continuous positive airway pressure device (CPAP) or an oral appliance may be prescribed. Likewise, there are medications available for those with narcolepsy, Parkinson’s, depression, hypothyroidism and restless leg syndrome.

But for those of you whose sleep issues are self-imposed, it may be time to change your sleep habits. Here are a few suggestions:

·      Maintain a consistent sleep schedule seven days a week

·      Try to get a healthy amount of sleep, 7-9 hours each night

·      Develop a regular bedtime routine

·      Create a comfortable sleep environment that is dark, quiet and cool

·      Remove TVs, computers, phones and work material

·      Limit alcohol consumption

·      Avoid caffeine in the second half of the day

By getting the help you need, or by implementing changes, you will be on your way to improving your daytime alertness.

 

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