Excessive Daytime Sleepiness: Causes and Treatment

We all get drained and rundown sooner or later—you already know that feeling the place you need to change your “to-do” checklist to a “do-nothing” checklist, and simply lie down and take a nap. However in the event you recurrently end up struggling to remain awake in the course of the day, it might be one thing greater than easy grogginess. It might be extreme daytime sleepiness.

Extreme daytime sleepiness (EDS) is a medical situation the place the necessity for sleep is so intense that it interferes with each day actions, even in the event you’ve gotten sufficient sleep at evening, per a Might 2021 scientific overview in Mayo Clinic Proceedings¹. In response to the overview, as many as 1 in 3 U.S. adults report coping with extreme sleepiness in the course of the daytime.

“Extreme daytime sleepiness is a selected medical time period for a powerful want or probability of falling asleep,” says Anne Marie Morse, DO, a board-certified pediatric neurologist with scientific and analysis pursuits in sleep medication, and director of Pediatrics Neurology at Geisinger Medical Center in Pennsylvania. “Folks must battle to remain awake and expertise inappropriate sleep during times of wakefulness.”

As a result of EDS impacts temper, reminiscence, focus, consideration, and productiveness, it could have an enormous impact on high quality of life, together with elevating the danger for accidents and different well being situations, in accordance with the NHS. EDS can also be sometimes a symptom of one other situation—which means it could have quite a few causes that take medical experience to diagnose and deal with, says Dr. Morse.

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Learn on to seek out out extra about EDS, the way it’s completely different from grogginess or fatigue, and what you are able to do in the event you suppose you’re coping with it your self.

Who does extreme daytime sleepiness primarily have an effect on?

Commonly not getting sufficient sleep (that’s, getting fewer than seven hours per evening) places you in danger for EDS, irrespective of the rationale behind your lack of zzzs, says Nancy Foldvary-Schaefer, DO, director of the Sleep Disorders Center on the Cleveland Clinic Neurological Institute.“Inadequate sleep is the primary trigger” of extreme daytime sleepiness, she says, including: “Forty % of grownup People are chronically sleep-deprived.”

There are two several types of EDS: main and secondary. Main EDS (often known as main hypersomnia) means the necessity to sleep shouldn’t be a symptom or brought on by one other medical situation, however occurs as a result of areas of the mind and nervous system concerned in sleep aren’t functioning correctly, per the Cleveland Clinic. Some examples of main EDS issues embrace narcolepsy and Kleine-Levin syndrome (typically known as “sleeping magnificence syndrome”).

Secondary EDS—or EDS from one other trigger—is rather more frequent than main EDS, in accordance with the American Academy of Family Physicians (AAFP). Whereas these causes are typically damaged down into “medical” and “nonmedical” classes, Dr. Morse says that is not totally correct. “Every little thing is a medical trigger as a result of one thing is biologically inflicting” the necessity to sleep, she explains.

Some secondary causes of EDS embrace the next, per AAFP:

• Sleep issues like obstructive sleep apnea, restless legs syndrome, or circadian rhythm sleep problem
• Medical situations that interrupt the sleep-wake cycle together with stroke, most cancers, and neurodegenerative situations like Parkinson’s illness
• Psychological well being situations, particularly melancholy
• Some prescription and over-the-counter drugs (together with sleeping drugs, opioids, and antihistamines)
• Behaviors that trigger sleep deprivation, equivalent to shift work, staying up too late, or jet lag

“It’s necessary to not normalize sleepiness. It’s not regular, it’s simply frequent.” —Anne Marie Morse, DO

How is it completely different from merely being drained?

Fatigue, tiredness, or grogginess are all frequent, however they aren’t the identical as having EDS, though the 2 situations can co-exist, says Dr. Morse. For instance, in the event you’re fatigued, you may really feel run-down bodily and mentally and less than doing sure duties, however not overly sleepy. However you probably have EDS, chances are you’ll must nap a number of occasions in the course of the day, regardless that you’ve slept sufficient at evening, she explains.

EDS can even have an effect on your life past bouts of tiredness. It is usually related to social {and professional} impairment, psychological misery, occupational and motorcar accidents, and interpersonal conflicts, says Dr. Foldvary-Schaefer.

“EDS invades all elements of life,” says Dr. Morse. “It’s possible you’ll be extra irritable, depressed, or anxious. It might probably impair your capability to carry out duties, making you extra liable to errors and extra pissed off when making errors.” As a result of these with EDS are liable to temper instability and irritability, the situation additionally impacts relationships, she provides.

There are potential dangers of daytime sleepiness, too

EDS doesn’t simply have an effect on high quality of life—it will increase the danger of accidents and different well being points. EDS is a significant explanation for work-related harm and is estimated to be the reason for virtually one-fifth of all motorcar accidents within the U.S., per a January 2018 article within the Journal of the Missouri State Medical Association². Together with the danger of falling asleep behind the wheel, EDS will increase response time, which might have an effect on a driver’s capability to shortly appropriate a car or maintain a car inside a lane, in accordance with a September 2023 article in Sleep³.

“EDS causes lapses in judgment and consciousness and places you in danger, whether or not you’re employed in an workplace or are a professional athlete,” says Dr. Morse. “Driving with EDS has the identical reaction-time danger and authorized penalties as driving drunk. If you happen to wouldn’t let your pal depart buzzed, don’t let your pal depart drained,” she provides.

Dr. Morse additionally says that in relation to driving, folks usually suppose they’ll “outsmart” sleepiness—however they’ll’t. “Folks will flip up the music or air-con or open the automobile home windows, however research have discovered whereas subjectively folks may really feel extra alert, objectively they’re not,” she provides.

Likewise, EDS can even take a toll in your well being. Sleep is essential to the well being of all of the physique’s programs and inadequate sleep raises the danger of diabetes, weight problems, psychological well being issues, a weakened immune system, and hormone abnormalities, per the National Library of Medicine. EDS can also be related to an elevated danger of cardiovascular disease and demise, in accordance with a December 2023 research within the Journal of the American Heart Association⁴.

Analysis and therapy for EDS

If you happen to suppose you are coping with EDS, Dr. Morse recommends retaining a symptom diary to document not solely when and the way lengthy you sleep, however another accompanying signs. This data may also help your physician and sleep specialists decide the foundation explanation for your EDS.

“Sleep and wakefulness are intimately related,” says Dr. Morse. “Common medication usually dismisses sleep, and sleep medication usually dismisses while you’re awake. However the two are interconnected, and we have to know your signs to grasp the affect throughout your awake hours and assist us perceive what’s happening.”

Together with sleep and symptom historical past, medical doctors may even use medical and drugs historical past and, if applicable, sleep testing, to assist decide the reason for EDS, says Dr. Foldvary-Schaefer. How EDS is then handled will depend upon what’s inflicting it, says Dr. Morse.

“Primarily based on the situation inflicting EDS, therapy may embrace life-style adjustments, drugs, or maybe gear,” equivalent to CPAP machines for sleep apnea, says Morse. “It’s actually a singular therapy for everybody.”

When to hunt assist for EDS

As a result of situations that trigger EDS may take a while to diagnose and contain seeing specialists, do not delay getting assist, says Dr. Morse. If you happen to’re coping with EDS three or extra days per week for at the very least three months, discuss to your physician about it, recommends Dr. Foldvary-Schaefer.

“It’s a name to motion if an individual is experiencing sleepiness chronically or episodically. Have a dialog along with your physician,” says Dr. Morse. “It’s necessary to not normalize sleepiness. It’s not regular, it’s simply frequent.”

And, above all, don’t suppose EDS is one thing you’ll be able to self-cure, says Dr. Morse. Whereas retaining a consistent sleep routine may assist with the occasional bout of fatigue, chances are you’ll want extra formal therapy for one thing like EDS (or issues like narcolepsy, for instance). “Don’t attempt to do it your self,” she says. “EDS has quick and long-term results if not handled. See a physician so you will discover the foundation trigger and discover therapy that offers you acute and power aid.”