Excessive Sleepiness

What is Excessive Sleepiness & How To Cope

According to a 2019 research, daytime sleepiness affects around 10 to 20% of America’s population. So though it’s not a disorder itself, excessive sleepiness is a condition that needs to be taken seriously. Struggling to stay awake can be disruptive and make it quite challenging for a person to carry out their typical daily routine.

What’s more, this condition can strain both personal and social relationships and, at worse, create serious risks when driving. Your body might be reacting due to sleep deprivation, or it may be raising signals about health conditions such as sleep disorders.

Either way, understanding daytime sleepiness is your first step toward addressing the issue. That said, here’s everything you need to know about excessive daytime sleepiness (EDS), including its causes, symptoms, and treatment options.

What Is Excessive Daytime Sleepiness?

Excessive sleepiness is a condition whereby you tend to fall asleep or feel tired during the day when you're expected to be wide awake. Unlike fatigue, which is generally more about low energy, EDS can impact concentration, alertness, and overall health.

Recent research in 2020 suggests that almost half of Americans feel drowsy between three and seven days a week. In addition, 40% reported that their sleepiness interferes with their normal routine, at least occasionally. These studies prove that daytime sleepiness is a significant problem despite being a mere symptom of other sleep-related disorders. 

What Are the Symptoms of Excessive Sleepiness?

Sleep plays a pivotal role in vital body processes such as restoring the immune system and consolidating memory. So, a lack of quality sleep leads to a host of symptoms, some of which you may not directly connect to sleep. For example, heavy eyelids, uncontrollable yawning, and a strong urge to sleep during the day are the common signs of daytime sleepiness.

Other symptoms that you need to watch out for irrespective of whether or not you consciously feel sleepy include:

  • Memory problems
  • Feelings of irritations
  • Slower reaction times
  • Trouble focusing
  • Trouble staying alert
  • Waking up with headaches
  • Loss of appetite

Note that a person can experience additional symptoms if their daytime sleepiness is due to an underlying health condition.

Causes of Excessive Sleepiness

It’s normal for someone to feel drowsy from time to time, especially after a long tiresome day. However, if you frequently experience a powerful urge to sleep during the day, chances are you’re suffering from excessive daytime sleepiness.

Any condition that deprives you of quality sleep at night can lead to excessive drowsiness during the day. Aside from having poor quality sleep and not sleeping long enough, other common causes of EDS include the following.

1. Restless Legs Syndrome

Restless legs syndrome (RLS) is an uncontrollable urge to move one’s legs when they’re at rest. This condition also causes prickly sensations in the legs. RLS can occur during both sleep and wakefulness.

For instance, you may be comfortably lying down on your bed when you begin feeling a throbbing sensation in your legs that can’t get better unless you stand and walk. Those who experience restless legs syndrome when still awake usually have a hard time getting to sleep.

If it happens during sleep, it causes a person’s legs to jerk continually or spasm throughout the night. Although this may not wake the person, it prevents them from having a restful sleep. Consequently, the person will feel tired and sluggish the following day. 

2. Sleep Apnea

Sleep apnea is a potentially severe disorder in which a person’s normal breathing is repeatedly interfered with throughout the night. For instance, if you snore loudly while you sleep and feel exhausted even after a quality night’s sleep, it might be due to sleep apnea.
Generally, there are three types of sleep apnea:

a. Obstructive sleep apnea (OSA)

OSA is among the most common sleep disorders. It occurs when your throat muscles relax while you sleep, thus partially covering your airway. When it happens, you might choke, snort, or gasp. This uncomfortable pattern can occur five to 30 times each hour throughout the night; hence you won’t achieve the deep, restful stages of sleep.

b. Central sleep apnea (CSA)

It occurs when your brain doesn’t send proper signals to your breathing muscles while you sleep. As a result, you might wake up with shortness of breath, have a hard time falling asleep or staying asleep.

c. Complex sleep apnea syndrome

Also referred to as treatment-emergent central sleep apnea, it’s a condition where a person has both central and obstructive sleep apnea.

3. Narcolepsy

Narcolepsy is a neurological disorder that interferes with the brain’s ability to control wakefulness and sleep cycles effectively. It’s often characterized by a person falling asleep unintentionally while engaging in typical activities throughout the day.

If you have narcolepsy, you’ll sleep fine during the night, but you’ll feel excessive sleepiness periodically throughout the day. You can even fall asleep during a meal or while holding a conversation.

In addition to EDS, patients who suffer from narcolepsy also experience hallucinations, sleep disturbance, sleep paralysis, and sleep disruption. These symptoms begin occurring during childhood to 30 years old. If one of your family members has narcolepsy, your chances of getting the condition are 20 to 40 times higher. 

4. Depression

Poor sleep is associated chiefly with depression. However, depression is a complex disorder that can affect more than just your emotional and mental health. People with depression often find it quite challenging to fall asleep or stay asleep during the night.

If you don’t sleep well at night, you’ll likely experience daytime sleepiness. There are many potential causes of depression, such as traumatic events, drug use, and medical conditions like a chronic illness. 

5. Insomnia

Insomnia is a common sleep condition that makes it hard for someone to sleep or even causes them to awaken too early and not get back to sleep. Besides sapping your mood and energy level, insomnia affects your work performance, quality of life, and health.

The amount of quality sleep varies from one person to the other, but most adults only need seven to eight sleep hours a night. Most people experience short-term (acute) insomnia at some point in life, which only lasts for a few days or weeks. It’s usually a result of life events, habits that disrupt sleep, or stress. Long-term (chronic) insomnia can last for a month or even more. It’s mainly associated with medical conditions and particular drug use. 

6. Medical And Drug Effects

In most cases, sleepiness comes from using pharmacologic agents, which affect the central nervous system. Sleep and wakefulness modulation is a complex process that involves multiple systems and factors.

When it comes to agents that contain sedative effects, ethanol is among the most widely used. However, non-prescription sleeping pills are also commonly used.
Some medications, especially drugs with hypnotic actions or clinical sedatives, affect the central neurotransmitters involved in the sleep and wakefulness neuromodulation (alteration of nerve activity via targeted delivery of a stimulus to specific neurological sites in the body).

These medications include:

  • Antidepressants
  • Skeletal muscle relaxants
  • Epilepsy medications
  • Antipsychotics
  • Antihistamines (medication for nasal congestion)
  • Antiemetics (remedy for nausea and vomiting)

Marijuana has sedating severe effects compared to other drugs of abuse. Most adolescents abusing such drugs experience persistent daytime drowsiness, especially after a long time of drug-induced wakefulness.

7. Parasomnia

Parasomnia is a sleep disorder associated with abnormal behaviors while sleeping. This includes sleep-talking, sleepwalking, and head-banging. Although this condition is common, it can make it challenging to get restful sleep.

What’s more, some parasomnias can be life-threatening since the affected person isn’t aware of their surroundings. This sleep disorder has many possible causes. It can occur due to multiple triggers such as substance use, depression, irregular sleep schedules, and neurological conditions.

8. Aging

Research has it that older people tend to spend more time in bed but get the lowest sleep quality. According to the study, the quality of sleep begins to worsen in middle-aged adults. As you age, you experience less time in the deeper sleep phases and awaken more during the night.

How To Treat Excessive Sleepiness

The appropriate treatment for EDS varies wildly, depending on the contributing factors and the specific cause. Here, it’s best to rely on a doctor to identify and tailor the appropriate treatment options.

Improve your Sleep Hygiene

It’s well-established that having a quality sleep is crucial to our mental and physical health. However, despite its importance, a disturbing number of individuals find themselves deprived of quality sleep. This makes them notably sleepy during the day.

Though there’s a wide variety of types and causes of sleep issues, one of the most straightforward steps persons with EDS can take to treat the condition is improving sleep hygiene. For many people, implementing these strategies can be a daunting task. But keep in mind that it’s not all-or-nothing; stall by making small progressive changes as you work your way toward healthier sleep hygiene (sleep habits).

Besides lessening the effects of sleep-related conditions, proper sleep hygiene promotes overall health and wellbeing. To improve your sleep hygiene:

  • Reduce consumption of drugs, caffeine, and alcohol
  • Exercise during daytime hours
  • Establish a consistent bedtime routine
  • Maintain a conducive sleep environment; dark, cool, and quiet

In addition to the strategies mentioned above, use your bed only for sleep and sex. Other activities like drinking, eating, reading, working on the computer, and reading, should be done outside the bed.

Available Medications For People With EDS

There are many drugs available for people with excessive daytime sleepiness. But remember, these medications often come with other types of therapies, treatments, and behavior modifications.

Some of the commonly prescribed drugs for patients with EDS include:

  • Sodium oxybate is a medication for narcolepsy. It improves the slow-wave sleep phase, thus improving daytime alertness. The drug, which is well-known for treating cataplexy, can limit nocturnal sleep disruptions and at night and consolidate sleep. Side effects include confusion, respiratory depression, and hypotension, which occurs at toxic doses.
  • Modafinil is an approved drug for treating excessive sleepiness associated with narcolepsy. Scientists believe that Modafinil affects the brain’s sleep-wake centers. When using this drug, you might experience mild to severe headaches. Some of the most severe side effects include the development of nervousness or insomnia.
  • Armodafinil. Similar to Modafinil, Armodafinil is a wake-promoting agent for treating EDS in patients with sleep apnea or narcolepsy.
  • Benzodiazepine receptor agonists are hypnotics effective in helping with nighttime sleep. Improving sleep quality and quantity during the night significantly helps reduce excessive sleepiness. The risks that come with using these drugs include dependency and withdrawal symptoms.
  • Methylphenidaten is a stimulant that encourages alertness. It’s also efficient in treating narcolepsy.
  • The body naturally releases melatonin a few hours before bedtime. Taking melatonin supplements before going to bed can help you fall asleep, stay asleep, and awaken on time.

It’s wise to consult your doctor before you start taking any medication. Share with them your health history and ensure they’re fully aware of any other supplements or drugs you take.

Treatment For Disorders That Cause EDS

When it comes to treating excessive sleepiness, doctors mostly identify either one or more of the below underlying disorders and suggest the corresponding treatments:

  • Restless legs syndrome - You can control this syndrome by changing your lifestyle. For instance, consider taking a warm bath or a leg massage before bedtime. In addition, exercising early in the day will not only help with RLS but also improve your ability to sleep. 
  • Sleep apnea - One of the most effective treatments for sleep apnea is continuous positive airway pressure (CPAP). This therapy technique uses a small bedside machine to pump air via a flexible hose to the mask on your nose and mouth.
  • Narcolepsy treatment includes scheduling naps and maintaining a regular sleeping and waking schedule every night and morning.
  • Depression treatment can be conducted with a combination of medications, life changes, and therapy.

Besides, making and maintaining healthier lifestyle changes like drinking less alcohol, keeping fit, and following a healthy diet can help you successfully overcome depression.

Get Medical Treatment

Daytime sleepiness can affect your life’s quality. You may experience difficulty concentrating, memory problems, and reduced performance at work. Instead of living with constant fatigue, book an appointment with your physician to discuss the many different ways to boost your treatment.

Other Sleep Disorders:

References:

1. Everything you need to know about restless legs syndrome

https://www.medicalnewstoday.com/articles/7882

2. Narcolepsy

https://www.mayoclinic.org/diseases-conditions/narcolepsy/symptoms-causes/syc-20375497#:~:text=Narcolepsy%20is%20a%20chronic%20sleep,time%2C%20regardless%20of%20the%20circumstances.

3. Insomnia

https://www.healthline.com/health/insomnia

4. Key Sleep Disorders

https://www.cdc.gov/sleep/about_sleep/key_disorders.html

5. Depression and Sleep: Understanding the Connection

https://www.hopkinsmedicine.org/health/wellness-and-prevention/depression-and-sleep-understanding-the-connection

6. Excessive Daytime Sleepiness

https://www.aafp.org/afp/2009/0301/p391.html#:~:text=The%20most%20common%20causes%20of,sleep%20disorders%2C%20such%20as%20narcolepsy.