Excessive Daytime Sleepiness: Causes and Treatment

We all get drained and rundown sooner or later— that feeling the place you wish to change your “to-do” checklist to a “do-nothing” checklist, and simply lie down and take a nap. However when you commonly end up struggling to remain awake through the day, it could possibly be one thing greater than easy grogginess. It could possibly 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 every day actions, even when you’ve gotten sufficient sleep at evening, per a Could 2021 medical evaluate in Mayo Clinic Proceedings1. In line with the evaluate, as many as 1 in 3 U.S. adults report coping with extreme sleepiness through the daytime.

“Extreme daytime sleepiness is a selected medical time period for a robust want or probability of falling asleep,” says Anne Marie Morse, DO, a board-certified pediatric neurologist with medical and analysis pursuits in sleep medication, and director of Pediatrics Neurology at Geisinger Medical Middle in Pennsylvania. “Folks must struggle 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 response to the NHS. EDS can also be sometimes a symptom of one other situation—that means it could have quite a few causes that take medical experience to diagnose and deal with, says Dr. Morse.

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

Who does extreme daytime sleepiness primarily have an effect on?

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

There are two several types of EDS: major and secondary. Major EDS (also called major hypersomnia) means the necessity to sleep shouldn’t be a symptom or attributable to one other medical difficulty, 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 major EDS issues embrace narcolepsy and Kleine-Levin syndrome (generally referred to as “sleeping magnificence syndrome”).

Secondary EDS—or EDS from one other trigger—is way more widespread than major EDS, in response to the American Academy of Household Physicians (AAFP). Whereas these causes are generally damaged down into “medical” and “nonmedical” classes, Dr. Morse says that is not fully correct. “Every part 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, stressed 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 capsules, opioids, and antihistamines) Behaviors that trigger sleep deprivation, reminiscent of shift work, staying up too late, or jet lag

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

How is it completely different from merely being drained?

Fatigue, tiredness, or grogginess are all widespread, however they aren’t the identical as having EDS, though the 2 situations can co-exist, says Dr. Morse. For instance, when you’re fatigued, you would possibly really feel run-down bodily and mentally and lower than doing sure duties, however not overly sleepy. However in case you have EDS, chances are you’ll have to nap a number of instances through the day, regardless that you’ve slept sufficient at evening, she explains.

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

“EDS invades all points of life,” says Dr. Morse. “Chances are you’ll be extra irritable, depressed, or anxious. It may impair your means 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 serious reason behind 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 Affiliation2. Together with the danger of falling asleep behind the wheel, EDS will increase response time, which may have an effect on a driver’s means to shortly appropriate a car or hold a car inside a lane, in response to 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 inebriated. Should you wouldn’t let your buddy go away buzzed, don’t let your buddy go away drained,” she provides.

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

Likewise, EDS may also take a toll in your well being. Sleep is essential to the well being of all of the physique’s methods and inadequate sleep raises the danger of diabetes, weight problems, psychological well being issues, a weakened immune system, and hormone abnormalities, per the Nationwide Library of Drugs. EDS can also be related to an elevated danger of heart problems and dying, in response to a December 2023 research within the Journal of the American Coronary heart Affiliation4.

Prognosis and therapy for EDS

Should you assume you are coping with EDS, Dr. Morse recommends protecting a symptom diary to report not solely when and the way lengthy you sleep, however every other accompanying signs. This data can assist your physician and sleep specialists decide the basis reason behind your EDS.

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

Together with sleep and symptom historical past, docs may also use medical and medicine 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.

“Based mostly on the situation inflicting EDS, therapy may embrace life-style adjustments, drugs, or maybe tools,” reminiscent of 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 would possibly take a while to diagnose and contain seeing specialists, do not delay getting assist, says Dr. Morse. Should you’re coping with EDS three or extra days per week for a minimum of three months, speak 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 together with your physician,” says Dr. Morse. “It’s necessary to not normalize sleepiness. It’s not regular, it’s simply widespread.”

And, above all, don’t assume EDS is one thing you’ll be able to self-cure, says Dr. Morse. Whereas protecting a constant 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 fast and long-term results if not handled. See a health care provider so you will discover the basis trigger and discover therapy that provides you acute and continual reduction.”