Excessive Daytime Sleepiness: Should I Be Concerned?

Excessive daytime sleepiness (EDS) is a debilitating symptom that significantly decreases the quality of life. A number of sleep disorders can cause EDS. These include conditions like obstructive sleep apnea (OSA), narcolepsy, insomnia, circadian rhythm disorders, parasomnias, and more. If you suspect you may have EDS, a sleep study can help uncover a potential underlying cause.

Key takeaways:

What is excessive daytime sleepiness?

Excessive daytime sleepiness is defined as an overwhelming feeling of exhaustion, tiredness, and fatigue. It is estimated that about 18% of individuals are affected by EDS. People who are excessively sleepy can find themselves falling asleep unintentionally in inappropriate situations. This can be very distressing, especially since EDS can impair a person’s ability to perform well at work, in school, or even while driving.

Symptoms of excessive daytime sleepiness

In addition to the symptoms of exhaustion and sleepiness, EDS can also cause other related symptoms, including:

  • Difficulty concentrating
  • Poor mood
  • Irritability
  • Cognitive dysfunction

Causes of excessive daytime sleepiness

Because EDS is a symptom and not a stand-alone diagnosis, it is important to understand that there are numerous health problems that can cause excessive daytime sleepiness. In the setting of sleep, EDS can be caused by several different types of sleep disorders that reduce sleep quality.

It is always best to consult a healthcare provider if you are struggling with EDS. It is likely you may be referred for a sleep study, which is a test that analyzes your sleep physiology and can look for many sleep disorders that may be contributing to your EDS. It is important to determine the underlying cause of EDS in order to make sure you receive the right treatment.

Obstructive sleep apnea

If you snore, wake up gasping at night, or find yourself feeling tired even after getting at least seven to eight hours of sleep at night, you may have obstructive sleep apnea. This is a sleep disorder characterized by repetitive obstruction of the airway at night, which causes a brief cessation in breathing. In response, the body experiences an “arousal” to help kick-start the body’s breathing back up. This constant disruption to sleep is what makes OSA a possible cause of EDS.

Insomnia

For some people, insomnia can understandably be the cause of EDS. People with insomnia have difficulty with initiating sleep, maintaining sleep, and returning to sleep after waking up at night. Because of this poor, fragmented sleep, EDS can often occur.

Narcolepsy

Narcolepsy is another possible cause of excessive daytime sleepiness. It is a very rare disorder, only affecting about one in every 2,000 people. People with narcolepsy have a deficiency in a neurotransmitter in the brain called orexin, also sometimes referred to as hypocretin. This insufficiency causes problems with the brain’s ability to regulate the sleep-wake cycle and causes severe EDS.

Circadian rhythm problems

Some people may suffer from circadian rhythm disorders, which occur as a result of the body’s natural clock being out of sync with the environment. Shift work is a common cause of circadian rhythm problems. People who work overnight, for example, are susceptible to EDS because being awake all night can cause confusion internally as to what time of day it really is. The irregular sleep pattern and confusion of the body clock is what cause EDS in these people.

Parasomnias

Parasomnias are any unwelcome behaviors or experiences that occur during sleep and happen as a result of incomplete arousal from a deep sleep. It is an umbrella term that includes several sleep problems including sleepwalking, nightmares, rapid eye movement behavior disorder, and more. Because of the disruptive nature of these behaviors on getting restful sleep, parasomnias can be a cause of EDS.

Restless legs syndrome, limb movements

Restless legs syndrome (RLS) is a sleep disorder that is characterized by an overwhelming urge to move the legs that is often worse at nighttime and is relieved by getting up and moving. It can be extremely disruptive to sleep given its occurrence in the nighttime hours and can make it hard to fall asleep and stay asleep. Once asleep, people with restless legs can sometimes experience periodic limb movements (PLM) as well, which can cause sleep disruption and subsequent EDS.

Treating excessive daytime sleepiness

The treatment for EDS is guided by the underlying cause. People with sleep apnea may be recommended a breathing machine known as a continuous positive airway pressure (CPAP) device to help correct their breathing. Behavioral therapies, medications, and certain supplements can be used to treat insomnia, narcolepsy, circadian rhythm disorders, parasomnias, and RLS/PLMs.

Excessive daytime sleepiness can be a debilitating symptom and is a feature of many sleep disorders. If you are struggling with EDS, it is important to consult with your healthcare provider to start looking for an underlying cause. While a sleep study may be recommended, you should follow the recommendations given to you as guided by your healthcare provider. While EDS can be distressing, there is a multitude of treatment options that can be employed to address this problem once a diagnosis is found.



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