Extreme Daytime Sleepiness: Causes and Therapy

We all get drained and rundown sooner or later—you already know that feeling the place you wish to change your “to-do” record to a “do-nothing” record, and simply lie down and take a nap. However if you happen to commonly 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 if you happen to’ve gotten sufficient sleep at night time, per a Could 2021 scientific assessment in Mayo Clinic Proceedings¹. In line with the assessment, 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 Heart in Pennsylvania. “Individuals 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 may well have a giant impact on high quality of life, together with elevating the chance for accidents and different well being situations, based on the NHS. EDS can also be sometimes a symptom of one other situation—which means it may well 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 if you happen to suppose you’re coping with it your self.

Who does extreme daytime sleepiness primarily have an effect on?

Often not getting sufficient sleep (that’s, getting fewer than seven hours per night time) places you in danger for EDS, irrespective of the rationale behind your lack of zzzs, says Nancy Foldvary-Schaefer, DO, director of the Sleep Issues Heart 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 various kinds of EDS: main and secondary. Major EDS (often known as main hypersomnia) means the necessity to sleep just isn’t a symptom or attributable to one other medical challenge, 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 (generally known as “sleeping magnificence syndrome”).

Secondary EDS—or EDS from one other trigger—is far more frequent than main EDS, based on 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 completely correct. “Every 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, 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 despair
• Some prescription and over-the-counter drugs (together with sleeping tablets, opioids, and antihistamines)
• Behaviors that trigger sleep deprivation, corresponding 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, if you happen to’re fatigued, you would possibly really feel run-down bodily and mentally and lower than doing sure duties, however not overly sleepy. However if in case you have EDS, you might must nap a number of instances in the course of the day, though you’ve slept sufficient at night time, she explains.

EDS also can 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 points of life,” says Dr. Morse. “You could be extra irritable, depressed, or anxious. It could possibly 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 chance of accidents and different well being points. EDS is a significant explanation for work-related damage 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 chance of falling asleep behind the wheel, EDS will increase response time, which may have an effect on a driver’s capability to shortly appropriate a automobile or hold a automobile inside a lane, based on 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. For those who wouldn’t let your pal depart buzzed, don’t let your pal depart drained,” she provides.

Dr. Morse additionally says that in the case of driving, individuals usually suppose they’ll “outsmart” sleepiness—however they’ll’t. “Individuals will flip up the music or air-con or open the automotive home windows, however research have discovered whereas subjectively individuals would possibly really feel extra alert, objectively they’re not,” she provides.

Likewise, EDS also can 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 chance of diabetes, weight problems, psychological well being issues, a weakened immune system, and hormone abnormalities, per the Nationwide Library of Medication. EDS can also be related to an elevated danger of heart problems and demise, based on a December 2023 research within the Journal of the American Coronary heart Affiliation⁴.

Prognosis and remedy for EDS

For those who suppose you are coping with EDS, Dr. Morse recommends protecting a symptom diary to document not solely when and the way lengthy you sleep, however every other accompanying signs. This data may also help your physician and sleep specialists decide the basis explanation for your EDS.

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

Together with sleep and symptom historical past, medical doctors can 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 rely on what’s inflicting it, says Dr. Morse.

“Based mostly on the situation inflicting EDS, remedy might embrace life-style modifications, drugs, or maybe gear,” corresponding to CPAP machines for sleep apnea, says Morse. “It’s actually a novel remedy 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. For those who’re coping with EDS three or extra days per week for not less than 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 may self-cure, says Dr. Morse. Whereas protecting a constant sleep routine might assist with the occasional bout of fatigue, you might want extra formal remedy 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 yow will discover the basis trigger and discover remedy that provides you acute and power aid.”