Extreme Daytime Sleepiness: Causes and Therapy

We all get drained and rundown sooner or later— 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 in case you usually end up struggling to remain awake throughout the day, it may very well be one thing greater than easy grogginess. It may very well 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 case you’ve gotten sufficient sleep at evening, per a Might 2021 medical assessment in Mayo Clinic Proceedings¹. In response to the assessment, as many as 1 in 3 U.S. adults report coping with extreme sleepiness throughout 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 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 in periods of wakefulness.”

As a result of EDS impacts temper, reminiscence, focus, consideration, and productiveness, it may 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 usually a symptom of one other situation—which means it may have quite a few causes that take medical experience to diagnose and deal with, says Dr. Morse.

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

Who does extreme daytime sleepiness primarily have an effect on?

Repeatedly 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 Issues Middle on the Cleveland Clinic Neurological Institute.“Inadequate sleep is the primary trigger” of extreme daytime sleepiness, she says, including: “Forty % of grownup Individuals are chronically sleep-deprived.”

There are two various kinds of EDS: major and secondary. Main EDS (also called major 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 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 rather more widespread than major 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 fully correct. “All the pieces 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 medicines (together with sleeping capsules, opioids, and antihistamines)
• Behaviors that trigger sleep deprivation, akin to shift work, staying up too late, or jet lag

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

How is it totally 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, in case you’re fatigued, you may really feel run-down bodily and mentally and less than doing sure duties, however not overly sleepy. However when you’ve got EDS, you might have to nap a number of occasions throughout the day, although you’ve slept sufficient at evening, she explains.

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

“EDS invades all points of life,” says Dr. Morse. “You might be extra irritable, depressed, or anxious. It may impair your means to carry out duties, making you extra liable to errors and extra annoyed 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 serious reason for work-related harm and is estimated to be the reason for virtually one-fifth of all motorized vehicle 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 might have an effect on a driver’s means to shortly appropriate a automobile or preserve 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. In case you wouldn’t let your buddy go away buzzed, don’t let your buddy go away drained,” she provides.

Dr. Morse additionally says that with regards to driving, individuals typically assume 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 individuals may really feel extra alert, objectively they’re not,” she provides.

Likewise, EDS may 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 loss of life, based on a December 2023 examine within the Journal of the American Coronary heart Affiliation⁴.

Analysis and therapy for EDS

In case you assume you are coping with EDS, Dr. Morse recommends retaining a symptom diary to report not solely when and the way lengthy you sleep, however some other accompanying signs. This data may help your physician and sleep specialists decide the basis reason for your EDS.

“Sleep and wakefulness are intimately related,” 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 impression throughout your awake hours and assist us perceive what’s happening.”

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

“Primarily based on the situation inflicting EDS, therapy might embrace life-style modifications, medicines, or maybe tools,” akin 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. In case you’re coping with EDS three or extra days per week for at the least 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 essential 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 retaining a constant sleep routine might assist with the occasional bout of fatigue, you might 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 instant and long-term results if not handled. See a physician so yow will discover the basis trigger and discover therapy that offers you acute and power reduction.”