Extreme Daytime Sleepiness: Causes and Remedy

We all get drained and rundown in some unspecified time in the future—you realize that feeling the place you need to change your “to-do” record to a “do-nothing” record, and simply lie down and take a nap. However should you commonly 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 should you’ve gotten sufficient sleep at evening, per a Might 2021 medical overview in Mayo Clinic Proceedings¹. In keeping with the overview, as many as 1 in 3 U.S. adults report coping with extreme sleepiness throughout the daytime.

“Extreme daytime sleepiness is a particular medical time period for a powerful need or chance 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 Heart in Pennsylvania. “Individuals should 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 possibly have an enormous impact on high quality of life, together with elevating the danger 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 possibly 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 totally different from grogginess or fatigue, and what you are able to do should you suppose you’re coping with it your self.

Who does extreme daytime sleepiness primarily have an effect on?

Commonly not getting sufficient sleep (that’s, getting fewer than seven hours per evening) places you in danger for EDS, irrespective of the explanation behind your lack of zzzs, says Nancy Foldvary-Schaefer, DO, director of the Sleep Problems 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 several types of EDS: major and secondary. Major EDS (also called major hypersomnia) means the necessity to sleep isn’t a symptom or brought on by one other medical subject, 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 embody narcolepsy and Kleine-Levin syndrome (generally referred to as “sleeping magnificence syndrome”).

Secondary EDS—or EDS from one other trigger—is far 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 solely correct. “Every little 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 embody 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 medicines (together with sleeping drugs, 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 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, should you’re fatigued, you would possibly really feel run-down bodily and mentally and lower than doing sure duties, however not overly sleepy. However when you’ve got EDS, you might have to nap a number of instances throughout the day, despite the fact that you’ve slept sufficient at evening, 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 motorized vehicle accidents, and interpersonal conflicts, says Dr. Foldvary-Schaefer.

“EDS invades all facets of life,” says Dr. Morse. “You might be extra irritable, depressed, or anxious. It might 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 danger of accidents and different well being points. EDS is a significant reason behind 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 danger of falling asleep behind the wheel, EDS will increase response time, which might have an effect on a driver’s means to shortly right a automobile or maintain 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. Should you wouldn’t let your good friend depart buzzed, don’t let your good friend depart drained,” she provides.

Dr. Morse additionally says that in relation to driving, individuals usually suppose they will “outsmart” sleepiness—however they will’t. “Individuals will flip up the music or air-con or open the automobile 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 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 loss of life, based on a December 2023 research within the Journal of the American Coronary heart Affiliation⁴.

Prognosis and remedy for EDS

Should you suppose you are coping with EDS, Dr. Morse recommends maintaining a symptom diary to file not solely when and the way lengthy you sleep, however every other accompanying signs. This info may help your physician and sleep specialists decide the basis reason behind your EDS.

“Sleep and wakefulness are intimately related,” says Dr. Morse. “Common medication usually dismisses sleep, and sleep medication usually 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 occurring.”

Together with sleep and symptom historical past, docs 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 upon what’s inflicting it, says Dr. Morse.

“Primarily based on the situation inflicting EDS, remedy may embody life-style modifications, medicines, 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. Should you’re coping with EDS three or extra days per week for at the very 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 necessary to not normalize sleepiness. It’s not regular, it’s simply widespread.”

And, above all, don’t suppose EDS is one thing you’ll be able to self-cure, says Dr. Morse. Whereas maintaining a constant sleep routine may 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 rapid and long-term results if not handled. See a physician so you’ll find the basis trigger and discover remedy that provides you acute and power aid.”