May 04, 2021

Could Sleep Apnea Be Causing Your Excessive Daytime Sleepiness?

Ever find yourself struggling to stay awake during the day or so tired that you can't concentrate on your work? 

Not the tiredness after a night out with friends on a weekday or a sleepless night caring for a baby at home. We're talking about excessive daytime sleepiness (EDS), otherwise called hypersomnia, that arises consistently after normal schedule sleep hours.

While plenty of people experience the occasional daytime fatigue and more than a third of the American general population is not getting enough sleep, feeling constantly exhausted during the day may be a sign of a more serious condition medical condition that should be evaluated by a doctor. 

What Is Excessive Daytime Sleepiness?

Excessive daytime sleepiness is one of the most common sleep-related patient symptoms, and it affects an estimated 20% of the population. In fact, it's the leading symptom of patients presenting to sleep clinics or people with sleep disorders. 

People with excessive daytime sleepiness are at risk of motor vehicle accidents and tend to have poor health. 

Causes of Excessive Daytime Sleepiness

The most common causes of excessive daytime sleepiness are:

- sleep deprivation

- circadian rhythm sleep-wake disorder

- restless leg syndrome (RLS)

- medication side effects

- sleep medicine.

- health problems 

- poor sleep hygiene

- illicit substance use

- jet lag

- obstructive sleep apnea (OSA)

- narcolepsy, a chronic neurological disorder characterized by excessive daytime sleepiness, rapid eye movement (REM), and nighttime sleep disturbances. 

- Idiopathic hypersomnia

- and other medical and psychiatric conditions

Being constantly tired can mean that you're more prone to make mistakes or be less productive, and it can impair your ability to fully take part in the things you normally like to do. 

Additionally, it is also linked to the prevalence of serious health issues such as cardiovascular disease, and increased risk of adverse health effects.

If you have excessive daytime sleepiness, it's important to find the root cause. The condition can harm and cause impairment in many aspects of your life, including work, relationships, and day-to-day activities.

Evaluating and Screening for Excessive Daytime Sleepiness

Sleep Questionnaires

Questionnaires such as the Stanford Sleepiness Scale and the Epworth Sleepiness Scale are validated, patient-completed assessments of daytime sleepiness are used as screening tests. A test score above 12 on the Epworth Sleepiness Scale or patient history of falling asleep while driving indicates that further evaluation and work-up are required.

Medical History

A targeted medical history, including a history of heart failure, a physical examination, and laboratory assessment are generally used to evaluate patients at risk of medical or psychological causes of secondary excessive daytime sleepiness. 

The medication history must address the use of all prescription and nonprescription medications and drugs of abuse, including medication for heart disease.

Sleep Pattern History

Information about sleep patterns and sleep problems should identify behavioral sleep deprivation. This is most common in adolescents and shift workers, and it can result in significant excessive daytime sleepiness if not addressed.

It may also indicate restless legs syndrome or obstructive sleep apnoea (OSA), common in people suffering from risk factors such as hypertension (high blood pressure), breathing disorders, diabetes, obesity, and coronary disease. In most cases, overnight polysomnography is required to confirm the diagnosis of OSA and to determine the appropriate pressure levels for treatment using continuous positive airway pressure (CPAP).

Treatment Options For Excessive Daytime Sleepiness

Excessive Daytime Sleepiness is not a condition but a symptom of a larger condition that's interfering with your sleep. After identifying the underlying cause of your sleepiness, your health care provider or sleep specialist will suggest several treatment options to improve wakefulness according to your specific diagnosis.

If you were diagnosed after a sleep study with obstructive sleep apnea (OSA) or sleep apnea syndrome, a sleep disorder that causes a collapse of the upper airway during sleep, treatment with oral appliances or CPAP therapy will improve your sleep quality and lower your risk for motor vehicle incidents, while alleviating related symptoms for your condition, such as snoring, drowsiness, waking up with a dry mouth, brain fog, etc.

  • Medication Adjustment or Discontinuation

Sometimes treatment of excessive daytime sleepiness can be as simple as discontinuing or modifying the use of certain medications.

Treatment methods will also consider sleep hygiene tips such as avoiding screen time before bedtime, eating 2 hours prior to sleeping, adhering to regular sleep schedules, and creating a soothing sleep environment.

Final Thoughts

Your sleep quality is essential to your health and wellbeing. If you suspect you may be suffering from excessive daytime sleepiness, please consult a sleep specialist or your health care provider.

Written by Karina Lima

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