About problem sleepiness

What is problem sleepiness?

Problem sleepiness occurs when sleepiness during the day interferes with work or social functioning.

  • Symptoms of problem sleepiness may include difficulty concentrating, falling asleep while driving, or problems with emotional control.
  • There are a number of causes of problem sleepiness, including sleep disorders; other medical conditions; certain medications; substances like drugs, alcohol, or caffeine; or an altered sleep-wake cycle.
  • Sleep disorders include narcolepsy, insomnia, sleep apnea, and restless legs syndrome.
  • Sleepiness is a major cause of motor vehicle accidents, poor school performance, and depressed mood.
  • Shift workers are especially susceptible to sleepiness and its risks.
  • Treatment may consist of improving sleep hygiene and avoiding precipitating factors.

What is problem sleepiness?

Everyone feels sleepy at times. However, when sleepiness interferes with daily routines and activities, or reduces the ability to function, it is called "problem sleepiness." A person can be sleepy without realizing it. For example, a person may not feel sleepy during activities such as talking and listening to music at a party, but the same person can fall asleep while driving home afterward.

What are the symptoms for problem sleepiness?

You may have problem sleepiness if you:

  • consistently do not get enough sleep, or get poor quality sleep;
  • fall asleep while driving;
  • have difficulty paying attention or concentrating at work, school, or home;
  • have performance problems at work or school;
  • are often told by others that you are sleepy;
  • have difficulty remembering;
  • have slowed responses;
  • have difficulty controlling your emotions; or
  • must take naps on most days.

What are the causes for problem sleepiness?

Sleepiness can be due to the body's natural daily sleep-wake cycles, inadequate sleep, sleep disorders, or certain drugs.

What are the treatments for problem sleepiness?

The treatment options for excessive sleepiness vary greatly, depending on the cause.

Obstructive sleep apnea

One of the most common treatments is continuous positive airway pressure (CPAP). This therapy employs a small bedside machine that pumps air through a flexible hose to a mask worn over your nose and mouth.

Newer versions of CPAP machines have smaller, more comfortable masks. Some people complain that CPAP is too loud or uncomfortable, but it remains the most effective OSA treatment available. It’s typically the first treatment a doctor will suggest for OSA.

Restless legs syndrome

RLS can sometimes be controlled with lifestyle changes. A leg massage or a warm bath before bedtime may help. Exercising early in the day may help with RLS and with your ability to fall asleep.

Your doctor may recommend iron supplements if it appears your iron levels are low. Your doctor may also prescribe medications to control RLS symptoms. If so, be sure to discuss any potential side effects with your doctor or pharmacist.

Narcolepsy

Narcolepsy symptoms may be treated with some lifestyle adjustments. Brief, scheduled naps may help. Sticking to a regular sleep-wake schedule every night and morning is also recommended. Other tips include:

  • getting daily exercise
  • avoiding caffeine or alcohol before bedtime
  • quitting smoking
  • relaxing before bed

All of these things can help you fall asleep and stay asleep better at night. This may help cut down on sleepiness during the day.

Depression

Treating depression can be done with a combination of therapy, medications, and lifestyle changes. Antidepressant drugs aren’t always necessary. If your doctor recommends them, they may be needed temporarily.

You may be able to ease depression through talk therapy and making certain lifestyle changes, such as exercising more, limiting alcohol, eating a nutritious diet, and managing stress.

Age-related sleep problems

The lifestyle changes that can help treat narcolepsy and insomnia can also help people experiencing age-related sleep problems. If lifestyle changes alone aren’t enough, talk with your doctor. They can prescribe sleep medications that can improve your quality of sleep.

Idiopathic hypersomnia

Since the cause of idiopathic hypersomnia isn’t known, treatment is focused on alleviating symptoms and may include stimulants, diet changes, or lifestyle changes.

The bottom line

Getting enough sleep is crucial to good health. If you can identify the cause of your excessive sleepiness and get treatment, you should find yourself feeling more energetic and with a better ability to concentrate during the day.

If your doctor doesn’t ask about your sleep routine, volunteer your symptoms of daytime sleepiness and discuss ways to overcome them. Don’t live with feeling tired every day when you might have a condition that’s easily and safely treated.

What are the risk factors for problem sleepiness?

Sleepiness is the desire to fall asleep. It's normal to feel sleepy at times, especially if you've been awake for a long time or haven't had enough sleep the night before. But when sleepiness interferes with your daily activities and causes problems at home, school or work, it can become a disorder called hypersomnolence.

Hypersomnolence usually involves extreme daytime sleepiness that affects your ability to function during the day. When you're hypersomnolent, it's hard for you to stay awake for more than a few hours at a time without taking a nap—even when you have the opportunity to sleep. Hypersomnolence can be caused by an underlying medical condition or by an emotional or behavioral problem.

It is a common symptom of several medical conditions, including depression, heart failure, chronic pain, and restless legs syndrome.

It can also be caused by certain medications such as antidepressants (SSRIs), amphetamines, and antihistamines. The problem sleepiness can also be a side effect of some over-the-counter medications such as cold medicine or pain relievers containing caffeine.

The four risk factors of problem sleepiness are:

1. Age: most people experience a decline in their ability to stay awake as they get older

2. Stress: stress can make you feel tired and sleepy

3. Sleep disorders: an untreated sleep disorder like insomnia can make it difficult for you to fall asleep and stay asleep throughout the night

4. Medical conditions: certain medical conditions such as heart disease, diabetes, cancer, or depression can increase your risk of experiencing problem sleepiness.

Symptoms
Difficulty concentrating during the day,Drowsiness during the day (including falling asleep at inappropriate times),Fatigue after waking up from sleep—or not feeling refreshed after sleeping enough hours for your body's needs,Having trouble waking up in the morning and/or falling asleep at night on a regular basis
Condition
Sleep Apnea,Insomnia,Shift Work Sleep Disorder (SWSD),Circadian Rhythm Disorders (CRDs),Narcolepsy,Sleep-Related Breathing Disorders (SRBDs)
Drugs
Trazodone (a selective serotonin reuptake inhibitor),Mirtazapine (a noradrenergic and specific serotonergic antidepressant),Nuvigil (modafinil)

Is there a cure/medications for problem sleepiness?

In general, medications do not help problem sleepiness, and some make it worse. Caffeine can reduce sleepiness and increase alertness, but only temporarily. It can also cause problem sleepiness to become worse by interrupting sleep.

While alcohol may shorten the time it takes to fall asleep, it can disrupt sleep later in the night, and therefore add to the problem sleepiness.

Medications may be prescribed for patients in certain situations. For example, the short-term use of sleeping pills has been shown to be helpful in patients diagnosed with acute insomnia. Long-term use of sleep medication is recommended only for the treatment of specific sleep disorders.

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