1414 116 th Ave NE Suite F Bellevue, WA 98004 Phone: (425) 451-8417 Fax: (425) 455-4089 Excessive Daytime Sleepiness Nearly everyone has days when they feel sleepy. But for some people, excessive sleepiness actually gets in the way of daily work, childcare and even leisure activities. This is known as hypersomnia, recurrent sleepiness that makes people want to nap repeatedly, even at work. Not surprisingly, the problem of daytime sleepiness usually starts at night. Even missing just a few nights sleep, or not getting enough uninterrupted sleep, can slow you down and sour your mood. Excessive daytime sleepiness is one of the most prevalent causes of sleep-related patient symptoms, affecting approximately 20% of the population. Persons with excessive daytime sleepiness generally have poorer health vs. adults of similar age. Excessive daytime sleepiness also referred to as EDS, is characterized by persistent sleepiness, and often a general lack of energy, even after apparently adequate night time sleep. EDS is a symptom of one of the two forms of the sleep disorder hypersomnia, the other being prolonged nighttime sleep.
Some persons with EDS, including those with narcolepsy, are compelled to nap repeatedly during the day; fighting off increasingly strong urges to sleep during inappropriate times such as while driving, while at work, during a meal, or in conversations. As the compulsion to sleep intensifies, the ability to competently complete tasks sharply diminishes, often mimicking the appearance of intoxication. Diagnosis An adult who is compelled to nap repeatedly during the day may have excessive daytime sleepiness. However, it is important to distinguish between occasional daytime sleepiness and excessive daytime sleepiness, which is chronic. A number of tools for screening for EDS have been developed. One is the Epworth Sleepiness Scale which grades the results of a questionnaire. The ESS generates a numerical score from zero (0) to 24 where a score of ten or higher may indicate that the person should consult a specialist in sleep medicine for further evaluation. Another tool is the Multiple Sleep Latency Test (MSLT), which has been used since the 1970s. It is used to measure the time it takes from the start of a daytime nap period to the first signs of sleep, called sleep latency. The test is based on the idea that the sleepier people are, the faster they will fall asleep. Causes EDS can be a symptom of a number of factors and disorders. Specialists in sleep medicine are trained to diagnose them. Some are: Insufficient quality or quantity of night time sleep. Misalignments of the body's circadian pacemaker with the environment (e.g. jet lag, shift work or other circadian rhythm sleep disorders). An underlying sleep disorder, such as narcolepsy, sleep apnea, hypersomnia or restless legs syndrome. Disorders such as clinical depression or atypical depression. Tumors, head trauma, anemia, kidney failure, hypothyroidism or an injury to the central nervous system. Drug and/or alcohol abuse. Genetic predisposition.
Coping EDS is often the manifestation of a disorder, and not a sign of a willful lack of effort. Without firm and knowledgeable counseling on the part of the physician, family members can easily fail to accept EDS as part of an illness. EDS can affect the ability to function in family, social, occupational, or other settings. A proper diagnosis, and treatment, of the underlying cause can help mitigate such complications. It can be difficult to accept that EDS is beyond a person's control; the unaffected may see sleepiness as an insult, a rejection, or as evidence for lack of interest. During occasional unique and/or stimulating circumstances, a person with EDS can sometimes remain animated, awake and alert, for brief or extended periods of time; this lends credence to an observer's assertions that the Poor sleep habits are often the cause of daytime sleepiness. Before you go through any more groggy and crabby days, try these 12 ways to improve nighttime sleep and avoid daytime sleepiness. 1. Get adequate nighttime sleep. That may sound obvious, but many of us succumb to shaving an hour or two off our sleep time in the morning or at night to do other things. Most adults need seven to nine hours a night and teenagers usually need a full nine hours. Block out eight or nine hours for sleep every night. 2. Keep distractions out of bed. Reserve your bed for sleep and sex, you shouldn t read, watch TV, play video games, or use laptop computers in bed. Don t do your bills or have heated discussions in bed either. They may leave you sleepless. 3. Set a consistent wake-up time. People who have problem sleepiness are often advised to go to bed and get up at the same time every day, including on weekends. But randomly setting an ideal bedtime can lead to more frustration if you suffer from insomnia and already have trouble falling asleep; Instead, start out by setting a wake-up time only. Stick by that for the first few weeks or even months to establish a rhythm, that process of always getting up at the same time helps to anchor the circadian rhythm. And if you do that and have a bad night, you ll also to be sleepier the next bedtime.
4. Gradually move to an earlier bedtime. Another approach to getting into a consistent schedule is to try going to bed 15 minutes earlier each night for four nights. Then stick with the last bedtime. Gradually adjusting your schedule like this usually works better than suddenly trying to go to sleep an hour earlier. 5. Set consistent, healthy mealtimes. Regular mealtimes, not just regular sleep times, help regulate our circadian rhythms. Eating a healthy breakfast and lunch on time rather than grabbing a doughnut and coffee in the morning or a late sandwich on the run also prevents energy deficits during the day that will aggravate your sleepiness. Plan to finish eating meals two to three hours before bedtime. 6. Exercise. Regular exercise (30 minutes a day on most days) offers multiple benefits for sleep. Exercise, especially aerobic exercise, generally makes it easier to fall asleep and sleep more soundly. Exercise also gives you more daytime energy and keeps your thinking sharp. And if you exercise outside in daylight, you get still more benefits. Sleep experts recommend 30 minutes of exposure to sunlight a day because daylight helps regulate our sleep patterns. Avoid exercising within three hours of bedtime. 7. De-clutter your schedule. If you don t think you can allow seven or eight hours for sleep, then you need to look at your schedule and make some adjustments, Move some activities from nighttime to early evening or from early to late morning. Try to eliminate tasks that aren t really important. Getting enough sleep at night will help you function better during your remaining activities. 8. Don t go to bed until you re sleepy. If you go to bed when you re just tired, you probably won t be able to fall asleep. Distinguish between the feeling of sleepiness and being tired. Get into bed when you re sleepy eyes droopy, you re drowsy, you feel like you re nodding off. It s a very different kind of feeling. 9. Don t nap late in the day. Late afternoon napping can make daytime sleepiness worse if because it can interfere with nighttime sleep.
10. Create a relaxing bedtime ritual. A relaxation routine before bedtime can help you separate from the day especially from activities that are over-stimulating or stressful, making it difficult to sleep. Try meditation, soaking in a hot bath, listening to soothing music, or reading a book. A cup of herbal tea or warm milk can also be soothing, but skip those if they cause you to wake at night to go to the bathroom. 11. Avoid nightcaps. People often think that alcohol helps sleep, but it actually robs you of deep sleep, which is essential for feeling well rested. When the effects of alcohol wear off during the night, you ll probably be wide awake again. 12. See a sleep specialist. Daytime sleepiness can be caused by sleep disorders. If you are excessively sleepy consistently during the day even when you sleep well or if you fall asleep without warning during daily activities, you may have a sleep disorder such as narcolepsy or sleep apnea, a breathing problem that occurs during sleep. Undiagnosed and untreated sleep disorders are probably the greatest cause of daytime fatigue and sleepiness. Problem sleepiness can also be caused by certain illnesses and medications. And mental conditions such as depression, posttraumatic stress disorder, and anxiety are very commonly linked to sleep problems. A sleep specialist can design a treatment program for you that treats the underlying sleep disorder and helps you develop better sleep habits and attitudes though cognitive behavioral therapy. Sometimes it takes a combination of medication and behavioral therapy to eliminate daytime sleepiness, but it can be done. GIVE US A CALL AT BEL-RED SLEEP DIAGNOSTIC CENTER WE CAN HELP!