What Is Excessive Daytime Sleepiness?
A particularly dangerous condition while driving
Medically reviewed by Sanja Jelic, MD
Excessive daytime sleepiness (EDS) is a symptom in which extreme sleepiness occurs during the day, even when you’ve gotten enough sleep at night. EDS is more than feeling groggy and fatigued; the need to sleep interferes with daily activities and increases the risk of health issues and traffic accidents.
Possible causes for EDS include sleep deprivation, sleep disorders, and medication use. Excessive daytime sleepiness affects up to 20% of the population.
This article will examine the medical and nonmedical causes of EDS, its symptoms and impact, and when to see a healthcare provider.
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Medical Causes of Excessive Daytime Sleepiness
The most common cause of EDS is not getting enough sleep. Medical causes for EDS can include the following conditions.
Hypersomnia Sleep Disorders
Hypersomnia sleep disorders happen when something goes wrong with parts of the brain or nervous system that signal the body to be asleep or alert.
Hypersomnia sleep disorders include:
Kleine-Levin Syndrome
Idiopathic hypersomnia (hypersomnia with no known cause)
Obstructive Sleep Apnea
People with obstructive sleep apnea experience lapses in breathing during sleep caused by throat muscles relaxing and blocking the airway. These pauses in breathing cause repeated waking during sleep. The resulting poor sleep quality can cause EDS.
Restless Leg Syndrome
Restless leg syndrome is a condition wherein a desire to move one’s legs at night, often accompanied by twitching or pricking sensations, makes falling and staying asleep difficult. Poor sleep quality from restless leg syndrome can lead to EDS.
Circadian Rhythm Sleep Disorders
Circadian rhythm sleep disorders occur when the body’s internal clock, which controls the sleep-wake cycle, isn't functioning properly. There are medical and nonmedical reasons circadian rhythm sleep disorders can occur, including:
Irregular sleep-wake rhythm disorder (typically caused by neurodegenerative conditions such as Parkinson’s disease or Alzheimer’s disease)
Non-24-hour sleep-wake rhythm disorder, which primarily affects those who are totally blind
Shift work
Depression and Other Mental Health Conditions
Excessive daytime sleepiness is experienced by up to two-thirds of adults with major depressive disorder. It is also common in those with bipolar disorder and seasonal affective disorder.
Medications
A number of over-the-counter (OTC) and prescription medications can cause EDS. Some of the most common include:
Prescription and nonprescription sleeping pills
Psychotropic medications such as antipsychotics and some antidepressants
Other Medical Conditions
Other medical conditions less commonly associated with EDS include:
Head trauma
Neurodegenerative conditions
Nonmedical Causes of Excessive Daytime Sleepiness
Nonmedical causes of EDS are typically ones that cause chronic lack of sleep. They include:
Shift work
Keeping an irregular schedule
Waking up at night to use the bathroom
How Much Sleep Do You Need?
For optimal health, adults should get seven hours or more of sleep per night, while teenagers should get eight to 10 hours of sleep per night.
How to Stop and Manage EDS With Treatment
Treatment for EDS will depend on whether it's due to a primary sleep-related cause or a secondary cause, such as another medical or psychiatric condition or medication use. If another condition is causing your EDS, that condition will need to be identified and treated first.
Behavioral treatments such as naps, getting more exercise, and sleep hygiene measures are often used to treat EDS.
Depending on the cause of EDS, medications that promote wakefulness or other types of medication might also be used. For obstructive sleep apnea, devices such as a continuous positive airway pressure (CPAP) machine may be prescribed.
Effects and Impact of Excessive Daytime Sleepiness
One of the most dangerous impacts of EDS is the increased risk of work and traffic accidents. EDS increases reaction time, which in the case of driving can affect the ability to quickly correct a vehicle’s path when necessary.
Lack of sleep is particularly associated with crashes in which the driver is unable to keep the vehicle in its lane, especially on monotonous roads.
EDS and Vehicle Accidents
EDS is estimated to cause almost one-fifth of motor vehicle accidents in the United States.
Sleep deprivation affects the entire body. EDS is associated with an increased risk of:
A weakened immune system
Hormone abnormalities
Neurodegenerative diseases
Mental health disorders
In addition to an increased risk of health issues and accidents, EDS can affect quality of life. It can make regulating emotions or moods difficult, limit work or school performance, and cause social or relationship problems.
How Do You Know You Have EDS Symptoms?
EDS is different from feeling tired. If you have EDS, you might regularly nap or fall asleep during the day, even though you've slept enough at night.
Chronic Fatigue Syndrome or Excessive Daytime Sleepiness?
EDS and chronic fatigue syndrome (CFS) can both cause daytime sleepiness; however, CFS
is marked by a high degree of fatigue or exhaustion, especially after exertion. Not everyone with CFS experiences daytime sleepiness.
The two conditions can overlap, and about 20% of those with EDS disorders also meet diagnostic criteria for CFS.
Common Symptoms of EDS
In addition to daytime sleepiness, other common symptoms of EDS include:
Trouble staying alert or focusing
Experiencing memory problems
Irritation
Difficulty making decisions
Slower reaction times
Risk-taking behaviors
Getting an EDS Diagnosis
An EDS diagnosis usually begins with your healthcare provider giving you a physical exam and taking a history of your sleep habits and patterns and any medications you’re taking. You might also have your sleep assessed through medical questionnaires to determine how well you're sleeping.
You might also be asked to keep a sleep log or diary and get referred to a sleep specialist for further testing and evaluation.
Sleep Habits With Excessive Daytime Sleepiness
Practicing good sleep hygiene and healthy sleep habits can help improve sleep quantity and quality. Good sleep hygiene practices include:
Going to bed and getting up at the same time, even on weekends
Keeping your bedroom quiet, dark, and at a comfortable temperature
Removing electronic devices, such as TVs and smartphones, from the bedroom
Avoiding large meals, caffeine, and alcohol before bed
Getting enough physical activity during the day so you can fall asleep more easily
When to See a Healthcare Provider About Sleep
You should contact a healthcare provider if EDS is affecting your daily life, you are constantly tired or fall asleep during the day, or you think you might have an underlying health condition that’s causing your excessive sleepiness.
Summary
Excessive daytime sleepiness can interfere with your daily life and increase your risk of accidents and certain health conditions. Because EDS can have a number of possible causes, you should see a healthcare provider if you are experiencing excessive sleepiness during the day.
A healthcare provider can help determine what's causing your EDS, work with you on steps toward getting better sleep, and prescribe medications and other treatments if necessary.
Read the original article on Verywell Health.
