Excessive Daytime Sleepiness

Being tired or sleepy is one of the most common reasons for a person to seek the advice of a Sleep Medicine specialist. There are a host of conditions known to cause excessive sleepiness, and it is one of the chief complaints of people in the general population.

Some who do not admit to being sleepy during a physician office visit have the misconception that sleep is not a medical or physical priority, so naturally a person can be tired. Indeed, the average sleep of American working age adults is around 6½ hours, 3 hours less than Americans of the 1800’s. Sleep deprivation is a personal choice, prompted by many societal and personal factors.

Other causes of daytime sleepiness include

• Medical illnesses (anemia, hypothyroidism, rheumatologic illness)
• Neurologic illnesses (multiple sclerosis, stroke)
• Psychiatric illness (bipolar depression)
• Medication side effects (antidepressants, anticonvulsants, cardiac meds)
• Primary sleep disorders (narcolepsy, insomnia, sleep apnea, restless legs) 

When is it appropriate to be evaluated by a sleep specialist for excessive daytime sleepiness?

Your primary physician should refer you if:
• Your sleepiness is interfering with your functions in everyday life.
• Your sleepiness has caused you to have an accident at work or on the
highway.
• Your sleepiness has nearly caused you to have an accident (the near-miss).
• Your sleepiness occurs very suddenly, unexpectedly.
• You also have sudden collapse of your bodily muscles in an emotional situation (cataplexy).
• Your sleepiness is associated with sleep-walking or observed apnea.

Treatment of excessive daytime sleepiness requires an examination of possible causes and often formal sleep testing is needed to define the causes, assess the degree of sleepiness, or see the effects of treatment. Stimulant drug therapy may be needed. This sort of analysis requires the special expertise of a sleep specialist.

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