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Excessive Daytime Sleepiness: Causes, Test and Treatments

Excessive Daytime Sleepiness (EDS) is defined by having an increased pressure to fall asleep during typical wake hours. It is a common complaint of many adults and children. It is the most common symptoms of people with sleep disorders. EDS is a leading cause of fatalities from motor vehicle accident.

Sleep deprivation has also been associated with the Chernobyl nuclear power plant meltdown, Exxon Valdez oil spill, and the space shuttle, Challenger, explosion.

Symptoms of Excessive Daytime Sleepiness

Excessive Daytime Sleepiness, sometimes also referred to as "Hypersomnia", is a non-specific symptom. There are several potential causes of EDS. EDS is difficult to assess objectively. There are several questionnaires available to assess EDS. One of the most popular questionnaires is the Epworth Sleepiness Scale (ESS). This scale uses eight questions composed of eight scenarios. The user rates the likelihood of falling asleep from 0 -3 points per scenario. The total is tallied up to a highest sleepiness score of 24.

Excessive daytime sleepiness (EDS) is usually a symptom of a condition.

Tests For Excessive Daytime Sleepiness

There are several tests that can be done to diagnose sleepiness, which will determine whether the individual has primary (originating in the brain) or secondary (originating as a result of another disease) sleepiness.  First, the physician will look for other obvious sleep disorders that could be causing the excessive sleepiness, with the primary goal being to determine if there are treatable medical conditions present.  These tests could include polysomnography, subjective scales such as the Epworth Sleepiness Scale and the Stanford Sleepiness Scale, as well as objective tests like the multiple sleep latency test.  The physician will usually make the diagnosis when symptoms have been present for three consecutive months and there are no other underlying diseases.

The Multiple Sleep Latency Test (MSLT) and Maintenance of Wakefulness Test (MWT) are tests that are performed in a sleep center. The patient is instructed to try to fall asleep (MSLT) or try to stay awake (MWT). These tests are usually performed during the daytime after a nighttime sleep study. They usually consist of 4 or 5 nap time tests.

How Common is Excessive Daytime Sleepiness

Primary sleepiness is less common than secondary sleepiness, affecting less than 1% of the population and usually associated with a more widely known diagnosis.

Causes of Excessive Daytime Sleepiness

Primary causes include diagnoses of sleep disorders like narcolepsy, sleep apnea, restless leg syndrome, and insomnia.

Secondary sleepiness is much more prevalent.  The excessive sleepiness can be a result of other conditions such as depression, obesity, epilepsy, or multiple sclerosis.  It is common in those with upper airway resistance syndrome, restless leg syndrome, sleep deprivation, and substance abuse.  Some people may be genetically predisposed to the condition as well.

There are a host of conditions that could lead to sleepiness; however, one of the most common cause is sleep apnea, affecting approximately 4% of the population.

Medications and over the counter products may also cause daytime sleepiness. These may include melatonin and sleeping pills.

Treatments for Excessive Daytime Sleepiness

Treatment will depend greatly on the underlying cause of sleepiness and whether it is a primary or secondary concern.  Sometimes, catching up on sleep will alleviate the excessive sleepiness; however, more often than not, it is more appropriate to treat the underlying cause than it is to treat the symptom.  Most common treatments include the use of stimulant medications like amphetamines to help the individual stay awake throughout the day.  In addition, behavioral therapy, sleep hygiene, and education are usually added to a treatment regimen. To help find out the cause of your EDS we recommend speaking with your doctor.  A service like lunella, allows you to take an online assessment and if at risk for sleep apnea, will send  a home sleep test and send results to a sleep specialist. Click here to find out more.

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2 comments on “Excessive Daytime Sleepiness: Causes, Test and Treatments”

  1. Adrian I have horrible day time fatigue and early morning wakening. LDN has been amazingly helpful when taken in the morning.
    You’re right, nobody really cares about us. The only “treatment” I received in the 9 years this has been disabling me was a sleep study that said I don’t have restless leg or apnea. I knew that already.

  2. I have excessive sleep for many years now and it bothers me, as I do not believe that I can even get up for a job for example. I have not, to date, been able to obtain treatment in this area. I have had several mental health conditions diagnosed, for which the medication is only partially effective, and it is quite likely that the excessive sleeping is linked with these conditions. Any advise, support and suggestions most welcome,

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