Excessive Daytime Sleepiness (EDS)

Excessive Daytime Sleepiness is defined as difficulty in staying awake or alert or strong desire to sleep during the day for at least three months.

If you experience sleepiness once in a while, it is considered Normal. But, if you experience daily for at least three months, you may have Excessive Daytime Sleepiness.

EDS most commonly occurs in older people, teenagers, and shift workers. In America, EDS affects 10% to 20% of population and research suggests that it’s on the rise.

Excessive Daytime Sleepiness is not a Disorder; but As it is associated with sleep disorder such as Obstructive Sleep Apnea, it should be considered seriously because it’s the body way of telling that you are not getting adequate sleep or it may be raising red flags about a sleep disorder or other health condition.

Symptoms of Excessive Daytime Sleepiness

You may have Excessive Daytime Sleepiness, if you have any of these symptoms:

Difficulty in waking up from sleep.
Falling asleep multiple times during the day.
Taking naps to prevent sleepiness but still not feeling refreshed.
Sleeping more than 9 hours but not feeling rested.
Constantly feeling tired.
Feeling of irritation throughout the day.
Difficulty in concentration / focusing on particular thing.
Difficult to learn new things.
Difficulty in making decisions.
Slower reaction times.
Loss of appetite / Headaches.

Causes of Excessive Daytime Sleepiness

No single cause contributes to excessive daytime sleepiness. There are many possible causes of excessive daytime sleepiness. That includes:

Sleep Deprivation – One of the most common reasons of excessive daytime sleepiness is sleep deprivation means not getting adequate sleep (at least 7 hours). According to the American Sleep Association, most adults need 7 to 9 hours of sleep each night.
Major reasons of Insufficient sleep (< 7 hours of sleep) would include long work hours, an irregular schedule, long screen hours, insomnia, stress, anxiety or other reasons.

Fragmented and Poor-Quality Sleep - Getting up multiple times in the night night for washroom would disrupt the natural progression of the sleep stages and may reduce the proportion of restorative slow-wave sleep.

Obstructive Sleep Apnea and Other Sleep Disorders.

Chronic Medical Conditions and Mental Health Disorders such as Chronic Stress, Depression, Anxiety, Schizophrenia, Chronic Pain etc.

Side effects of certain medications – may lead to insufficient sleep.

Smoking, Alcohol and Narcotics

Poor Lifestyle – Staying up late, catching only a few hours of sleep a night, you may feel sluggish, drowsy, and tired the following day, all signs of excessive sleepiness.

Long-term Sleep Deprivation

If you are deprived of sleep (<7hours of sleep) for long term, you may have higher chances of developing:

Obesity
Diabetes
Hypertension
Heart Disease
Other Chronic Conditions.

Consequences of Excessive Daytime Sleepiness

Excessive Daytime Sleepiness affect the person’s health and cause problems at work, school or for other daily activities.

Consequences of excessive daytime sleepiness include:

Decreased productivity of work or Academic Performance
Increased risk of car and work accidents
Difficulty in concentration and Attention span
Problems regulating mood and emotions
Social and relationship problems
Poor quality of life

Research shows that:

In Children - Excessive sleepiness may affect development.
In Adults and Older Adults - Excessive sleepiness increases the risk for falls and may be a risk factor for cognitive impairment , memory loss, and earlier mortality.

Diagnosis of Excessive Sleeping

It is quite normal to feel little sleepy and tiredness occasionally, particularly if you had a late night or after a long day work. You are likely to feel drowsy or sleepiness the following day more than a few times at work. A good night’s sleep should resolve this.

However, if you feel excessive daytime sleepiness during the day quite often, despite of multiple measures you take to fix, it still disrupting your day-to-day functioning, you should speak to your doctor about it. They will PLAN Assessments and a Sleep study to determine the underlying cause of your sleepiness.

Visit Your Doctor or Sleep Specialist if:

If You are feeling excessive sleeping or tiredness all the time.
If Excessive daytime sleepiness is affecting your daily life.
If it is associated with sleep disorder.

The sleep specialist will assess the following and recommend you to go for sleep study to find out the exact reason of your daytime sleepiness.

Thorough Assessment – includes your sleep history, medical history, current medications and your physical evaluation. Your bed partner will also provide detailed information about your snoring, sleeping patterns, gasp or choking, or whether move your legs during sleep.
Questions – related to your sleep habits, sleeping schedule, sleep position, your sleeping patterns, sleep environment etc.
Questionnaire - The Epworth Sleepiness Scale and the Stanford Sleepiness Scale used as screening tests to determine Excessive Daytime sleepiness.
Sleep Study – to rule out if excessive daytime sleepiness could be due to Obstructive Sleep Apnea or other sleep disorder.

Treatment

Treatment methods for daytime sleepiness depends on the underlying cause. Excessive daytime sleepiness is considered to be a very treatable condition with some lifestyle changes, medications and exercises.

For the Average person, this can simply be rectified by getting adequate sleep (at least for 7 hours) and fixing your sleep schedule. In severe cases, medical intervention may be required.
Treatment plan for underlying disorders.
Adjusting the dose of the medications you take on regular basis if it causing excessive daytime sleepiness.
Counselling and Cognitive-behavioural therapies to change their sleep habits and learn how to reduce stress when possible.
Following Sleep Hygiene tips for a good sleep and to get more sleep.
“Stop Snoring and Sleep Apnea Exercise Program” if associated with Obstructive sleep apnea.

Excessive Daytime Sleepiness