When daytime sleepiness becomes a warning sign

Have you ever felt tired ‘out of nowhere’ in the middle of the afternoon? Sleeping during the day can happen to anyone who had a bad night, exercised a lot, or even came down with a cold or flu, which drains our energy. All this is normal. But when that uncontrollable daytime exhaustion is excessive or continuous, it can be a warning sign for daytime sleepiness.

What is daytime sleepiness?

Also known as hypersomnia or hypersomnolence, excessive daytime sleepiness (EDS) is the inability to stay alert or awake during the day. The mental dispersion is so great that the person can fall asleep or nap during the most mundane routine tasks.

And there is the danger. Imagine a person with EDS driving and falling asleep.

According to neuroscientist Russell Foster, an estimated 31% of drivers fall asleep while driving at least once in their lives. No wonder the rate of fatalities as a result of drivers falling asleep has already exceeded those of driving drunk and under the influence of drugs together.

It is also important to differentiate daytime sleepiness from fatigue, which is a condition of tiredness acquired with prolonged mentally and/or physically exhausting activities. One way to set them apart is the kind of recovery that each requires: while fatigue is solved with rest, EDS requires sleep.

The causes of SED

In many cases, daytime sleepiness is a consequence of sleep deprivation, the effect of medications such as antihistamines or muscle relaxants, sleep apnea, or depression, among others. In this case, it is classified as a secondary condition.

Primary hypersomnia ‘is less common,’ explains the American Academy of Family Physicians. In this case, drowsiness may reflect other medical conditions such as narcolepsy, which affects between 0.02% and 0.18% of the population, or idiopathic hypersomnia.

How to detect daytime sleepiness?

The diagnosis must be made by a doctor, who must evaluate a series of clinical factors such as medical history and the impact of sleepiness on the patient’s daily life, especially to differentiate it from fatigue.

Physical exams focus on issues such as hypertension, neck circumference and jaw structure, all of which are closely related to sleep apnea.

As many people are sleepier than they actually realize, there are also medical questionnaires that help to thoroughly determine the intensity of EDS.

One such questionnaire is the Epworth Sleepiness Scale. It is made up of eight everyday situations and the patient must score each one from 0 to 3 points, with 0 being ‘no chance of getting drowsy doing it’ and 3 being ‘high chances of getting drowsy doing it’. See the questions below:

– reading while sitting;

– watching television;

– inactive sitting in public space (such as theater or meetings);

– traveling by car as a passenger for an hour, non-stop;

– lying down in the afternoon to rest;

– talking to someone;

– sitting after dinner, not drinking alcohol;

– while in the car, stopping for a few minutes in traffic.

If you score more than 11 points, see a doctor to report daytime sleepiness.

If you score less than 11 points, but you’ve ‘fished’ behind the wheel or regularly nap in class or meetings, you also need to see a sleep health professional.

Both cases are warning signs for daytime sleepiness. And now you will find out if it is your case.

Treatment for daytime sleepiness

Hypersomnia treatment depends on its type. It usually begins with the correction of potential aggravating clinical causes, such as hypothyroidism or chronic anemia. 

In the case of secondary sleepiness, the process has to consider its cause. When it is caused by medications, for example, treatment alternatives or combination of drugs that reduce sleep should be discussed between doctor and patient. 

It is worth highlighting that EDS treatment is always individualized and should be based on its severity and symptoms.

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