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Many people feel drowsy in early afternoon and they have a desire for a quick nap. This is probably normal and different from excessive daytime sleepiness, which is a much more significant problem. Hypersomnia is a disorder of excessive sleepiness as evidenced by either prolonged sleep episodes or daytime sleep episodes that occur almost daily and will cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
How much sleep is too much or too little?
Most adults need 7 to 9 hours a night for the best amount of sleep, although some people may need as few as 6 hours or as many as 10 hours of sleep each day. Older adults (ages 65 and older) need 7-8 hours of sleep each day. Women in the first 3 months of pregnancy often need several more hours of sleep than usual.
Why my child has Daytime Sleepiness?
In children, not sleeping enough at night or not having good sleep habits usually causes daytime sleepiness. Some medicines can also make your child sleepy in the daytime.
What causes sleepiness?
Sleep Deprivation By far, the most common cause of excessive daytime sleepiness in modern society is chronic sleep deprivation. Healthy adults can require anywhere from 4 to 10 hours of sleep. Therefore, people who need 8 hours of sleep a night but receive only 6 hours may become severely sleep deprived and notably hyper somnolent.
there are many possible causes of extreme daytime sleepiness including dietary deficiencies, depression, diabetes, anemia, or thyroid problems, chronic daytime fatigue can very likely be caused by a sleep disorder. Such as:
Sleep apnea – People with this condition stop breathing for short periods during sleep.
Narcolepsy – People with this condition are very sleepy in the daytime and sometimes fall asleep suddenly during normal activities.
Insomnia – People with this condition have trouble falling or staying asleep.
Not having good sleep habits – For example, not having enough time to sleep at night or not having a regular sleep schedule.
Things that disturb your sleep, such as:
Sounds – For example, if you have a new baby, he or she might cry and wake you up at night.
Health conditions, such as restless legs syndrome or nighttime leg cramps.
Schedule changes that affect sleep – This might include working a night shift or traveling to another time zone.
Medication-Induced Hypersomnia :Certain agents may cause true hypersomnia. sedative-hypnotic agents, such as barbiturates, benzodiazepines and Many medications such as tricyclic antidepressants and antihistaminic agents may cause drowsiness.
What is Primary Hypersomnia?
It Is excessive sleepiness for at least 1 month and is not related to other mental disorder or direct physiological effects of a substance (eg, drug of abuse, medication).
Excessive daytime sleepiness leading to prolonged naps that are not refreshing, nocturnal sleep of long duration (as much as 12 h or more) and sleep drunkenness. These patients do not feel refreshed following naps and, therefore, fight sleepiness as long as they are able. Patients are difficult to awaken from sleep or naps.
Before a diagnosis of primary hypersomnia, all other causes of hypersomnia, should be excluded, so elimination of other causes of excessive daytime somnolence helps diagnose primary hypersomnia.
Is it bad to sleep a lot?
Too much sleep on a regular basis can increase the risk of diabetes, heart disease, stroke, and death according to several studies done over the years. Too much is defined as greater than nine hours.
Should I see a doctor?
See a sleep doctor if:
You are often very sleepy in the daytime.
Falling asleep in the middle of normal activities.
You fall asleep in a dangerous situation, such as while driving.
See or hear things that are not there.
When you wake up, you can’t move right away.
Your muscles feel weak if you laugh or get excited or angry.
What is the Appropriate Diagnostic Approach for Hypersomnia Patient?
All patients with chronic daytime sleepiness should have a thorough history, sleep history, physical exam, and neurological exam seeking evidence of cataplexy, hypnagogic, hypnopompic hallucinations, or sleep paralysis.
Subjective measures of excessive daytime sleepiness can be measured by The Epworth Sleepiness scale. It is a self-administered questionnaire in which patients rate their likelihood of falling asleep in eight different life situations each situation is scored on scale from 0 (not at all likely to fall asleep) to 3 (very likely to fall asleep). The resulting total score is between 0 and 24. Although what score constitutes abnormal sleepiness is controversial, total scores above 10 generally warrant investigation.
Objective measures of excessive daytime sleepiness can be measured by all-night polysomnogram (PSG) followed up with multiple sleep latency testing (MSLT) the day after.
Measurement of the concentration of orexin-A/hypocretin-1 in CSF is primarily a research tool, but it can be useful in certain clinical situations.
HLA testing is not a routine diagnostic testing for narcolepsy now.
Blood testing to exclude metabolic or endocrine disorder and to exclude anemia, in addition some genetic tests may help to direct you to the right diagnosis.
CT images for the brain to exclude pathological reason for the hypersomnia.
Your doctor or nurse will decide which tests you should have. There are many different tests, but you might not need any. It depends on your age, other symptoms, and individual situation.
How can I stop Feeling sleepy?
That depends on what is causing your daytime sleepiness. Treatments can include:
Lifestyle changes – These can include changing your work schedule, taking naps, losing weight, or avoiding caffeine and alcohol. Including good sleep hygiene. Most patients improve if they maintain a regular sleep schedule, usually 7.5-8 hours of sleep per night, scheduled naps during the day also may help in addition avoiding shift work is essential
Devices you wear at night – These can help people with sleep apnea.
Medicines – These can help you stay awake in the daytime or sleep better at night.
Stimulant medications, such as modafinil (Provigil) an alpha1-agonist, has been used for several years to treat narcolepsy and hypersomnia.
Tricyclic antidepressant can treat cataplexy attacks. Such as clomipramine or a selective serotonin reuptake inhibitor (SSRI), most commonly fluoxetine, while for sleep paralysis we use imipramin and clomipramine
Surgery – A few people with sleep apnea have surgery to treat it. However, most people don’t need surgery for daytime sleepiness.
How do you stop feeling sleepy?
Get adequate nighttime sleep.
Keep distractions out of bed.
Set a consistent wake-up time.
Gradually move to an earlier bedtime.
Set consistent, healthy mealtimes.
Keep regular schedule.
Don’t go to bed until you’re sleepy.
What is Narcolepsy?
Narcolepsy is a brain disorder that makes you feel sleepy most of the time. People with narcolepsy sometimes fall asleep all of a sudden, even when they don’t expect to. They can even fall asleep while they are in the middle of activities, such as eating, talking, or driving.
People usually develop narcolepsy during their teens or early 20s. Some people get it earlier and others later. Once it starts, the disorder can make it hard to work, do schoolwork, or do other normal activities.
What are the Symptoms of Narcolepsy?
Daytime sleepiness: all patients with narcolepsy have chronic sleepiness. They are prone to fall asleep throughout the day, often at inappropriate times. The sleepiness may be so severe that patients with narcolepsy can doze off with little warning; these episodes are the “sleep attacks”. Sleepiness associated with narcolepsy usually improves temporarily after a brief nap, and most patients feel rested when they awake in the morning.
Cataplexy: It is emotionally triggered transient muscle weakness. The muscle weakness is often partial, affecting the face, neck, and knees. Severe episodes can induce bilateral weakness or paralysis, causing the patient to collapse. Consciousness remains intact during cataplexy, and the weakness usually resolve in less than two minutes
Hypnagogic hallucinations: Which are vivid, often frightening visual, tactile, or auditory hallucinations that occur as the patient is falling asleep.
Sleep paralysis: Sleep paralysis is the complete inability to move for one or two minutes immediately after awakening.
What is the main cause of Narcolepsy?
Lack of the brain chemical hypocretin (also known as orexin) which regulates sleep can cause narcolepsy.
Yes. If your doctor or nurse suspects you have narcolepsy, he or she might send you for a “sleep study.” For the study, you go to a sleep lab where you are hooked up to different machines that monitor your heart rate, breathing, brain activity, and other body functions while you sleep at night. Several hours after the sleep study is done, another test is done in which the lights are dimmed and you are given privacy and asked to try napping several times.
People with narcolepsy have abnormal sleep patterns during naps and at night and the sleep test will diagnose it.
How is Narcolepsy Treated?
Narcolepsy is usually treated with behavior changes. People with the disorder should:
Avoid medicines that can make people sleepy, such as some allergy medicines.Take naps just before important events and at scheduled times during the day.Keep a regular sleep schedule.Make sure they get enough sleep at night.
People who are still very sleepy even if they make these changes require a specific medicines to help them stay awake.
People who have muscle weakness when they feel strong emotions can get medicines to help with that problem, too.
Can Narcolepsy go away on its own?
Narcolepsy can be a difficult condition to live with, with debilitating excessive daytime sleepiness and cataplexy, so it is natural to wonder about the long-term prognosis.
Is Narcolepsy considered a mental illness?
Narcolepsy without comorbid psychiatric conditions can be mistaken for psychiatric illness, including psychosis.
Can Narcoleptics drive?
When sleepiness is under good control, many people with narcolepsy are safe to drive. However, they must know their limits. Some individuals may be safe driving around town for 30 minutes but not on a four-hour, boring highway drive
Being a sleepy-driver is a serious issue, here are a few tips to not be one:
Start any trip by getting enough sleep beforehand.
If possible, take a nap shortly before you expect to go on duty.
Be alert for feelings of drowsiness, especially between 2 a.m. and 6 a.m.
If you feel too drowsy to drive, stop in safe area and take a nap.
If you are driving in a team, talk to your co-driver. However, if your co-driver is sleeping, remember that he or she needs to get some rest.
Parking on the shoulder is dangerous and is prohibited on highways. Find a truck stop, rest area, or pull off to a safe location.
Schedule a break every two hours. Stop sooner if you show any danger signs of sleepiness.
During your break take a nap, stretch, take a walk, and get some exercise before getting back into your car.
Get some fresh air into your car.
Do not drive if you have a sleep disorder that is not being treated.
Discuss everything that you are taking (including nonprescription items) with your doctor or pharmacist.
Of course, do not discontinue prescribed drugs without the approval and awareness of the physician who prescribed it to you.
