While everyone feels sleepy at times, excessive daytime drowsiness can be a sign of a medical or behavioral condition. In fact, it has been linked to motor vehicle accidents attributed to falling asleep while driving and psychiatric comorbidities.

Fortunately, with a careful history and proper diagnostic workup, underlying conditions can often be identified. Treatment methods include improving sleep hygiene, adjusting medications and creating a plan for addressing the contributing health or behavior issues.

Identifying the Cause

Patients with excessive daytime sleepiness should have their underlying health condition identified and referred to a specialist. Research suggests that these conditions often have a bidirectional relationship with sleep problems and can result in reduced quality of life and productivity.

Patients should be screened using a validated tool, such as the Epworth Sleepiness Scale (ESS), in their primary care clinics. They should also be asked about their lifestyle, medications and emotional health, as these can have a big impact on how tired they feel.

Some health conditions, including obstructive sleep apnea, periodic limb movement disorder, restless legs syndrome, and narcolepsy, can disrupt the normal sleep cycle and lead to feeling excessively sleepy during the day. Additionally, aging may change the way that people sleep, making them more likely to feel drowsy.

Getting a Night’s Sleep

Getting enough sleep and a consistent sleep schedule can help. However, if your sleep is interrupted frequently and you still feel tired during the day, it may be a sign of a health problem.

A doctor will do a physical evaluation and review your medical history to identify what could be the cause of your excessive daytime sleepiness. They will also look at your lifestyle habits and medications. They might ask you to bring a sleep partner along to give them more insight into your bedtime behavior.

Depending on the reason for your excessive sleepiness, they might prescribe medication to promote wakefulness. This includes non-benzodiazepines stimulants such as Provigil (Modafinil). Other prescription drugs include methylphenidates such as Ritalin, and amphetamines such as Adderall. They might also prescribe clonidine, levodopa or bromocriptine.

Managing Stress

It is normal to feel stressed sometimes, but if you are feeling overwhelmed by new stressors or your self-care measures aren’t working, consider talking to a professional counselor or therapist. There are many cognitive behavioural and mindfulness-based approaches that can help you find healthy ways to cope with the things that are bothering you.

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In addition, if you are having trouble getting good quality sleep because of chronically poor sleep habits such as frequent waking throughout the night, try to reduce those habits. Some of these habits may be interfering with your REM cycle and decreasing the amount of restorative slow-wave sleep you get. This can make you more prone to experiencing excessive daytime sleepiness. Medications and certain health conditions like obstructive sleep apnea can also cause excessive daytime sleepiness as a side effect.

Managing Your Diet

Feeling drowsy or tired once in a while is normal, but constant fatigue can be dangerous. It can cause road and workplace accidents, affect mood and relationships and lead to depression, anxiety and chronic illness. If your feelings of drowsiness and fatigue are interfering with daily life, make an appointment to see your doctor.

He or she may run tests to identify the underlying problem that is causing your sleepiness. Your doctor will ask about your lifestyle habits, medications and physical health and will be able to help you find ways to improve the situation. They can also offer advice on fatigue management techniques that suit your unique needs. Research suggests that a healthy diet and regular exercise can help reduce feelings of fatigue.

Managing Your Medication

Excessive daytime sleepiness can be a symptom of multiple conditions. It’s important to identify the underlying disorder or condition so that it can be treated.

A thorough patient history and physical examination are essential to identifying the underlying cause of EDS. This includes asking about sleep duration and quality, snoring and witnessed apneas, use of medications (especially sedative/hypnotics), drug withdrawal symptoms, psychiatric disorders, and medical conditions such as narcolepsy or obstructive sleep apnea.

In cases of primary hypersomnia, including narcolepsy and idiopathic hypersomnia, wake-promoting medications may help. These include amphetamines and methylphenidate, which are also used to treat attention-deficit/hyperactivity disorder. These drugs are typically well tolerated and can be used for extended periods of time. However, they can have adverse effects, such as decreased blood pressure and heart rate.