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Brandon Peters, M.D.

30 Days to Better Sleep: Consider If You Are Too Sleepy

By January 28, 2013

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In the grand scheme of improving your sleep, it is important to assess the gains and recognize if you are simply too sleepy during the day. The irony is that the sleepier you are, the less you might recognize the degree of impairment in yourself. What are the causes of persistent excessive daytime sleepiness? How might being too sleepy affect your daytime function in regards to memory, focus, and mood? Take a moment and consider whether you may still be too sleepy and why.

Remember the difference between sleepiness and fatigue. Sleepiness or drowsiness is a strong compulsion to fall asleep. When it occurs during the day, it is marked by the ability to take naps. It may contribute to accidents if coupled with driving. It may lead to cognitive performance issues, including poor concentration, attention, and short-term memory. It may contribute to mood complaints, including depression and irritability. Perhaps it is easy to recognize when you feel sleepy, but how do you know when you are too sleepy?

There are a few measures used to assess excessive daytime sleepiness. The most common is the Epworth sleepiness scale. It assesses your ability to fall asleep in passive situations. Scores higher than 10 are consider to be pathological and should prompt an evaluation for sleep disorders. You may be too sleepy if you take daily, especially prolonged naps. If you fall asleep in less than 5 minutes at night, you may also be too sleepy. In addition, there are other objective tests available to assess the degree of sleepiness, including multiple sleep latency testing (MSLT) and maintenance of wakefulness testing (MWT).

What causes excessive sleepiness? The most common reason for people to feel sleepy during the day is inadequate total sleep time. Sleep deprivation leads to an increasing desire to sleep, especially in the afternoon when the waking effects of the circadian rhythm naturally dip. It's a simple relationship: if you don't sleep enough at night, you will be too sleepy during the day.

Sleep that is of poor quality will also contribute to daytime sleepiness. This may be caused by conditions such as sleep apnea or insomnia, in which sleep overnight becomes greatly fragmented or disrupted. In addition, there are conditions that cause rapid transitions between sleep and wakefulness, leading to profound sleepiness in the day, such as may be seen as part of narcolepsy.

Sleep deprivation or sleep that is of poor quality can lead to great impairment. There may be physical signs and symptoms, including hallucinations and even death. One of the key tasks of sleep is to clear away a neurotransmitter in the brain called adenosine. This chemical contributes to the feeling of sleepiness, and if it is not removed, our thinking becomes muddled. We may not even recognize the degree to which we are actually impaired. Therefore, it is important to get the perspective of other observers in our lives, including our family, friends, and coworkers. Get a candid assessment of your performance and mood, and if there is room for improvement, consider what role your sleep may have in the situation.

Excessive daytime sleepiness does not have to be a familiar part of our day. It may suggest that our sleep at night is in need of our attention. With a little collaborative information in hand, you can discuss your situation with your doctor and pursue appropriate testing, including an overnight sleep study. Start by considering if you are too sleepy, and if you are, reach out and get the help that you need to wake feeling rested and function at your best throughout the day.

Check out the entire series, "How to Sleep Better in 30 Days."

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