Ask the Docs
HYPERSOMNOLENCE or EXCESSIVE DAYTIME SLEEPINESS
By Vanessa Vizcaino, M.D.
Thinking about an article for November reminded me of Thanksgiving and turkey dinners. I became tired instantly! So I thought this is a great way to introduce this very common issue in the general population. Most of the information below comes from my trusted AAFP articles.
Excessive daytime sleepiness is one of the most common sleep-related patient symptoms, and it affects an estimated 20 percent of the population. Persons with excessive daytime sleepiness are at risk of motor vehicle and work-related incidents, and have poorer health than comparable adults. The most common causes of excessive daytime sleepiness are sleep deprivation, obstructive sleep apnea, and sedating medications. Other potential causes of excessive daytime sleepiness include certain medical and psychiatric conditions and sleep disorders, such as narcolepsy. Obstructive sleep apnea is a particularly significant cause of excessive daytime sleepiness. An estimated 26 to 32 percent of adults are at risk of or have obstructive sleep apnea, and the prevalence is expected to increase. The evaluation and management of excessive daytime sleepiness is based on the identification and treatment of underlying conditions (particularly obstructive sleep apnea), and the appropriate use of activating medications.
Common Causes of Excessive Daytime Sleepiness
|
Cause |
|
|
|
Primary hypersomnias of central origin |
||
|
-Narcolepsy |
|
|
|
-Idiopathic hypersomnia |
|
|
|
-Other rare primary hypersomnias |
Example: Kleine-Levin syndrome |
|
|
Secondary hypersomnias |
||
|
-Sleep disorders |
||
|
|
Sleep-related breathing disorders |
Excessive daytime sleepiness secondary to obstructive sleep apnea |
|
|
Behavioral sleep deprivation |
Especially common in adolescents and shift workers |
|
|
Other sleep disorders |
Includes circadian rhythm sleep disorders, sleep-related movement disorder |
|
-Medical or psychiatric conditions |
||
|
|
Medication effects |
Includes prescription, nonprescription, and drugs of abuse |
|
|
Psychiatric conditions |
Especially depression |
|
|
Medical conditions |
Includes head trauma, stroke, cancer, inflammatory conditions, encephalitis, neurodegenerative conditions |
note: Hypersomnia due to secondary causes is much more common than primary hypersomnia.
You can use this questionnaire below to determine your risk:
Patient Health Questionnaire: Excessive Daytime Sleepiness
A test score in excess of 12 on the Epworth Sleepiness Scale or a patient history of falling asleep while driving are clear indications that further evaluation and work-up are required. If you believe you are at risk and suffer from Excessive Daytime Sleepiness, please consult your primary care provider. A good history and physical including a review of all medications (Rx and OTC) can be helpful in determining the possible cause. Blood work in some cases is helpful and there’s always the potential to be referred for a sleep study and/or a sleep disorders specialist. Just know that you are not alone, and you don’t have to go through life in a sleepy fog! Ask for help.
As always, if we can be of help, please contact Family Medical and Wellness Center at (561) 721-1953.
Have a GREAT THANKSGIVING!
V. Vizcaino, MD