As folks age, many often nod off during the day. However, if the need to sleep becomes overwhelming and hard to resist, this could very well be a sign of excessive daytime sleepiness or EDS.
Approximately 20 percent of Americans suffer from EDS, and African Americans also exhibit more significant daytime sleepiness than their white counterparts. EDS is the most complained about condition that sleep specialists hear about frequently. However, recognizing the difference between normal run-of-the-mill sleepiness and EDS is crucial, but over 60 percent of folks cannot do so.
According to Raj Dasgupta, M.D., a pulmonary and sleep specialist at the University of Southern California’s Keck School of Medicine, “People with EDS have a difficult time staying awake or alert during the day and may doze off during inappropriate times such as during meals, in the middle of a conversation, or even when in a car stopped for a few minutes in traffic.”
EDS is a hallmark of narcolepsy, a chronic disorder that causes sudden sleep attacks. However, not everyone who suffers from EDS has narcolepsy. Diagnosing narcolepsy is tricky as it can mimic other conditions such as sleep apnea, depression, or insomnia.
How is EDS diagnosed? A physician or sleep expert must determine if poor sleep habits or a disorder is causing EDS. A doctor will ask for information about your sleep habits, such as:
- How long you’ve been excessively sleepy
- How many hours do you sleep on weeknights and weekend nights
- Whether you wake up regularly during the night
- Have there been any changes in your environment that could affect your sleep habits (such as a new work schedule)
After collecting some baseline info about your excessive daytime sleepiness, your physician will probably recommend polysomnography, or a sleep test, to gain deeper insight into your condition. From there, your doctor can put together a course of action to help you get back on track with your life.
The underlying cause of EDS must be addressed, and this often means tweaking a sleep schedule, habits and routines, stress management, or sleeping environment. If there is a diagnosis of a sleep disorder known as sleep apnea, a treatment course that involves a continuous positive airway pressure machine (CPAP) is often the best remedy. If sleep apnea is the diagnosis and a CPAP machine is used, but drowsiness still occurs during the day, a physician may suggest a drug to combat it. Before taking medication for EDS, a doctor must have a complete picture of your mental and physical health.
Medication can be prescribed for patients with narcolepsy to help them remain awake. Shift workers who persistently feel sleepy during work hours may also benefit from medication. It’s important to note that drugs will not replace healthy sleep. Most often, medication for EDS will complement or supplement other forms of treatment, both behavioral (improving sleep habits or managing anxiety) and medical (treatment for sleep apnea).
The bottom line is that good quality sleep is a must to function properly. The National Sleep Foundation offers tips on the best sleep practices to follow to achieve good sleep hygiene:
Stick to a sleep schedule with the same bedtime and wake-up time, even on the weekends. A schedule helps to regulate your body’s clock and could help you fall asleep and stay asleep for the night.
Practice a relaxing bedtime ritual. A relaxing, routine activity right before bedtime conducted away from bright lights helps separate your sleep time from events that can cause excitement, stress, or anxiety, making it more difficult to fall asleep, get sound and deep sleep, or remain asleep.
If you have trouble sleeping, avoid naps, especially in the afternoon. Power napping may help you get through the day, but if you find that you can’t fall asleep at bedtime, eliminating even short catnaps may help.
Exercise daily. Vigorous exercise is best, but even light exercise is better than no activity. Exercise at any time of day, but not at the expense of your sleep.
Evaluate your room. Design your sleep environment to establish the conditions you need for sleep. Your bedroom should be cool–between 60 and 67 degrees. Your bedroom should also be free from any noise or light that can disturb sleep. This includes a bed partner’s sleep disruptions, such as snoring. Consider using blackout curtains, eye shades, ear plugs, white noise machines, humidifiers, fans, and other devices.
Sleep on a comfortable mattress and pillows. Make sure your mattress is comfortable and supportive. For most good-quality mattresses, the one you have been using for years may have exceeded its life expectancy – about 9 or 10 years. Have comfortable pillows and make the room attractive and inviting for sleep but also free of allergens that might affect you and objects that can cause you to slip or fall if you have to get up during the night.
Use bright light to help manage your circadian rhythms. Avoid bright light in the evening and expose yourself to sunlight in the morning. This will keep your circadian rhythms, a natural internal process that regulates the sleep-wake cycle and roughly repeats every 24 hours, in check.
Avoid alcohol, cigarettes, and heavy meals in the evening. Alcohol, cigarettes, and caffeine can disrupt sleep. Eating big or spicy meals can cause discomfort from indigestion that can make it hard to sleep. Avoid eating large meals for two to three hours before bedtime if you can. Try a light snack 45 minutes before bed if you’re still hungry.
Wind down. Your body needs time to shift into sleep mode, so spend the last hour before bed doing a calming activity like reading. For some people, using an electronic device such as a laptop can make it hard to fall asleep because the particular type of light emanating from the screens of these devices is activating to the brain. If you have trouble sleeping, avoid electronics before bed or in the middle of the night.
If you can’t sleep, go into another room and do something relaxing until you feel tired. It is best to take work materials, computers, and televisions out of the sleeping environment. Use your bed only for sleep and sex to strengthen the association between bed and sleep. If you associate a particular activity or item with anxiety about sleeping, omit it from your bedtime routine.
If you’re still having trouble sleeping, don’t hesitate to speak with your doctor. You may also benefit from recording your sleep in a Sleep Diary to help you better evaluate common patterns or issues you may see with your sleep or sleeping habits.
For more information on anything sleep-related, including finding a sleep specialist contact the National Sleep Foundation at sleepfoundation.org