Excessive Sleepiness during the Day: Ignore This Trait at Your Own Risk

Sleep disorders have an unobtrusive and stealthy way of entering our lives. Take the example of a situation which is marked by excessive sleepiness during the day. Initially, it all seems harmless. It ends up with most of us ignoring such minor developments as part of a passing phase. But once left untreated, the same seemingly inoffensive signs worsen and pave way for incredible suffering and distress, in no time.

What is the most common perception of feeling excessively sleepy? Either it is due to over-work at home or office; too many consecutive late nights; or something as simple as minor and temporary sleep deprivation.

The point most of us miss is that feeling excessively sleepy could mean many things – it could be sending us a silent signal that not all is well with our health. In short, it could herald the onset of several types of sleep disorders, many of which are both dangerous and disabling in the short and long term.

Symptom that sends confusing signals

Chances of misdiagnosis increase because of the high prevalence of this indicator in multiple sleep disorders. For example, hypersomnia – both primary and idiopathic is misdiagnosed as Narcolepsy sleep disorder. Though similar in many ways, some characteristic differences help the doctor to identify the specific disorder the patient is suffering from. For example, sleep apnea sets in when the patient is around 50 years of age, whereas the average age of onset of other sleep disorders could be different.

Do not rule out hypersomnolence

What is hypersomnolence? Excessive daytime sleepiness is medically known as hypersomnolence and the name of the disorder is hypersomnia.

This disorder has been identified as a ‘rare disease’ by the Office of Rare Diseases (ORD) of the National Institutes of Health (NIH), presently affecting less than 200,000 people in the US.

A patient also experiences…

– It makes the patient fall off to sleep anytime anywhere.
– During the day, the patient takes repeated half-hour naps which do not have any impact; he or she still feels sleepy all the time.
– Tendency to sleep more than 10 hours; confusion and disorientation on waking up.
– Impairment of speech, slow reflexes; reduced thinking ability, poor memory, hallucinations, reduced appetite, etc announce the onset.
– The patient may start to show initial signs between 15 and 30 years of age. 40% patients are likely to show all the symptoms sooner or later.
– No matter how hard the doctor tries, the illness normally does not respond to any kind of therapy.

Treatments: multiple approaches

Treatments involve professional counseling for family and friends, self-help, lifestyle changes and medication.
– Family counseling is important as everyone involved with the patient needs to understand the various facets of the illness; this also helps the patient to cope better.
– Self-help includes physical exercise, weight loss, and doing relaxation exercises before bedtime, quitting alcohol and other psychoactive substances like caffeine, nicotine, etc.
– Lifestyle modifications include maintaining better sleep routine, avoiding late night socializing, etc.

Recommended drugs for the management of excessive sleepiness during the day are:
– Modafinil, sodium oxybate, amphetamine, methamphetamine, dextroamphetamine, methylphenidate, and selegiline
– Tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), clonidine, levodopa, bromocriptine, amantadine, and methysergide.

Marc MacDonald is an independent sleep researcher on persistent daytime hypersomnolence, narcolepsy, and sleep apnea. To learn more about this article’s main topic, please visit his Primary Hypersomnia website.

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