Excessive Daytime Sleepiness | Causes & Treatments (2024)

What is excessive daytime sleepiness?

Excessive daytime sleepiness (EDS) is when it’s difficult to stay awake or alert during the day, or when you have a strong desire to sleep during the day. It’s not just feeling tired after a bad night’s sleep. People with EDS deal with these symptoms every day for weeks or months. About 20% of the population experience EDS, according to a study published in American Family Physician.

Some of the most common causes of EDS are sleep deprivation, obstructive sleep apnea, drug or alcohol use, and certain medications. In some cases, the cause of EDS is unknown (called idiopathic hypersomnia).

Common causes

1 . Obstructive sleep apnea

Obstructive sleep apnea, or OSA, causes you to have apneas (absences of breathing) and/or decreased breathing rate while sleeping. Your oxygen level drops and you may wake up multiple times during the night.

OSA is from a blockage that prevents air from entering your upper airway. It’s most commonly caused by excess tissue around and in the neck, throat, and airway. Being overweight or obese increases your chance of having this excess tissue.

Very common: OES is most likely to affect adults 30–60 years old, occurring in 9% of women and 24% of men in that age group. People with obesity and the elderly are more likely to have OSA [Source: American Family Physician].

Symptoms you may have:

  • Excessive daytime sleepiness
  • Excessive snoring
  • Waking up often during sleep
  • Unable to pay attention during the day

Treatment and urgency: The majority of people with OSA are undiagnosed. If you have EDS and snore, tell your doctor as soon as possible. If left untreated, OSA can lead to serious health issues, including diabetes, stroke, and heart attacks. Treatment includes:

  • Mouthpieces and devices that help open your airway while you sleep, such as a continuous positive airway pressure (CPAP) machine
  • Surgery

2. Sleep deprivation

Sleep deprivation occurs when you don’t get enough quality sleep. You may not be giving yourself enough time to sleep. Or you may have a condition such as insomnia (difficulty falling or staying asleep), narcolepsy, or idiopathic hypersomnia. Some mood disorders, such as bipolar disorder, can also prevent you from getting enough quality sleep.

Very common: This is the most common cause of EDS.

Symptoms you may have:

  • Daytime hyperarousal (when sleep deprivation is caused by chronic insomnia)
  • Mood and behavior changes (short temper, anxiety)
  • Difficulty concentrating
  • Problems planning, organization, and judgment

Treatment and urgency: Sleep deprivation is not an emergency, but some causes should be identified and treated as soon as possible. Treatment depends on the cause. For example, if bipolar disorder is causing insomnia, your doctor will recommend mood-stabilizing medications or antipsychotics. If you have insomnia, you may have to change your bedtime routine and other daily habits, like limiting screen time at night or avoiding caffeine.

3. Depression

Depression causes overwhelming feelings of sadness, loss of self-worth, decreased interest in activities you once enjoyed, and thoughts of hopelessness.

Very common: Depression affects 1 in 15 adults annually. It occurs 1 in 6 people at some point throughout their life [Source: JAMA Psychiatry].

Symptoms you may have:

  • Isolating yourself from others
  • Poor energy
  • Loss of appetite
  • Low self-worth or self-esteem
  • Engaging in purposeless activities

Treatment and urgency: See a doctor or mental health provider if you have symptoms of depression, particularly if it's severe. Get help immediately if you have thoughts of suicide. Treatment includes:

  • Talk therapy to help identify the underlying causes of your depression and how to work through it
  • Antidepressant medications such as Lexapro or Prozac
  • Treatments such as electroconvulsive therapy or ketamine infusions (usually only recommended when other therapies have failed)

4. Attention-deficit/hyperactivity disorder (ADHD)

ADHD is a neurodevelopmental disorder that is often diagnosed in childhood. There are two main types of ADHD: inattentive or hyperactive-impulsive.

People with inattentive ADHD tend to have difficulties engaging and finishing tasks, following instructions, and completing conversations. Those with hyperactive-impulsive ADHD tend to have excessive energy, interrupt others, and speak at inappropriate times. Some people have symptoms of both types.

Common: ADHD affects an estimated 9–10% of children in the U.S. [Source: CDC].

Symptoms you may have:

  • Excessive daydreaming
  • Fidgeting
  • Forgetfulness
  • Difficulty interacting with others
  • Excessive talking

Treatment and urgency: See your doctor if you have symptoms of ADHD. Treatment includes:

  • Cognitive behavioral therapy (CBT), which can help you better understand your illness and learn how to control your behaviors
  • Medications that help with symptoms, like Vyvanse or Adderall

Dr. Rx

Give yourself enough time to fall asleep prior to the time you ideally want to be asleep. The ideal environment is quiet and dark without surrounding stimulation. Avoid stimulating foods and drinks and stimulating activities before bed. —Dr. Manuelpillai

5. Narcolepsy

Narcolepsy is a sleep disorder that causes episodes of overwhelming sleepiness (“sleep attacks”) throughout the day. It affects the brain’s ability to control sleep-wake cycles.

There are two types of narcolepsy. People with type 1 experience cataplexy (episodes of muscle weakness triggered by emotions). They also have low levels of a brain hormone called hypocretin, which helps regulate states of sleep and awakening. Type 1 may be an autoimmune disorder. Type 2 is less understood and usually doesn’t cause cataplexy or low levels of hypocretin.

Relatively rare: Type 1 is more common than type 2.

Symptoms you may have:

  • Cataplexy (type 1)
  • Disrupted nighttime sleep
  • Sleep paralysis
  • Sleep-related hallucinations

Treatment and urgency: See your doctor right away if you have symptoms of narcolepsy. Sleep attacks can occur in dangerous situations, like while you’re driving. Treatment includes:

  • Practicing good sleep hygiene, which includes avoiding stimulating tasks before bed, sleeping in a dark room without your phone or other devices, and trying not to stay up late.
  • Medications that help keep you awake, such as modafinil and methylphenidate.

6. Chronic fatigue syndrome

Chronic fatigue syndrome causes excessive fatigue that’s not helped by sleeping. It makes it hard to do everyday activities.

The fatigue tends to worsen after physical or mental activity. The cause is unknown, but possible triggers include viral infections, hormonal imbalances, and physical or emotional trauma.

Uncommon: Chronic fatigue syndrome affects about 836,000 to 2.5 million people in the U.S. [Source: CDC].

Symptoms you may have:

  • Memory problems
  • Difficulty sleeping
  • Headaches
  • Difficulty standing or sitting for a period of time (orthostatic intolerance), which can worsen symptoms
  • Digestive problems such as irritable bowel syndrome
  • Muscle aches and pains

Treatment and urgency: There is no cure for chronic fatigue syndrome. It is treated by managing the symptoms. For example, if you have muscle aches or pains, over-the-counter pain relievers may be recommended. If you develop depression, cognitive behavioral therapy and antidepressants may help control your symptoms.

7. Fibromyalgia

Fibromyalgia is a chronic condition that causes muscle pain throughout the body. It’s believed to be caused by pain signals not being processed in the right way. Certain conditions can increase your risk of fibromyalgia, such as lupus and rheumatoid arthritis.

Common: Fibromyalgia affects about 4 million U.S. adults [Source: CDC].

Symptoms you may have:

  • Difficulty sleeping
  • Fatigue
  • Pain and stiffness
  • Depression
  • Anxiety
  • Memory problems
  • Headaches

Treatment and urgency: See your doctor if you have symptoms of fibromyalgia. Treatment includes:

  • Cognitive behavior therapy to treat underlying depression
  • Regular exercise
  • Over-the-counter pain medications like ibuprofen (Advil) and acetaminophen (Tylenol)
  • Prescription medications such as opioids and gabapentin
  • Good sleep hygiene

8. Restless leg syndrome

Restless leg syndrome, or RLS, causes an irresistible urge to move your legs. It’s worse in the evening and while you’re resting. It can interfere with your ability to fall asleep and stay asleep.

Moving the legs temporarily relieves discomfort, but it eventually comes back and the cycle continues. Most people with RLS also have periodic limb movement disorder (PLMS), which causes involuntary movement or jerking of the legs and arms during sleep.

It’s not clear what causes RLS, but it may be an imbalance of a brain chemical called dopamine, which helps control movement. Low iron levels may also contribute to it.

Relatively common: RLS affects 7–10% of the U.S. population [Source: National Institutes of Health].

Symptoms you may have:

  • Aching
  • Throbbing
  • Itching or crawling

Treatment and urgency: See your doctor or a neurologist if you have symptoms of RLS. Treatments include:

  • Iron supplements, if RLS is caused by an iron deficiency
  • Medications that increase the effect of dopamine, such as gabapentin
  • Sedating medications, such as opiates or benzodiazepines, before bed

9. Alcohol

Drinking alcohol has a sedating effect because it affects alertness, judgment, and responsiveness. When you drink a lot of alcohol, you may “black out” and fall asleep.

Very common: Alcohol consumption is extremely common among adults and teenagers. Nearly 15 million people ages 12 and older have alcohol use disorder [Source: National Institute on Alcohol Abuse and Alcoholism].

Symptoms you may have:

  • Slurred speech
  • Diminished reaction times
  • Lack of judgment
  • Loss of coordination
  • Loss of consciousness

Treatment and urgency: If you drink excessively and begin to develop a chemical dependence on alcohol, get help immediately. Treatment includes:

  • Counseling and support groups that help change drinking behavior, like Alcoholics Anonymous
  • Prescription medications such as naltrexone that help stop or reduce drinking and prevent relapse

10. Illicit drugs

Illicit drugs, particularly stimulants like cocaine and methamphetamine, can cause EDS. These drugs can keep you awake for extended periods of time and make it hard to get quality sleep.

Very common

Symptoms you may have:

  • Poor appetite or loss of appetite
  • Heart palpitations
  • Chest pain
  • Shortness of breath
  • Agitation
  • Aggressive behavior
  • Sweating

Treatment and urgency: Get help immediately if you’re using stimulants regularly. Stimulant abuse can lead to very serious complications, such as psychotic symptoms, heart attack, and renal failure.

Other causes of excessive daytime sleepiness

  • Sedation is a side effect of many medications, including benzodiazepines, muscle relaxants, antihistamines, and some anti-seizure medications.
  • Kleine-Levin syndrome
  • Idiopathic hypersomnia

Pro Tip

If you have trouble with sleeping and/or excessive daytime sleepiness, it is important to discuss it with your doctor. They can rule out a medical/organic cause, as well as refer you to a sleep specialist if needed. —Dr. Manuelpillai

FAQs about daytime sleepiness

These are some frequently asked questions about daytime sleepiness.

Can depression cause daytime sleepiness?

Yes. Depression and other medical conditions, including other psychiatric conditions like anxiety, substance abuse, and bipolar disorder, can cause EDS. Sleep disorders like insomnia and narcolepsy and certain disorders like Parkinson's disease and multiple sclerosis can cause daytime sleepiness.

What medications can affect sleepiness?

Antianxiety drugs like benzodiazepines, antihistamines, anti-seizure drugs, sedating antidepressants, and antipsychotics can all cause sleepiness. Additionally, alcohol, narcotics, or stimulant withdrawal (such as caffeine and cocaine) can also cause sleepiness.

Why am I always tired after eating?

There are many theories that may explain sleepiness after eating a large meal. Large meals may activate the parasympathetic nervous system, which causes sleepiness. Insulin released to process sugar may also increase brain levels of tryptophan, an amino acid that can make you feel sleepy.

Excessive Daytime Sleepiness | Causes & Treatments (2024)


Excessive Daytime Sleepiness | Causes & Treatments? ›

Sleep deprivation, sleep disorders, and other health conditions are common causes of excessive sleepiness

excessive sleepiness
Excessive sleepiness, also called hypersomnolence, is a common experience for those that are chronically sleep deprived. Most cases of excessive sleepiness are related to insufficient or interrupted sleep, but some people's extreme tiredness cannot be relieved even after quality rest.
https://www.sleepfoundation.org › hypersomnia
. Treatment methods can include improving your sleep hygiene, adjusting your medication regimen, and creating a treatment plan for any underlying disorders.

What is the best medication for excessive daytime sleepiness? ›

Your doctor can also prescribe various drugs to treat hypersomnia. These may include: Stimulants, such as methylphenidate (Ritalin) or modafinil (Provigil) Antidepressants, such as citalopram (Celexa), fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft)

What is the most common cause of excessive daytime sleepiness? ›

The most common causes of excessive sleepiness are sleep deprivation and disorders like sleep apnea and insomnia. Depression and other mental health conditions, certain medications, and medical conditions affecting the brain and body can cause daytime drowsiness as well.

How can I stop being sleepy throughout the day? ›

How to Stay Awake Naturally
  1. Get up and move around to feel awake. ...
  2. Take a nap to take the edge off sleepiness. ...
  3. Give your eyes a break to avoid fatigue. ...
  4. Eat a healthy snack to boost energy. ...
  5. Start a conversation to wake up your mind. ...
  6. Turn up the lights to ease fatigue. ...
  7. Take a breather to feel alert.

What neurological disorder causes excessive sleepiness? ›

Narcolepsy is a chronic, neurological sleep disorder with no known cause. The main characteristic of narcolepsy is excessive and overwhelming daytime sleepiness, even after adequate nighttime sleep: In addition to a complete medical history and physical exam, there are several lab tests to confirm the diagnosis.

What can I take to keep me awake all day? ›

Summary. When you're feeling tired but need to stay awake, sipping a little caffeine, taking frequent breaks, or eating a light snack can help you fight sleepiness. Exercising, power-napping, getting fresh air, enjoying natural light, and lowering the temperature in a room can also help you stay awake during the day.

How long does it take for Quviviq to work? ›

Quviviq starts working within 30 minutes to help you sleep. Keep in mind that taking Quviviq with food or right after eating may delay the drug's effects by more than an hour. In Quviviq's clinical trials, some people reported sleeping better in the first week of treatment.

Why do I want to sleep all the time and have no energy? ›

Common causes of tiredness and fatigue include: not getting enough sleep or finding it hard to get to sleep (insomnia) an unhealthy lifestyle (such as having an unhealthy diet and not getting much exercise) stress, depression and dealing with life challenges, such as bereavement or looking after a new baby.

Why am I sleepy all day every day? ›

Even though everyone has days when they feel exhausted, constantly feeling run down and tired isn't normal. Many possible factors cause chronic fatigue, such as underlying medical conditions, nutrient deficiencies, sleep disturbances, caffeine intake, and chronic stress.

Why do I just want to sleep all the time? ›

Hypersomnia means excessive sleepiness. There are many different causes, the most common in our society being inadequate sleep. This may be due to shiftwork, family demands (such as a new baby), study or social life. Other causes include sleep disorders, medication, and medical and psychiatric illnesses.

What autoimmune disorders cause excessive daytime sleepiness? ›

Narcolepsy with cataplexy (NC) (also known as narcolepsy type 1) is a chronic sleep disorder of autoimmune origin characterized by dysregulation of REM sleep secondary to impaired hypocretin (HCRT) neurotransmission in the brain.

What autoimmune disease causes excessive sleepiness? ›

Profound and debilitating fatigue is the most common complaint reported among individuals with autoimmune disease, such as systemic lupus erythematosus, multiple sclerosis, type 1 diabetes, celiac disease, chronic fatigue syndrome, and rheumatoid arthritis.

What medical conditions affecting the brain and body can cause daytime drowsiness? ›

  • CNS Injury and Stroke.
  • Dementia.
  • Epilepsy and Sleep.
  • Genetics.
  • Movement Disorders.
  • Multiple Sclerosis/Neuroinflammation.
  • Neuro-oncology.
  • Neurodegeneration - Cellular & Molecular.

What medication is FDA-approved for excessive daytime sleepiness? ›

Medications FDA-Approved for Sleepiness
  • Stimulant medications (i.e., derivatives of amphetamines)
  • Non-stimulant wake-promoting medications, which includes several classes of medications. modafinil (e.g., Provigil) and armodafinil (e.g., Nuvigil) solriamfetol (e.g., Sunosi) ...
  • Oxybates (e.g., Xyrem and Xywav)

Is there medication for being tired all the time? ›

In addition to relieving depression, these drugs can reduce fatigue and muscle tension, and improve sleep. Side effects vary. Antidepressants often prescribed for chronic fatigue include: Tricyclics: amitriptyline (Elavil), desipramine (Norpramin), notriptyline (Pamelor)

What is the new medication for hypersomnia? ›

XYWAV is the first and only FDA-approved treatment for adults with IH. XYWAV oral solution, 0.5 g/mL total salts (equivalent to 0.413 g/mL of oxybate) is the only FDA‑approved treatment for cataplexy and/or excessive daytime sleepiness in narcolepsy and for idiopathic hypersomnia (IH) in adults.

Which drug is indicated for the improvement of wakefulness in patients who have excessive daytime sleepiness? ›

Modafinil and armodafinil increase wakefulness and both have been shown to be helpful in conditions with excessive sleepiness including narcolepsy, obstructive sleep apnea and shift-work sleep disorder.

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