As many as 20% of Americans complain about excessive daytime sleepiness that causes sluggishness and fatigue that makes it a struggle to stay awake all day. Despite popular belief, excessive daytime sleepiness is not a condition. In fact, it is actually a symptom that indicates your sleep is being affected in some way. Oftentimes, excessive daytime sleepiness is also accompanied by memory problems, feelings of irritability or anxiety, and a loss of appetite. Obstructive sleep apnea (OSA) is one of the most common causes of excessive daytime sleepiness.
Hypersomnia vs. Fatigue
When discussing excessive daytime sleepiness (EDS), it is important to distinguish hypersomnia from fatigue and vice versa. Hypersomnia, therefore, means excessive sleepiness. It is characterized by feeling constantly tired, despite long periods of sleep or taking naps throughout the day. Fatigue, on the other hand, is a feeling of exhaustion, strain, or lack of energy. Instead of feeling sleepy or drowsy, fatigue is characterized by having no motivation and no energy. Fatigue also usually improves with rest, unless it is due to a physical or mental health condition.
How OSA Contributes to Daytime Sleepiness
OSA causes sleep arousal and/or disturbances due to a lack of proper airflow. This can take the form of hypopnea, or restricted airflow that causes shallow breathing, or apnea, which is when breathing completely stops. A diagnosis of OSA is usually made by totaling the amount of times that hypopnea and apnea occur per hour of sleep. This is called the apnea-hypopnea index (AHI). The American Academy of Sleep Medicine defines mild OSA as being 5-15 events per hour, moderate OSA as being 15-30 events per hour, and severe OSA as being 30 or more events per hour. It is interesting to note, however, that the level of daytime sleepiness is said to be surprisingly similar among those with mild or severe OSA, despite the fact that those with severe OSA experience more disruptive events throughout the night.
Traditionally, it is theorized that EDS from OSA stems from a lack of deep sleep due to frequent arousals during sleep. While this is still generally accepted for most cases of OSA, recent research indicates that there could be more at play. An article published May 2021 in the Annals of the American Thoracic Society notes that the two primary consequences of OSA, sleep fragmentation and recurring periods of decreased oxygen levels, could be the result of neuronal injury and degeneration in wake-promoting brain regions. Simply stated, sleep fragmentation and a lack of oxygen can cause irreversible brain damage that impairs wakefulness. However, the article also notes that the exact mechanisms of EDS in OSA are still unclear and require more research.
Treating Excessive Daytime Sleepiness
Currently, there are many effective treatments for excessive daytime sleepiness caused by sleep apnea. New research also promises treatment advancements as more is learned about the exact relationship between EDS and OSA. In the meantime, excessive daytime sleepiness can be treated using one of more of the following:
- CPAP (Continuous Positive Airway Pressure)-The most common and effective treatment for sleep apnea is continuous positive airway pressure (CPAP). CPAP uses gentle air pressure through a mask placed over your nose or mouth to keep your throat open while you sleep. The goal of this treatment is not just to alleviate symptoms but also to improve your quality of life.
- Oral Appliances – Oral appliances may also be used to reposition the jaw and tongue in order to open up the airway and promote proper airflow.
- Lifestyle Modifications – Lifestyle modifications, such as losing weight with diet and exercise, and avoiding sleeping pills or alcohol, can also help reduce symptoms associated with sleep apnea.
- Positional sleep techniques – Sleeping on your side instead of sleeping on your back.
- Nerve Stimulators – Implanted hypoglossal nerve stimulator
- Surgical Procedures
Do you suffer from excessive daytime sleepiness that makes it hard to stay awake all day? Contact Doctor Dreamweaver today for your home sleep apnea test so you sleep well and be well.