Excessive daytime sleepiness (EDS) is the tendency to fall asleep during the daytime when one is expected to be awake. EDS can impact alertness, concentration, attention, and overall health. This health concern affects up to 18% of the U.S. population. EDS is not a sleep disorder in itself; instead, it is a symptom of other sleep-related disorders.
The following sleep disorders commonly cause excessive daytime sleepiness:
Some psychiatric disorders—especially those that affect mood (anxiety, depression) or psychosis (schizophrenia) —can also impact sleep and can cause EDS. Heart failure, renal failure, liver failure, and obesity are medical conditions that can contribute to EDS. Neurological disorders including Parkinson’s, stroke, multiple sclerosis, and epilepsy also can affect EDS.
Other causes of EDS are inadequate sleep hygiene, excessive use of caffeine or other stimulants, chronic drug and alcohol use, and insufficient sleep. Sleep deprivation that leads to EDS is often a consequence of altered sleep patterns, like those that occur due to jet lag or shift work.
A broad, nonpharmacologic step everyone with EDS can take is improving sleep hygiene. Proper sleep hygiene can lessen the effects of sleep-related disorders and promote overall health and wellbeing. To improve sleep hygiene:
Other appropriate treatments for EDS depend on the underlying disorder. Work with your physician to accurately identify the cause of your EDS rather than making assumptions. As the disorders or causes are addressed—often using a combination of treatments—daytime sleepiness improves.
When it comes to treating EDS, physicians commonly identify one or more of the following underlying disorders and recommend the corresponding treatments:
Although there are many medications available for people with excessive sleepiness, they are often recommended along with other types of treatments, therapies, and behavior modifications. The following are commonly prescribed medications for patients with EDS:
Consult your physician before starting or stopping any medication. Ensure they are fully aware of your health history, including allergies, and physical, and mental health diagnoses. Also, share with them any other medications, herbal supplements, or over-the-counter drugs you take, as these could interfere with your prescribed medication.
If you receive a prescription to treat excessive daytime sleepiness, carefully follow the directions provided by your physician and pharmacist. Avoid any potentially dangerous activities such as driving until you are sure of how the medication affects you.
Remember that these medications can have a variety of side effects. Take note of any side effects you experience and report them to your physician. In the case of an emergency, seek immediate medical attention.
There are some over the counter caffeine pills intended to help you “wake up,” and, at 200 mg, they often contain as much or more caffeine than a cup of coffee. Although some of these pills may provide an energy boost, they can also have negative side effects such as jitteriness, headaches, and increased heart rate. Excessive caffeine can also impact your circadian rhythm, making sleeping at night more difficult. Also, as a person becomes dependent on caffeine, it can be less effective at providing alertness.
Sometimes people opt for herbal supplements in hopes of obtaining better sleep. Common choices include chamomile, lavender, and kava. However, little research has been conducted on these supplements and there is little evidence to suggest their positive impact on sleep.
For instance, chamomile does not appear to help people with insomnia sleep better but may help improve the quality of sleep for people without insomnia. Kava can be used to treat anxiety, but there’s not enough research yet on its effect on sleep. Kava usage may add to a risk of liver injury.
Overall, it is better to focus on sleep quality and quantity whenever possible rather than relying on pills and supplements. A daily routine and good sleep hygiene will be most helpful and least likely to produce negative effects in the long-term.