Excessive Sleepiness: Everything You Need To Know

At some point you may have felt the fabled afternoon slump or had a hard time getting going in the morning. But if you stay tired throughout the day, you may be experiencing excessive daytime sleepiness. Excessive sleepiness can make you want to fall asleep all day long, and feeling sleepy all day keeps you from doing your best in school and work and can even cause dangerous accidents. Below, we’ll look at what causes excessive sleepiness, the risks involved, and what you can do about it.

Note: The content on Sleepopolis is meant to be informative in nature, but it shouldn’t be taken as medical advice, and it shouldn’t take the place of medical advice and supervision from a trained professional. If you feel you may be suffering from any sleep disorder or medical condition, please see your healthcare provider immediately.

Long Story Short

• Daytime sleepiness describes feeling the need to sleep throughout the day.
• Excessive daytime sleepiness (EDS) can be caused by not getting enough sleep, but also by some mental and medical conditions.
• Frequent EDS can put you at risk for accidents, poor brain function, and medical issues.
• You can treat EDS by addressing the underlying issue or by catching up on sleep.

What Is Excessive Daytime Sleepiness?

Excessive daytime sleepiness, or EDS, describes the frequent urge to sleep during the day. (1) People commonly confuse excessive sleepiness with general fatigue, feeling tired, or hypersomnia, but they are all unique. 

“General sleepiness, general fatigue, and hypersomnia are related terms, but they each refer to different experiences or conditions,” Dr. Peter G. Polos, MD, pulmonologist, sleep medicine physician, and associate professor of sleep medicine at Hackensack JFK Medical Center tells Sleepopolis. If you have EDS, you have trouble staying awake and alert throughout your day for at least three months. (1)

“General fatigue is a broad term that can encompass both mental and physical feelings of tiredness. It can explain why we might feel sluggish and not as productive throughout the day,” Polos explains. “While sleepiness is characterized by the desire to sleep, fatigue is more like a lack of energy or motivation to do things.” (3)

Symptoms of Excessive Sleepiness

So what do the symptoms of excessive sleepiness look like? Not just feeling sleepy, it turns out, although that’s the most common. EDS can come with other effects, too. (2):

• Extra napping: needing more than one nap a day
• Higher sleep inertia: trouble waking up, with irritability and confusion upon waking
• Oversleeping: sleeping a long time (over nine hours) but waking unrefreshed
• Sleep attacks: falling asleep suddenly without feeling sleepy first

These symptoms are bothersome in and of themselves, but they can also lead to more serious risks.

Risks of Excessive Sleepiness

Excessive sleepiness comes with a long list of risks. Some may sound obvious, but others may surprise you.

Accidents

Excessive daytime sleepiness leads to motor vehicle accidents every year, many of which are fatal. (2) “Drowsy driving has been compared to driving under the influence of alcohol and poses a hazard to the driver and those around them,” Polos says. “People with excessive daytime sleepiness could be at a higher risk of workplace accidents or when operating machinery due to decreased alertness and a slower reaction time.” 

Additionally, when physicians and other healthcare providers experience EDS, studies show they are much more likely to make medical errors. These errors often lead to poor outcomes for patients. (2)

Brain Fog

Have you ever tried to take a test after a bad night’s sleep? Or struggled to perform complex tasks at work? You’re not alone. Excessive daytime sleepiness can interfere with your brain function, making it harder to pay attention, remember things, and make decisions, Polos says. He adds, “This could lead to an increase in making mistakes or errors and a reduction in productivity at work or school.” 

Mood Disorders

“People with chronic daytime sleepiness also report mood disturbances such as irritability, mood swings, depression, and anxiety. This can manifest in short temperament or frequent frustration,” says Polos. Experts say anxiety and depression can both cause and be caused by EDS, so treatment of one may help improve the other. (2)

Health Conditions

Some underlying medical issues can be associated with EDS, like sleep apnea, narcolepsy, and other sleep disorders, says Polos. “Each of [these] comes with their own set of health risks if not diagnosed and treated.” If you cope with EDS, it may mean you’re not getting enough sleep, which can put you at a higher risk of infection, says Polos. 

Some studies suggest a diagnosis of EDS along with a sleep disorder correlates with a high risk of heart disease. (3) Polos adds that conditions like sleep apnea could lead to metabolic changes that contribute to weight gain and obesity, which also add risk.

Causes of Excessive Sleepiness

Excessive sleepiness can stem from a variety of causes. “One of the most common reasons is simply that the individual is not getting enough sleep,” says Polos. (2) Let’s have a look at some other EDS origins.

Poor Sleep Hygiene or Quality

Snuggling up in your bed for hours doesn’t always equal quality sleep, and lack of quality sleep can leave you feeling drowsy all day. While some factors impacting your sleep may be out of your control, there are many habits or elements you can change for the better — starting with sleep hygiene.

Sleep hygiene describes your routines around sleep and bedtime. If you go to bed at different times each night, eat heavy meals before bed, or keep your room warm and bright, you may not get the nightly rest you need. (4)

Not all sleep is equal. “If there is an interruption in any stage of the sleep cycle, including REM, we can experience sleepiness, memory issues, and an overall decline in our health,” says Polos.

As an adult, you need at least seven hours of sleep per night. (5) If you find yourself needing more than nine hours on a regular basis, you may not be getting enough quality or deep sleep.

Sleep Disorders 

Sleep disorders can steal your rest and lead to excessive daytime sleepiness. Here are some of the most common culprits:

• Sleep apnea: causes pauses in breathing and frequent awakening throughout the night
• Narcolepsy: causes you to fall asleep suddenly
• Restless leg syndrome (RLS): characterized by an uncomfortable sensation in your limbs and an uncontrollable feeling of needing to move them to relieve it
• Insomnia: inability to fall asleep or stay asleep

“[Any of these] may interrupt a peaceful night of sleep or pose difficulty in falling asleep,” Polos says.

Diet

Your diet doesn’t just affect your energy and waistline…it can impact your sleep, too. For example, caffeine consumed too late in the day can keep you up no matter what time your alarm is set. Alcohol can make you sleepy come bedtime, but then disrupt your snoozing later on. As your blood alcohol level decreases throughout the night, your sleep stages can get muddled, leading to multiple wake ups. (6) 

If you eat too big a meal or snack close to bedtime, your body may take that as a cue to gear up for hours of wakefulness. Foods with too much fat can also change your breathing patterns and disrupt stages of sleep, which can lead to daytime sleepiness, Polos says. (7)

Mental Health

Sleep has a bidirectional connection with stress, anxiety, and depression. That means poor sleep can lead to mental health complications, and vice versa. “Chronic stress and anxiety can be mentally exhausting and disrupt regular sleep patterns, leading to daytime sleepiness,” says Polos. (8) Similarly, poor sleep can worsen mental health symptoms. (9)

Medical Conditions

Some chronic medical conditions can disrupt your sleep and lead to EDS, says Polos, including chronic pain, brain injuries, and neurological disorders. (10,11,12) Quite a few medical conditions can disrupt sleep, especially during flare-ups or in early diagnosis. (13)

Medications

At times, medications themselves can cause daytime sleepiness, Polos says. The Food and Drug Administration (FDA) includes the following in that category: (14)

• Anti-anxiety medications
• Anti-diarrhea medications
• Antihistamines
• Antipsychotic medications
• Anti-seizure medications
• Diet pills
• Motion sickness medications
• Muscle relaxers
• Opioid pain relievers
• Sleeping pills
• Some antidepressants

These medications aren’t the only things you might ingest that can cause daytime sleepiness — stimulants like caffeine can even cause drowsiness once their effects wear off. (15)

Treatments for Excessive Sleepiness

Treatment for excessive sleepiness can include anything that helps you sleep better. For his patients, Polos recommends the following approach. 

1. Review Medical History, Medication History, Exams, and Tests with Your Doctor

“I would first look at the patient’s medical history to understand their sleep habits, lifestyle factors, medication, and any underlying conditions,” says Polos. Next comes a physical exam to check for signs of health conditions like: 

• Cardiovascular disease
• Metabolic disorders
• Neurologic conditions 
• Obesity

Some people may need their blood drawn for labs, Polos says. For example, iron levels in your blood can offer valuable clues in diagnosing a disorder like restless leg syndrome. (16)

2. Try Sleep Tracking

Tracking your sleep can help your provider see your sleep patterns and create a plan of action, says Polos. One way to do this is to keep a sleep diary. 

You can also use one of many available online apps and tools to track your sleep, either through manual entry or biometric tracking, like with an Apple watch or Fitbit. “These insights can help you better understand the importance of maintaining a consistent sleep schedule and can help you improve your sleep over time,” Polos says.

3. Consider a Sleep Study

Some people may want to get a sleep study to rule out sleep apnea. During a sleep study, you typically stay overnight at a health center so staff can monitor your breathing and vital signs while you sleep. Depending on your situation, you may be able to do your sleep study at home. (17) Your provider can help you decide if this option is right for you. 

4. Take Counsel on Sleep Hygiene and Lifestyle Changes

“Oftentimes, a simple adjustment to one’s sleep habits and lifestyle can alleviate excessive sleepiness,” says Polos. “I’d talk to the patient about the importance of maintaining and promoting good sleep hygiene and provide tips around diet, exercise, and stress management.” 

Practices for Improving Sleep Hygiene

• Aim for the same bedtime and wake time every day.
• Avoid alcohol, caffeine, or large meals too close to bedtime.
• Avoid long or late naps.
• Get outside in the sun at least once per day.
• Keep your room cool and dark.
• Reserve your bed for sex and sleep only.
• Stay away from blue light from screens before bed.
• Try playing white or colored noise while you sleep.

The Difference Between Excessive Sleepiness and Hypersomnia

Hypersomnia and EDS may share common causes and symptoms, but they are two different things. (18) “Hypersomnia is a condition where someone feels excessively sleepy during the day no matter how much sleep they may have had the night before,” says Polos. 

Furthermore, excessive sleepiness can be fixed by getting enough sleep and paying down sleep debt, but hypersomnia cannot. “While we all may go through a period of inadequate sleep and daytime sleepiness, the term hypersomnia is used for individuals in whom this is a more chronic condition,” Polos says. 

When to Talk to Your Doctor 

If you find you just can’t wake up throughout the day and nothing seems to help, you may want to let your provider know. “It’s important to consult with a healthcare professional if you experience any of the symptoms persistently,” says Polos, who gives the following qualifications for seeking medical help:

• It impacts daily life
• It persists for more than a few weeks
• Lifestyle changes to improve your sleep hygiene do not help
• You experience a sudden onset of excessive sleepiness
• You notice a decline in memory or concentration
• You suspect a new medication is causing increased drowsiness

Bottom line: When in doubt, get it checked out.

FAQs

What causes excessive sleepiness in the elderly?

“Excessive sleepiness in the older adult population could be caused by a multitude of factors, which could be age-related physiological changes, medical conditions or environmental factors,” says Dr. Polos, who explains these can include chronic pain, sleep apnea, medications, mental health issues, and an altered sleep schedule. (19)

What is excessive sleepiness a sign of?

Excessive sleepiness can be a sign you aren’t getting enough good sleep. It can also point to mental health disorders, medical issues, or sleep disorders. (4,8)

The Last Word From Sleepopolis 

Excessive daytime sleepiness doesn’t have to be your norm. While we all go through stages of life that steal more sleep, consistent tiredness during the day can cause problems for you in the long run. Try out some of our sleep hygiene tips to get more quality slumber. But if these don’t work for you, don’t hesitate to reach out to your provider. Good sleep is out there, and they can help you find it.

Sources

1. Brown J, Makker HK. An approach to excessive daytime sleepiness in adults. BMJ. Published online March 27, 2020:m1047. doi:10.1136/bmj.m1047
2. Gandhi KD, Mansukhani MP, Silber MH, Kolla BP. Excessive Daytime Sleepiness. Mayo Clinic Proceedings. 2021;(5):1288-1301. doi:10.1016/j.mayocp.2020.08.033
3. Bock J, Covassin N, Somers V. Excessive daytime sleepiness: an emerging marker of cardiovascular risk. Heart. 2022;(22):1761-1766. doi:10.1136/heartjnl-2021-319596
4. Alanazi EM, Alanazi AMM, Albuhairy AH, Alanazi AAA. Sleep Hygiene Practices and Its Impact on Mental Health and Functional Performance Among Adults in Tabuk City: A Cross-Sectional Study. Cureus. Published online March 16, 2024. doi:10.7759/cureus.36221
5. Sleep FAQs – Sleep Education by the AASM. Sleep Education. Accessed August 13, 2024. https://sleepeducation.org/sleep-faqs/#
6. He S, Hasler BP, Chakravorty S. Alcohol and sleep-related problems. Current Opinion in Psychology. Published online December 2019:117-122. doi:10.1016/j.copsyc.2019.03.007
7. Bove C, Jain V, Younes N, Hynes M. What You Eat Could Affect Your Sleep: Dietary Findings in Patients With Newly Diagnosed Obstructive Sleep Apnea. American Journal of Lifestyle Medicine. 2018;(3):305-312. doi:10.1177/1559827618765097
8. Ramos JN, Muraro AP, Nogueira PS, Ferreira MG, Rodrigues PRM. Poor sleep quality, excessive daytime sleepiness and association with mental health in college students. Annals of Human Biology. 2021;(5):382-388. doi:10.1080/03014460.2021.1983019
9. Karna B. Sleep Disorder – StatPearls – NCBI Bookshelf. National Center for Biotechnology Information. Accessed August 13, 2024. https://www.ncbi.nlm.nih.gov/books/NBK560720/
10.  Haack M, Simpson N, Sethna N, Kaur S, Mullington J. Sleep deficiency and chronic pain: potential underlying mechanisms and clinical implications. Neuropsychopharmacology. 2019;(1):205-216. doi:10.1038/s41386-019-0439-z
11. Aoun R, Rawal H, Attarian H, Sahni A. <p>Impact of traumatic brain injury on sleep: an overview</p> Nature and Science of Sleep. Published online August 2019:131-140. doi:10.2147/nss.s182158
12. Bishir M, Bhat A, Essa MM, et al. Sleep Deprivation and Neurological Disorders. Martorana A, ed. BioMed Research International. Published online November 23, 2020:1-19. doi:10.1155/2020/5764017
13. Are there medical conditions that may disrupt sleep patterns? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development. https://www.nichd.nih.gov/. Accessed August 15, 2024. https://www.nichd.nih.gov/health/topics/sleep/conditioninfo/sleep-disruption
14. Some Medicines and Driving Don’t Mix | FDA. U.S. Food and Drug Administration. Accessed August 15, 2024. https://www.fda.gov/consumers/consumer-updates/some-medicines-and-driving-dont-mix
15. O’Callaghan F, Muurlink O, Reid N. Effects of caffeine on sleep quality and daytime functioning. Risk Management and Healthcare Policy. Published online December 2018:263-271. doi:10.2147/rmhp.s156404 
16. Restless Legs Syndrome | National Institute of Neurological Disorders and Stroke. National Institute of Neurological Disorders and Stroke. Accessed August 13, 2024. https://www.ninds.nih.gov/health-information/disorders/restless-legs-syndrome
17. Sleep Studies – Sleep Studies | NHLBI, NIH. NHLBI, NIH. Accessed August 13, 2024. https://www.nhlbi.nih.gov/health/sleep-studies#
18. Hypersomnia | National Institute of Neurological Disorders and Stroke. National Institute of Neurological Disorders and Stroke. Accessed August 13, 2024. https://www.ninds.nih.gov/health-information/disorders/hypersomnia#
19. Tatineny P, Shafi F, Gohar A, Bhat A. Sleep in the Elderly. Missouri Medicine. Published online September 2020;117(5):490-495.
20. Polos, Peter G., MD. Personal Interview. August 10, 2024.