Source:

The Nurse Practitioner

May 2011, Volume 36 Number 5 , p 33 - 34 [FREE]

Authors

Abstract

Sleep is important for the body, but excessive (or chronic) sleepiness (ES) means you have trouble staying awake enough to do what you usually do.Here are answers to common questions about ES.Some causes of ES are poor sleep habits, shift work sleep disorder, sleep apnea, and narcolepsy.Poor sleep habits. Do you feel like you do not get enough sleep? If so, you are not alone. Many people try to get by with less sleep so they can get more things done. They may get less sleep because they have to work more than one job to make enough money to live or they may work and go to school.Shift work sleep disorder. Working the night shift or rotating shifts makes it hard to sleep without interruption. If you work evening or night shifts and there is no other cause for your sleepiness, like a medication (drug) or a medical condition, you might have shift work sleep disorder.Sleep apnea. In sleep apnea, your breathing stops or gets very shallow several times while you sleep. Obstructive sleep apnea (OSA) is the most common type of sleep apnea. OSA occurs when throat muscles block the airway while a person sleeps. Many times people do not even know this is happening. Risks for OSA include obesity, smoking, heart disease, high blood pressure, stroke, and type 2 diabetes.People with OSA often snore loudly and have a hard time staying awake during the day. They are at risk for high blood pressure, heart disease, stroke, diabetes, depression, and death.Narcolepsy. People with narcolepsy are extremely drowsy and can fall asleep suddenly during the day. They don't sleep longer during the night, but often wake up several times.Other causes. Other causes of ES are insomnia and hypersomnia. Insomnia means it is hard for you to get to sleep or stay asleep. If you have hypersomnia, you might sleep more than 10 hours at once and are hard to wake up while you sleep. But, you are still sleepy during the day and may take several naps.Restless legs syndrome (RLS) is an unpleasant (crawly, prickly)

 

Sleep is important for the body, but excessive (or chronic) sleepiness (ES) means you have trouble staying awake enough to do what you usually do.

 

Here are answers to common questions about ES.

 

Some causes of ES are poor sleep habits, shift work sleep disorder, sleep apnea, and narcolepsy.

 

Poor sleep habits. Do you feel like you do not get enough sleep? If so, you are not alone. Many people try to get by with less sleep so they can get more things done. They may get less sleep because they have to work more than one job to make enough money to live or they may work and go to school.

 

Shift work sleep disorder. Working the night shift or rotating shifts makes it hard to sleep without interruption. If you work evening or night shifts and there is no other cause for your sleepiness, like a medication (drug) or a medical condition, you might have shift work sleep disorder.

 

Sleep apnea. In sleep apnea, your breathing stops or gets very shallow several times while you sleep. Obstructive sleep apnea (OSA) is the most common type of sleep apnea. OSA occurs when throat muscles block the airway while a person sleeps. Many times people do not even know this is happening. Risks for OSA include obesity, smoking, heart disease, high blood pressure, stroke, and type 2 diabetes.

 

People with OSA often snore loudly and have a hard time staying awake during the day. They are at risk for high blood pressure, heart disease, stroke, diabetes, depression, and death.

 

Narcolepsy. People with narcolepsy are extremely drowsy and can fall asleep suddenly during the day. They don't sleep longer during the night, but often wake up several times.

 

Other causes. Other causes of ES are insomnia and hypersomnia. Insomnia means it is hard for you to get to sleep or stay asleep. If you have hypersomnia, you might sleep more than 10 hours at once and are hard to wake up while you sleep. But, you are still sleepy during the day and may take several naps.

 

Restless legs syndrome (RLS) is an unpleasant (crawly, prickly) feeling in the legs that causes the urge to move them. RLS can cause insomnia. Certain medications can also cause ES.

 

When you are tired, your reaction time is slower, a big problem when driving and doing other things that need a quick response. Sleepiness causes at least 100,000 car crashes each year, and the number is probably much higher. It also can cause work-related accidents, especially when heavy or special machinery is involved.

 

Lack of sleep slows down your ability to think: You are less alert and it is harder for you to focus and pay attention. You may be unable to make good decisions. Not getting enough sleep also impairs your memory (you forget and misplace things) and makes it harder to learn.

 

People who have ES are at risk for depression. They are often irritable and may have trouble with their personal relationships.

 

People with ES do not sleep the way other people do. They may sleep longer than normal, shorter than normal, or keep waking up during sleep. They feel tired and sleepy during the day. Often, it takes time to become aware of the problem. You may have ES for as long as 6 months before you realize it.

 

Your healthcare provider can help you find out if you have ES. Be sure to tell your provider about your sleep habits and routines. Your family can also tell providers if you snore or have other problems when you sleep. Keeping a sleep diary of hours asleep and when you feel sleepy during the day is helpful. You can get a copy of the American Sleep Association's sleep diary at http://www.sleepassociation.org/sleepdiary.pdf and its sleep log at http://www.sleepassociation.org/sleep_log.pdf.

 

The Epworth Sleepiness Scale and the Stanford Sleepiness Scale may also be helpful. You can get a copy of the Epworth scale at http://epworthsleepinessscale.com/wp-content/uploads/2009/09/epworth-sleepiness-. A score of 10 or higher could mean you have trouble with ES.

 

If your healthcare provider thinks you have a medical problem, he or she may order overnight sleep studies at a sleep center. A polysomnogram is a study that measures brain waves and body movements during sleep. Another study, called multiple sleep latency, is done during the day after the overnight polysomnogram, and it measures how fast a person enters a deep sleep over different 2-hour periods.

 

Treatment of ES depends on its cause.

 

Poor sleep habits. The best solution is to get more, good-quality sleep. Making changes in your daily routine can help. Sometimes this is all you need to do to fix the problem.

 

OSA. The most common treatment is a continuous positive airway pressure (CPAP) device. A CPAP device gives compressed air through a hose to a nose or face mask that the person wears. An oral device might be used to hold the jaw in a forward position while the person sleeps so the airway does not get blocked. In some cases, surgery might be needed. It's also a good idea to lose extra weight and stay away from alcohol.

 

Shift work sleep disorder. If you cannot change your shift, you can try using the same tips for those with poor sleep habits.

 

Narcolepsy. People can make lifestyle changes to make it easier to live with the problem, but there's no cure for the condition. It is best to take short, 20-minute naps during the day and practice other good sleep habits.

 

Medications. There are medications to treat ES. Talk to your healthcare provider about the medications used to treat ES. Your provider should determine the right medication for you and will discuss with you the benefits and possible adverse reactions of the medication.

Sleep is important for the body, but excessive (or chronic) sleepiness (ES) means you have trouble staying awake enough to do what you usually do.

Here are answers to common questions about ES.

What causes ES?

Some causes of ES are poor sleep habits, shift work sleep disorder, sleep apnea, and narcolepsy.

Poor sleep habits. Do you feel like you do not get enough sleep? If so, you are not alone. Many people try to get by with less sleep so they can get more things done. They may get less sleep because they have to work more than one job to make enough money to live or they may work and go to school.

Shift work sleep disorder. Working the night shift or rotating shifts makes it hard to sleep without interruption. If you work evening or night shifts and there is no other cause for your sleepiness, like a medication (drug) or a medical condition, you might have shift work sleep disorder.

Sleep apnea. In sleep apnea, your breathing stops or gets very shallow several times while you sleep. Obstructive sleep apnea (OSA) is the most common type of sleep apnea. OSA occurs when throat muscles block the airway while a person sleeps. Many times people do not even know this is happening. Risks for OSA include obesity, smoking, heart disease, high blood pressure, stroke, and type 2 diabetes.

 
Figure. Did you know... - Click to enlarge in new windowFigure. Did you know? 29% of Americans fall asleep or become very sleepy at work.

People with OSA often snore loudly and have a hard time staying awake during the day. They are at risk for high blood pressure, heart disease, stroke, diabetes, depression, and death.

Narcolepsy. People with narcolepsy are extremely drowsy and can fall asleep suddenly during the day. They don't sleep longer during the night, but often wake up several times.

Other causes. Other causes of ES are insomnia and hypersomnia. Insomnia means it is hard for you to get to sleep or stay asleep. If you have hypersomnia, you might sleep more than 10 hours at once and are hard to wake up while you sleep. But, you are still sleepy during the day and may take several naps.

Restless legs syndrome (RLS) is an unpleasant (crawly, prickly) feeling in the legs that causes the urge to move them. RLS can cause insomnia. Certain medications can also cause ES.

What problems does ES cause?

When you are tired, your reaction time is slower, a big problem when driving and doing other things that need a quick response. Sleepiness causes at least 100,000 car crashes each year, and the number is probably much higher. It also can cause work-related accidents, especially when heavy or special machinery is involved.

Lack of sleep slows down your ability to think: You are less alert and it is harder for you to focus and pay attention. You may be unable to make good decisions. Not getting enough sleep also impairs your memory (you forget and misplace things) and makes it harder to learn.

People who have ES are at risk for depression. They are often irritable and may have trouble with their personal relationships.

 
Figure. Did you know... - Click to enlarge in new windowFigure. Did you know? Adults need 7 to 9 hours of sleep each night.

How do I know if I have ES?

People with ES do not sleep the way other people do. They may sleep longer than normal, shorter than normal, or keep waking up during sleep. They feel tired and sleepy during the day. Often, it takes time to become aware of the problem. You may have ES for as long as 6 months before you realize it.

Your healthcare provider can help you find out if you have ES. Be sure to tell your provider about your sleep habits and routines. Your family can also tell providers if you snore or have other problems when you sleep. Keeping a sleep diary of hours asleep and when you feel sleepy during the day is helpful. You can get a copy of the American Sleep Association's sleep diary at http://www.sleepassociation.org/sleepdiary.pdf and its sleep log at http://www.sleepassociation.org/sleep_log.pdf.

The Epworth Sleepiness Scale and the Stanford Sleepiness Scale may also be helpful. You can get a copy of the Epworth scale at http://epworthsleepinessscale.com/wp-content/uploads/2009/09/epworth-sleepiness-. A score of 10 or higher could mean you have trouble with ES.

 
Figure. Did you know... - Click to enlarge in new windowFigure. Did you know? 36% of Americans drive drowsy or fall asleep while driving.

If your healthcare provider thinks you have a medical problem, he or she may order overnight sleep studies at a sleep center. A polysomnogram is a study that measures brain waves and body movements during sleep. Another study, called multiple sleep latency, is done during the day after the overnight polysomnogram, and it measures how fast a person enters a deep sleep over different 2-hour periods.

How is ES treated?

Treatment of ES depends on its cause.

Poor sleep habits. The best solution is to get more, good-quality sleep. Making changes in your daily routine can help. Sometimes this is all you need to do to fix the problem.

OSA. The most common treatment is a continuous positive airway pressure (CPAP) device. A CPAP device gives compressed air through a hose to a nose or face mask that the person wears. An oral device might be used to hold the jaw in a forward position while the person sleeps so the airway does not get blocked. In some cases, surgery might be needed. It's also a good idea to lose extra weight and stay away from alcohol.

Shift work sleep disorder. If you cannot change your shift, you can try using the same tips for those with poor sleep habits.

Narcolepsy. People can make lifestyle changes to make it easier to live with the problem, but there's no cure for the condition. It is best to take short, 20-minute naps during the day and practice other good sleep habits.

Medications. There are medications to treat ES. Talk to your healthcare provider about the medications used to treat ES. Your provider should determine the right medication for you and will discuss with you the benefits and possible adverse reactions of the medication.

Tips for better sleep

 

* Avoid food and drinks with caffeine during the second half of the day. Soda, tea, and coffee all have caffeine.

 

* Get rid of noise, distractions (such as televisions, computers), and light where you sleep and keep the room slightly cool.

 

* Stick to a set sleep schedule even on the weekends.

 

* Exercise, but not before bedtime.

 

* Use your bedroom only for sleep and sex.

 

* Avoid alcohol and cigarettes.

 

* Take naps as needed if you have narcolepsy and when it's safe to do so.