What Causes Excessive Sleepiness?

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Do you have trouble waking up in the morning, or do you feel sleepy during the day — even if you've tried taking a nap? You might be among the 20% of Americans who deal with excessive sleepiness. Along with the obvious inability to stay awake and alert, symptoms often include appetite loss, memory issues, muddled thinking, anxiety and irritability. Sleepiness can also be severe enough to disrupt your normal activities and relationships, among other aspects of your life.

It's one of the main reasons that people decide to visit sleep clinics and doctors. If you're experiencing excessive sleepiness and, if it's interfering with your life, it's important to talk with a knowledgeable medical professional. That's the best way to get to the bottom of what's causing it and come up with a treatment plan.

Insomnia Prevents Sleep Overall

Insomnia affects up to 30% of the U.S. population at one point or another. This common sleep disorder is marked by symptoms like having difficulty falling asleep, waking frequently during the night and waking too early without being able to fall back to sleep. There are two types of insomnia: short-term, which typically lasts for several days or weeks, and long-term, which can last for a month or longer.

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In addition to excessive sleepiness, insomnia can also cause increases in irritability, anxiety and depression. It can limit your ability to focus, cause memory problems and even increase your likelihood of making mistakes or getting into an accident.

Narcolepsy Disrupts Daily Wakefulness

Narcolepsy is a condition that interferes with your brain's ability to control your normal sleep-wake cycles. As a result, you might feel rested when you first wake up and then feel excessively sleepy throughout the rest of the day. This disorder affects men and women equally, with symptoms typically beginning between the ages of 7 and 25, although it can happen at any stage in life.

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Symptoms of narcolepsy include excessive daytime sleepiness, loss of muscle control (cataplexy) and hallucinations ― usually while falling asleep or when waking up. Sleep paralysis is another common symptom. This usually lasts from a few seconds to several minutes and is marked by an inability to talk or move when waking or falling asleep.

Obstructive Sleep Apnea Impacts Breathing — Not Just Sleep

Obstructive sleep apnea (OSA) goes far beyond loud snoring. When someone has OSA, their upper airway gets blocked during sleep, forcing the muscles in their chest and diaphragm to work harder. It's often marked by shallow breathing and periods of not breathing at all. If you have OSA, you might find yourself gasping or jerking in your sleep as you start breathing again. However, most people don't even know that it's happening. OSA typically causes poor sleep quality. It can also reduce the amount of oxygen getting to the rest of your body and affect the rhythm of your heart.

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Symptoms include excessive sleepiness and fatigue, sore throat or dry mouth upon waking up, night sweats, restless sleeping, waking suddenly while gasping or choking, and snoring. OSA can also lead to a lower sex drive, memory issues and other health issues like high blood pressure.

Restless Legs Syndrome Movements Affect Downtime

When you have restless legs syndrome (RLS), your sleep is disrupted by the feeling that you need to move your legs constantly. This happens because you experience a crawling, itching or tingling sensation in your feet and lower legs. It usually happens at nighttime, particularly when you're resting — seated or lying down. Moving provides relief from the sensations.

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RLS can also cause twitching in your legs at night while you’re asleep. This condition can be disruptive to sleep and hamper your ability to get truly restful sleep. In time, this leads to excessive sleepiness and can start interfering with your ability to go about your normal activities during the day.

Neurological or Psychiatric Conditions Interfere With Sleep

There’s a range of conditions affecting the brain that can cause excessive sleepiness. Many of these conditions don't just cause sleepiness, but they also interfere with sleep, leading to daytime fatigue. Common issues include concussions, Parkinson's disease and psychiatric conditions like depression or anxiety.

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There are also medical conditions — such as gastrointestinal disorders, infections and asthma — that can impact your sleep. In many cases, excessive sleepiness doesn’t seem like a symptom that would be tied to one of these conditions. This underscores the importance of seeing a doctor if you’re feeling excessively tired.

Medications Have Lasting Side Effects

Sleepiness is a common side effect of many medications, both prescription and over-the-counter. Some of the medications that most frequently result in excessive sleepiness include antipsychotics, anticonvulsants, antidepressants, antihistamines, benzodiazepines and muscle relaxers. Taking these kinds of medications in addition to other substances like alcohol can increase their fatigue-inducing effects.

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Certain illegal drugs, including cocaine, keep you awake for a long time, leading to excessive sleepiness later after the drugs’ initial effects have faded. Providing your doctor with a full list of all the medications and substances you use is an essential step in figuring out the root cause of any excessive sleepiness you're experiencing.

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