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Problem Sleepiness: Get the Facts on Causes and Treatment

Problem sleepiness facts*

*Problem sleepiness facts medical author: Melissa Conrad Stöppler, MD

  • Problem sleepiness occurs when sleepiness during the day interferes with work or social functioning.
  • Symptoms of problem sleepiness may include difficulty concentrating, falling asleep while driving, or problems with emotional control.
  • There are a number of causes of problem sleepiness, including sleep disorders; other medical conditions; certain medications; substances like drugs, alcohol, or caffeine; or an altered sleep-wake cycle.
  • Sleep disorders include narcolepsy, insomnia, sleep apnea, and restless legs syndrome.
  • Sleepiness is a major cause of motor vehicle accidents, poor school performance, and depressed mood.
  • Shift workers are especially susceptible to sleepiness and its risks.
  • Treatment may consist of improving sleep hygiene and avoiding precipitating factors.

What is problem sleepiness?

Everyone feels sleepy at times. However, when sleepiness interferes with
daily routines and activities, or reduces the ability to function, it is called
“problem sleepiness.” A person can be sleepy without realizing it. For example,
a person may not feel sleepy during activities such as talking and listening to
music at a party, but the same person can fall asleep while driving home
afterward.

What are the symptoms of problem sleepiness?

You may have problem sleepiness if you:

  • consistently do not get enough sleep, or get poor
    quality sleep;
  • fall asleep while driving;
  • struggle to stay awake when inactive, such as when
    watching television or reading;
  • have difficulty paying attention or concentrating at
    work, school, or home;
  • have performance problems at work or school;
  • are often told by others that you are sleepy;
  • have difficulty remembering;
  • have slowed responses;
  • have difficulty controlling your emotions; or
  • must take naps on most days.

How to Stay Awake Naturally

By Camille Peri
WebMD Feature

Reviewed by Brunilda Nazario, MD

With more and more of us getting less and less sleep, it’s tempting to reach
for a Red Bull or an espresso when we feel sleepy at work. But consuming
caffeine to combat sleepiness can lead to a vicious cycle.

The java jolt that helps you stay awake can take up to eight hours to wear
off. Caffeine can also reduce your sleep time, alter the normal stages of sleep,
and decrease the quality of your sleep.

How can you stay awake naturally? Try some of these 12 jitter-free tips to
take the edge off sleepiness.

1. Get Up and Move Around to Feel Awake

In one well-known study, Robert Thayer, PhD, a professor at California State
University, Long Beach, studied whether people were more energized by eating a
candy bar or taking a brisk 10-minute walk. Though the candy bar provided a
quick energy boost, participants were actually more tired and had less energy an
hour later. The 10-minute walk increased energy for two hours. That’s because
walking pumps oxygen through your veins, brain, and muscles.

If you work at a desk, get up frequently for short walks. At meal breaks,
walk to a restaurant or, if you bring your lunch, head for a nice spot to eat
it. Whether you take a walk outside or just in the building where you work, it
will make you feel more alert and refreshed….

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    Problem sleepiness and adolescents

    Many U.S. high school and college students have signs of problem sleepiness,
    such as:

    • difficulty getting up for school;
    • falling asleep at school; and/or
    • struggling to stay awake while doing homework.

    The need for sleep may be 9 hours or more per night as a person goes through
    adolescence. At the same time, many teens begin to show a preference for a later
    bed time, which may be due to a biological change. Teens tend to stay up later
    but have to get up early for school, resulting in their getting much less sleep
    than they need.

    Many factors contribute to problem sleepiness in teens and young adults, but
    the main causes are not getting enough sleep and irregular sleep schedules. Some
    of the factors that influence adolescent sleep include:

    • social activities with peers that lead to later
      bedtimes;
    • homework to be done in the evenings;
    • early wake-up times do to early school start times;
    • parents being less involved in setting and enforcing
      bedtimes; and
    • employment, sports, or other extracurricular activities that decrease
      the time available for sleep.

    Teens and young adults who do not get enough sleep are at risk for problems
    such as:

    • automobile crashes;
    • poor performance in school and poor grades;
    • problems with peer and adult relationships.

    Many adolescents have part-time jobs in addition to their classes and other
    activities. High school students who work more than 20 hours per week have more
    problem sleepiness and may use more caffeine, nicotine, and alcohol than those
    who work less than 20 hours per week or not at all.

    Shift work and problem sleepiness

    About 20 million Americans (20 to 25 percent of workers) perform shift work.
    Most shift workers get less sleep over 24 hours than day workers. Sleep loss is
    greatest for night shift workers, those who work early morning shifts, and
    female shift workers with children at home. About 60 to 70 percent of shift
    workers have difficulty sleeping and/or problem sleepiness.

    The human sleep-wake system is designed to prepare the body and mind for
    sleep at night and wakefulness during the day. These natural rhythms make it
    difficult to sleep during daylight hours and to stay awake during the night
    hours, even in people who are well rested. It is possible that the human body
    never completely adjusts to nighttime activity and daytime sleep, even in those
    who work permanent night shifts.

    In addition to the sleep-wake system, environmental
    factors can influence sleepiness in shift workers. Because our society is
    strongly day-oriented, shift workers who try to sleep during the day are often
    interrupted by noise, light, telephones, family members, and other distractions.
    In contrast, the nighttime
    sleep of day workers is largely protected by social customs that keep noises and
    interruptions to a minimum.

    Problem sleepiness in shift workers may result in:

    • increased risk for automobile crashes, especially
      while driving home after a night shift;
    • decreased quality of life;
    • decreased productivity (night work performance may be
      slower and less accurate than day performance); and/or
    • increased risk of accidents and injuries at work.

    What treatments and remedies can help problem
    sleepiness?

    Sleep-There is no substitute!

    Many people simply do not allow enough time for sleep on a regular basis. A
    first step may be to evaluate daily activities and sleep-wake patterns to
    determine how much sleep is obtained. If you are consistently getting less than
    8 hours of sleep per night, more sleep may be needed. A good approach is to
    gradually move to an earlier bedtime. For example, if an extra hour of sleep in
    needed, try going to bed 15 minutes earlier each night for four nights and then
    keep the last bedtime. This method will increase the amount of time in bed
    without causing a sudden change in schedule. However, if work or family
    schedules do not permit the earlier bedtime, a 30 to 60 minute daily nap may
    help.

    Medications/drugs

    In general, medications do not help problem sleepiness, and some make it
    worse. Caffeine can reduce sleepiness and increase alertness, but only
    temporarily. It can also cause problem sleepiness to become worse by
    interrupting sleep.

    While alcohol may shorten the time it takes to fall asleep, it can disrupt
    sleep later in the night, and therefore add to the problem sleepiness.

    Medications may be prescribed for patients in certain
    situations. For example, the short-term use of sleeping pills has been shown to
    be helpful in patients diagnosed with acute insomnia. Long-term use of sleep
    medication is
    recommended only for the treatment of specific sleep disorders.

    If you’re sleepy—don’t drive!

    A person who is sleepy and drives is at high risk for an automobile crash.
    Planning ahead may help reduce that risk. For example, the following tips may
    help when planning a long distance car trip:

    • Get a good night’s sleep before leaving
    • Avoid driving between midnight and 7 a.m.
    • Change drivers often to allow for rest periods
    • Schedule frequent breaks

    If you are a shift worker, the following may help:

    • decreasing the amount of night work;
    • increasing the total amount of sleep by adding naps
      and lengthening the amount of time allotted for sleep;
    • increasing the intensity of light at work;
    • having a predictable schedule of night shifts;
    • eliminating sound and light in the bedroom during
      daytime sleep;
    • using caffeine (only during the first part of the
      shift) to promote alertness at night; or
    • possibly using prescription sleeping pills to help daytime sleep on
      occasional basis (check with your doctor).

    If you think you are getting enough sleep, but still feel sleepy during the
    day, check with your doctor to be sure your sleepiness is not due to a sleep
    disorder.

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