Melomed Articles

14 February 2019 - Dr. Tony  Tom

Excessive Sleepiness: What you should know

We all feel tired sometimes and catching a quick nap may sound like the right thing to do. But then, when you're in the middle of some exciting conversation and you feel the urge to sleep or when you're watching your favorite TV program and feel like laying your head for a quick nap, you may be dealing with excessive sleep and may not know it. Let's face it, you really shouldn't feel sleepy until its bed time. 

Now the million dollar question is how do I know if I'm struggling with excessive sleepiness? It's simple. As a professional with years of experience of treating people who have this condition, we usually diagnose excessive sleepiness using what we call the Epworth Sleepiness Scale.

Using this screening method, we often ask patients to rate on the scale of 0-3 their chances of dozing off with each question regarding the eight normal real life situations; for instance, when sitting down and reading a book or when talking to someone. If your score is 10 or more, it only means you may be having excessive sleep issues. That's not all; we proceed to get further information like duration, quality of sleep, intensity of sleep, timing of sleep, medications and a lot of other factors.

So, you may be wondering, what is the major cause of excessive sleep? Without mincing words, not getting enough sleep is one of the major causes of excessive sleepiness among people. Look at it this way, it is like you're hungry but still don't get to eat, does it make any sense? And one of the major reasons for this is that a lot of people are too busy and never make out enough time to sleep. Another reason for not getting enough sleep could be attributed to insomnia. 

For those who have no idea, insomnia is a condition where people struggle to sleep, stay asleep or wake up earlier even when there is still more than enough time to sleep. And yes, the quality of sleep may be poor, even at that, my patients still agree they get 8-10 hours of sleep but still feel drowsy and may be wondering what is wrong with them.

Here is what I tell them, you may be having a breathing problem. Talking about breathing problem, the most common breathing problem associated with excessive sleep is what is known as sleep apnea.

Do you have sleep apnea? Here, check out some ways you can find out. 

A simple screening test called the STOPBANG mnemonic may prove quite useful. STOPBANG mnemonic means
  • S- Snoring
  • T- Tiredness
  • O- Observed stopped breathing ( patients may witness a situation where they stop breathing during sleeping)
  • P- Pressure elevated blood pressure
  • Body Mass Index > 35
  • Age> 50yrs
  • Neck Size- 41cm in females or 43cm in males, check your collar size.
  • Gender- males and postmenopausal women

  • When you have any of these scores below, you should know that your chance of having sleep apnea is high. 
    3> - 80-85% chance of sleep apnoea
    5> 90-95% chance of sleep apnoea

    Besides this, here are other clues for sleep apnea you should be on the lookout for. 
  • If you struggle to lose weight despite eating healthy and exercising 
  • If you're overweight or slightly obese with a BMI>30
  • If you struggle to control high blood pressure on 3> agents
  • Dealing with reflux oesophagitis
  • If  you develop wheezing as an adult

  • Of course, these aren't all the issues that can result to drowsiness. When you sleep erratically because of the nature of your job, abuse substance, taking medications like pain killers or even having other brain related problems like stroke, Parkinson, depression and many others, drowsiness may become a norm for you.

    After finding out all this, you may be thinking what should I do? Here is my advice. Do the Epworth sleepiness scale and see if you potentially have excessive sleepiness. If you discover you have excessive sleepiness, your best bet is to consult your doctor who will carry out further evaluation and provide you with the needed assistance to fix your condition.


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