Considerations

Excessive daytime sleepiness (without a known cause) may be a sign of a significant sleep disorder. It is different from fatigue.

Depression, anxiety, stress, and boredom can all contribute to excessive sleepiness, but these conditions more typically cause fatigue and apathy.

Causes

• Chronic pain
• Diabetes
• Having to work long hours or different shifts (nights, weekends)
• Medications (tranquilizers, sleeping pills, antihistamines)
• Hyponatremia /hypernatremia
• Not sleeping for long enough
• Sleep disorders (such as sleep apnea syndrome and narcolepsy)
• Too much calcium in your blood (hypercalcemia)
• Underactive thyroid (hypothyroidism)

Home Care

You can relieve drowsiness by treating the cause of the problem. First, determine whether your fatigue is due to depression, anxiety, boredom, or stress. If you are not sure, talk with your health care provider.

For drowsiness due to medications, talk to your health care provider about switching or stopping your medications. Never stop taking or change your medication without first talking to your health care provider.

What to Expect at Your Office Visit

The doctor will examine you to determine the cause of your drowsiness and ask questions about your sleep patterns and health. Questions may include:

• How well do you sleep?
• How much do you sleep?
• Do you snore?
• Do you fall asleep during the day when do not plan to nap (such as when watching TV or reading)? If so, do you awake feeling refreshed? How often does this happen
• Are you depressed, anxious, stressed or bored
• What medications do you take?
• What have you done to try to relieve the drowsiness? How well did it work?
• What other symptoms do you have?

Tests that may be done include:

• Blood tests (such as a CBC and blood differential, blood sugar level, electrolytes, and thyroid hormone levels)
• CT scan of the head
• EEG
• Sleep studies
• Urine tests (such as a urinalysis)

Treatment depends on the cause of your drowsiness.

Alternative Names

Sleepiness - during the day; Hypersomnia; Somnolence

References

Morgenthaler T, Kramer M, Alessi C, Friedman L, Boehlecke B, Brown T, et al. Practice parameters for the psychological and behavioral treatment of insomnia: an update. An American Academy of Sleep Medicine report. Sleep. 2006;29:1415-1419.

Schwartz JR, Roth T. Shift work sleep disorder: burden of illness and approaches to management. Drugs. 2006;66:2357-2370.

Update Date: 4/28/2012

Reviewed by: Jeffrey Heit, MD, Internist with special emphasis on preventive health, fitness, and nutrition, Philadelphia VA Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.