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Sleep Disorders

Sleeping in day time and I cant control sleep

02/13/2007

Question:

I am 23 years old (male,60 kg, 167 cm) software professional. I used to sleep from 12 am to 8 am daily. Eventhough I sleep 8 hours a day, I feel sleepy during day time in the following conditions,

1. When I am sitting and a person talks to me more than 5 min. I feel sleepy 2. During group meeting, after 5 mins I start to sleep 3. in seminars, the same time after 5 mins I will sleep. 4. When sit ideal for 5 mins I will sleep

I cannot control my sleep. When I start sleeping I cannot control and for this reason I was sent out of the seminar hall for a number of times.

Please help me. Whether I`m having any sleeping disorders...

Answer:

Your main complaint is that of excessive daytime sleepiness. This is quite a common condition in modern society and has a number of potential underlying causes, all of which can be treated with some degree of success.

Probably the most common cause of excessive sleepiness is simply a lack of adequate hours of sleep. Individual sleep needs vary, but most people require at least 7 1/2 to 8 hours of sleep daily to feel rested. As you state in your question, it appears you are likely getting adequate sleep and thus you may be suffering from a primary sleep disorder. Sleep disorders commonly associated with daytime sleepiness include obstructive sleep apnea (OSA), narcolepsy, idiopathic hypersomnolence, periodic limb movements in sleep and a delayed sleep phase (usually resulting in inadequate sleep time).

Obstructive sleep apnea (OSA) is due to the recurrent complete or partial closure of the airway during sleep. As a result, individuals with OSA suffer from fragmented sleep and tend to feel unrefreshed upon awakening as well as sleepy and tired during the daytime. The main risk factors for the development of sleep apnea include being overweight and/or having specific anatomic abnormalities (such as large tonsils) that may narrow the airway. Aside from unrefreshing sleep and daytime sleepiness, individuals with sleep apnea often complain of loud snoring, headaches upon awakening, a poor sense of well-being, decreased ability to concentrate and reduced alertness. It is important to diagnose and treat this condition as treatment can improve symptoms and reduce the risks of long term complications associated with OSA. The diagnosis typically requires a sleep study.

Narcolepsy is a condition that is caused by the inability of the brain to regulate the sleep-wake cycle normally. Individuals with narcolepsy may have "cataplexy" which is a sudden loss of muscle tone usually precipitated by a strong emotion such as anger or laughter. Narcoleptics may also have dream-like hallucinations during sleep onset or when awakening or experience episodes of inability to move when trying to awaken. The evaluation for narcolepsy typically also requires a sleep study as well as a daytime nap test.

Individuals with periodic limb movement disorder can have unrefreshing sleep and daytime sleepiness. Often times, an individual’s bed partner is the first to complain about the patient’s restless sleep, with frequent leg jerks or kicks. This condition is usually diagnosed by obtaining a good history a sleep study.

In the delayed sleep phase syndrome, the timing of the biological clock is out of sync with the desired sleep and wake hours. People with this condition typically are young like you, and have a hard time falling asleep before midnight and waking up in the morning. This may lead to insufficient or inadequate sleep.

Aside from these conditions, numerous other factors may influence the quality of your sleep. These can range from the environment you sleep in (i.e. too warm, too loud) to your other medical problems (i.e. heartburn or breathing problems) to medications you may taking. Fragmented sleep from any of these conditions can lead to daytime fatigue and sleepiness. In addition, certain medications and medical conditions can make individuals feel tired and sleepy during the daytime, independent of their effects on sleep. In some cases, no clear cause for sleepiness can be found and the condition is labeled as idiopathic hypersomnia.

To determine if there is sleep-related cause for your problems, a thorough history and physical examination are needed. A referral to a Sleep Specialist by your primary care physician may be necessary to help sort out whether further testing is needed. Once a history and physical examination have been performed, the Sleep Specialist will decide if evaluation by a sleep study is necessary. If a primary sleep disorder is discovered, you should maintain hope as all of these problems are treatable with a fairly high degree of success.

To learn more about sleep or other sleep disorders, please visit the American Academy of Sleep Medicine website. In addition to information, the website contains a list of Sleep Centers across the country so that you may locate one near you. The website Sleep Education.com also provides plenty of good consumer friendly information. Good luck and here's to good sleep!

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Response by:

Dennis   Auckley, MD Dennis Auckley, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University