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Sleep Disorders

Always sleepy

02/20/2008

Question:

I feel sleepy all the time. I get an average of 6-8 hours of sleep on weekdays. When I get home and go to sleep, I won`t wake up until around 8 p.m. or 9 p.m. or the next day. But on the weekends when I can actually sleep in and get more than 8 hours of sleep I feel good. During the weekdays I have no energy what so ever. I feel like my eyes are droopy with sleep. Could I have a sleep disorder?

Answer:

While your excessive sleepiness could be due to a number of potential causes, it is most likely related, at least in part, to a lack of adequate regular sleep. From your question, when given the opportunity, you sleep up to 8 hours and feel rested. This is normal for most individuals, who need between 7-8 hours a night to feel refreshed. Ensuring you get the required amount of sleep on a nightly basis will probably alleviate much of your problem. A chronic lack of sleep could have numerous bad effects on your health and well-being and thus getting more sleep is really in your best interest

While we don't completely understand the reasons we sleep and what the function of sleep is, growing research suggests that adequate sleep is important for the process of functioning and health. Studies have found that individuals that are sleep deprived tend to perform poorly in test situations, have reduced concentration and tend to be more irritable and anxious. Chronic partial sleep deprivation can also affect our ability to learn and thus can have a significant impact on school and job performance. Believe it or not, but we actually “learn” (take daytime experiences or what we have studied during the day and store them into long-term memory) better with sleep than if we’re to stay awake all night.

We are really just now beginning to understand the wide ranging impact that lack of adequate sleep can have on our health and well-being. Recent research has shown, in pretty convincing fashion, that insufficient (lack of enough) sleep can contribute to significant weight gain. This appears to be due to changes in hormones that control appetite and cravings for certain foods. Weight gain, in turn, can lead to other medical problems, such as diabetes, hypertension, sleep apnea, etc. While not as clear, chronic lack of sleep by itself may contribute directly to the development of hypertension.

As mentioned above, another area of concern is the impact that insufficient sleep has on vigilance, ability to concentrate and daytime sleepiness. These all can be impaired by insufficient sleep and, as a result, can have wide ranging consequences, including increased rates of car accidents and work-related accidents. Some of the largest man made disasters in modern times were attributed, in part, to sleep deprived individuals making poor decisions (Three Mile Island, the Exxon Valdez, etc.). As you can see, lack of adequate sleep can have serious consequences, affecting your learning, health and social function.

Of course there are other potential causes of sleepiness that could be impacting how you feel. 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. Primary 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). In some cases, no clear cause for sleepiness can be found and the condition is labeled as idiopathic hypersomnia.

I recommend that first you attempt to get an adequate amount of regular sleep for 1-2 weeks. If you do this and your symptoms resolve, then no further evaluation is needed. However, if you do this, but still feel sleepy, then you should talk to your doctor about your symptoms. Further history will help determine if you need additional testing or evaluation by a Sleep Specialist.

If you have other specific questions about sleep, lack of sleep, or other sleep disorders, please visit the American Academy of Sleep Medicine. In addition to information, the website contains a list of Sleep Centers and Sleep Specialists across the country so that you may locate one near you. The website Sleep Education.com also contains plenty of consumer friendly information about sleep and sleep apnea. Good luck and here's to better sleep!

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Response by:

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