Excessive Daytime Sleepiness

Excessive Daytime Sleepiness is a condition where a person feels an overwhelming sense of sleepiness during the day, making it difficult to stay awake, alert, or focused, even after what seems like an adequate night of sleep.
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What are the common causes of Excessive Daytime Sleepiness?

Sleep deprivation (most common)

Sleep disorders:

  • Obstructive Sleep Apnea (OSA).
  • Narcolepsy.
  • Idiopathic hypersomnia.
  • Restless Legs Syndrome / Periodic Limb Movement Disorder.
  • Medical conditions: Depression, hypothyroidism, head trauma, neurodegenerative disease.
  • Medications / substances: Sedatives, antihistamines, alcohol, illicit drugs.
  • Circadian rhythm disturbances: Shift work, jet lag, delayed sleep phase.

How to evaluate for Excessive Daytime Sleepiness?

  • History: Sleep schedule, naps, caffeine/alcohol use, medications, mood
  • Screening tools: Epworth Sleepiness Scale (ESS)
Objective testing:

  • Polysomnography (overnight sleep study)
  • Multiple Sleep Latency Test (MSLT) for narcolepsy/idiopathic hypersomnia
  • Maintenance of Wakefulness Test (MWT) for ability to stay awake

What are the key features of Excessive Daytime Sleepiness?

Persistent tiredness or drowsiness during the day Trouble staying awake in quiet settings (e.g., meetings, reading, driving)
Unrefreshing or poor-quality sleep at night
Impaired concentration, memory, or performance

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