Many people complain that they are excessively sleepy during the daytime including me. I feel like I need a nap every once in a while.

There are plenty of reasons for that and when they are combined, which they mostly are, daytime sleepiness can be pretty intense. If you commute to work by public transport, you probably notice quite a lot of people napping on a bus, metro, and so on. Besides, we all have been in a huge line for coffee during the lunch break. Is this normal that people need to nap or multiple caffeinated drinks during the day? Let’s figure it out together.

The extreme sleepiness – causes

Let’s first talk about the extreme sleepiness causes that definitely require special attention and treatment. There is a medical term “hypersomnia” that comprises different conditions in which affected individuals suffer from excessive daytime sleepiness.

Hypersomnias can be different. First of all, there are primary and secondary hypersomnias.

Primary hypersomnias are the neurological disorders of unknown reason which have no underlying diseases that can cause them. This group of disorders has only two subclasses: narcolepsy and idiopathic hypersomnia.

Narcolepsy is the most pronounced type of hypersomnia. It means that sleepiness that occurs in this disorder is the most severe and frequently affected individuals cannot cope with it without the help of potent prescription stimulants. Besides the unbearable or irresistible sleepiness attacks, this disorder is also distinguished by other major symptoms that can be of different severity but in most cases, they are all present:

- Difficulty falling asleep at night, night awakenings with trouble going back to sleep;
- Sudden muscle weakness triggered by emotions (cataplexy);
- Sleep paralysis, i.e. inability to move or talk for seconds after awakening or when falling asleep;
- Hallucinations occurring when a sleepiness attack occurs or after waking up from it;

If you have some of these symptoms or all of them, you should go straight away to a sleep specialist called somnologist to get diagnosed. The thing is that other doctors may not be qualified to identify this rare disease and only a somnologist can quickly confirm the diagnosis, appoint necessary tests and prescribe you the safest and the most effective antinarcoleptic medications such as Armodafinil.

The problem for many people with narcolepsy is that they cannot get properly diagnosed as a simple therapist usually gets you checked for everything but narcolepsy and if no disease is found, affected individuals end up with their condition without proper treatment.

Idiopathic hypersomnia like narcolepsy is associated with an excessive need for sleep and even microsleeps during the day, i.e. a couple of seconds-sleep that can occur when you are at your computer, driving, etc. But the main difference is that the people who have it can somehow cope with sleepiness. It is defined as: they do not fall asleep when “actively awake” but can easily fall asleep when “passively awake” (i.e. watching a movie, reading a book while lying down, etc.). Besides, cataplexy or sudden muscle weakness, awakening/falling asleep-related hallucinations are also not typical for this condition while sleep paralysis and trouble falling asleep can also be present. In case you have these symptoms or at least are excessively sleepy during the daytime while you believe your sleep routine is fine and you regularly sleep for 7-8 hours, I would also advise you go to a somnologist as a general practitioner would probably simply recommend you getting vitamins and getting your sleep routine established.

Unfortunately, since the nature of primary hypersomnias isn’t established, they cannot be cured. But people who suffer from them need prescription wakefulness-promoting drugs such as Armodafinil. However, there is a problem that they cannot be bought without a prescription if you don’t have the official diagnosis of narcolepsy, shift work sleep disorder (SWSD), or obstructive sleep apnea (OSA). And it is surprising that idiopathic hypersomnia and even depression in which an individual finds it very hard to stay awake during the day are not in the list of approved uses while SWSD and OSA are and they are basically caused by the lack of proper night sleep. The other uses are considered off-label. In general medical practice doctors know that these drugs can do no harm, on the contrary, they can improve many peoples’ lives but not all doctors are ready to risk their license to prescribe Armodafinil for off-label uses. Fortunately, you can find these drugs at online drugstores willing to sell the pills without you showing them a prescription.

Secondary hypersomnias are the disorders that cause daytime sleepiness but are caused by known reasons. There are many diseases that can either drain your energy or make your night sleep poor even if you don’t notice it like obstructive sleep apnea which is characterized by frequent micro-awakenings during the night due to short-term respiratory arrests due to the obstruction of the airways. Needless to say, these types of hypersomnias also require therapy and comprehensive diagnosis. But in their case, the most of the treatment is aimed at the elimination of the cause. However, when the cause cannot be quickly eliminated or the brain wakefulness-sleepiness regulation is violated irreversibly, wakefulness-promoting drugs are also prescribed.

What tests do you need to undergo to get properly diagnosed?

There are two main tests that you need to do to identify whether you do have a sleepiness disorder and a character of it:
- Polysomnography;
- Multiple sleep latency test (MSLT).

These tests show specialists certain indicators that help distinguish narcolepsy from idiopathic hypersomnia, OSA, and other disorders of sleep. However, to be sure that there is no organic reason for the drowsiness I would advise you also do computed tomography (CT) or magnetic resonance imaging (MRI) of the head. This test can show whether there are any changes in your brain such as tumors, infectious diseases or other liaisons, and so on. It is crucial not to get potential life-threatening diseases neglected.

Besides, you can do general blood tests, check your sugar level, vitamin deficiency, and other possible reasons because diabetes, low red cells blood count, vitamin D deficiency, and many other imbalances can indeed make you excessively sleepy.

How can you check yourself without doctors whether you have a sleepiness disorder?

Although I highly recommend you to go to a specialist especially if besides sleepiness you have other symptoms described for narcolepsy or general weakness or any pains, there are several tips how you can check yourself whether your daytime drowsiness caused by insufficient sleep, poor sleep, exhaustion, and so on or not.

- If you don’t have an established sleep routine (like most of us), try sticking to the one which ensures 7.5-8 hours of sleep every night for at least a couple of weeks. Scientists say that we feel fully awake and vigorous in the morning if we wake up at the end of one of the sleep cycles which is 1.5 hours. The optimal number of sleep hours is 5, so if you sleep for 7.5 hours (give yourself also some time for falling asleep), you can see a real change. If this works for you, maybe you shouldn’t worry about sleepiness disorders and getting checked for them.
- To make following the first tip easier, put away your phone, laptop, turn off your TV, and so on (all screens) to avoid exposure to blue light as it prevents melatonin production which a hormone we naturally produce in night hours that ensures easy falling asleep.
- To cope with morning sleepiness, do some gymnastics in the morning. This is the best way to awaken your body. It can be challenging to do a whole workout in the morning if you are not used to but try some easy youtube morning workouts for 10-15 minutes for at least two weeks to see the difference.
- To normalize your internal clock, get exposed to natural light as much as possible. Make sure your windows aren’t covered during the day. If you work in a dark room, it’s no surprise that you can become sleepy easily as it signals your brain that it’s night and you need to sleep.
- Drink 2 liters of clean water a day. Yes, we need water not to fall asleep. It is proven that people who do not drink enough water get tired and sluggish easily.
- Make sure the premise you work at is ventilated. Insufficient fresh air also can make you drowsy. Besides, it would be highly beneficial to do some strolls outside every day to combine healthy moving with fresh air exposure.

If these tips work for you, maybe you shouldn’t worry about sleepiness disorders and getting checked for them. If drowsiness is still there, I definitely recommend you get checked and if no diseases are diagnosed, probably you suffer from idiopathic hypersomnia or narcolepsy and the safest way to improve your life is to use modern nootropics such as Armodafinil.

Author's Bio: 

This post is made by Phillip Jones, a freelance junior java developer based in Copenhagen with the help of Emma Ager, MD, a specialist in sleep disorders diagnostics and treatment who helped the author diagnose and manage his disorder.