Fatigue and Excessive Sleepiness

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Do you find it difficult to get out of bed in the morning? Do you sometimes feel sleepy while watching television or driving? If so, you may be one of the millions of Americans who suffer from excessive sleepiness, a condition that can significantly reduce quality of life, decrease productivity and interfere with relationships. Most people feel tired occasionally, but excessive sleepiness that persists is neither normal nor healthy.


One of the primary causes of excessive sleepiness among Americans is self-imposed sleep deprivation. In the U.S. and many other parts of the world, sleep loss may occur as a result of economic or societal pressures. People may skimp on sleep in hopes of getting more done, and widespread access to technology makes it possible to stay busy (at the computer, for example) around the clock. By some estimates, people now sleep about 20 percent less than they did a century ago.

Working at night and sleeping during the day can also cause excessive sleepiness. Some people are able to adjust to such a schedule. However, others may never overcome the body’s natural tendency to be awake during the day and asleep at night. A similar phenomenon occurs with jet lag, in which the body is “out of sync” with the natural environment. In general, symptoms of jet lag increase with the number of time zones crossed. That is, someone flying from Beijing to San Francisco is more likely to suffer worse jet lag than someone flying from San Francisco to New York.

Excessive sleepiness is also linked with a number of primary sleep disorders. For example, sleep disordered breathing (SDB), which includes snoring and obstructive sleep apnea (OSA), is often associated with excessive sleepiness. Because SDB may result in frequent interruptions during sleep, it can lead to abnormal sleepiness during waking hours no matter how many hours a person actually spent in bed.

Insomnia is another main cause of perceived daytime sleepiness or fatigue. Insomnia symptoms may include difficulty falling asleep, difficulty staying asleep, and/or waking up still tired as well as daytime impairments such as excessive sleepiness, cognitive