Everyone feels sleepy at times. However, when sleepiness interferes with daily routines and activities, or reduces the ability to function, it is called “problem sleepiness.” A person can be sleepy without realizing it. For example, a person may not feel sleepy during activities such as talking and listening to music at a party, but the same person can fall asleep while driving home afterward. You may have problem sleepiness if you:

• consistently do not get enough sleep, or get poor quality sleep

• fall asleep while driving

• struggle to stay awake when inactive, such as when watching television or reading

• have difficulty paying attention or concentrating at work, school, or home

• have performance problems at work or school

• Are often told by others that you are sleepy

• have difficulty remembering

• have slowed responses

• have difficulty controlling your emotions

• must take naps on most days

What Causes Problem Sleepiness?

Sleepiness can be due to the body’s natural daily sleep-wake cycles, inadequate sleep, sleep disorders, or certain drugs. Sleep-Wake Cycle Each day there are two periods when the body experiences a natural tendency toward sleepiness: during the late night hours (generally between midnight and 7 a.m.) and again during the mid-afternoon (generally between 1 p.m. and 4 p.m.). If people are awake during these times, they have a higher risk of falling asleep unintentionally, especially if they haven’t been getting enough sleep.

Inadequate Sleep

The amount of sleep needed each night varies among people. Each person needs a particular amount of sleep in order to be fully alert throughout the day. Research has shown that when healthy adults are allowed to sleep unrestricted, the average time slept is 8 to 8.5 hours. Some people need more than that to avoid problem sleepiness; others need less.

If a person does not get enough sleep, even on one night, a “sleep debt” begins to build and increases until enough sleep is 2 obtained. Problem sleepiness occurs as the debt accumulates. Many people do not get enough sleep during the work week and then sleep longer on the weekends or days off to reduce their sleep debt. If too much sleep has been lost, sleeping in on the weekend may not completely reverse the effects of not getting enough sleep during the week.

If a lack of sleep continues it is recommended that you contact your doctor and talk to them about whether a sleep aid might be right for you. Often times prescription sleep remedies can have worse side effects than not getting any sleep at all.  For prolonged insomnia it is best to try a natural sleep aid that will work with your body and not make you feel like a zombie the next morning.

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Is your bed large enough? Do you have enough room to stretch and turn comfortably in bed, or are you cramped? Sharing the bed with another person makes this even more important. Both your partner and yourself should have plenty of room to stretch out. Consider getting a larger bed if you don’t have enough space.

Your mattress, pillows and bedding. Are you waking up with a cramp in your back or a sore neck? You may want to experiment with different levels of mattress firmness and pillows that provide more support. If your mattress is too hard, you can add a foam topper for additional softness. Experiment with different types of pillows – feather, synthetic, and special pillows for side, back or stomach sleepers. Consider your bedding. Scratchy sheets might be making you uncomfortable in the middle of the night, or your comforter might not be keeping you warm enough. Consider soft, breathable cotton sheets. Flannel sheets may be cozy for the winter months.

Is your room setup properly?

Ideally, to maximize sleep, your room should be quiet, dark and at a comfortable temperature and ventilation.

Keep the noise level down. Too much noise, loud outside conversations, televisions blaring and traffic noise can make it difficult to sleep. When the source of outside noise can’t be eliminated, sometimes it can be masked. A fan or white noise machine can help block outside noise. Some people enjoy recordings of soothing sounds such as waves, waterfalls or rain. Earplugs may also help, although you want to make sure they don’t block out important noises like an alarm clock if you use one.

Morning light can send your body clock the wrong signal that it is time to wake up. Perhaps there is a streetlamp shining right in your window at night.  Heavy shades can help block light from windows, or you can try an eye mask to cover your eyes.

Room temperature and ventilation. Who can sleep in a hot stuffy room? Or for that matter, a cold drafty one? If you can, experiment with the room temperature. Most people sleep best in a slightly cooler room.  Make sure that you have adequate ventilation as well - a fan can help keep the air moving. You also might want to check your windows and doors to make sure that drafts are not interfering with sleep.

Reserve your bed for sleeping. Do you sometimes balance your checkbook propped up on your pillows? Or jot down some notes for tomorrow’s meeting? It might feel relaxing to do tasks like these on a comfortable bed. However, if you associate your bed with events like work or errands, it will only make it harder to wind down at night.  Use your bed only for sleep and sex.

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Breathing pauses can last from a few seconds to minutes. They often occur 5 to 30 times or more an hour. Typically, normal breathing then starts again, sometimes with a loud snort or choking sound.

Sleep apnea usually is a chronic (ongoing) condition that disrupts your sleep 3 or more nights each week. You often move out of deep sleep and into light sleep when your breathing pauses or becomes shallow.

This results in poor sleep quality that makes you tired during the day. Sleep apnea is one of the leading causes of excessive daytime sleepiness.

Sleep apnea often goes undiagnosed. Doctors usually can’t detect the condition during routine office visits. Also, there are no blood tests for the condition.

Most people who have sleep apnea don’t know they have it because it only occurs during sleep. A family member and/or bed partner may first notice the signs of sleep apnea.

The most common type of sleep apnea is obstructive sleep apnea. This most often means that the airway has collapsed or is blocked during sleep. The blockage may cause shallow breathing or breathing pauses.

When you try to breathe, any air that squeezes past the blockage can cause loud snoring. Obstructive sleep apnea happens more often in people who are overweight, but it can affect anyone.

Central sleep apnea is a less common type of sleep apnea. It happens when the area of your brain that controls your breathing doesn’t send the correct signals to your breathing muscles. You make no effort to breathe for brief periods.

Central sleep apnea often occurs with obstructive sleep apnea, but it can occur alone. Snoring doesn’t typically happen with central sleep apnea.

Possible consequences

Untreated sleep apnea can:

• Increase the risk for high blood pressure, heart attack, stroke, obesity, and diabetes
• Increase the risk for or worsen heart failure
• Make irregular heartbeats more likely
• Increase the chance of having work-related or driving accidents

Lifestyle changes, mouthpieces, sleep remedies, surgery, and/or breathing devices can successfully treat sleep apnea in many people.

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