Excessive daytime sleepiness: 7 key questions to ask your doctor

Excessive daytime sleepiness (EDS), also known as hypersomnia, goes beyond ordinary fatigue. People with EDS struggle to stay awake or alert during the day, often feeling the need for multiple naps or extended nighttime sleep, yet they may still feel unrefreshed. In some cases, this can lead to dozing off at unsafe moments, such as while driving or eating.

If you suspect you might have EDS, consulting a doctor is crucial. These seven questions can guide your conversation and help identify the cause of your symptoms.

What causes excessive daytime sleepiness?

• EDS can result from poor sleep hygiene or insufficient sleep, but it may also signal an underlying health issue. Common causes include:
• Sleep apnea: Brief pauses in breathing during sleep can trigger loud snoring, gasping, and morning headaches.
• Narcolepsy: A disorder causing sudden sleep episodes at any time.
• Mental health conditions: Depression and bipolar disorder may contribute to persistent fatigue.
• Restless legs syndrome: Discomfort in the legs can disrupt nighttime rest.
• Medications: Some allergy, pain, and psychiatric drugs may cause drowsiness.

In certain cases, no identifiable cause is found—known as idiopathic hypersomnia.

Who is at risk?

EDS can affect anyone, though research indicates it’s increasingly common among U.S. adults. About one-third of American adults experience excessive sleepiness, with half of them experiencing related symptoms. Children and adolescents may also be affected.

Risk factors vary depending on the underlying condition; for instance, obesity increases the likelihood of sleep apnea. Age can also play a role, as sleep patterns change over time.

How do doctors test for excessive daytime sleepiness?

A thorough evaluation typically begins with a physical exam, blood work, and a review of your medical history.

Doctors may recommend a sleep study (polysomnogram) to monitor breathing, heart rate, and other data overnight. To measure daytime sleepiness directly, a multiple sleep latency test may be conducted. This exam consists of five scheduled naps, each around 15 minutes, to track how quickly and deeply you fall asleep.

When should you be concerned?

Occasional fatigue is normal, but persistent daytime sleepiness even after 7–9 hours of sleep is a warning sign. Seek medical advice if sleepiness interferes with daily activities like work, school, or commuting, or if you find yourself dozing off during conversations, reading, or watching TV.

What are the risks of excessive daytime sleepiness?

Beyond discomfort, EDS can be dangerous. Falling asleep unexpectedly can lead to accidents, particularly while driving, contributing to an estimated 100,000 car accidents per year.

Additionally, EDS may indicate serious underlying conditions like sleep apnea, which can raise the risk of diabetes, heart disease, high blood pressure, and even early mortality if left untreated.

How is excessive daytime sleepiness treated?

• Primary sleep disorders: Stimulants (e.g., amphetamines) or wakefulness-promoting drugs like modafinil may help.
• Secondary to another condition: Managing the primary illness can relieve EDS, for example, using a CPAP machine for sleep apnea or treating depression with appropriate medications.

What lifestyle changes can help manage symptoms?

While lifestyle adjustments alone may not cure EDS, they can support better daytime alertness:

• Take short, early naps when needed.
• Keep your bedroom cool, dark, and free from electronics.
• Limit late-day caffeine and alcohol.
• Quit smoking with medical guidance.
• Exercise regularly, avoiding workouts close to bedtime.
• Adjust work schedules to allow evening relaxation.