If you feel like you are always tired during the day, you may be suffering from sleep-disorder-related excessive daytime sleepiness, also known as hypersomnia.
Everyone has days where they feel tired. It might be that you didn’t get enough sleep the night before, but sometimes underlying sleep disorders can make this even more complicated. People with hypersomnia often have trouble concentrating or normally functioning because they are tired enough that it affects their daily life.
Hypersomnia can be caused by many sleep disorders such as sleep apnea, be brought on by stress or lifestyle changes, or might not have a known cause (idiopathic hypersomnia). In many cases there are things you and your doctor can work together and treat the underlying issue and improve wakefulness during the day.
Lifestyle Changes: Doctors will often try and eliminate as many lifestyle causes for sleepiness before trying to find out if there is an underlying condition. Things like cutting back on caffeine right before bedtime, alcohol to excess, or going to be earlier could all be things that a doctor might suggest. Even things like light in your room, the number of blue-light electronic devices you use or sleeping alone can affect your sleep and should be considered when trying to improve wakefulness.
These can be relatively easy to implement, but sometimes the lifestyle causes can’t be avoided. If you do shift work or use computers for your job, then you might need different treatment options.
Stimulants: Medications such as methylphenidate (Ritalin) or modafinil (Provigil) can make a huge difference for excessive daytime sleepiness. While not necessarily fighting the underlying cause, they do allow patients to feel more alert and focused during the day which can at least help them function.
However, this affect can be short-lived. After you experience the extreme wakefulness and alertness of being on stimulants, it can disrupt your sleep patterns. This means followed by the extreme “up” you experience while on the drug also results in an extreme “down.” This means that stimulants can eventually make you more tired than you were before their long-term use.
Antidepressants: Fluoxetine (Prozac), citalopram (Celexa), paroxetine (Paxil), and sertraline (Zoloft) are also sometimes prescribed to patients with hypersomnia because of their ability to regulate sleep-wakeful cycles and help initiate REM sleep. If the underlying sleep disorder is insomnia, then having additional aide in regulating sleep cycles can be beneficial.
But like stimulants, one of the main side-affects of antidepressants is more excessive daytime sleepiness, and proper dosage is key to not making the problem worse.
Sodium oxybate (Xyrem): Used to treat excessive daytime sleepiness associated with narcolepsy and it can decrease the number of catapeltic attacks (weak /paralyzed muscles) associated with it. This treatment is also associated with side-affects that include drowsiness.
Remember that your doctor has prescribed medication or lifestyle changes because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using treatments do not have serious side effects and find that their treatment works for them.
New Treatments in Development: Many drug companies are working on new types of treatment, such as TAK-925 and TAK-994 which are orexin agonists which is a different way to treat sleep disorders.
There are pros and cons to many of the treatments currently on the market, and unfortunately none of them are perfect. New treatments are currently in development that might help aide those that live with excessive daytime sleepiness.
If you are interested in learning more about clinical trials for sleep disorders and to be alerted when trial is enrolling in your area that might be a good fit for you, sign up for our email list. We send you occasional updates on the state of clinical trials that might be important to you and we will alert you when we think we have found a hit.