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Causes of Excessive Sleepiness: Sleep Apnea, Narcolepsy, RLS

Sleep Apnea and Excessive Sleepiness

Sleep apnea is becoming a more common cause of sleepiness in children and adults.

Sleep apnea occurs when the upper airway collapses for at least 10 seconds during sleep -- and does so up to hundreds of times each night. Obstructive sleep apnea is the result of a blockage in the airway. Central sleep apnea occurs when the brain fails to send signals to the muscles that control breathing.

Snoring and gasping for air as the airway reopens occur often with sleep apnea. But you may not be aware you have sleep apnea unless your bed partner tells you about the ruckus you’re making.

Because your breathing is interrupted, so is your sleep, leading to sleepiness during school, work, or other activities. You might mistake yourself as a “good sleeper” because you can sleep anytime, anywhere. But falling asleep in traffic or at work is obviously less than ideal. People with sleep apnea have many more auto accidents than people who don’t have the condition.

Sleep apnea can cause other problems, too: wide swings in heart rate as well as a decrease in oxygen levels. It is associated with and the possible cause of other medical conditions such as:

  • High blood pressure
  • Heart disease
  • Headaches
  • Diabetes
  • Depression
  • Elevated hemoglobin, or thickened blood
  • Fatigue


Treatment for Sleep Apnea

The most common treatments for sleep apnea include:

  • Continuous positive airway pressure (CPAP). In this treatment, a nasal device attached to a machine with a blower unit helps keep the airway open. CPAP is the most common treatment used for obstructive sleep apnea. 
  • Armodafinil and modafinil. These stimulant medications can help relieve sleepiness in people who do not respond well enough to CPAP alone.
  • Oral appliance therapy. Devices move the tongue, lower jaw, or soft palate forward, which opens the airway. 
  • Weight loss. If you are obese, losing weight can decrease risk for sleep apnea by reducing fat deposits in the neck. It also reduces many of the other risks associated with sleep apnea, such as heart disease. 
  • Surgery. This may be an option if other treatments don’t work.

In addition to treatments for sleep apnea, it is important to manage other conditions, such as high blood pressure, that often exist along with it.

Narcolepsy and Extreme Sleepiness

Narcolepsy is a sleep disorder that causes disabling daytime sleepiness and other symptoms. Narcolepsy is related to the dreaming period of sleep called REM (rapid eye movement) sleep. With narcolepsy, though, REM periods can occur throughout the day. In addition to drowsiness that doesn’t improve, narcolepsy may cause brief uncontrollable moments of sleep, or “sleep attacks,” without warning.

Another daytime hallmark of narcolepsy is sudden loss of muscle control, or cataplexy. This can be a slight feeling of weakness or total body collapse. It can last from seconds up to a minute. Cataplexy is related to the muscle immobility, or “paralysis,” that is part of REM sleep. It is often triggered by emotions or fatigue.

WebMD Medical Reference

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