2 minute read
Why Am I Always Tired?
What is the difference between chronic fatigue and excessive sleepiness?
Fatigue means low energy or tiredness, and it can be associated with a number of medical problems such as anemia, low thyroid, kidney disease, cancer, or mental health issues such as depression. Excessive sleepiness usually occurs due to insufficient sleep, or due to a sleep disorder such as obstructive sleep apnea or narcolepsy.
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What are the symptoms of excessive sleepiness?
Individuals with excessive sleepiness may experience and perceive their symptoms differently. Adults with excessive sleepiness will tend to nap easily whenever they are sitting for longer periods, or in monotonous situations such as a boring meeting or class. Some will fall asleep in potentially dangerous situations such as while driving or operating machinery. Others may experience waxing and waning of attention or focus, leading to poor work efficiency, recurrent careless errors, or forgetfulness. Children with excessive sleepiness may be irritable, hyperactive, and highly distractible, leading some to question whether the child has Attention Deficit-Hyperactivity Disorder (ADHD).
The person with chronic fatigue has trouble mobilizing such as getting up to do things, following through on tasks or projects, and difficulty being motivated.
When should I see a doctor about fatigue or excessive sleepiness?
An individual should discuss their symptoms with his/her primary care provider to help direct the evaluation. The primary care provider may perform laboratory tests and can help identify possible causes of these problems and determine whether a referral to a specialist is necessary. Individuals with excessive daytime sleepiness even though the person is obtaining at least 7-8 hours of sleep per night should consider seeing a sleep specialist to assess for certain sleep disorders.
The treatment will depend on the underlying cause of the sleepiness. If the person has a breathing problem during sleep called obstructive sleep apnea, there are several treatment options including weight loss, changing body position during the night, use of an oral appliance, or treatment with continuous positive airway pressure (CPAP). If the person has excessive sleepiness due to insufficient sleep, modifying the sleep schedule to include 8 hours of sleep per night should help. If the sleepiness is due to narcolepsy, medication is often necessary. It’s important for the person with sleepiness to avoid driving and other potentially dangerous activities during periods of drowsiness. Sometimes the person may not be fully aware of how drowsy he or she is, and others around the person need to speak up to inform the person that they are excessively sleepy.
Dr. Wise is a neurologist and sleep medicine specialist in the full-time practice of sleep medicine at Mid-South Pulmonary and Sleep Specialists. He sees the full range of sleep disorders, including children, adolescents, and adults. He has served on the board of directors of the American Academy of Sleep Medicine (AASM), the leading professional organization dedicated to sleep medicine.
