Drowsiness or fatigue
The distinction has practical significance. When tired, a person feels a lack of strength, but when he finds himself in bed during the day, he cannot fall asleep. When drowsy, he falls asleep quickly and in inappropriate places: in line, at a meeting, in front of the TV, in public transport. For assessment, doctors use simple scales where they need to assess the likelihood of falling asleep in different situations. How a person wakes up is also important: if a night’s sleep of sufficient duration does not bring rest, its quality, rather than quantity, most likely suffers. Separately, they check whether the person snores and whether they have noticed close breathing stops.
- Falling asleep in a calm environment during the day
- Lack of rest after a night's sleep
- Morning headache
- Snoring and breathing pauses
- Difficulty with concentration and memory
- Irritability and decreased mood
Reasons
The most common and at the same time underestimated reason is a banal lack of sleep: a regular reduction in sleep accumulates and leads to persistent daytime sleepiness. The second leading cause in adults is obstructive sleep apnea, in which the airways are repeatedly blocked, sleep is fragmented, and the brain does not receive deep stages. This also includes restless legs syndrome. Bodily causes include iron deficiency, hypothyroidism, diabetes, chronic liver and kidney disease, and depression. A significant contribution is made by medications: antihistamines, sedatives, some drugs for blood pressure and epilepsy, as well as alcohol.
- Chronic lack of sleep and shift work
- Obstructive sleep apnea syndrome
- Restless legs syndrome
- Iron deficiency and anemia
- Hypothyroidism
- Diabetes mellitus
- Depression
- Side effects of drugs and alcohol
- Narcolepsy and other rare disorders
Why is daytime sleepiness dangerous?
The main danger is the risk of accidents. Falling asleep while driving and at work is a serious cause of injury, and a person may not even notice a short episode of sleep lasting a few seconds. Chronic sleepiness impairs attention, memory and decision-making ability, reduces performance and increases conflict. If sleep apnea is the basis, medical risks are added: increased blood pressure, heart rhythm disturbances, worsening diabetes. Therefore, drowsiness should not be considered a character trait or an inevitable accompaniment of being busy.
- Risk of accidents and work injuries
- Decreased attention and memory
- Worsening of hypertension with apnea
- Heart rhythm disturbances
- Poor sugar control
- Decreased mood and quality of life
Survey
They start with a detailed conversation about the regime: how many hours a person sleeps on weekdays and weekends, what time he goes to bed, whether he wakes up at night, whether he snores. A one to two week sleep diary is helpful. Basic tests can rule out iron deficiency, thyroid disorders and diabetes. If apnea is suspected, the main method is a sleep study - polysomnography, which records breathing, blood oxygen saturation and sleep structure. Be sure to review the medications you are taking, since changing the medication often solves the problem.
- Sleep diary and routine assessment
- Daytime sleepiness scales
- Complete blood count and ferritin
- TSH
- Blood glucose
- Polysomnography for suspected apnea
- Review of medications taken
- Assessing mood and symptoms of depression
What helps
If the cause is lack of sleep, the solution is simple, but requires discipline: increase the duration of sleep and stabilize the time you get up, including weekends. For sleep apnea, therapy with a device that creates constant positive pressure in the airways is effective; Losing weight, avoiding alcohol in the evening, and sleeping on your side also help. Deficiencies are replenished, thyroid function is corrected. Caffeine is acceptable as a temporary measure, but does not solve the problem and worsens night's sleep if consumed in the afternoon. Until the cause is determined, it is important to avoid driving while drowsy.
- Sufficient duration and regular sleep pattern
- Apnea therapy as prescribed by a specialist
- Weight loss if you are overweight
- Avoiding alcohol and sleeping pills without prescription
- Replenishing iron deficiency
- Correction of thyroid function
- Limiting caffeine in the afternoon
- Avoid driving if you feel very drowsy
