How Well Are You Sleeping? : Sleepy During the Day, Snoring

by Food and Drug Administration (FDA)

(Page 3 of 4)

Sleepy During the Day

Feeling tired every now and then during the day is normal. But it's not normal for sleepiness to interfere with your routine activities. For example, you shouldn't be dozing off while reading the newspaper, during business meetings, or while sitting at a red light. Slowed thinking, trouble paying attention, heavy eyelids, and feeling irritable are other warning signs.

If you're feeling sleepy frequently during the day, you might simply need to make more time to sleep. "Every year, a couple of people will come see me and say that they go to bed late and wake up early, and ask if I could give them a pill to help them feel more refreshed," Raphaelson says. "I tell them to sleep."

Experts say that most adults need at least eight hours of sleep every night to be well rested, but this varies from person to person. The bottom line is that you should sleep for the number of hours it takes for you to feel rested, refreshed, and fully alert the next day. If you've had a good sleep, you shouldn't feel drowsy during the day.

Naps can be good, but the American Academy of Sleep Medicine recommends napping before 3 p.m. and for no longer than an hour so that it doesn't interfere with falling asleep at night.

If you are sleeping an adequate amount and you still feel drowsy going about your day-to-day routine, or if adjusting your sleeping habits hasn't helped, then you should talk with your health-care provider.

Overwhelming daytime sleepiness could be due to a number of sleep disorders. For example, people with narcolepsy experience excessive sleepiness even after a full night's sleep. "Some people may be able to sleep, but the sleep quality is no good," Raphaelson says. "If you look at the brain as a rechargeable flashlight, some people don't hold the charge very well." They may have sleep attacks, sometimes at very inappropriate times such as while eating or talking. But not all cases present this way.

Richard Bernstein, 46, of Baltimore, says he can remember always falling asleep very easily, wanting to take naps, and having a hard time getting up. "When I was a child, my mother used to say that waking me up was like moving mountains." Even after sleeping all night, he'd wake up too tired to get out of bed, which often meant missing school or work. "I've lost jobs over this," says Bernstein, who works as an airline customer service representative.

Bernstein was diagnosed with narcolepsy after taking a multiple sleep latency test, which measured how quickly he fell asleep. Most people take between 10 and 20 minutes to fall asleep. People who do it in less than five minutes may have a serious sleep disorder.

"There's definitely a stigma to it," Bernstein says. "People used to tease me or call me lazy and say that I was sleeping my life away." He says he's found some improvement since taking Provigil (modafinil) for the past two years. The drug is approved by the FDA to improve wakefulness in people with narcolepsy. Potential side effects include headaches and nausea.

Some people with narcolepsy experience episodes of cataplexy, a condition characterized by weak or paralyzed muscles such as buckling knees. In July 2002, the FDA approved Xyrem (sodium oxybate or gamma hydroxybutyrate, also known as GHB) to treat this condition.

Snoring

Snoring is noisy breathing during sleep that occurs when relaxed structures in the throat vibrate and make noise. Most snoring is harmless, though it can be a nuisance that interferes with the sleep of others. Some snoring can be stopped with lifestyle changes, particularly losing weight, cutting down on smoking and alcohol, and changing sleeping positions. This generally means keeping snorers off their backs and on their sides as a way to keep the airway more open during sleep. There are over-the-counter nasal strips that are placed over the nose to widen the space in the nose and make breathing easier. Read labels carefully because these strips are only intended to treat snoring. The labels point out certain symptoms that require a doctor's care.

The trick is figuring out the cause of snoring. It could be related to allergies or structural abnormalities such as nasal polyps or enlarged adenoids, which are lymphoid tissue behind the nose.

If your snoring is loud and frequent and you also have excessive daytime sleepiness, you could have sleep apnea. People with sleep apnea tend to also be overweight, and it's more common among men than women.

When a person with sleep apnea tries to breathe in air, it creates suction that collapses the windpipe and blocks the flow of air. Blood oxygen levels fall and the brain awakens the person, who then snorts or gasps for air and then resumes snoring. This cycle is typically repeated many times during the night. It results in frequent awakenings that prevent people from reaching the deepest stages of sleep, which leaves them sleepy during the day.

"In this case, snoring is not just noisy, but could be a silent killer," says Jeffrey Hausfeld, M.D., the author of a book titled Don't Snore Anymore and an associate professor of surgery in the department of otolaryngology at George Washington University School of Medicine and Health Sciences in Washington, D.C. "Sleep apnea has been linked to heart disease, high blood pressure, and stroke," says Hausfeld, whose father suffered from sleep apnea and died of a stroke at age 66.

Hausfeld says that recognizing the signs of sleep apnea in children is a challenge because unlike adults, kids push through daytime sleepiness and keep going. "Sometimes you might see the child struggling to get air or moving around a lot in bed," Hausfeld says. "Rather than being noticeably tired, kids with sleep apnea may do poorly in school."

About the Author

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FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.