Excessive daytime sleepiness

Excessive daytime sleepiness (EDS) is characterized by persistent sleepiness, and often a general lack of energy, even after apparently adequate night time sleep. Sudden involuntary sleep onset, and microsleeps are common complications. EDS is one of the two forms of hypersomnia, the other being prolonged nighttime sleep.

Some persons with EDS, including those with narcolepsy, are compelled to nap repeatedly during the day; fighting off increasingly strong urges to sleep during inappropriate times such as while driving, while at work, during a meal, or in conversations. As the compulsion to sleep intensifies, the ability to competently complete tasks sharply diminishes, often mimicking the appearance of intoxication.

Diagnosis
An adult who is compelled to nap repeatedly during the day may have excessive daytime sleepiness. One diagnosis tool is the Epworth Sleepiness Scale, which helps determine the extent of EDS in a subject. A self test is available from Stanford University Medical School.

Causes
EDS can be a symptom of a number of factors and disorders. Specialists in sleep medicine are trained to diagnose them. Some are:
 * Insufficient quality or quantity of night time sleep.
 * Misalignments of the body's circadian pacemaker with the environment (eg. jet lag, shift work or other circadian rhythm sleep disorders).
 * An underlying sleep disorder, such as narcolepsy, sleep apnea, hypersomnia or restless legs syndrome.
 * Disorders such as clinical depression or atypical depression.
 * Tumors, head trauma, anemia, kidney failure, hypothyroidism or an injury to the central nervous system.
 * Smoking, drug or alcohol abuse.
 * Genetic predisposition.

Coping
EDS is often the manifestation of a disorder, and not a sign of a willful lack of effort. Without firm and knowledgeable counseling on the part of the physician, family members can easily fail to accept EDS as part of an illness.

EDS can affect the ability to function in family, social, occupational, or other settings. A proper diagnosis, and treatment, of the underlying cause can help mitigate such complications. It can be difficult to accept that EDS is beyond a person's control; the unaffected may see sleepiness as an insult, a rejection, or as evidence for lack of interest. During occasional unique and/or stimulating circumstances, a person with EDS can sometimes remain animated, awake and alert, for brief or extended periods of time; this lends credence to an observer's assertions that the alertness is simply a matter of self control and that EDS can be 'willed away'.

The medications Provigil and Xyrem have been approved as a first-line treatment for EDS symptoms in the U.S., and have been proven extremely effective in the treatment of most symptoms. While there is declining usage of other drugs such as Ritalin, Dexedrine, Adderall, Desoxyn, and Cylert, these psychostimulants still provide additive assistance under varying circumstances. .