Insomnia and Excessive Daytime Sleepiness (EDS)

Insomnia is trouble falling asleep, trouble staying asleep, or getting poor-quality sleep. When your sleep is of poor quality you don't feel rested or refreshed in the morning.

Excessive daytime sleepiness (EDS) is having a lot of trouble staying awake during the day.

• Insomnia usually causes EDS, but EDS has other causes besides insomnia

• Insomnia and EDS may be caused by poor sleep habits but may also be due to a medical problem

• If you have mild insomnia, a regular sleep schedule or other simple changes may fix the problem

• If you have insomnia for a long time, you're at risk for other health problems

Poor sleep habits are a common cause of insomnia, for example:

• Napping a lot during the day

• Drinking caffeine (for example, in soda, coffee, or tea) in the afternoon or evening

• Watching an exciting TV show right before bedtime

• Exercising within a few hours of bedtime

Other causes of insomnia include:

• Stress, depression, or anxiety

• Physical discomfort from health problems or injuries

• Use of certain medicines or street drugs

Common causes of EDS include:

• Insomnia (insomnia from any cause tends to make you sleepy during the day)

• Frequently switching to different shifts at your job

• Traveling to a different time zone

• Staying up too late a lot

• Sleep apnea

• Sleep disorders, such as narcolepsy or restless legs syndrome

With insomnia:

• You may have trouble falling asleep at bedtime

• You may fall asleep normally but wake too soon and have trouble falling back asleep

With insomnia, you're likely to have EDS. You may take naps during the day to catch up. But napping creates a vicious circle. Napping makes it even harder to fall asleep at night. Then you want to nap even more the next day.

With EDS you're sleepy during the day and you:

• May be irritable or have trouble concentrating

• May fall asleep while at work, school, or while driving

See a doctor if your sleep problem interferes with your daily life, or if you have any of the following warning signs:

• Falling asleep while driving or during other dangerous situations

• Falling asleep often without warning

• Waking up gasping or choking

• A partner notices you stop breathing during sleep

• Moving violently or hurting yourself or others during sleep

• Sleepwalking

If you’re healthy and have had symptoms for 2 weeks or less, you can try to correct any poor sleep habits. If these changes don’t help after a week, you should see a doctor.

Doctors may have you fill out a questionnaire about your sleepiness. They may have you keep a sleep diary. In a sleep diary, you write down how you slept and how long. If doctors aren't sure what the problem is or how severe it is, they may send you to a sleep specialist. The specialist may do:

• A sleep test

If the doctor thinks your symptoms may be caused by a medical problem, you may have blood tests or brain imaging tests such as an MRI.

Doctors will treat the cause of your problem if they can find the cause.

If your insomnia is mild, doctors may suggest:

• Going to bed and getting up at the same time every day (even on weekends)

• Having a bedtime routine

• Keeping your bedroom dark and quiet

• Spending time in bright light during the day

• Getting regular exercise

• Avoiding daytime naps (these can make it harder to fall asleep at night)

• Limiting alcohol and caffeine and avoiding eating a lot before going to bed

If simple changes don't help, treatment may include:

• Prescription or over the counter sleep aids (sleeping pills)

There are many different kinds of sleeping pills. Most are safe as long as your doctor helps pick out one that's right for you and watches out for side effects. Older people are more likely to have side effects, with both prescription and non-prescription sleep aids, particularly ones that contain antihistamines.