Malady Wise

View Original

Excess Daytime Sleepiness

Maladywise

Excess Daytime Sleepiness = EDS

Overview

  • EDS can be described as tiredness, fatigue, lack of energy

  • EDS = inability to maintain wakefulness and alertness during the major waking episodes of the day with sleep occurring unintentionally and inappropriately for at least 3 months

  • Hypersomnia is used interchangable

  • Fatigue = Lack of physical or mental energy

    • Inability to initiate activity

    • Reduced capacity to maintain activity

    • Difficulty with concentration, memory, emotional stability

Prevalence

  • 10 to 25% of the population

Risk factors

These were most likely associated with EDS

  • Insomnia

  • Smoking

  • Anxiety / depression

  • Somatic symptoms

  • Snoring

  • Obesity

Causes

Insufficient sleep

  • Sleep deprivation

  • Environmental intrusions

Sleep Disorders

  • OSA

  • Central sleep apnea

  • Sleep related hypoventilation

  • Central hypersomnolence

    • Narcolepsy

    • Idiopathic

  • Circadian rhythm sleep-wake disorders

    • Delayed sleep-wake phase

    • Advanced, Irregular, Non-24h, Jet lag, Shift work

  • RLS and PLMD

Neurological

  • Neurodegenerative (PD, MSA, Alzheimer’s, DLB)

  • Myotonic dystrophy

  • MS and ALS

  • ABI

Medical and Genetic

  • Thyroid

  • Obesity

  • CKD

  • Adrenal insufficency

Psychiatrist

  • Depression

  • Anxiety

  • Susbtance use

  • Psychogenic

Medication

  • Benzodiazepines

  • Antipsychotics

  • Beta-Blockers

  • Antihistamines

  • Sedative Antidepressants

Evaluation

  • Snoring

  • Leg discomfort

  • Cataplexy

  • Depression

Exam

  • Usually normal

Tools

  • ESS

Testing

  • Polysomnography

  • Home sleep apnea testing

  • MSLT

Management

  • Behavioural counselling

  • CPAP

  • Medication for RLS

  • Stimulants for a central disorder of hypersomnolence

  • Changes in medication that cause hypersomnolence

  • Treat underlying psychiatric conditions, chronic pain or depression

Resources: