Many people with obstructive sleep apnea (OSA) live with excessive daytime sleepiness (EDS). It can leave you exhausted, affecting memory, judgment, and even reaction times during activities like driving. But there are treatments and lifestyle changes to help you manage.
What Is Excessive Daytime Sleepiness?
EDS is when you have trouble staying awake and alert during the day, often dozing off by accident. Tackling it may involve medication, devices, and lifestyle changes like diet and exercise. Here are some of your treatment options.
Positive Airway Pressure (PAP)
PAP therapy keeps your airway open while you snooze. Ideally, that means fewer disruptive sleep events (the number of times you stop breathing while asleep) and more restful slumber. EDS is less likely when you’re well-rested.
Medications Used to Treat Excessive Daytime Sleepiness
Some people who use PAP therapy still deal with EDS. The good news is that there are medications you can use alongside PAP therapy to help you stay awake during the day. They include:
Armodafinil and modafinil. These drugs work by affecting brain chemicals, like dopamine, to boost alertness.
Pitolisant. This medicine triggers your brain cells to release histamine. That’s a neurotransmitter involved in keeping you awake. Doctors mainly prescribe pitolisant for narcolepsy, but scientists have found that it could also work well to treat EDS in people with OSA who still have lots of sleepiness even when doing PAP therapy.
Solriamfetol. This drug raises dopamine and norepinephrine activity in the brain.
Lifestyle Changes to Help Excessive Daytime Sleepiness
Be on your way to better sleep with these tips:
Stick to a regular schedule. That means going to bed and waking up at the same time every day, even on weekends.
Set the mood for good sleep. Make sure your bedroom is dark, cool, and quiet. Turn off or silence all electronics, including your cell phone.
Avoid stimulating food, drink, and activities. That means no alcohol, caffeine, or high-fat and high-carb meals before bedtime. Nix nicotine and intense exercise, too.
Get moving. Research shows that aerobic exercise can ease OSA symptoms and improve EDS. OSA is more common in people with obesity, affecting around 30% of people with the condition.
Excessive Daytime Sleepiness at Work
EDS can impact work in many ways, including concentration, memory, and the ability to stay awake to perform your duties.
Some people with sleep disorders may qualify for reasonable workplace accommodations under the Americans With Disabilities Act (ADA). These are changes to your job or work environment that help you carry out your duties without causing your employer hardship. Small employers with less than 15 workers aren’t usually required to provide reasonable accommodations, but state and local laws may override this.
You and your employer will work together to figure out accommodations. Examples for people with EDS include:
- Time and a quiet space to take a nap
- Activity breaks to keep you alert
- A flexible work schedule or a different shift
- Using paid or unpaid leave to make up for time missed from work
- Working from home
- Employer-paid transportation if you can’t drive safely
- Recorded meetings
- Special equipment, such as a standing desk, to help you stay awake
- Reassigning less critical tasks to co-workers
- Standing during meetings
- A desk near a window for natural light
The ADA doesn’t offer a specific list of medical conditions that qualify as disabilities. Instead, the law defines a person with a disability as someone who has a physical or mental impairment that greatly limits one or more major life activities and has a history or record of the impairment. For advice and more information, contact an employment or disability lawyer.
Talking to Others About Excessive Daytime Sleepiness
Friends and family may notice the effects of OSA and EDS. If you’re comfortable sharing your medical condition, here’s how you can approach the conversation:
Get the facts. Before you educate your loved ones, learn more yourself. Look for trustworthy websites, forums, and support groups.
Plan out what you want to say. Tell them how EDS affects you and what they can do to help. Share reliable websites they can visit to learn more.
Be able to describe your condition in a few sentences. You could say, “I have a sleep disorder that causes my breathing to stop and start when I sleep. That wakes me up a lot, which means I don’t sleep well at night. This leaves me really tired and less alert during the day.”
Let them know you’re often exhausted no matter how early you go to bed the night before — and that you may have problems with focus, memory, and mood changes. You may have trouble staying awake while spending time with them or need an unplanned nap or flexibility when making plans.
Make sure it’s the right timing. Talk to your loved ones when you typically feel the most awake. That’s different for everyone.
Show Sources
Photo Credit: BananaStock/Getty Images
SOURCES:
UpToDate: “Evaluation and management of residual excessive sleepiness in adults with obstructive sleep apnea.”
National Institutes of Health: “CPAP.”
National Sleep Foundation: “Do I Have Excessive Sleepiness?”
Chest: “Long-Term Efficacy and Safety of Pitolisant for Residual Sleepiness Due to OSA.”
Cleveland Clinic: “Norepinephrine (Noradrenaline),” “Obstructive Sleep Apnea.”
Annals of the American Thoracic Society: “Excessive Daytime Sleepiness in Obstructive Sleep Apnea. Mechanisms and Clinical Management.”
Cureus: “Cultivating Lifestyle Transformations in Obstructive Sleep Apnea.”
Society for Women’s Health Research: “Narcolepsy in the Workplace: Considerations for Employers and Employees.”
Hypersomnia Foundation: “Planning for job accommodations and disability income,” “Educating others about your sleep disorder.”
U.S. Department of Labor: “Job Accommodations.”
Harvard Medical School Division of Sleep Medicine: “Daily Life.”
Sleep: “Daytime Sleepiness in Obesity: Mechanisms Beyond Obstructive Sleep Apnea—A Review.”
