Ask The Doctor

Having Trouble Staying Awake?

Dear Dr. Garner,

I love your TV show and tune in every Tuesday night. But I can’t make it though the hour without falling asleep.

I fall asleep at movie theaters and on the commute to and from work. I feel tired all the time and have little energy most days. I am becoming depressed.

I am 58 years old without any other major medical problems.

Is there anything you can think of to make me less sleepy and more alert?

Sleepiness in Sheepshead Bay

Dear Sleepiness,

Thanks for the compliment (I think) about my “Ask the Doctor” show. I will try to be more entertaining in the future.

The symptoms you describe strongly suggest a condition known as Excessive Daytime Sleepiness (EDS). Symptoms may also include:

  • Struggling to stay awake when not active,
  • Having difficulty paying attention or concentrating at work, school, or home,
  • Having poor performance issues at work or school,
  • Being told by others that you are always sleepy,
  • Difficulty remembering,
  • Difficulty controlling your emotions,
  • Needing to nap most days.

The sleepiness can progress to a very serious level such as during active conversations or even while driving.

The sleepiness may arise from a lack of sleep or factors that disturb normal sleep patterns, thus producing sleep that is not satisfying or useful to your body.

A good way to gauge if one is sleep deprived is to examine the number of minutes it takes to fall asleep. If someone falls asleep in less than five minutes, that person is probably not getting enough sleep. It should take about 20 minutes to fall asleep on average.

If one’s sleepiness is related to lack of sleep, this is can be treated by going to sleep earlier and practicing good bedtime sleep habits, such as avoiding exercise before sleep, avoiding the computer at night and also avoiding caffeine or alcohol within eight hours of one’s bedtime.

Once a lack of sleep (less than seven hours per night) has been ruled out as a cause for excessive daytime sleepiness, other causes should be considered.

Causes for excessive sleepiness include: shift work or jet lag, which interferes with the body’s natural clock and normal sleep pattern; underlying sleep disorders, such as narcolepsy, sleep apnea or restless leg syndrome; disorders such as clinical depression; tumors, head trauma, anemia, kidney failure hypothyroidism, congestive heart failure; genetic predisposition; and medications, such as Benadryl or heart medications.

There are medications that have been used to treat this disorder. Of course they require prescriptions, and must be monitored very carefully as they are stimulants and can become addictive.

It is important to visit your doctor so he or she can perform a complete history and physical exam. Your doctor will be able to evaluate you for: sleep apnea, shift of work disorder, narcolepsy and restless leg syndrome.

EDS is often under diagnosed. Your symptoms sound as though you might be suffering from this. I urge you, as well as any of our other readers with similar symptoms to see a doctor to help evaluate if you could benefit from treatment.

And be sure to tune into the next two live episodes of “Ask the Doctor” when the topics will be pulmonary medicine and cardiology (Feb. 3) and internal medicine and dentistry (Feb. 10).

If you have any questions related to these topics, please call 718-499- 6101 during the show, or email your questions in advance to askthedoctor@netny.net.

Dr. Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on NET TV, Tuesdays at 8 p.m. on Time Warner Channel 97, Cablevision Channel 30 and Verizon FiOS on Demand.

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