A common cause of persistent daytime sleepiness is obstructive sleep apnea. Constant drowsiness, which disrupts the normal functioning of the patient, is the main daytime manifestation of obstructive sleep apnea. At night, this disease is primarily indicated by strong snoring and periodic respiratory arrests.
Why does apnea cause sleepiness during the day?
Each episode of lack of breathing during sleep is accompanied by oxygen starvation and the accumulation of carbon dioxide in the blood. In this case, an impulse is sent to the brain to wake up. Brain activation (incomplete awakening or micro -awakening ) lasts only 3-15 seconds, but even this disrupts normal sleep. Considering that the number of respiratory arrests (and hence awakenings) in obstructive sleep apnea can reach 500 per night (depending on the severity of the disease), then the patient has practically no deep sleep. Violation of the structure of sleep and is the cause of the subsequent drowsiness during the day. Still, how to get enough sleep here if they manage to wake you up to 500 times a night?
A few words about the danger of constant drowsiness. As the severity of obstructive sleep apnea increases, drowsiness increases and becomes permanent . Most often, with constant drowsiness, the apnea- hypopnea index (that is, the number of respiratory disorders per hour) is 40 or more episodes.
Constant drowsiness, which interferes with the normal functioning of the patient, may be evidence of a severe course of the disease. Such a patient has heart rhythm disturbances, high blood pressure, nocturnal angina attacks, signs of chronic respiratory and heart failure, and other severe symptoms and conditions. However, the relationship between the severity of the disease and drowsiness does not always appear, sometimes patients get used to drowsiness and stop noticing this forged sign of a dangerous disease.
How can daytime sleepiness be assessed? That’s what the Epworth scale is for . This scale is considered a simple and reliable method for determining the degree of drowsiness – mild, moderate and severe. The range of values can be from 0 to 24 points. If a total score of 0–10 is normal, 11–15 is excessive daytime sleepiness, and 16–24 is severe daytime sleepiness.
Identifying daytime sleepiness and diagnosing sleep apnea is very important! Drivers with undiagnosed and untreated sleep apnea put their lives and the lives of those around them at great risk due to the possibility of falling asleep at the wheel and the risk of traffic accidents. Patients with moderate to severe sleep apnea with a sleepiness index ≥10 have a 5.8-fold increased risk of road accidents.
In addition to obstructive sleep apnea, constant daytime sleepiness ( hypersomnia ) can be caused by various neurological and mental illnesses. Hypersomnia is not an independent disease, but a symptom that occurs in narcolepsy, periodic limb movement syndrome during sleep, neurotic disorders, organic diseases and brain injuries, depression, diabetes mellitus and hypothyroidism.
If you are worried about constant drowsiness, do not put off a visit to the doctor to find out its causes and adequate treatment.
Treatment of the underlying disease, in this case obstructive sleep apnea, will eliminate daytime sleepiness, increase efficiency and improve quality of life. If a person does not have indications for surgical treatment of sleep apnea, then the most effective will be the use of CPAP therapy. A positive result of CPAP therapy is noted after a trial course of treatment, from the first days.
In the video, the patient shares his impressions of the first night of treatment with the CPAP machine. His condition has changed dramatically.