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What causes excessive sleepiness?

It is normal for people to feel sleepy from time to time, particularly after a long day. However, excessive sleepiness can be disruptive and make it difficult for a person to go about their normal daily activities.Some of the more common causes of excessive sleepiness include not sleeping long enough and having poor quality sleep.…

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What causes excessive sleepiness?
It is normal for people to feel sleepy from time to time, particularly after a long day. However, excessive sleepiness can be disruptive and make it difficult for a person to go about their normal daily activities.

Some of the more common causes of excessive sleepiness include not sleeping long enough and having poor quality sleep.

In some cases, excessive sleepiness may be due to a sleep disorder or another underlying health condition.

Read on to learn about the various causes of excessive sleepiness, along with their symptoms and treatment options.

Causes

a man experiencing Excessive sleepiness

Excessive sleepiness can disrupt a person’s daily activities.

Excessive sleepiness can be difficult to quantify, as it may mean different things to different people.

In general, it is a feeling of fatigue or sleepiness that lasts throughout the day or for many days.

Excessive sleepiness is a relatively common issue. A 2019 study in Nature Communications notes that 10–20% of people deal with excessive sleepiness to some degree.

There are several possible causes of excessive sleepiness, each of which has different treatments.

Sleep deprivation

Sleep deprivation occurs when a person does not get enough sleep. The American Academy of Sleep Medicine (AASM) note that adults need between 7 and 8 hours of sleep each night to feel alert and well-rested the following day.

However, according to the AASM, about 20% of adults fail to get enough sleep.

A person who does not get enough sleep during the night is likely to experience excessive sleepiness the next day. People who regularly fail to get enough sleep may feel constantly tired.

Some common causes of sleep deprivation include:

  • excessive or inconsistent work hours
  • personal obligations
  • an underlying medical condition

Underlying medical causes require their own specific treatments. In most other cases, simple lifestyle changes can usually improve the duration and quality of a person’s sleep.

Insomnia

Insomnia is a sleep condition in which people have difficulty sleeping. People who have insomnia tend to feel excessively sleepy but are unable to fall or stay asleep.

People may experience insomnia in different ways. Some common symptoms include:

  • being unable to get to sleep
  • waking continually throughout the night
  • waking very early in the morning and being unable to fall back to sleep

Insomnia can be difficult to diagnose. The Centers for Disease Control and Prevention (CDC) note that doctors generally only diagnose insomnia by ruling out other potential sleep disorders.

Treatment

Treatment for insomnia may involve a combination of therapies. Examples include:

  • sedative-hypnotic medications
  • antidepressants
  • behavioral techniques to promote regular sleep

Obstructive sleep apnea

Sleep apnea is a disorder in which a person temporarily stops breathing during sleep. It is a relatively common cause of excessive daytime sleepiness.

There are two types of sleep apnea:

  • Obstructive sleep apnea (OSA): OSA occurs when the soft tissues in the back of the throat collapse, blocking the airflow.
  • Central sleep apnea (CSA): CSA occurs when the brain fails to signal to the respiratory muscles to breathe.

Some people experience mixed sleep apnea, which is a combination of OSA and CSA.

Episodes of sleep apnea may occur dozens or even hundreds of times in a single night. As a result, they can greatly disturb a person’s sleep cycle.

Common symptoms of sleep apnea include very loud snoring and gasping for air throughout the night.

During an episode of sleep apnea, a person’s body becomes temporarily starved of oxygen. This lack of oxygen may lead to other issues, such as an irregular heartbeat. Over time, this can lead to serious chronic conditions, such as high blood pressure and heart disease.

Sleep apnea commonly occurs when a person is overweight. When this is the case, weight loss will be the first recommended treatment.

Treatment

Two common treatments for sleep apnea include:

  • Positive airway pressure devices: These devices consist of a machine that attaches to a mask, which the person wears over their face. The machine supplies pressurized air into a person’s throat while they sleep. The air prevents the throat from collapsing.
  • Oral appliances: These are similar to a mouthguard or orthodontic appliance. The devices hold the lower jaw forward slightly during sleep. This positioning prevents the soft tissues in the back of the throat from collapsing and blocking the airways.

Restless legs syndrome

Restless legs syndrome (RLS) refers to an uncontrollable urge to move the legs when they are at rest. The condition usually also causes uncomfortable sensations in the legs.

RLS may occur during both wakefulness and sleep. People who experience RLS when awake may have difficulty getting to sleep.

If RLS happens during sleep, it may cause a person’s legs to spasm or jerk repeatedly throughout the night. While this may not be enough to wake the person, it can prevent them from reaching the stages of deep, restful sleep. As a result, the person may feel sluggish and tired the following day.

Some scientists believe that RLS is due to abnormalities in the neurotransmitter dopamine, which plays a role in controlling muscle movements.

Treatment

Certain lifestyle changes may be beneficial for people with milder cases of RLS. These include:

People with more severe cases of RLS may need medication to regulate the levels of dopamine and iron in the body.

Narcolepsy

Narcolepsy is a neurological condition that causes a person to fall asleep suddenly and at inappropriate times.

People with narcolepsy usually experience extreme and persistent sleepiness throughout the day. Most people with this condition will also have one or more of the following symptoms:

Treatment

Treatment usually involves stimulant medications, which help the person stay awake. Antidepressant medications may help control hallucinations and episodes of sleep paralysis.

Doctors may also recommend that people take a few good naps throughout the day, as this can improve narcolepsy symptoms.

Depression

Depression may contribute to sleep issues, including excessive daytime sleepiness, as well as oversleeping, or sleep that is not restful. Likewise, sleep issues may contribute to symptoms of depression.

General fatigue and daytime tiredness are common among people with depression. Other symptoms of depression include:

  • feelings of sadness
  • feelings of hopelessness or despair
  • feelings of anxiety
  • difficulty concentrating
  • difficulty remembering details

Treatment

therapist in counseling session talking with patient

Psychotherapy may help treat depression.

Treatment for depression may involve drug therapy, psychotherapy, or a combination of the two.

Several different types of antidepressant medication are available. A person can talk to their doctor about which medication would be most appropriate for them.

Common psychotherapies for depression include cognitive behavioral therapy (CBT) and interpersonal therapy. According to the Anxiety and Depression Association of America, these therapies appear to be particularly effective in treating depression.

Certain medications

In some cases, daytime sleepiness may be a side effect of a particular medication, such as:

It is important to discuss the side effects of any medication with a doctor. If side effects such as sleepiness are too difficult to deal with, the doctor may recommend a change in medication or dosage.

Symptoms

Excessive sleepiness is not a disorder in itself but a symptom of insufficient sleep or an underlying health condition.

People who experience excessive sleepiness may notice the following:

  • fatigue
  • mental fog
  • inability to focus
  • grogginess
  • sluggishness

Excessive sleepiness may also cause:

  • difficulty waking up or getting out of bed in the morning
  • feeling sluggish and unmotivated throughout the day
  • napping frequently throughout the day
  • falling asleep at inappropriate times, such as while driving or during meals
  • lapses in attention
  • loss of appetite
  • difficulty remembering events throughout the day
  • difficulty concentrating
  • irritation
  • poor performance in work or school activities

A person may experience additional symptoms if their excessive sleepiness is the result of an underlying health condition.

Diagnosis

Correctly diagnosing the underlying cause of excessive sleepiness is important for establishing the best treatment.

During the diagnostic procedure, a doctor may ask questions about a person’s lifestyle habits and any medications that they are taking. The doctor may also ask questions relating to mental health.

In some cases, a doctor may order the following diagnostic tests:

  • A sleep study called a polysomnography: This test records a person’s brain waves, oxygen levels, and body movements during sleep to assess their sleep cycle.
  • Electroencephalogram: This noninvasive test records electrical activity in the brain.

General treatment for excessive sleepiness

senior man running in the park

Regular exercise might help people get a better night’s sleep.

The specific treatment for excessive sleepiness will depend entirely on the cause.

Most healthcare professionals will not want to prescribe highly addictive drugs to assist with sleep, and people who receive a prescription for sleep medications should not take them every day.

However, some general lifestyle changes may help people get a better night’s sleep. These include:

  • eating a healthful, balanced diet
  • limiting caffeine and alcohol intake
  • exercising regularly
  • creating a relaxing sleep environment
  • taking a warm bath before bedtime
  • keeping a consistent sleep schedule

Summary

Excessive sleepiness is normal after a night of poor or insufficient sleep. However, persistent sleepiness could be a symptom of a sleep disorder or some other underlying health condition.

Anyone who regularly experiences excessive sleepiness should visit their doctor for a diagnosis. Treating the underlying cause can improve sleep quality, and it may reduce the risk of other complications.

Many treatment plans incorporate simple lifestyle changes that can help improve sleep quality.

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Health

Warren’s New Medicare for All Plan Is an Extremely Clever Dodge

Two weeks after Elizabeth Warren released her much-ballyhooed and Warrenishly detailed plan for how she would pay for Medicare for All, the 2020 contender released another proposal on Friday about how, as president, she would transition the country to a system under which the government provides health insurance to everyone. Like the other plans from…

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Warren’s New Medicare for All Plan Is an Extremely Clever Dodge

Two weeks after Elizabeth Warren released her much-ballyhooed and Warrenishly detailed plan for how she would pay for Medicare for All, the 2020 contender released another proposal on Friday about how, as president, she would transition the country to a system under which the government provides health insurance to everyone. Like the other plans from the “I have a plan for that” candidate, this document was long on details and full of proposals likely to have broad support on the left. But when you zoom out from those details, it amounts to an admission that Warren won’t push for Medicare for All, and instead will embrace a more cautious path to expanding insurance coverage.

One important thing about this plan is that it is less about what Warren wants the U.S. healthcare system to look like and more about specifically what she would do as president, a level of detail that is often elided in Democratic debates. She says that she will reverse Donald Trump’s executive actions that have weakened the Affordable Care Act and use the powers of the presidency to lower drug prices by cracking down on the pharmaceutical industry. She also wants the government to manufacture generic medications, and severely limit the lobbying power of Big Pharma.

But the big question facing 2020 Democratic candidates isn’t about those kinds of policies, but how hard they would push for a government-provided health insurance system, a progressive goal since the days of FDR. Warren has said she favors Medicare for All, a position that has become controversial as debate moderators and her opponents have pressed her to admit such a massive expansion of government spending would require a tax increase. In this plan, she tweaks her stance somewhat: The bill she’ll focus on early in her administration would be a “Medicare for All Option.”

That last word matters a lot. Medicare for All is sometimes a somewhat vague phrase, but generally it means putting everyone on a single government-run health insurance system, abolishing private insurance. Warren’s Medicare for All Option wouldn’t be that disruptive. Instead of forcing everyone to buy insurance from the government, Warren would expand Medicare benefits and extend coverage to everyone younger than 18 and those making up to 200 percent of the poverty level. People who earn more than that and who are uninsured would pay premiums capped at 5 percent of their incomes.

By providing government insurance to those who want it, rather than requiring everyone to have it, this proposal seems akin to the “public option” systems favored by candidates like Joe Biden and Pete Buttigieg, though as the New York Times noted, Warren’s slate of benefits is more generous than theirs. On Friday, the Buttigieg campaign attacked Warren’s plan as an effort to “paper over” Warren’s plan to “force 150 million people off their private insurance.”

Warren says this isn’t the end goal of her healthcare policy. “No later than my third year in office,” she writes, she will push for legislation moving the country into true Medicare for All, wiping out private insurance for good. Many progressives have praised this plan, including Pramila Jayapal, the Democrat who is the chief sponsor of the House’s Medicare for All bill. But the assurance that Warren will eventually get to Medicare for All wasn’t enough for her critics on the left, who saw this as a capitulation. If you aren’t willing to fight for full Medicare for All from day one of your presidency, they argue, you have no chance of getting it.

If Warren’s plan is a dodge, it’s also an extremely logical piece of political strategy. She claims that unlike Medicare for All, she could pass her bill through a Senate process known as “reconciliation,” meaning it would require 50 votes, not 60. Furthermore, Warren supporters could argue, it’s extremely unlikely that centrist Democrats like West Virginia’s Joe Manchin and Arizona’s Kyrsten Sinema would vote for Medicare for All—meaning you might not even have 50 votes for M4A—but they might vote for a slightly less radical option.

But where this pragmatism falls apart is the idea that Warren would get to Medicare for All by year three of her term. As many people have pointed out, most presidents lose seats in Congress during midterm elections and struggle to pass big pieces of legislation late in their terms as a result. A candidate saying she’ll fight for Medicare for All in 2023 rather than 2021 sounds like your parents promising to get you a puppy two birthdays from now—in other words, just putting off a tough decision.

Not that there’s anything wrong with that. Warren’s position on healthcare is still far more ambitious than anything contemplated by the Obama administration, and she’s previously said that her highest priority will be fighting political corruption (in other words, not healthcare). A President Bernie Sanders might launch a contentious, uphill battle to try to ram through Medicare for All, but a President Warren likely will not. If that wasn’t obvious before this latest plan, it’s clear now.

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Ditch Your Phone Habits, Not Your Friendships

The label “Silicon Valley trend” is a pretty good indicator that something is going to be goofy as hell, weirdly extreme, kind of dangerous, or a heady combination of the three. Dopamine fasting is an SV-home-brewed “biohack” where people do and consume nothing for anywhere from 24 hours to a week, with the misguided aim…

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Ditch Your Phone Habits, Not Your Friendships

The label “Silicon Valley trend” is a pretty good indicator that something is going to be goofy as hell, weirdly extreme, kind of dangerous, or a heady combination of the three. Dopamine fasting is an SV-home-brewed “biohack” where people do and consume nothing for anywhere from 24 hours to a week, with the misguided aim of “resetting” some kind of neurochemical imbalance (per VICE’s coverage, this is not really how any of this works). . But because the “fast” mostly focuses on things like technology, media consumption, substance use, and social behaviors like spending time with friends, talking to other people, or having sex, it isn’t quite as ill-advised and unhealthy as other, more restrictive tech-bro fasting practices can be. (Think: Twitter CEO Jack Dorsey’s infamous “3 day water fast.”) That doesn’t mean it’s without flaws of its own. As VICE previously reported, “making you feel good” isn’t the sole function of dopamine, and dopamine isn’t the only neurotransmitter that produces, dare I say, posi vibes. And it turns out dopamine fasting is based on a fundamental misconception about the value of social interaction that could stop fast participants from gleaning any real benefits.

According to scientists who spoke with Psych Central, a mental health website run by mental health professionals, the kind of social isolation that dopamine fasting entails could actually be detrimental to mental health. Kim Hellmans, a neuroscience researcher and professor at Carleton University, told Psych Central that interacting with other people, especially people you actually like, is actually good for you. “Humans have evolved as a highly social species, and as such, loneliness and very little social stimulation can be coded in the nervous system as a threat — since loneliness is one of the most potent stressors,” Hellmans said to Psych Central.

Yes, another earth-shattering dispatch from Big Science: Spending time with people you like is literally good for you. Studies have shown that social support from family, friends, and romantic partners has a wide range of benefits, like decreased stress levels, increased happiness, improvements in cardiovascular health, and boosts in the effectiveness of other healthy activities, like exercising regularly. Meanwhile, loneliness is on the rise, so much so that experts are working on creative solutions like meal-sharing to coax people away from their solitary habits. That’s because social isolation is absolutely a trend worth combatting: One study that found loneliness rivals smoking cigarettes when it comes to increasing mortality risk, and being lonely is way less fun than smoking cigarettes.

The element of dopamine fasting that researchers believe does have merit is the part where fasters disengage with technology. “We could all serve to ‘unplug’ every once in a while,” Hellemans said, but with a caveat: “To attribute any perceived benefits to reduced dopamine levels is an over-simplification and misrepresentation of the complexity of the nervous system.” Of course, the benefits of unplugging aren’t breaking news, either.

So: Meeting up with a friend, ditching your phones, and going for a walk outside while you have a meaningful conversation about life, love, and the ugly wedding dresses of mutual acquaintances? Awesome for your mental and physical well-being. Declining hangout invitations because you need to stay indoors, write a list of goals, and focus on not masturbating in pursuit of some questionable mental health benefits? Not so much. I think you know what to do with that information.

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Imagine Being Kicked off Your Health Insurance Two Months After Giving Birth

When Madavia Johnson gave birth to Donald Ray Dowless III last year, she was hit by a case of severe postpartum anxiety. She was scared to carry her son downstairs or drive him in a car. She couldn’t manage to continue law school―and could hardly leave the house―because she didn’t trust anyone to watch him.…

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Imagine Being Kicked off Your Health Insurance Two Months After Giving Birth

When Madavia Johnson gave birth to Donald Ray Dowless III last year, she was hit by a case of severe postpartum anxiety.

She was scared to carry her son downstairs or drive him in a car. She couldn’t manage to continue law school―and could hardly leave the house―because she didn’t trust anyone to watch him. Her weight dropped from 140 to 115 pounds.

“It was very stressful for me mentally,” said Johnson, now 29, who lives in Clayton, North Carolina. And she found it hard to secure medical assistance because her Medicaid coverage ran out just two months after her son’s birth. Public health advocates are pushing to change that.

The difficulties Johnson faced contribute to the United States’ dismal record on maternal and child health. The U.S. is one of only three countries where maternal deaths are on the rise, joining Sudan and Afghanistan, according to the Alliance for Innovation on Maternal Health, a program of the Council on Patient Safety in Women’s Health. And data from the Centers for Disease Control and Prevention indicates that about 700 women die in the U.S. every year from pregnancy complications. Sixty percent of those deaths are deemed preventable.

Democratic presidential candidates such as Senator Cory Booker of New Jersey and Senator Kamala Harris of California have talked about those problems on the campaign trail, offering sweeping proposals to address disparities that lead to poor health for many new mothers.

Though maternal and child health experts appreciate the attention to the issue, they also point to what they say is a fairly minor policy option that could make a major difference: increasing access to Medicaid for postpartum women.

“Given that we know that this crisis disproportionately falls on low-income people … Medicaid is a very smart starting place to make sure these people are getting access to needed care,” said Valarie Blake, an associate professor of law at West Virginia University who focuses on health care law.

Take Johnson, for instance. At the time of her pregnancy, she was eligible for Medicaid based on a rule that provides women who otherwise might not qualify under strict income restrictions with coverage during pregnancy and for 60 days after. She gave birth August 14, 2018.

But North Carolina has tight eligibility requirements. It is also one of the 14 states that have not chosen to expand Medicaid under the Affordable Care Act. So, by mid-October, Johnson was no longer “Medicaid eligible.” Because her physician was backed up on appointments, she lost her coverage before she had a “six-week” checkup.

Eventually, she reapplied for Medicaid and was able to qualify because her status changed since she had a child. But Donald was 8 months old before she was able to see a doctor.

Experts point to the 60-day timeline as a sort of clock ticking on some severe postpartum medical issues: bleeding, infections, breastfeeding issues, and mental health screening, among others.

“If you’re on postpartum Medicaid, you need to get those issues solved right away,” Blake said.

And that 60-day countdown? It is arbitrary, said Alison Stuebe, a professor of obstetrics and gynecology at the University of North Carolina School of Medicine. It has roots in a general idea across cultures that women need special care after giving birth, but the 60-day mark isn’t based on medicine.

“It comes from the same place as the six-week postpartum visit,” Stuebe said. “We don’t know where it comes from either.”

Stuebe chaired a task force for the American College of Obstetricians and Gynecologists that recommended a different approach. Providers should check women two weeks after giving birth, and then continue holistic care for 12 weeks, eventually transitioning the patient to primary care.

That prolonged contact is essential, she said. ”Postpartum depression, if untreated, can begin to spiral,” Stuebe said. “Even if you’re in treatment, after 60 days, you’re not better.”

Johnson, though, was left to wrestle with severe postpartum anxiety on her own.

She sought support from other new moms on Facebook who were coping with anxiety. Since her son had Medicaid for the first year of his life, his pediatrician was a source of help. She also got care through her local health department’s free clinics.

At the federal level, the idea of extending postpartum Medicaid is getting more attention. At a September House hearing, representatives from the American Medical Association, the Icahn School of Medicine, and the Kaiser Family Foundation called for expanding postpartum Medicaid to 12 months as a possible solution to the maternal mortality crisis. The American College of Obstetricians and Gynecologists has also recommended it. Booker’s bill would extend Medicaid coverage from 60 days to 12 months alongside other far-reaching proposals. (Kaiser Health News is an editorially independent program of the foundation.)

Beyond protecting women during the medically vulnerable time after they deliver, experts think increasing Medicaid could go a long way toward addressing the racial disparities that exist in maternal mortality rates. Black women are two to three times more likely to die from pregnancy-related causes than white women.

“It’s not a silver bullet,” said Jamila Taylor, the director of health care reform at The Century Foundation, a nonpartisan think tank. “There’s racism in the health care system. Coverage is a piece of that, but we need to transform the system.”

Kaiser Health News (KHN) is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation that is not affiliated with Kaiser Permanente.

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