Excessive Daytime Sleepiness: Seeking Help and Solutions

Is it narcolepsy?

Hello, Doctor.
This is my first letter to you.
Due to my increasingly severe hypersomnia, I am writing to seek your advice.
I am 23 years old and currently work as an administrative assistant in the computer industry.
However, irregular overtime has disrupted my sleep schedule.
I have experienced similar issues in the past, often arriving late to work.
I thought it was due to stress or lack of sleep, which made me hit the snooze button in the mornings.
Recently, I have noticed that things are getting worse.
I have been trying hard to wake up early, go to bed early, and not overexert myself.
I even bought multiple alarm clocks, but despite my efforts, I still cannot wake up.
I really don't understand why.
Because of my constant tardiness, even though I am cooperative at work, it has created a very negative impression of me in the company.
I often get reprimanded by my supervisor, who says I am not working hard enough, that my performance is poor, and that I have low self-expectations, to the point where I might be at risk of being fired.
Honestly, I have been trying to improve these symptoms, but I feel lost and helpless.
Please tell me what I should do and where I can seek help.

Qi Qing Wa Wa, 20~29 year old female. Ask Date: 2000/10/17

Dr. Li Junren reply Psychiatry

Hello, I apologize for the late response.
To determine whether your condition may be narcolepsy, further information is needed.
Here are a few points for your consideration:
1.
During consecutive holidays, do you tend to go to bed very late and wake up late? If so, your issue might be related to a common problem many young people face: delayed sleep phase disorder.
This is a normal phenomenon, but if it affects your work, you might try to identify your natural waking time and gradually adjust by waking up half an hour earlier each week.
If work commitments prevent this, you could consider consulting a psychiatrist for a prescription of melatonin to help regulate your circadian rhythm.
2.
If you find that you need more than ten hours of sleep each day to stay awake during the day, this could indicate hypersomnia.
The solution is similar: try to shift your sleep schedule earlier to avoid work hours.
3.
Narcolepsy is characterized by sudden, uncontrollable episodes of sleep during the day, where one may find it difficult to wake up, typically lasting around ten minutes before waking naturally.
This condition is not very common and can be managed with medication to alleviate symptoms.
Generally, a psychiatrist should be able to address your concerns.
If you are looking for a specialist in sleep disorders, in the northern region, Dr.
Li Yuzhou from National Taiwan University Hospital's psychiatry department is available; in the central region, Dr.
Chen Zhanhang from Chung-Hwa Medical University; and in the southern region, you can visit the stress adjustment clinic at Chia-Nan Psychiatric Hospital or the psychiatry department at Kaohsiung Chang Gung Memorial Hospital for detailed answers.

Reply Date: 2000/10/17

More Info

Hello! Thank you for reaching out with your concerns about excessive daytime sleepiness. It sounds like you're experiencing a challenging situation that is affecting both your personal and professional life. Let's break down your issues and explore potential solutions.

First, it's important to understand that excessive daytime sleepiness (EDS) can stem from various factors, including sleep disorders, lifestyle choices, and even underlying medical conditions. Given your situation, where irregular work hours and stress seem to play a significant role, it’s crucial to address both your sleep hygiene and any potential medical issues.

1. Sleep Hygiene Improvements
Improving your sleep hygiene can significantly impact the quality of your sleep and help reduce daytime sleepiness. Here are some strategies you can implement:
- Establish a Consistent Sleep Schedule: Try to go to bed and wake up at the same time every day, even on weekends. This helps regulate your body's internal clock.

- Create a Relaxing Bedtime Routine: Engage in calming activities before bed, such as reading, taking a warm bath, or practicing relaxation techniques like deep breathing or meditation. This can signal to your body that it's time to wind down.

- Limit Screen Time: Reduce exposure to screens (phones, computers, TVs) at least an hour before bed. The blue light emitted by screens can interfere with melatonin production, making it harder to fall asleep.

- Optimize Your Sleep Environment: Ensure your bedroom is conducive to sleep—dark, quiet, and cool. Consider using blackout curtains, earplugs, or a white noise machine if necessary.

2. Lifestyle Adjustments
Given your job in the computer industry, which may involve long hours and irregular schedules, consider the following lifestyle adjustments:
- Physical Activity: Regular exercise can improve sleep quality and reduce stress. Aim for at least 30 minutes of moderate exercise most days, but try to avoid vigorous workouts close to bedtime.

- Dietary Considerations: Be mindful of your caffeine and alcohol intake. Both can disrupt sleep patterns. Try to limit caffeine consumption in the afternoon and evening.

- Manage Stress: Since you mentioned feeling stressed, consider incorporating stress management techniques such as yoga, mindfulness, or talking to a therapist. These can help reduce anxiety and improve your overall well-being.

3. Seek Professional Help
If your excessive daytime sleepiness persists despite making these changes, it may be time to consult a healthcare professional. Here are some options:
- Sleep Specialist: A sleep specialist can conduct a thorough evaluation, which may include a sleep study (polysomnography) to diagnose any underlying sleep disorders such as sleep apnea, narcolepsy, or insomnia.

- Primary Care Physician: Your primary care doctor can also help assess your symptoms and may refer you to a specialist if necessary. They can evaluate for other potential medical issues that could be contributing to your sleepiness, such as thyroid problems or depression.

- Mental Health Professional: If stress and anxiety are significant factors in your situation, a mental health professional can provide support and strategies to cope with these challenges.

Conclusion
It's commendable that you are seeking help and looking for solutions to improve your situation. Remember that making changes to your sleep habits and lifestyle can take time, and it's essential to be patient with yourself during this process. If you continue to struggle with excessive daytime sleepiness, don't hesitate to reach out to a healthcare provider for further evaluation and support. You deserve to feel rested and perform well in your job. Good luck, and take care!

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