Excessive Daytime Sleepiness: When to Seek Help - Psychiatry

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Hypersomnia?


I often find myself dozing off during class, regardless of whether I had a good night's sleep the previous day.
Frequently, I fall asleep as soon as the first period begins, and sometimes I even sleep until the afternoon, missing lunch.
Even though I usually go to bed around 11 or 12 at night, I still struggle to stay awake the next day.
I often experience dizziness and sometimes have insomnia at night; despite feeling very tired, I just can't fall asleep.
I frequently get sick, catching colds or experiencing gastrointestinal discomfort, and sometimes I have severe abdominal pain.
I've seen doctors, but there hasn't been any resolution.
With school starting soon, I'm worried that my previous teachers will have a negative impression of me again.
Should I go to the hospital for a consultation?

Lucy, 10~19 year old female. Ask Date: 2002/08/06

Dr. Zhang Xuncheng reply Psychiatry


After reading your letter, I noticed that many young people today exhibit similar symptoms.
Therefore, I would like to offer a few suggestions not only for Lucy but also for young people in general:
1.
Regular Routine, Proper Nutrition, and Sufficient Exercise: Many young individuals spend excessive time in internet cafes or online, sitting in front of computer screens for long periods, which leads to a lack of physical activity.
They become immersed in the virtual world and have little connection with nature, resulting in deteriorating health.
Common complaints include unexplained back pain, chest tightness, headaches, and dizziness.
Additionally, due to their reluctance to go offline, they often eat in front of the computer, resorting to junk food—high-calorie, low-nutrient fried foods.
Prolonged computer use disrupts normal biological rhythms, and the lack of exercise and proper nutrition (any one of which can lead to serious consequences) can cause excessive daytime sleepiness and insomnia at night.
People often think they can catch up on sleep by sleeping longer for a day or two, but this can lead to an accumulation of carbon dioxide in the body, resulting in persistent drowsiness, dizziness, fatigue, and lack of energy.
Fried foods also contain high levels of free radicals, which can damage physiological molecular structures.
While the immediate effects on mental state or sleep may not be apparent, long-term poor dietary habits (with insufficient nutritional intake) can lead to neurological or endocrine disorders, further affecting immunity and mental health, making individuals more susceptible to colds or unusual illnesses.
Therefore, it is advisable to reduce the intake of overly processed and fried foods.
In other words, “natural is better”—increase the consumption of fruits and vegetables!
2.
Eat Less, Move More, and Maintain a Balanced Diet: It is crucial to ensure a balanced intake of nutrients.
In today’s society, many young women equate thinness with beauty, leading them to follow fad diets, take weight loss pills, or visit slimming centers for “sculpting.” Media advertisements further exacerbate this trend, resulting in numerous cases of physical and mental harm due to improper dieting.
There have been distant cases of diet-related incidents leading to pulmonary fibrosis, and more recent cases of liposuction resulting in shock, with some patients ultimately dying despite medical intervention.
Despite these unfortunate incidents, many young women continue to pursue extreme weight loss measures.
The key to successful weight loss is simply “eat less, move more, and maintain a balanced diet,” which guarantees healthy weight loss without side effects.
3.
Say No to Drugs: From past trends like “Youth! Relax!” to recent substances such as “Happy Pills” and the current so-called “One Grain Sand” pills, these drugs are severely harming the youth today.
They often say things like, “A few times won’t hurt,” “It makes you feel indescribably high,” “We all dare to try it; those who don’t are cowards,” or “Don’t worry about overdosing!” However, one should consider whether anyone has ever become great or achieved significant success through drug use.
While there may be a brief period of happiness, it quickly turns into suffering.
The outcome of drug use can only be described as tragic.
Therefore, bravely say “no” to drugs and do not succumb to peer pressure.
4.
Limit Stimulant Beverages: Some individuals with sensitive constitutions should avoid stimulant beverages such as tea, coffee, and cola, which can enhance alertness.
After consuming these drinks, one may feel overly energized, even when it’s time to sleep, leading to fatigue the next day as they drag themselves through work or classes.
This creates a vicious cycle, and within a few days, the body may develop health issues.
5.
Pay Attention to Body Signals: If you maintain a regular routine, have a balanced diet, engage in moderate exercise, do not take weight loss pills or engage in extreme dieting, and avoid stimulants and drugs, yet still experience fatigue, excessive sleepiness, or physical discomfort, it is advisable to undergo a thorough medical examination at a reputable hospital.
Many internal medical conditions present initial symptoms such as fatigue and excessive sleepiness, such as hepatitis B.
These conditions can often be detected early and treated effectively, leading to recovery.
If all tests confirm that your health is fine, then consider visiting a psychiatrist.

Reply Date: 2002/08/06

More Info


Excessive daytime sleepiness (EDS) can be a significant concern, especially for students who need to maintain focus and performance in their studies. Your experience of frequently dozing off during classes, despite having what seems to be an adequate amount of sleep, suggests that there may be underlying issues affecting your sleep quality and overall health. It’s important to address these symptoms, as they can impact not only your academic performance but also your mental and physical well-being.


Understanding Excessive Daytime Sleepiness
EDS is characterized by persistent sleepiness during the day, which can lead to difficulties in concentration, memory, and overall cognitive function. It can stem from various causes, including:
1. Sleep Disorders: Conditions such as sleep apnea, narcolepsy, or restless leg syndrome can disrupt your sleep cycle, leading to poor quality sleep and excessive daytime sleepiness.


2. Poor Sleep Hygiene: Irregular sleep patterns, such as going to bed at inconsistent times or engaging in stimulating activities before bed, can affect your ability to fall asleep and stay asleep.

3. Medical Conditions: Chronic illnesses, including gastrointestinal issues, can lead to discomfort that interrupts sleep. Additionally, mental health conditions like anxiety or depression can also contribute to sleep disturbances.

4. Lifestyle Factors: Diet, exercise, and stress levels play a significant role in sleep quality. Poor nutrition or lack of physical activity can exacerbate feelings of fatigue.


When to Seek Help
Given your symptoms—falling asleep in class, experiencing dizziness, insomnia, and recurrent abdominal pain—it would be prudent to seek medical advice. Here are some indicators that suggest it’s time to consult a healthcare professional:
- Persistent Symptoms: If your excessive daytime sleepiness continues despite attempts to improve your sleep hygiene, it’s important to get evaluated.


- Impact on Daily Life: If your sleepiness is affecting your academic performance, relationships, or overall quality of life, it’s crucial to address these issues.

- Associated Symptoms: The dizziness and abdominal pain you mentioned could indicate underlying health problems that need to be investigated.


Steps to Take
1. Consult a Healthcare Provider: Schedule an appointment with a primary care physician or a sleep specialist. They can conduct a thorough evaluation, which may include a sleep study to assess for sleep disorders.

2. Keep a Sleep Diary: Document your sleep patterns, including when you go to bed, when you wake up, and any instances of waking during the night. Note how you feel during the day, including any episodes of sleepiness or dizziness. This information can help your doctor understand your situation better.

3. Evaluate Your Lifestyle: Consider your diet, exercise routine, and stress levels. Making adjustments in these areas can sometimes improve sleep quality. For instance, regular physical activity and a balanced diet can enhance overall health and well-being.

4. Practice Good Sleep Hygiene: Establish a consistent sleep schedule, create a relaxing bedtime routine, and ensure your sleep environment is conducive to rest (dark, quiet, and cool).

5. Explore Mental Health Support: If you suspect that anxiety or stress is contributing to your sleep issues, consider speaking with a mental health professional. They can provide strategies to manage stress and improve your overall mental health.


Conclusion
Your symptoms warrant further investigation, and seeking help from a healthcare provider is a proactive step toward understanding and addressing your excessive daytime sleepiness. By identifying potential underlying causes and making necessary lifestyle changes, you can improve your sleep quality and overall health. Remember, it’s essential to prioritize your well-being, and addressing these issues early can lead to better outcomes in your academic and personal life.

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