Are you yawning a lot? Do you need that third or fourth cup of coffee to make it through the afternoon at work? Such signs of sleepiness may be a red flag of a serious sleep deficit that could put you in physical danger and harm your long-term health, according to a new position paper by the American Academy of Sleep Medicine.
The Risks of Sleepiness
According to the position paper, sleepiness is a serious health concern with wide-reaching consequences. From drowsy driving crashes to workplace errors and long-term health risks, the effects of excessive daytime sleepiness impact individuals and society every day.
“Sleepiness is a serious health concern with wide-reaching consequences,” said AASM President Dr Eric Olson, a pulmonologist and sleep medicine specialist at the Mayo Clinic in Rochester, Minnesota.
The Consequences of Sleep Deficit
Not getting a quality night’s rest of at least seven to eight hours has been linked to the development or worsening of diabetes, depression, heart and kidney disease, high blood pressure, obesity and stroke, experts say.
- Diabetes: Sleep disturbances can increase the risk of developing type 2 diabetes.
- Depression: Sleep deficits can exacerbate symptoms of depression.
- Heart disease: Chronic sleep deprivation can increase the risk of heart disease and stroke.
- Obesity: Sleep disorders can contribute to weight gain and obesity.
- Stroke: Sleep deficits can increase the risk of stroke.
With one-third of US adults reporting they experience excessive sleepiness, the importance of identifying interventions that recognize, assess, and treat it cannot be understated,” Olson added.
The Hidden Dangers of Sleepiness
People often write off signs of sleepiness, such as dozing off during a work meeting, as an insignificant issue instead of a sign of a potentially dangerous sleep deficit, experts say.
“Nodding off in boring meetings is an indication of insufficient sleep. Someone who is fully rested will not fall asleep in meetings, no matter how boring the meeting is,” said sleep specialist Kristen Knutson, an associate professor of neurology and preventive medicine at Northwestern University’s Feinberg School of Medicine in Chicago.
The Unawareness of Sleep Deficit
“Excessive daytime sleepiness can impair performance and be an indicator of underlying sleep disorders or other issues,” Knutson said via email. “If someone is experiencing excessive daytime sleepiness regularly, they should discuss this with their physician.”
“The unfortunate thing is data shows that with chronic partial sleep deprivation the ability to perceive our own level of impairment is no longer accurate – we think we’re OK when we’re really not,” said AASM board member and second author Dr Indira Gurubhagavatula, a professor of sleep medicine at the Veteran’s Administration Medical Center at Penn Medicine in Philadelphia.
The Signs of Sleep Deficit
The body does odd things when it’s continuously sleepy, including overcoming those yawns and sending signals that you are, in fact, coping with the lack of sleep. However, those signals couldn’t be further from the truth, said Dr Gurubhagavatula.
“The unfortunate thing is data shows that with chronic partial sleep deprivation the ability to perceive our own level of impairment is no longer accurate – we think we’re OK when we’re really not,” she said.
“When we do actual tests to measure how well your brain is functioning – reaction time, the ability to recall, memory tests, coordination – we find people are actually making a lot of mistakes,” she said.
The Dangers of Continued Sleepiness
With continued sleepiness, the brain may take mini naps, or what specialists call microsleeps, Dr Gurubhagavatula said.
“Your brain is actually going into brief two-second, three-second, 10-second microsleeps and then popping back out and you may not even realize this is happening,” she said.
“It can be very dangerous if you’re driving or doing something that involves safety. So if you do feel like you might fall asleep, pay attention to that, as it’s an indication it’s not safe to drive.”
The Importance of Testing Sleepiness
How do you know if your sleepiness is crossing into the danger zone? You can measure it on various scales, including the Epworth Sleepiness Scale, Dr Gurubhagavatula said.
Questions on the test include how likely you’ll fall asleep while sitting quietly after a lunch with no alcohol; lying down in the afternoon; sitting inactive in a public place; sitting and reading; sitting and chatting with someone; riding as a passenger in a car for an hour; sitting in traffic for a few minutes while driving; and watching television.
The Risks of Drowsy Driving
About 100,000 car accidents a year are linked to drowsy driving, according to statistics.
The Additional Causes of Sleepiness
Sleep disorders such as sleep apnea, insomnia, restless leg syndrome and circadian rhythm sleep disorders, as well as chronic pain conditions and medications can also contribute to sleepiness, which will be ruled out by a sleep specialist.
“You can also ask your pharmacist about your prescriptions, and you should also consider any over-the-counter medications,” Dr Gurubhagavatula said.
The Lifestyle Behaviours That Contribute to Sleepiness
Certain lifestyle behaviours also can contribute to chronic sleepiness, experts say.
“Things like too much caffeine, alcohol use before bed, using marijuana, the amount of exercise you’re doing, and practicing poor sleep hygiene, such as sleeping in a bright, cold, hot or noisy bedroom, will definitely affect how your sleep will be organised and how refreshing it’s going to be,” Dr Gurubhagavatula said.
“Many people turn to alcohol or marijuana in the mistaken belief that it can improve sleep. While alcohol appears to make it easier to fall asleep, the body will wake in the middle of the night once the alcohol is metabolized, experts say.
“I have patients that are very surprised how much better their sleep is when they get rid of that one drink they have with dinner,” Dr Gurubhagavatula said.
“As for marijuana, we know it actually has unwanted side effects on sleep.
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