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Symptoms, Their Causes & Cures: Drowsiness

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Drowsiness

WHEN TO SEE YOUR DOCTOR

* You experience repeated episodes of drowsiness for a week or more but are getting adequate (six to eight hours) sleep every night.

* Drowsiness affects your alertness or puts you and others in physical danger, such as when driving.

* You also snore excessively or experience frequent interruptions in your sleep.

* Sleep overtakes you so suddenly that you collapse.

What Your Symptom Is Telling You

Feeling drowsy all the time? Join the crowd! America is a nation of sleep-starved yawners fighting a daily battle against the sandman. We increasingly live in a world where people drive themselves on a relentless schedule that never lets up. Something has to be pushed aside, and for far too many of us, it's our sleep time. No wonder so many people are rubbing their eyes and nodding out at inappropriate times!

Irregular sleep patterns are just as likely to cause drowsiness as lack of adequate sleep. Jet lag, shift work, inconsistent bedtimes and weekend partying can all disturb our natural sleep/wake cycles, says Charles Pollak, M.D., director of the Sleep-Wake Disorders Center at the New York HospitalCornell Medical Center in White Plains. "Too often people try to function when their brains and bodies are in the sleep mode," he says.

In addition to reflecting how much and when you are sleeping, drowsiness can also be a sign of the quality of your sleep. Millions of Americans, especially snorers, may suffer from a potentially life-threatening sleep disorder called obstructive sleep apnea, in which closures in the upper airway cause breathing to periodically stop for 30 to 60 seconds or even longer. The brain, sensing a lack of breathing, will trigger a snorting or gasping reflex that partially reawakens the individual and restarts normal breathing.

These events can occur hundreds of times a night, preventing you from enjoying the restorative benefits of uninterrupted deep sleep. People with chronic sleep apnea also run an increased risk of high blood pressure, heart disease and stroke. And the drowsiness associated with sleep apnea is the suspected cause of thousands of industrial and highway accidents every year. (For more information on sleep apnea, see Snoring on page 486.)

Sleep factors are not the only thing that can cause drowsiness, however. Virtually any virus, allergy or illness can interfere with sleep, leaving you drowsy and craving more than 40 winks. Among the most common offenders are the flu and the common cold. And some of the medications used to fight these ailments—especially antihistamines—can leave you positively struggling to keep your eyes open. Many medications have drowsiness as a side effect.

Alcohol, of course, can leave you in a drowsy stupor. And so can the withdrawal of caffeine.

In addition, narcolepsy is a relatively rare neurological condition that causes extreme drowsiness and severe, recurrent sleep attacks.

Symptom Relief

Tired of feeling like a zombie? Ready to face the world with a glimmer in your eye and a spring in your step? Here are some tips to chase away that lousy, drowsy feeling.

Get more quality sleep. More likely than not, you need to catch more Zs. But how much is enough? "It differs from person to person, but for most of us it's eight hours or more," says biological psychologist David F. Dinges, Ph.D., associate professor in the psychiatry department at the University of Pennsylvania School of Medicine in Philadelphia. "We tend to devalue sleep by living with less. There is a cumulative sleep debt that develops from living that way, and the body will come to collect its due if we don't pay it back." If you've been depriving yourself of sleep, Dr. Dinges recommends getting at least one more hour of shut-eye every night to pay back your sleep debt. Once you've determined your optimal night's sleep, get that same amount of sleep every night in the same time period. Depending on your sleep debt, it could take a day or two to repay. (For other tips about getting a good night's sleep, see Insomnia on page 274.)

Take naps. Napping is a great way to make up for lost sleep and to rejuvenate yourself when drowsiness hits, says Wilse B. Webb, Ph.D., professor of psychology at the University of Florida in Gainesville. Up to 45 minutes in the early afternoon will do the job nicely. Naps are especially helpful to people who have narcolepsy.

Try a cup of java. "Caffeine is a powerful stimulant that can be very helpful," says Philip R. Westbrook, M.D., director of the Sleep Disorders Center at Cedars-Sinai Medical Center in Los Angeles. One to two cups of coffee in the morning and then one cup at lunch is sufficient in a day. More than that could lead to a caffeine crash in the afternoon. That's worse than the drowsiness you're trying to reduce.

Keep active. "If you are in a low-demand situation like driving or reading, you can get drowsy," says Dr. Webb. "By contrast, no one ever went to sleep playing tennis. Continuing to do active, busy things like walking and talking will interfere with the urge to sleep."

Light up your life. Bright lights or a walk in the sunshine may erase some of your drowsiness, according to recent studies. Light may have a stimulating effect on the central nervous system, resets your biological clock and suppresses the production of melatonin—a hormone thought to induce drowsiness.

Get the sensation. A hot shower, a cold breeze, loud rock music, physical contact or any stimulus that jars the senses can activate and increase your alertness, says Dr. Westbrook.

Review your medications. List every medication you're currently taking—both prescription and over-the-counter—and show the list to your doctor. Your doctor may be able to suggest alternatives that won't cause drowsiness.

See also Afternoon Slump; Fatigue; Insomnia

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