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Excessive Daytime Sleepiness

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Written by
Carina Ryder, MS, BSN.
Certified Nurse Midwife, Takoma Park Gynecology
Last updated March 22, 2022

Excessive daytime sleepiness quiz

Take a quiz to find out what's causing your excessive daytime sleepiness.

Understand daytime sleepiness symptoms, including 8 causes & common questions.

Excessive daytime sleepiness quiz

Take a quiz to find out what's causing your excessive daytime sleepiness.

Take excessive daytime sleepiness quiz

Symptoms of daytime sleepiness

Not sleeping at night is a valid explanation for daytime sleepiness. Maybe you had a fun weekend away with friends, unfortunately resulting in sleep deficits, or maybe you've had a lot on your plate lately, leading to racing thoughts and restless nights. Perhaps you know you have insomnia or some other medical condition. But what if you are sleeping well through the night but still don't feel rested? Daytime fatigue can be due to something as benign (and easily treated) as poor sleep hygiene. Daytime fatigue can also be due to a traumatic brain injury.

Common accompanying symptoms of daytime sleepiness

Depending on the cause of your daytime sleepiness symptoms, you may also experience:

  • Pain
  • Emotional distress or irritability
  • Unintentional weight gain
  • Difficulty regulating your body temperature
  • Weakness
  • Headache
  • Palpitations
  • Shortness of breath
  • Difficulty concentrating
  • Lack of interest in your usual activities
  • Dizziness

What causes daytime sleepiness?

Poor sleep hygiene

Sleep habits affect the quality of your sleep. Quality sleep is essential to avoid daytime sleepiness. When you have habits that interfere with your quality of sleep, you are practicing poor sleep hygiene.

Sleep deprivation

Most adults require seven to nine hours of sleep each night. Inadequate sleep negatively impacts your executive function, or your ability to process and respond to information. Inadequate sleep also increases your risk for diabetes, obesity, certain cancers, and Alzheimer's.


Insomnia is difficulty falling asleep, difficulty staying asleep, or waking up too early. This combination of inadequate sleep and poor sleep quality can cause chronic daytime sleepiness. Treating insomnia is not always as easy as improving your sleep habits.


Hormones may be to blame for daytime sluggishness. Whether due to hypothyroidism, premenstrual syndrome, or premenstrual dysphoric disorder, hormonal fluctuations can interfere with both your quality and quantity of sleep.

Fibromyalgia and chronic fatigue syndrome

Chronic fatigue syndrome and fibromyalgia have similar symptoms, but they are different disorders. The exact cause of these disorders is not fully understood, but a level of fatigue which interferes with day-to-day activities characterizes both.

Sleep apnea

If you have obstructive sleep apnea, your airway becomes blocked as your tongue and other parts of your upper airway relax with sleep. When your airway becomes blocked, you stop breathing, if only for a couple of seconds. During these seconds, you wake up, even though you may not remember waking — interrupting your normal sleep cycle. When your sleep cycle is interrupted, you miss out on the refreshing benefits of sleep and may wake up feeling like you have not slept at all or feel sleepy throughout the day.

Restless legs syndrome and periodic limb movement disorder

Restless legs syndrome and periodic limb movement disorder sound similar but are different disorders. With restless legs syndrome, your legs are still, but the sensation you feel in your legs keeps you awake. If you have a periodic limb movement disorder, the involuntary movement of your legs may repeatedly wake you from sleep. Restless legs syndrome and periodic limb movement disorder are similar in that they both result in poor sleep.

Excessive daytime sleepiness quiz

Take a quiz to find out what's causing your excessive daytime sleepiness.

Take excessive daytime sleepiness quiz

Post traumatic brain injury syndrome

Sleep cycles change after a traumatic brain injury. As the injury heals, sleep cycles start to reestablish themselves. As the quality of sleep improves, you experience increased levels of alertness, and daytime sleepiness begins to resolve.

This list does not constitute medical advice and may not accurately represent what you have.

Sleep deprived

Sleep deprivation is also called sleep debt. It is the state of not getting adequate sleep, either in the short term or the long term.

Sleep apnea is a common cause, as is the routine of modern life with too many hours of work and activities.

Symptoms include clumsiness, irritability, difficulty concentrating, memory lapses, slow healing, daytime sleepiness, and sometimes depression. Often there is weight gain, partly due to metabolic disturbance and partly due to eating more in an effort to maintain energy and continue working.

Sleep deprivation interferes with quality of life. There is risk of job loss due to inability to concentrate, as well as risk of accidents from becoming sleepy while driving or operating machinery. Weight gain and Type 2 diabetes are both more common in those who are chronically sleep deprived.

Diagnosis is made through patient history and sometimes through a sleep study in a lab.

Treatment involves addressing any underlying medication issues or other causes, as well as establishment of "sleep hygiene" habits and routines that contribute to better sleep.

Rarity: Common

Top Symptoms: fatigue, daytime sleepiness, sleep duration less than 7 hours, difficulty concentrating

Symptoms that always occur with sleep deprived: sleep duration less than 7 hours, daytime sleepiness

Symptoms that never occur with sleep deprived: nausea or vomiting, being severely ill, fever, unintentional weight loss

Urgency: Wait and watch

Insomnia disorder

Insomnia disorder is a short-term or chronic condition whereby individuals have difficulty

sleeping. Other common symptoms include fatigue, difficulty with concentration, social

dysfunction, reduced motivation, and behavioral changes. The short-term form of

the condition is usually ...

Idiopathic hypersomnia

Idiopathic hypersomnia is an uncommon, chronic neurologic sleep disorder that is characterized by excessive daytime sleepiness that persists and is not alleviated by an adequate night's sleep. The condition can develop over weeks to months and is distinct from other slee...


Hypothyroidism, or "underactive thyroid," means that the thyroid gland in the neck does not produce enough of its hormones. This causes a slowing of the body's metabolism.

The condition can occur due to autoimmune disease; any surgery or radiation treatment to the thyroid gland; some medications; pregnancy; or consuming too much or too little iodine. It is often found among older women with a family history of the disease.

Common symptoms include fatigue, constantly feeling cold, weight gain, slow heart rate, and depression. If left untreated, these and other symptoms can worsen until they lead to very low blood pressure and body temperature, and even coma.

Diagnosis is made through a simple blood test.

Hypothyroidism is easily managed with daily oral medication. The patient usually starts feeling better after a couple of weeks and may even lose some extra weight. It's important for the patient to be monitored by a doctor and have routine blood testing so that the medication can be kept at the correct levels.

Rarity: Rare

Top Symptoms: fatigue, depressed mood, difficulty concentrating, weight gain, muscle aches

Urgency: Primary care doctor


Depression is a mental disorder in which a person feels constantly sad, hopeless, discouraged, and loses interest in activities and life on more days than not. These symptoms interfere with daily life, work, and friendships.

Rarity: Common

Top Symptoms: fatigue, depressed mood, headache, anxiety, irritability

Symptoms that always occur with depression: depressed mood

Urgency: Primary care doctor

Obstructive sleep apnea

Obstructive sleep apnea (OSA) is a relatively common condition, especially in obese adults. It refers to obstruction (blockage) of the airway during sleep. This obstruction is usually caused by the back of the tongue and the muscles of the palate relaxing and falling ...

Chronic fatigue syndrome

CFS is a chronic, debilitating condition of extreme fatigue that persists for more than six months and results in a substantially lower level of occupational, educational, or social functioning than experienced prior.

It is characterized by fatigue that worsens wi...


Fibromyalgia is a set of chronic symptoms that include ongoing fatigue, diffuse tenderness to touch, musculoskeletal pain, and usually some degree of depression.

The cause is not known. When fibromyalgia appears, it is usually after a stressful physical or emotional event such as an automobile accident or a divorce. It may include a genetic component where the person experiences normal sensation as pain.

Almost 90% of fibromyalgia sufferers are women. Anyone with rheumatic disease, such as rheumatoid arthritis or lupus, may be more prone to fibromyalgia.

Poor sleep is often a symptom, along with foggy thinking, headaches, painful menstrual periods, and increased sensitivity to heat, cold, bright lights, and loud noises.

There is no standard test for fibromyalgia. The diagnosis is usually made when the above symptoms go on for three months or more with no apparent cause.

Fibromyalgia does not go away on its own but does not get worse, either.

Rarity: Common

Top Symptoms: fatigue, arthralgias or myalgias, anxiety, depressed mood, headache

Symptoms that always occur with fibromyalgia: arthralgias or myalgias

Urgency: Primary care doctor

Excessive daytime sleepiness quiz

Take a quiz to find out what's causing your excessive daytime sleepiness.

Take excessive daytime sleepiness quiz

Daytime sleepiness treatments and relief

When it is an emergency

Seek medical care if you have daytime sleepiness symptoms and:

How to practice good sleep hygiene

To prepare your body for a good night's sleep, consider the following.

  • Go to bed at the same time every night
  • Get up at the same time every morning
  • Avoid caffeine in the afternoon and evening
  • Avoid alcohol late at night
  • Avoid long-term use of sleeping pills
  • Stop using screens: Such as your cell phone, laptop, or tablet two to three hours before going to bed
  • Avoid afternoon and evening naps of more than 30 minutes
  • Exercise regularly: Preferably in the morning or afternoon
  • Avoid eating in bed

FAQs about daytime sleepiness

Here are some frequently asked questions about daytime sleepiness.

Can depression cause daytime sleepiness?

Yes. Depression and other medical conditions, including other psychiatric conditions like anxiety, substance abuse, and bipolar disorder can cause daytime sleepiness. Other causes of daytime sleepiness include insufficient sleep — the most common cause. Less commonly, sleep disorders like insomnia, narcolepsy, and certain genetic neurological disorders like Parkinson's disease and multiple sclerosis can cause daytime sleepiness.

What medications can affect sleepiness?

Antianxiety drugs like benzodiazepines, over-the-counter drugs like first generation (H1) antihistamines, anti-seizure drugs, sedating antidepressants, and antipsychotics can all cause sleepiness. Additionally, substances like alcohol, narcotics, or stimulant withdrawal (e.g. caffeine, cocaine) can also cause sleepiness.

How can you measure daytime sleepiness?

Your physician may administer a series of questions, called the Epworth Sleepiness Scale, which measures your chance of falling asleep during routine tasks. In some cases, the physician may order polysomnography (sleep study), which measures brain activity and can show the efficiency of your sleep and how deprived of sleep you are.

Why I am always tired after eating?

There are multiple theories to explain sleepiness after eating a large meal. Large meals may activate the parasympathetic nervous system, which causes sleepiness. Insulin released to process sugar may also increase the amount of tryptophan in the brain.

What does persistent daytime sleepiness mean?

Persistent daytime sleepiness most commonly means that you aren't getting adequate sleep. However, a lack of high-quality nighttime sleep may come from a variety of causes beyond simple sleep deprivation. Insomnia, depression, anxiety, or other sleep disorders, such as sleep apnea, may also play a role. If you are getting an adequate quality and quantity of sleep, you may have a medical disorder that causes increased sleepiness during the daytime.

Questions your doctor may ask about daytime sleepiness

  • Do you have trouble sleeping?
  • Are you feeling irritable (easily made upset)?
  • Are you having difficulty concentrating or thinking through daily activities?
  • What is your body mass?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

Share your story
Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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