The American Academy of Sleep Medicine’s (AASM) has published a new position statement on daytime sleepiness and how it impacts our lives (not in a good way, obviously).
“The position states that sleepiness is a critical patient-reported outcome that is associated with an increased risk for adverse health effects and diminished quality of life,” the AASM said in an April 14 press release. “The statement urges health-care professionals, policymakers, and researchers to prioritize the evaluation, management and treatment of sleepiness to improve public health.”
Here are five takeaways from that position statement:
— A lot of us are sleepy. The position statement noted that one-third of adults in the United States report “excessive sleepiness,” defined as the inability to stay awake and alert during daytime periods.
The AASM’s position statement quotes the National Sleep Foundation and the American Thoracic Society as saying adults generally need seven to nine hours of good-quality sleep per night. Kids usually need more sleep than grownups do, but their sleep needs vary with age; younger kids tend to need more sleep than older ones.
— Sleepiness and tiredness/fatigue are not the same things. We might use those terms interchangeably in everyday conversations, but the AASM’s position statement defined fatigue/tiredness as physical exhaustion. Sleepiness, meanwhile, is associated with chronic sleep apnea and narcolepsy, which the National Institute of Neurological Disorders and Stroke noted is a chronic neurological disorder that affects the brain’s ability to control sleep-wake cycles. Cleveland Clinic said narcolepsy “is a condition where your brain can’t control your ability to sleep or stay awake.”
So, the tiredness you feel because you have a newborn infant in the house or because you’ve just pulled an all-nighter for a work project is different than the sleepiness you’d feel that was caused by sleep apnea or narcolepsy.
— We think we’re doing OK when we’re sleepy. We’re not. Research shows that when we go several nights in a row without enough sleep, we’ll report feeling acutely sleepy at first. But in the following days, we’ll likely add that our sleepy feelings have leveled off or only worsened a bit.
In reality, “cognitive performance continues to deteriorate,” the AASM said. So when we think we’ve acclimated to getting far less sleep than recommended and are now doing all right … we’re wrong. We just don’t realize it.
— Many, many factors can cause sleepiness. In addition to sleep apnea and narcolepsy, medical conditions including infections (e.g., encephalitis, chronic viral infections), inflammation (e.g., rheumatoid arthritis, allergies), brain injury and stroke, and neurodegenerative diseases (Parkinson’s, dementia) can result in daytime sleepiness. So can psychiatric conditions, such as mood disorders (e.g., depression, bipolar disorder), substance abuse, and schizophrenia. Genetic disorders such as Prader-Willi syndrome and myotonic dystrophy resulting in muscle wasting and weakness can cause sleep difficulties. So can iron deficiencies.
Healthy sleep can also be disrupted by more mundane things, such as ingesting too much caffeine or alcohol, or trying to sleep in an environment that’s too noisy, hot, cold or bright. Over-the-counter and prescription medications can also interrupt sleep.
— But sleepiness needs to be confronted; just because it’s common doesn’t mean it’s acceptable. “Sleepiness is associated with cognitive and functional impairments that can have a negative impact on performance, health, mood, safety and quality of life,” the AASM position said.
In addition to obvious dangers such as driving while sleepy, children who are chronically sleepy may do poorly in school because they can’t focus, or they’ll exhibit behavioral problems that can make learning difficult. Performing certain jobs or tasks while sleepy could also result in unintentional, but devastating errors or accidents. Sleepiness can impact relationships at home and overall, lead to a poorer quality of life.
The bottom line of the AASM position statement is that sleep and circadian care is health care at its core. And we therefore need to do all we can to ensure a good night’s sleep for all.
