What is Excessive daytime sleepiness?

Excessive Daytime Sleepiness (also known as hypersomnia) refers to the inability to stay awake and alert during the normal waking hours that results in unexpected lapses of Sleep or drowsiness. It can even occur after long stretches of sleep.

There are two types of hypersomnia; primary and secondary.
Primary hypersomnia occurs without an underlying medical condition. The only symptom is excessive fatigue.
Secondary hypersomnia, on the other hand, occurs due to a medical condition.

Some symptoms of hypersomnia include:
- Anxiety
- Irritability
- Low energy
- Loss of appetite
- Restlessness

A 2019 study in Nature Communications documented that nearly 10–20% of people deal with excessive sleepiness to some degree.

How Does Genetics Influence the Risk of Excessive Daytime Sleepiness?

Studies have shown that certain genetic variants influence daytime sleepiness, which explains why some individuals need more sleep than others. Twin study results have estimated a 38% genetic variance in daytime sleepiness.

Studies have found an association between excessive daytime sleepiness and certain variations in the HCRTR2, PATJ, AR-OPHN1, KSR2,, and PDE4D genes.

The HCRTR2 gene encodes a protein that belongs to the G-protein coupled receptor, involved in the regulation of appetite, energy balance, neuroendocrine functions, and wake promotion.
Latest research studies suggest that variations in the HCRTR2 gene may influence the sleep-wake process.

Non-genetic Influence on EDS Risk

The most common causes of excessive sleepiness include:
- Low sleep duration
- Poor quality sleep
- Sleep deprivation
- Obstructive sleep apnea
- Medications with sedative properties
- Narcolepsy

Research has also indicated that other health conditions can increase the risk of excessive sleepiness. Some of them include:
- High BMI (Obesity)
- Type 2 diabetes
- Depression

Effects Of Excessive Daytime Sleepiness (EDS) on Health

Studies have shown that EDS is associated with an increased risk of developing coronary heart disease and stroke. However, the risk can be managed by improving the quality of sleep.
People with EDS also have poorer health than comparable adults.
According to a study, EDS is associated with negative effects on cognitive function. In fact, EDS is a common symptom in neurological conditions like Parkinson’s and psychiatric conditions like depression.

Tips for Managing Obstructive Sleep Apnea

1. Having a consistent sleep cycle routine, maintaining a healthy weight, avoiding smoking and alcohol consumption, a comfortable bedroom environment, and exercise during the day are some of the lifestyle changes that can help prevent and also manage obstructive sleep apnea.
2. If lifestyle changes don’t help you manage your sleep apnea, do consult a doctor. This applies to moderate and severe sleep apnea.
3. The doctor may ask you to use an oral device (mouthpiece) designed to keep your throat and airway open.
4. Positive airway pressure treatment reduces the respiratory events that occur when you sleep, thereby reducing snoring also.
5. In some cases, surgery is also done to manage obstructive sleep apnea.

Summary

1. Excessive daytime sleepiness refers to the inability to stay awake and alert during the normal waking hours, resulting in unexpected lapses of sleep or drowsiness.
2. Anxiety, low energy, restlessness, loss of appetite, and irritability are the symptoms of hypersomnia.
3. The HCRTR2 gene encodes a protein involved in the regulation of appetite, energy balance, neuroendocrine functions, and wake promotion. Variations in this gene may influence the sleep-wake process and influence hypersomnia.
4. Sleep deprivation, OSA, poor quality of sleep, low sleep deprivation, certain medications, and narcolepsy are some of the non-genetic factors that are associated with insomnia hypersomnia.
5. Various lifestyle changes can help manage this disease. It can also be treated by treating the underlying cause like sleep apnea.

References:

https://pubmed.ncbi.nlm.nih.gov/31409809/
https://pubmed.ncbi.nlm.nih.gov/27992416/
https://pubmed.ncbi.nlm.nih.gov/29783161/

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