What women should know about excessive daytime sleepiness and fatigue.Do you feel tired all the time? Do you find yourself dozing off while reading a book or watching television? If so, you are not alone. A 1998 poll on women and sleep conducted by the National Sleep Foundation revealed that 31 percent of women report some drowsiness during the day, with 25 percent reporting significant daytime sleepiness.While women tend to dismiss their sleepiness or fatigue as an inevitable result of their hectic lifestyles, sleepiness and fatigue can affect quality of life, safety and productivity. What's more, these complaints can be red flags for serious underlying medical conditions. It's critical that women bring persistent excessive daytime sleepiness excessive daytime sleepiness Sleep disorders A subjective difficulty in maintaining an awake state, and an increase ease of falling asleep when the person is sedentary; EDS may be quantified with subjective rating scales of sleepiness and fatigue symptoms to the attention of their health care professionals. Here is how medical experts define excessive daytime sleepiness and fatigue: * Excessive Daytime Sleepiness (EDS (Electronic Data Systems, Plano, TX, www.eds.com) Founded in 1962 by H. Ross Perot (independent candidate for the President of the U.S. in 1992), EDS is the largest outsourcing and data processing services organization in the country. ). An inability to stay awake, even in situations when wakefulness wakefulness believed to occur when the tonic flow of impulses from the reticular activating system exceeds the critical level for sustaining consciousness; reduction of reticular activating system activity is the basis of the pharmacological induction of sedation. is important--such as behind the wheel of a car. * Fatigue. A state of overwhelming, sustained exhaustion and decreased capacity for physical and mental work that is unrelieved by rest. After discussing your symptoms, your health care professional may refer you to a board-certified sleep specialist. The American Board of Sleep Medicine certifies physicians in sleep medicine. Visit www.absm.org for more information. Underlying Causes of Excessive Daytime Sleepiness EDS can be a symptom of many different sleep disorders: * Uncontrollable sleep attacks during the day, sudden episodes of muscle weakness or paralysis, hallucinations or fragmented nighttime sleep may indicate narcolepsy narcolepsy, a sleep disorder characterized by excessive daytime sleepiness and recurring unwanted episodes of sleep ("sleep attacks"). People with narcolepsy may abruptly fall asleep at almost any time, including while talking, eating, or even walking. . * Snoring and gasping for breath during the night may point to sleep apnea. * Creepy-crawly sensations in the legs, especially at night, can be a sign of restless leg syndrome restless leg syndrome Nocturnal myoclonus Sleep disorders A clinical complex characterized by nocturnal cramping of the anterior calf, restlessness, a feeling of heaviness, aching, painful paresthesia and tingling in legs with uncontrolled twitching, relieved by . This condition may be accompanied by involuntary leg movements, a symptom of periodic limb movement disorder. * Working the night shift or having a non-traditional work schedule, as well as traveling across time zones, can disrupt the body's natural rhythms, resulting in a circadian rhythm disorder. What Fatigue Means Fatigue often is an early sign of a neurological or psychological illness: * Debilitating fatigue can be an early sign and a symptom of either multiple sclerosis or Parkinson's disease. * Some studies show that eight out of 10 patients with depression report fatigue. Talk to Your Health Care Professional It's important to see your health care professional if you experience persistent or prolonged symptoms of EDS or fatigue. The Epworth Sleepiness Scale Epworth Sleepiness Scale Sleep disorders A testing instrument used to indicated a person's risk of dozing in specific situations, as well as daytime sleepiness. See Sleep disorder. (on the other side of this sheet) is one assessment used by health care professionals to measure EDS. When you discuss your symptoms with your health care professional, be prepared to ask questions based on your specific symptoms, for example: * I occasionally doze off at my desk at work. Is this a sign of a sleep disorder? * My husband says I snore snore (snor) 1. rough, noisy breathing during sleep, due to vibration of the uvula and soft palate. 2. to produce such sounds during sleep. snore v. loudly most nights. Do I have a medical problem? * I have felt moody lately, and I can't sleep at night. What's going on What's Going On is a record by American soul singer Marvin Gaye. Released on May 21, 1971 (see 1971 in music), What's Going On reflected the beginning of a new trend in soul music. ? Your health care professional may refer you to a sleep specialist or other specialist for additional tests and a definitive diagnosis. Scoring your results Now that you have completed the questionnaire, it is time to score your results and evaluate your own level of daytime sleepiness. It's simple. Just add up the numbers you put in each box to get your total score. The Epworth Sleepiness Scale Key * A total score of less than 10 suggests you may not be suffering from excessive daytime sleepiness. * A total score of 10 or more suggests that you may need further evaluation by a physician to determine the cause of your excessive daytime sleepiness and whether you have an underlying sleep disorder. Your next steps * This scale should not be used to make your own diagnosis. It is intended as a tool to help you identify your own level of daytime sleepiness, which can be a symptom of many sleep disorders. * If your score is 10 or more, please share this information with your physician. Be sure to describe all your symptoms, as clearly as possible, to aid in your diagnosis and treatment. * It is important to remember that true excessive daytime sleepiness is almost always caused by an underlying medical condition that can be easily diagnosed and effectively treated. References Aaronson, L.S., et al. (1999). Defining and measuring fatigue. The Journal of Nursing Scholarship, 31, 45-50. Karlsen, K., et al. (1999). Fatigue in patients with Parkinson's disease. Movement Disorders, 14(2):237-41. Krupp, L.B., et al. (1989). The Fatigue Severity Scale. Application to patients with multiple sclerosis and systemic lupus erythematosus Systemic Lupus Erythematosus Definition Systemic lupus erythematosus (also called lupus or SLE) is a disease where a person's immune system attacks and injures the body's own organs and tissues. Almost every system of the body can be affected by SLE. . Archives of Neurology The Archives of Neurology is a monthly professional medical journal published by the American Medical Association. Archives of Neurology publishes original, peer-reviewed scientific research of the nervous system as well as the various mechanisms of disease. , 46(10): 1121-23. Littner, M, et al. Practice parameters for the treatment of narcolepsy: An update for 2000. Sleep, 24(4): 451-56. Mahowald, M.W. (2000). What is causing excessive daytime sleepiness? Postgraduate Medicine, 107(3): 108-23. Menza, M.A., et al. Modafinil augmentation of antidepressant treatment in depression. Journal of Clinical Psychiatry, 61(5): 378-81. Rammohan, K.W., et al. (2002). Efficacy and safety of modafinil (Provigil[R]) for the treatment of fatigue in multiple sclerosis: a two centre phase 2 study. Journal of Neurology, Neurosurgery neurosurgery /neu·ro·sur·gery/ (noor´o-sur?jer-e) surgery of the nervous system. neu·ro·sur·ger·y n. Surgery on any part of the nervous system. & Psychiatry, 72: 189-183. "2002 Sleep in America Poll, April 2002." National Sleep Foundation. Thomas, C. A. Fatigue and Parkinson's Disease. APDA APDA American Parkinson's Disease Association APDA Alaska Public Defender Agency APDA American Parliamentary Debate Association APDA Afghan Peace and Democracy Act APDA Apple Programmers and Developers Association APDA Association of Peyronie's Disease Advocates Young Parkinson's Newsletter, Spring 1999. http://members.aol.com/apdaypd/young/ fatigue.htm "Restless Legs Syndrome Restless Legs Syndrome Definition Restless legs syndrome (RLS) is characterized by unpleasant sensations in the limbs, usually the legs, that occur at rest or before sleep and are relieved by activity such as walking. Foundation Medical Bulletin--Revised April 2001." Restless Legs Syndrome Foundation. http://www.rls.org/medical_bulletin/default.htm Resources American Academy of Sleep Medicine One Westbrook Corporate Center Suite 920 Westchester, IL 60154 708-492-0930 www.aasmnet.org A clearinghouse for information on sleep, including abstracts of research papers, educational materials and the journal Sleep. National Sleep Foundation 1522 K Street, NW Suite 500 Washington, DC 20005 202-347-3471 www.sleepfoundation.org Produces consumer-friendly publications and fact sheets, as well as the results of the most recent sleep polls. National Heart, Lung and Blood Institute Information Center PO Box 30105 Bethesda, MD 20824-0105 301-592-8573 www.nhlbi.nih.gov Offers resources on diseases of the heart, blood vessels, lungs and blood, and sleep disorders. RELATED ARTICLE: Epworth Sleepiness Scale (ESS). The following questionnaire will help you measure your general level of daytime sleepiness. You are to rate the chance that you would doze off or fall asleep during different routine daytime situations. Answers to the questions are rated on a reliable scale called the Epworth Sleepiness Scale (ESS). Each item is rated from 0 to 3, with 0 meaning you would never doze or fall asleep in a given situation, and 3 meaning that there is a very high chance that you would doze or fall asleep in that situation. How likely are you to doze off or fall asleep in the following situations, in contrast to just feeling tired? Even if you haven't done some of these activities recently, think about how they would have affected you. Use this scale to choose the most appropriate number for each situation: 0=would never doze 1=slight chance of dozing 2=moderate chance of dozing 3=high chance of dozing It is important that you circle a number (0 to 3) on each of the questions. Situation Chance of dozing (0 to 3) Sitting and reading 0 1 2 3 Watching television 0 1 2 3 Sitting inactive in a public place-- for example a theatre or meeting 0 1 2 3 As a passenger in a car for an-- 0 1 2 3 hour without a break Lying down to rest in the afternoon 0 1 2 3 Sitting and talking to someone 0 1 2 3 Sitting quietly after lunch (when In a car, while stopped in traffic 0 1 2 3 Total score:-- -- -- -- -- |
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