Everyone gets tired. A late night, a busy week, a new baby, a run of night shifts. That’s normal, and it usually passes.
But what if it doesn’t? What if you sleep a full night and still feel flat by mid-morning? Or you catch yourself nodding off in meetings, in front of the TV, or even at the wheel?
That’s a different problem, and it’s worth taking seriously. This guide helps you work out whether your tiredness might be something more, how to check, and exactly what to do next.
Tired vs Sleepy: There’s a Difference
These two words get used as if they mean the same thing, but doctors treat them differently.
Tired usually means low energy. You feel worn out, but if you lay down you might not actually fall asleep.
Sleepy means you struggle to stay awake. Your eyes close, your head drops, and you doze off when you didn’t mean to.
Excessive daytime sleepiness is the second one. It means being unusually likely to fall asleep during the day, even when you’ve had what should be enough sleep. It’s a symptom, not a diagnosis, and it can have several different causes.
Signs It Might Be More Than Ordinary Tiredness
It’s worth paying attention if you notice:
- You fall asleep unintentionally during the day, such as in meetings, while reading, or watching TV
- You feel drowsy while driving, or have had a near miss
- You wake up unrefreshed even after seven to nine hours in bed
- Your partner says you snore loudly or seem to stop breathing in your sleep
- You get morning headaches or wake up with a dry mouth
- You rely on lots of coffee or energy drinks just to function
- Your concentration, memory, or mood has dropped
- This has gone on for weeks or months, not just a rough patch
Having one or two of these doesn’t mean something is wrong. Having several, for a long time, is a good reason to see your GP.
A Quick Self-Check: The Epworth Sleepiness Scale
Doctors in Australia often use a short questionnaire called the Epworth Sleepiness Scale. It was developed by Dr Murray Johns at the Epworth Hospital in Melbourne, and it’s used around the world.
It asks how likely you are to doze off in eight everyday situations, such as sitting quietly after lunch, watching TV, being a passenger in a car, or sitting and talking with someone. You rate each one from 0 (would never doze) to 3 (high chance of dozing), and add up the total out of 24.
Rough guide to the results:
- Lower scores suggest normal levels of sleepiness
- Scores above about 10 are higher than normal and worth discussing with a doctor
- Scores above about 16 suggest a high level of sleepiness that should be checked properly
The exact cut-offs vary a little between sources, so don’t get too hung up on a single number. It’s also important to know what this scale isn’t: it can’t diagnose anything on its own. It simply gives you and your doctor a clear starting point.
What Could Be Causing It?
Excessive daytime sleepiness has many possible causes. The common ones include:
- Not enough sleep. The most common cause by far, and the easiest to overlook
- Obstructive sleep apnoea. Your breathing repeatedly pauses during sleep, so the sleep you get isn’t restful
- Shift work. Working nights or rotating shifts can disrupt your body clock and lead to shift work sleep disorder
- Narcolepsy. A less common brain condition that affects the sleep-wake cycle
- Medications. Some prescription medicines and sedating antihistamines can cause drowsiness
- Mood. Depression and anxiety can disrupt sleep or cause fatigue
- Other health issues. Low iron, an underactive thyroid, diabetes, and other conditions can cause tiredness or sleepiness
Because the causes vary so much, guessing isn’t a great strategy. A proper check-up is the most reliable way to find out.
How to Get the Most Out of Your GP Appointment
A little preparation makes the visit far more useful. Before you go:
Keep a simple sleep diary for one to two weeks. Note when you go to bed, roughly when you fall asleep, when you wake up, and how sleepy you feel during the day.
Do the Epworth Sleepiness Scale and bring your score.
Ask your partner or housemate what they’ve noticed. Snoring, gasping, or pauses in breathing are all important clues.
Write down your medications and supplements, including anything over the counter.
Note the impact on your life. Mention anything involving work, driving, or safety. Doctors take drowsy driving seriously.
Be specific. “I fall asleep during meetings about three times a week” gives your doctor much more to work with than “I’m always tired.”
What Usually Happens Next
Your GP will ask about your sleep, health, and lifestyle, and may order some basic blood tests to check for things like low iron or thyroid problems.
If a sleep disorder seems likely, the next step is often a sleep study. In Australia, there are two main types:
- A home sleep study. You wear a small monitor in your own bed overnight. It’s often used first when sleep apnoea is the main suspect.
- An in-lab sleep study. You stay overnight at a sleep clinic with more detailed monitoring. This may be recommended for more complex cases or when other sleep disorders are suspected.
Referral rules and Medicare rebates for sleep studies have required certain screening questionnaire scores, including the Epworth scale, so your GP will usually ask you to complete these. The rules can change, so it’s best to ask your doctor what applies to you right now.
A sleep physician then reviews your results and recommends treatment.
What Treatment Might Involve
Treatment depends on the cause. It could include:
- Improving your sleep habits and routine
- CPAP therapy if you have sleep apnoea, which keeps your airway open overnight
- Managing shift work and light exposure to support your body clock
- Reviewing medications that might be making you drowsy
- In some diagnosed cases, a doctor may consider a wakefulness-promoting medicine such as Modafinil. This is only for specific, diagnosed conditions, and only after a proper assessment
Don’t Ignore Drowsy Driving
One more thing, and it’s important. If you ever feel yourself nodding off while driving, pull over somewhere safe and rest. Drowsy driving is dangerous, and a coffee won’t fix it for long. If it’s happening regularly, don’t wait for your next routine check-up. See your GP soon and tell them about it.
The Bottom Line
Ongoing daytime sleepiness isn’t something you just have to put up with. It’s a real symptom with real, treatable causes. A quick self-check, a bit of preparation, and an honest chat with your GP are usually enough to start getting answers. The sooner you find the cause, the sooner you can start feeling like yourself again.
This article is general information only and isn’t medical advice. If you’re experiencing persistent excessive daytime sleepiness, speak with your GP.