Are you Sleepy or Fatigued?

I often ask the patient, “Which one of these situations describes you the best?  Are you sleepy, meaning you can’t keep your eyes open when you sit down or are you fatigued, meaning you have no gas in your tank and you can’t get off the couch?” Sometimes even patients have a hard time determining which one of these descriptors apply to their situation. 

A study in the Journal of Sleep Research in 2005, noted that both sleepiness and fatigue can be subjective symptoms of an underlying sleep disorder. Of interest, 4% were referred for excessive fatigue and 16% were referred for excessive sleepiness but when they were evaluated with the Epworth Sleepiness Scale and the Fatigue Severity Scale, 64% of the referred patients reported excessive fatigue and only 4% reported excessive sleepiness. The report suggested that both fatigue and sleepiness can be a symptom of an underlying sleep disorder.

If you look at the questions on the two types of scales many of the questions will overlap which may explain these findings. In particular, the new Idiopathic Hypersomnia Severity Scale (IHSS) has many overlapping questions similarly to the fatigue scales simply interchanging the words hypersomnia or sleepiness with fatigue. Examples: “Does fatigue interfere with your daily activities of living or your work performance? versus “Does hypersomnia interfere with your daily activities of living or your work performance? “ 

Whether you are fatigued or sleepy these symptoms can impact your quality of life significantly and both may suggest you have an underlying sleep disorder.  We spend an hour with our patients and have plenty of time to dive into the complexities of your complaints to bring you solutions.