Key History and Physical Examination Findings in the Sleepy Patient

Excessive daytime sleepiness (EDS) is defined as “the inability to stay awake and alert during the major waking episodes of the day, resulting in unintended lapses into drowsiness or sleep.” This symptom is common among the population; National Sleep Foundation (NSF) polls have suggested that more than 30 % of the surveyed population has daytime sleepiness that interferes with their quality of life. Daytime sleepiness can have significant consequences, particularly when combined with activities requiring alertness for safety, such as operating a car. Drowsy driving is an unfortunate, but common, occurrence; 52 % of polled subjects had driven while drowsy in a recent NSF poll. Patients may not use the words “daytime sleepiness” to describe the way that they feel; some will use other terminology, such as “drowsiness,” “tendency to fall asleep,” and “decreased alertness.”.