SELF-HELP GUIDE TO UNDERSTANDING AND
CONTROLLING EXCESSIVE SLEEPINESS-3

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IMPORTANT!--REALIZE THAT DISORDERS OF EXCESSIVE SLEEPINESS OFTEN SEEM TO
WORSEN TEMPORARILY ON A PERIODIC BASIS, OFTEN WITHOUT ANY OBVIOUS CAUSE.

Many individuals report periods during which they "just don't do as well" (usually lasting 2-5 days). These occur in both men and women, and in women they aren't always related to menstrual cycles. The best course of action is to be aware that these may occur periodically, usually will clear up on their own, and that feelings of anxiety and/or depression may only prolong what otherwise would have been a 'short term" setback.

If people tend to underestimate their sleepiness, how can I know if my treatment is adequate?

This is an important question, particularly since available tests for diagnosing excessive sleepiness are much better than current laboratory methods for evaluating the adequacy of its treatment. It is important to ensure that you're not just 'better' but truly, 'better enough'. This issue is particularly important when it comes to driving, because of the potential risks to yourself and others if you're not alert at the wheel.

It appears advisable to enlist the help of others and actively seek their observations and input on how you're doing. In most cases, their perception of your levels of alertness is likely to be more accurate than what you can sense yourself

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TROUBLE SHOOTING GUIDE FOR EXCESSIVE SLEEPINESS

If you have been doing well, then suddenly find you are worse--it may help to go through the following sequence:

A. First, look for a cause-

1. Am I sleep deprived? Are my sleep habits more irregular?

2. Do I have an infection?

3. Am I taking other medications now? Drinking alcohol?

4. Am I forgetting to take my medication, or did I change its timing or dosage?

5. Am I eating foods that perhaps might be making me worse?

6. Am I depressed or under unusual stress?

7. (Women only)-where am I in my menstrual cycle?

8. Am I less physically active than before? Can I change that?

B. If you find a possible cause, take appropriate steps to correct it.

C. On the other hand, it you can't pinpoint any cause--don't despair! Remind yourself the problem may only be temporary and that in many cases, it simply will clear up on its own.

D. THEN, if this period of 'worsening' persists past 7 days, and if you weren't able to identify a correctable cause, contact your treating physician with your concerns and observations.

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It is hoped that the above ideas will help you analyze and manage your sleepiness, and
that they also will facilitate your efforts to render your treatment maximally effective.

What other measures have you noted to be helpful in improving your alertness?

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