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Harvard Medical School
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General Medical Questions
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Question : Lately, I can't seem to stay awake. As soon as I sit down anywhere I start falling asleep. All I do all day is sleep. I have a cough and my voice is hoarse but I don’t have a cold.
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The Trusted Source
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Howard LeWine, M.D.

Howard LeWine, M.D., is chief editor of Internet Publishing, Harvard Health Publications. He is a clinical instructor of medicine at Harvard Medical School and Brigham and Women's Hospital. Dr. LeWine has been a primary care internist and teacher of internal medicine since 1978.

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September 21, 2012
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A:

Your symptoms certainly could be explained by a thyroid problem. Typical symptoms for an underactive thyroid gland (hypothyroidism) include:

  • Fatigue or low energy
  • Feeling cold when everyone else is comfortable
  • Constipation
  • Feeling depressed
  • Dry skin
  • Weight gain
  • A hoarse voice

Women may also have changes in the menstrual period.

Your doctor can order a simple blood test to see if your thyroid is working properly. The test is called TSH, which is short for thyroid stimulating hormone. If your symptoms are caused by hypothyroidism, a daily dose of thyroid hormone medicine may dramatically improve your symptoms within weeks.

Thyroid disease is very common, especially in women. It is also the main condition that would explain all of your symptoms.

But if your major concern is the excessive sleepiness, there are other diagnoses to think about. These might include:

  • Obstructive sleep apnea (OSA). This is a common breathing disorder that results in poor sleep patterns and characteristically causes daytime drowsiness.
  • Other type of sleep problems, such as narcolepsy or restless leg syndrome.
  • Depression or life stress. These conditions often make people feel tired or want to stay in bed.
  • Certain medicine. This includes those used for allergies, seizures, pain or mental health conditions.

Excessive drowsiness can also be caused by simply not getting enough sleep. This is a common and generally under-appreciated problem. Many people try to get by on five or six hours per night. But over a period of time that adds up to a significant sleep deficit.

I recommend trying to get eight or more hours per night for at least a week. If your symptoms don’t begin to improve, see your doctor for a more thorough evaluation.

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