I often fall asleep as soon as I sit down.

It can happen anywhere and anytime.

I don't realize I've fallen asleep. I do it when I come home from work, at social functions, when visitors come and at dinner. I've done this for 25 years, but it's getting worse as I get older. Do you know what condition would cause this? Is treatment available?

The most common cause of excessive daytime drowsiness is sleep apnea.

Sleep apnea affects about 18 million adults in the United States. It's most common among overweight men. With sleep apnea, the airway becomes blocked or breathing muscles stop moving. Breathing temporarily stops or becomes shallower. This can happen hundreds of times each night. Clues you may have sleep apnea include:

Loud snoring four or more times per week

Someone telling you that you periodically stop breathing or gasp for air during your sleep

Daytime drowsiness, as you describe

Morning headaches

A large neck (collar size); 17 inches or more in men, 16 inches or more in women

History of high blood pressure

People with untreated sleep apnea can have difficulty concentrating and are more likely to get into traffic accidents. Sleep apnea can lead to an enlarged heart and heart failure.

If you suspect that you may have sleep apnea, talk with your doctor. The usual test to confirm the diagnosis is a sleep study called a polysomnogram.

A much less likely reason for your symptoms is narcolepsy. People with narcolepsy can fall asleep anytime, even when they are standing up and active. It is an uncommon disorder.

There is excellent treatment available for both conditions. The standard treatment for sleep apnea is CPAP, or continuous positive airway pressure. You're fitted with a special mask you wear at night. A machine delivers a constant flow of air under light pressure, just enough to keep your airway open.

Narcolepsy is treated with medication, such as methylphenidate (Ritalin, Concerta), amphetamines (Adderall, Dextrostat) or modafinil (Provigil).

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