If you keep falling asleep at work, your body may be forcing a reset.

If you find yourself dozing off at your desk or nodding off during meetings, it may be your body’s way of forcing a “reset.” Daytime sleepiness can result from many factors—some benign, others that deserve prompt medical attention. Understanding why you keep falling asleep at work can help you take steps to feel more alert, productive, and safe on the job.

Why does your body force a “reset”?
When you chronically lack restorative sleep, your brain accumulates sleep pressure. At a certain point, it activates protective mechanisms to make you rest, even if that means involuntarily drifting off in the middle of the day. This drive to reset can be influenced by:

• Sleep debt from poor-quality or insufficient nighttime sleep
• Disruptions in your circadian rhythm (your internal clock)
• Underlying medical conditions that affect sleep regulation
• Medications or substances that promote drowsiness

Common causes of daytime sleepiness

1. Poor sleep habits
   • Irregular bedtimes or wake times
   • Exposure to screens or bright lights before bed
   • Caffeine or heavy meals late in the evening
2. Sleep disorders
   • Obstructive sleep apnea: pauses in breathing that fragment sleep
   • Insomnia: difficulty falling or staying asleep
   • Restless legs syndrome: uncomfortable leg sensations that wake you up
3. Work-related factors
   • Night or rotating shifts that clash with your biological clock
   • Sedentary tasks with low mental stimulation
   • Excessive stress or burnout
4. Medical conditions
   • Depression or anxiety
   • Hypothyroidism
   • Diabetes
   • Chronic liver disease and hepatic encephalopathy (HE)
   – In advanced liver disease, the brain may become more sensitive to toxins that normally the liver would clear. Symptoms can include confusion, altered sleep–wake patterns, and daytime drowsiness. (Vilstrup et al., 2014; Prakash & Mullen, 2010; EASL, 2018)
5. Medications and substances
   • Antidepressants, antihistamines, muscle relaxants
   • Alcohol or opioids
   • Overuse of sleep aids

Signs that your daytime sleepiness may be more than run-of-the-mill fatigue

• You’re drifting off even during activities that should keep you alert (e.g., talking with colleagues, driving short distances)
• You experience sudden muscle weakness or “sleep attacks” (possible narcolepsy)
• You wake up gasping for air or with a choking sensation (suggestive of sleep apnea)
• Your mood, memory, or decision-making is worsening
• You develop tremors, confusion, or difficulty concentrating

Step-by-step approach to feel more awake at work

1. Improve nighttime sleep quality
   • Aim for 7–9 hours of sleep per night on a consistent schedule
   • Create a wind-down routine: dim lights, relaxation exercises, avoid screens
   • Keep the bedroom cool, dark, and quiet
2. Optimize your daytime environment
   • Get natural sunlight first thing in the morning to reset your circadian clock
   • Take short breaks every 60–90 minutes to stretch or walk around
   • Use a standing desk or alternate between sitting and standing
3. Watch your diet and hydration
   • Avoid heavy meals or sugary snacks that can trigger a “crash”
   • Drink water regularly—dehydration can worsen fatigue
   • Limit caffeine to early in the day; switch to water or herbal tea after lunch
4. Incorporate regular exercise
   • Moderate activity (e.g., brisk walking, cycling) boosts energy and improves sleep
   • Aim for at least 150 minutes of moderate exercise per week
5. Manage stress
   • Practice mindfulness, meditation, or breathing exercises
   • Break big tasks into smaller steps to reduce overwhelm
   • Seek social support from friends, family, or coworkers

When to seek professional help
If lifestyle changes don’t help, or if you notice warning signs (see above), it’s time to consult a healthcare professional. You might also consider doing a free, online symptom check for sleepiness to help you determine possible causes and next steps. Speak candidly with your doctor about:

• Your sleep habits and daytime symptoms
• Any chronic medical conditions (e.g., liver disease, thyroid issues)
• Medications or supplements you’re taking
• Your work schedule and stress levels

Possible medical evaluations

• Sleep study (polysomnography) to diagnose sleep apnea or other sleep disorders
• Blood tests to check thyroid function, blood sugar, liver enzymes, and other markers
• Neurological evaluation if you experience confusion, memory loss, or muscle weakness
• Review of your medications to identify those that could be contributing to drowsiness

Specific considerations for chronic liver disease and hepatic encephalopathy
In patients with advanced liver disease, the build-up of toxins—especially ammonia—can disrupt brain function. This may lead to:

• Altered sleep–wake cycles, with increased daytime sleepiness
• Cognitive changes (e.g., difficulty concentrating, memory lapses)
• Personality or mood shifts

If you have known liver disease and are experiencing worsening sleepiness or confusion, it’s especially important to see your hepatologist or primary care provider. They may recommend:

• Lactulose or rifaximin to reduce ammonia levels
• Nutritional adjustments to ensure proper protein intake without worsening toxin build-up
• Regular assessments for minimal or overt hepatic encephalopathy (Vilstrup et al., 2014; Prakash & Mullen, 2010; EASL, 2018)

Key takeaways

• Frequent daytime dozing is your body’s way of forcing a reset when sleep debt or other issues become overwhelming.
• Most causes—poor sleep habits, shift work, stress—can improve with lifestyle changes.
• Underlying conditions (sleep apnea, depression, thyroid disease, liver disease) may require medical evaluation and treatment.
• If you keep falling asleep at work despite good sleep hygiene, or if you have warning signs (e.g., confusion, “sleep attacks,” gasping during sleep), see a healthcare provider promptly.

Remember, excessive sleepiness can have serious consequences—especially if you operate machinery or drive. Don’t ignore repeated dozing or other alarming symptoms. If you’re unsure what’s behind your fatigue, consider doing a free, online symptom check for sleepiness to guide your next steps. And always speak to a doctor about anything that could be life-threatening or serious.