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Somnolence

February 16, 2024

Somnolence (alternatively sleepiness or drowsiness) is a state of strong desire for sleep, or sleeping for unusually long periods (compare hypersomnia). It has distinct meanings and causes. It can refer to the usual state preceding falling asleep,[1] the condition of being in a drowsy state due to circadian rhythm disorders, or a symptom of other health problems. It can be accompanied by lethargy, weakness and lack of mental agility.[2]

Somnolence
Other namesSleepiness, drowsiness
SpecialtyPsychiatry

Somnolence is often viewed as a symptom rather than a disorder by itself. However, the concept of somnolence recurring at certain times for certain reasons constitutes various disorders, such as excessive daytime sleepiness, shift work sleep disorder, and others; and there are medical codes for somnolence as viewed as a disorder.

Sleepiness can be dangerous when performing tasks that require constant concentration, such as driving a vehicle. When a person is sufficiently fatigued, microsleeps may be experienced. In individuals deprived of sleep, somnolence may spontaneously dissipate for short periods of time; this phenomenon is the second wind, and results from the normal cycling of the circadian rhythm interfering with the processes the body carries out to prepare itself to rest.

The word "somnolence" is derived from the Latin "somnus" meaning "sleep".

Causes edit

 
Some features of the human circadian (24-hour) biological clock. Click to enlarge

Circadian rhythm disorders edit

Main article: Circadian rhythm sleep disorder

Circadian rhythm ("biological clock") disorders are a common cause of drowsiness as are a number of other conditions such as sleep apnea, insomnia and narcolepsy.[2] The body clock disorders are classified as extrinsic (externally caused) or intrinsic. The former type is, for example, shift work sleep disorder, which affects people who work nights or rotating shifts. The intrinsic types include:[3]

  • Advanced sleep phase disorder (ASPD) – A condition in which patients feel very sleepy and go to bed early in the evening and wake up very early in the morning
  • Delayed sleep phase disorder (DSPD) – Faulty timing of sleep, peak period of alertness, the core body temperature rhythm, hormonal and other daily cycles such that they occur a number of hours late compared to the norm, often misdiagnosed as insomnia
  • Non-24-hour sleep–wake disorder – A faulty body clock and sleep-wake cycle that usually is longer than (rarely shorter than) the normal 24-hour period causing complaints of insomnia and excessive sleepiness
  • Irregular sleep–wake rhythm – Numerous naps throughout the 24-hour period, no main nighttime sleep episode and irregularity from day to day

Physical illness edit

Sleepiness can also be a response to infection.[4] Such somnolence is one of several sickness behaviors or reactions to infection that some theorize evolved to promote recovery by conserving energy while the body fights the infection using fever and other means.[5][6] Other causes include:[7]

Medicine edit

Assessment edit

Quantifying sleepiness requires a careful assessment. The diagnosis depends on two factors, namely chronicity and reversibility. Chronicity signifies that the patient, unlike healthy people, experiences persistent sleepiness, which does not pass. Reversibility stands for the fact that even if the individual goes to sleep, the sleepiness may not be completely gone after waking up. The problem with the assessment is that patients may only report the consequences of sleepiness: loss of energy, fatigue, weariness, difficulty remembering or concentrating, etc. It is crucial to aim for objective measures to quantify the sleepiness. A good measurement tool is the multiple sleep latency test (MSLT). It assesses the sleep onset latency during the course of one day—often from 8:00 to 16:00.[10] An average sleep onset latency of less than 5 minutes is an indication of pathological sleepiness.[11]

Severity edit

A number of diagnostic tests, including the Epworth Sleepiness Scale, are available to help ascertain the seriousness and likely causes of abnormal somnolence.[12][13]

See also edit

References edit

  1. ^ Bereshpolova, Y.; Stoelzel, C. R.; Zhuang, J.; Amitai, Y.; Alonso, J.-M.; Swadlow, H. A. (2011). "Getting Drowsy? Alert/Nonalert Transitions and Visual Thalamocortical Network Dynamics". Journal of Neuroscience. 31 (48): 17480–7. doi:10.1523/JNEUROSCI.2262-11.2011. PMC 6623815. PMID 22131409.
  2. ^ a b "Drowsiness – Symptoms, Causes, Treatments". www.healthgrades.com. 26 June 2014. Retrieved 2015-10-31.
  3. ^ "Circadian Sleep Disorders Network". www.circadiansleepdisorders.org. Retrieved 2015-11-02.
  4. ^ Mullington, Janet; Korth, Carsten; Hermann, Dirk M.; Orth, Armin; Galanos, Chris; Holsboer, Florian; Pollmächer, Thomas (2000). "Dose-dependent effects of endotoxin on human sleep". American Journal of Physiology. Regulatory, Integrative and Comparative Physiology. 278 (4): R947–55. doi:10.1152/ajpregu.2000.278.4.r947. PMID 10749783. S2CID 10272455.
  5. ^ Hart, Benjamin L. (1988). "Biological basis of the behavior of sick animals". Neuroscience & Biobehavioral Reviews. 12 (2): 123–37. doi:10.1016/S0149-7634(88)80004-6. PMID 3050629. S2CID 17797005.
  6. ^ Kelley, Keith W.; Bluthé, Rose-Marie; Dantzer, Robert; Zhou, Jian-Hua; Shen, Wen-Hong; Johnson, Rodney W.; Broussard, Suzanne R. (2003). "Cytokine-induced sickness behavior". Brain, Behavior, and Immunity. 17 (1): 112–118. doi:10.1016/S0889-1591(02)00077-6. PMID 12615196. S2CID 25400611.
  7. ^ "Drowsiness: MedlinePlus Medical Encyclopedia". www.nlm.nih.gov. Retrieved 2015-10-31.
  8. ^ Zimmermann, C.; Pfeiffer, H. (2007). "Schlafstörungen bei Depression". Der Nervenarzt. 78 (1): 21–30. doi:10.1007/s00115-006-2111-1. PMID 16832696.
  9. ^ Watanabe, Norio; Omori, Ichiro M; Nakagawa, Atsuo; Cipriani, Andrea; Barbui, Corrado; Churchill, Rachel; Furukawa, Toshi A (2011). "Mirtazapine versus other antidepressive agents for depression". Cochrane Database of Systematic Reviews (12): CD006528. doi:10.1002/14651858.CD006528.pub2. PMC 4158430. PMID 22161405.
  10. ^ Kushida, Clete A.; Sullivan, Shannon S. (2008-10-01). "Multiple Sleep Latency Test and Maintenance of Wakefulness Test". Chest. 134 (4): 854–861. doi:10.1378/chest.08-0822. ISSN 0012-3692. PMID 18842919.
  11. ^ Roehrs, Timothy; Carskadon, Mary A.; Dement, William C.; Roth, Thomas (2017), "Daytime Sleepiness and Alertness", Principles and Practice of Sleep Medicine, Elsevier, pp. 39–48.e4, doi:10.1016/b978-0-323-24288-2.00004-0, ISBN 9780323242882
  12. ^ Carskadon, M.A.; Dement, W.C.; Mitler, M.M.; Roth, T.; Westbrook, P.R.; Keenan, S. Guidelines for the Multiple Sleep Latency Test (MSLT): a standard measure of sleepiness. Sleep 1986; 9:519–524
  13. ^ Johns, MW (March 2000). "Sensitivity and specificity of the multiple sleep latency test (MSLT), the maintenance of wakefulness test and the epworth sleepiness scale: failure of the MSLT as a gold standard". Journal of Sleep Research. 9 (1): 5–11. doi:10.1046/j.1365-2869.2000.00177.x. PMID 10733683.

External links edit

February 16, 2024
somnolence, alternatively, sleepiness, drowsiness, state, strong, desire, sleep, sleeping, unusually, long, periods, compare, hypersomnia, distinct, meanings, causes, refer, usual, state, preceding, falling, asleep, condition, being, drowsy, state, circadian, . Somnolence alternatively sleepiness or drowsiness is a state of strong desire for sleep or sleeping for unusually long periods compare hypersomnia It has distinct meanings and causes It can refer to the usual state preceding falling asleep 1 the condition of being in a drowsy state due to circadian rhythm disorders or a symptom of other health problems It can be accompanied by lethargy weakness and lack of mental agility 2 SomnolenceOther namesSleepiness drowsinessSpecialtyPsychiatrySomnolence is often viewed as a symptom rather than a disorder by itself However the concept of somnolence recurring at certain times for certain reasons constitutes various disorders such as excessive daytime sleepiness shift work sleep disorder and others and there are medical codes for somnolence as viewed as a disorder Sleepiness can be dangerous when performing tasks that require constant concentration such as driving a vehicle When a person is sufficiently fatigued microsleeps may be experienced In individuals deprived of sleep somnolence may spontaneously dissipate for short periods of time this phenomenon is the second wind and results from the normal cycling of the circadian rhythm interfering with the processes the body carries out to prepare itself to rest The word somnolence is derived from the Latin somnus meaning sleep Contents 1 Causes 1 1 Circadian rhythm disorders 1 2 Physical illness 1 3 Medicine 2 Assessment 3 Severity 4 See also 5 References 6 External linksCauses edit nbsp Some features of the human circadian 24 hour biological clock Click to enlargeCircadian rhythm disorders edit Main article Circadian rhythm sleep disorder Circadian rhythm biological clock disorders are a common cause of drowsiness as are a number of other conditions such as sleep apnea insomnia and narcolepsy 2 The body clock disorders are classified as extrinsic externally caused or intrinsic The former type is for example shift work sleep disorder which affects people who work nights or rotating shifts The intrinsic types include 3 Advanced sleep phase disorder ASPD A condition in which patients feel very sleepy and go to bed early in the evening and wake up very early in the morning Delayed sleep phase disorder DSPD Faulty timing of sleep peak period of alertness the core body temperature rhythm hormonal and other daily cycles such that they occur a number of hours late compared to the norm often misdiagnosed as insomnia Non 24 hour sleep wake disorder A faulty body clock and sleep wake cycle that usually is longer than rarely shorter than the normal 24 hour period causing complaints of insomnia and excessive sleepiness Irregular sleep wake rhythm Numerous naps throughout the 24 hour period no main nighttime sleep episode and irregularity from day to dayPhysical illness edit Sleepiness can also be a response to infection 4 Such somnolence is one of several sickness behaviors or reactions to infection that some theorize evolved to promote recovery by conserving energy while the body fights the infection using fever and other means 5 6 Other causes include 7 Anxiety Brain tumor Chronic pains Concussion a mild traumatic brain injury Diabetes Fibromyalgia Head injury Hypercalcemia too much calcium in the blood Hypermagnesemia Hyponatremia low blood sodium Hypothyroidism the body doesn t produce enough hormones that control how cells use energy Meningitis Mood disorders depression Multiple sclerosis Narcolepsy disorder of the nervous system Skull fractures Sleeping sickness caused by a specific parasite StressMedicine edit This section needs additional citations for verification Please help improve this article by adding citations to reliable sources in this section Unsourced material may be challenged and removed Find sources Somnolence news newspapers books scholar JSTOR November 2019 Learn how and when to remove this template message Analgesics mostly prescribed or illicit opiates such as OxyContin or heroin Anticonvulsants antiepileptics such as phenytoin Dilantin carbamazepine Tegretol Pregabalin Lyrica and Gabapentin Neurontin Antidepressants for instance sedating tricyclic antidepressants 8 Amitriptyline and mirtazapine Somnolence is less common with SSRIs 9 and SNRIs as well as MAOIs Antihistamines for instance diphenhydramine Benadryl Nytol doxylamine Unisom 2 hydroxyzine Atarax and promethazine Phenergan Antipsychotics for example Lurasidone Latuda thioridazine quetiapine Seroquel olanzapine Zyprexa risperidone and ziprasidone Geodon but not haloperidol Dopamine agonists used in the treatment of Parkinson s disease e g pergolide ropinirole and pramipexole HIV medications such as efavirenz Hypertension medications such as amlodipine Hypnotics or soporific drugs commonly known as sleeping pills Tranquilizers such as zopiclone Zimovane or the benzodiazepines such as diazepam Valium or nitrazepam Mogadon and the barbiturates such as amobarbital Amytal or secobarbital Seconal Other agents impacting the central nervous system in sufficient or toxic dosesAssessment editQuantifying sleepiness requires a careful assessment The diagnosis depends on two factors namely chronicity and reversibility Chronicity signifies that the patient unlike healthy people experiences persistent sleepiness which does not pass Reversibility stands for the fact that even if the individual goes to sleep the sleepiness may not be completely gone after waking up The problem with the assessment is that patients may only report the consequences of sleepiness loss of energy fatigue weariness difficulty remembering or concentrating etc It is crucial to aim for objective measures to quantify the sleepiness A good measurement tool is the multiple sleep latency test MSLT It assesses the sleep onset latency during the course of one day often from 8 00 to 16 00 10 An average sleep onset latency of less than 5 minutes is an indication of pathological sleepiness 11 Severity editA number of diagnostic tests including the Epworth Sleepiness Scale are available to help ascertain the seriousness and likely causes of abnormal somnolence 12 13 See also edit nbsp The dictionary definition of drowsiness at Wiktionary Chronic fatigue syndrome Decision fatigue Fibromyalgia Insomnia Hypersomnia Dyssomnia Fatigue Narcolepsy Postprandial somnolence Restless legs syndrome Periodic limb movement disorder Hypnopompic Hypnagogia Sleep apneaReferences edit Bereshpolova Y Stoelzel C R Zhuang J Amitai Y Alonso J M Swadlow H A 2011 Getting Drowsy Alert Nonalert Transitions and Visual Thalamocortical Network Dynamics Journal of Neuroscience 31 48 17480 7 doi 10 1523 JNEUROSCI 2262 11 2011 PMC 6623815 PMID 22131409 a b Drowsiness Symptoms Causes Treatments www healthgrades com 26 June 2014 Retrieved 2015 10 31 Circadian Sleep Disorders Network www circadiansleepdisorders org Retrieved 2015 11 02 Mullington Janet Korth Carsten Hermann Dirk M Orth Armin Galanos Chris Holsboer Florian Pollmacher Thomas 2000 Dose dependent effects of endotoxin on human sleep American Journal of Physiology Regulatory Integrative and Comparative Physiology 278 4 R947 55 doi 10 1152 ajpregu 2000 278 4 r947 PMID 10749783 S2CID 10272455 Hart Benjamin L 1988 Biological basis of the behavior of sick animals Neuroscience amp Biobehavioral Reviews 12 2 123 37 doi 10 1016 S0149 7634 88 80004 6 PMID 3050629 S2CID 17797005 Kelley Keith W Bluthe Rose Marie Dantzer Robert Zhou Jian Hua Shen Wen Hong Johnson Rodney W Broussard Suzanne R 2003 Cytokine induced sickness behavior Brain Behavior and Immunity 17 1 112 118 doi 10 1016 S0889 1591 02 00077 6 PMID 12615196 S2CID 25400611 Drowsiness MedlinePlus Medical Encyclopedia www nlm nih gov Retrieved 2015 10 31 Zimmermann C Pfeiffer H 2007 Schlafstorungen bei Depression Der Nervenarzt 78 1 21 30 doi 10 1007 s00115 006 2111 1 PMID 16832696 Watanabe Norio Omori Ichiro M Nakagawa Atsuo Cipriani Andrea Barbui Corrado Churchill Rachel Furukawa Toshi A 2011 Mirtazapine versus other antidepressive agents for depression Cochrane Database of Systematic Reviews 12 CD006528 doi 10 1002 14651858 CD006528 pub2 PMC 4158430 PMID 22161405 Kushida Clete A Sullivan Shannon S 2008 10 01 Multiple Sleep Latency Test and Maintenance of Wakefulness Test Chest 134 4 854 861 doi 10 1378 chest 08 0822 ISSN 0012 3692 PMID 18842919 Roehrs Timothy Carskadon Mary A Dement William C Roth Thomas 2017 Daytime Sleepiness and Alertness Principles and Practice of Sleep Medicine Elsevier pp 39 48 e4 doi 10 1016 b978 0 323 24288 2 00004 0 ISBN 9780323242882 Carskadon M A Dement W C Mitler M M Roth T Westbrook P R Keenan S Guidelines for the Multiple Sleep Latency Test MSLT a standard measure of sleepiness Sleep 1986 9 519 524 Johns MW March 2000 Sensitivity and specificity of the multiple sleep latency test MSLT the maintenance of wakefulness test and the epworth sleepiness scale failure of the MSLT as a gold standard Journal of Sleep Research 9 1 5 11 doi 10 1046 j 1365 2869 2000 00177 x PMID 10733683 External links edit Retrieved from https en wikipedia org w index php title Somnolence amp oldid 1191990425, wikipedia, wiki, book, books, library,

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