The disorder known as daytime sleepiness or fatigue is also called "excessive daytime sleepiness or ESD." It consists of the inability to sustain wakefulness with an uncontrollable desire to sleep, even with the awareness that this would be risky or not advisable.
The symptoms affect the entire daily life of these people; They cannot drive, nor can they stay awake in work meetings. They even find it difficult to hold conversations with people close to them or strangers.
What is daytime sleepiness or fatigue?
Daytime sleepiness or fatigue disorder is an alteration of the circadian rhythm, that is, the internal and external periods of the body whose function is to regulate the moments of a day, a month, a year and even a life. The altered cycle here is the sleep-wake cycle.
Patients with daytime sleepiness fall asleep anywhere, regardless of the type of activity they are doing. The time doesn't matter either, even if they woke up from sleeping all night less than an hour ago.
This desire, which is physiological and natural to rest the tissues and balance the internal environment, happens unexpectedly and involuntarily. It is about the excess of a basic need.
The study of sleep medicine has separated sleepiness into two variants: subjective and objective. Based on them, it is established that the desire to sleep, normal or pathological, responds to measurable cellular changes and a personality configuration that is very particular.
Subjective sleepiness
In subjective sleepiness, the need perceived by the person takes precedence. Sometimes a single yawn is enough to enter that state of tiredness that doesn't seem to be resolved any other way than by sleeping.
Also the loss of concentration, the eyelids falling below their level and the inability to solve usual tasks are indicative.
Objective drowsiness
Objective sleepiness is the propensity to fall asleep as such, and can be measured through instruments designed for that purpose. An electroencephalogram can detect it, as well as an oculogram. They are measurements of the electrical activity of tissues that reveal when the body requests rest.
What is daytime sleepiness or fatigue?
Drowsiness is a disorder that can interfere with carrying out daily tasks. It even increases the risk of accidents.
Causes of the disorder
The origins of daytime sleepiness or fatigue are varied. In general terms, we can distinguish two causal groups: primary and secondary.
Primary
Among the primary causes we have the following:
Narcolepsy: is a state of excessive sleepiness that appears as acute attacks of drowsiness.
Idiopathic hypersomnia: this is the name given to the appearance of the disease without finding another way to classify it. Its intimate mechanisms are not known and its characteristic sign is excessive difficulty in waking the person once they have fallen asleep.
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Secondary causes of daytime sleepiness or fatigue are pathologies that include, among their symptoms, excessive sleep, whether due to a hormonal imbalance, a change in oxygenation or an imbalance in heart rhythms. Some are the following:
Obstructive sleep apnea: These patients sleep poorly at night because not enough oxygen enters them. Because of this, they feel tired during the day.
Jet lag : this famous change in schedule due to a flight that crosses several countries is one of the heart rhythm disturbances. It is temporary, since after a few days or even hours, normal sleep returns.
Night worker syndrome: The tasks that involve performing at night affect the normal functioning of the body during the day. Night watchmen, for example, or nurses with rotating shifts, may experience drowsiness during some of their shifts.
Strokes: After a stroke, people can be left with neurological consequences, including excessive fatigue.
Meningitis and encephalitis: Inflammation of brain tissue or its compression could alter the functioning of the biological clock that is controlled from the region known as the "thalamus."
Psychiatric illnesses: Depression and anxiety, as major representatives of this group, cause sleep disturbances that include insomnia. These patients can spend entire nights without sleep, which in the short term leads to sleepiness during the day, in daily tasks.
Drowsiness can be a secondary symptom of other conditions such as sleep apnea.
How is daytime sleepiness or fatigue diagnosed?
Diagnosing the disorder is not always easy. Sometimes, when the symptoms are clear, there is not much doubt that the professional may have. However, the difficulty lies in finding the ultimate cause of excessive sleepiness, because depression is not the same as narcolepsy.
To refine the diagnosis, measuring instruments are used that are, above all, subjective. That is, the doctor and the patient complete questionnaires and scales that determine, broadly speaking, the severity of the condition.
Among the tests carried out by the professional is the observation of behavior, recording yawns, blinking frequency and possible forward head swings. In turn, it can be evaluated whether the patient is functional or not, measuring his response to stimuli and reflexes.
The affected person themselves have the option of filling out certain scales and questionnaires to help with the diagnosis. There are many of them, such as Stanford and Epworth.
As a last option, there are neurophysiology tests. Electrical activity is measured during some time of the day to find out if certain tissues tend to become drowsy physiologically, even if off-hours. Electroencephalograms, polysomnograms and evoked potentials are used.
Can this problem be treated?
Treatment of daytime sleepiness or fatigue is complicated. If its root cause is established, then the approach will aim to correct that. Let's take obstructive sleep apnea as an example, which will lead to the use of a night mask to improve oxygen intake during the night.
If the cause is primary, one of the few medications that exists for the purpose is modafinil. It is not an amphetamine, but its effect is similar, since it activates the body in general. However, strict control is imposed on its use due to the risk of dependency.
Finally, it is key that the doctor certifies the patient's ability to do or not do certain tasks. Some people cannot even drive their own vehicle because of the risk that entails. Certain changes must be applied to daily routines to reduce the consequences of this disorder.
PRONAPRESA
"Because prevention is better than cure"
