Somnolence (alternatively "sleepiness" or "drowsiness") is a state of strong desire for sleep, or sleeping for unusually long periods (cf. 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] 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. The word "somnolence" is derived from the Latin "somnus" meaning "sleep."
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
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][8]
Hypothyroidism – The body doesn't produce enough hormones that control how cells use energy
A number of diagnostic tests, including the Epworth Sleepiness Scale, are available to help ascertain the seriousness and likely causes of abnormal somnolence.[11][12]
Somnolence is a symptom, so the treatment will depend on its cause. If the cause is the behavior and life choices of the patient (like working long hours, smoking, mental state), it may help to get plenty of rest and get distractions. It’s also important to investigate what’s causing the problem, such as stress or anxiety, and take steps to reduce the feeling.[7]
^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 Physiology278 (4): R947–55. PMID10749783.
^Hart, Benjamin L. (1988). "Biological basis of the behavior of sick animals". Neuroscience & Biobehavioral Reviews12 (2): 123–37. doi:10.1016/S0149-7634(88)80004-6. PMID3050629.
^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 Immunity17 (1): 112–118. doi:10.1016/S0889-1591(02)00077-6. PMID12615196.
^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
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