Etiologies and sequelae of excessive daytime sleepiness

Etiologies and sequelae of excessive daytime sleepiness Excessive dynamic sleepiness (EDS), the primary complaint of patients seen in sleep clinics, affects up to 12% of the general population. The effects of EDS can be debilitating and even life threatening. Patients with EDS may exhibit psychosocial distress, decreased work or school performance, and increased risk for accidents. The differential diagnosis of EDS requires objective assessments, such as polysomnography and the Multiple Sleep Latency Test. There are four major causes of EDS: (1) central nervous system (CNS) pathologic abnormalities, such as narcolepsy and idiopathic CNS hypersomnia; (2) qualitative or quantitative sleep deficiencies, such as sleep apnea and insufficient nocturnal sleep; (3) misalignments of the body's circadian pacemaker with the environment (eg, jet lag or shift work); and (4) drugs, which can increase sleepiness either therapeutically or as a side effect. Depending on etiology, management strategies for EDS include extension of time in bed, naps, surgery, various medical devices (eg, oral appliances, continuous positive airway pressure), and pharmacotherapy. Pharmacotherapy is generally achieved with stimulants, such as amphetamine sulfate, methylphenidate, and pemoline or newer, safer compounds like modafinil. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Clinical Therapeutics Elsevier

Etiologies and sequelae of excessive daytime sleepiness

Clinical Therapeutics, Volume 18 (4) – Jul 1, 1996

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Publisher
Elsevier
Copyright
Copyright © 1996 Elsevier Ltd
ISSN
0149-2918
D.O.I.
10.1016/S0149-2918(96)80207-4
Publisher site
See Article on Publisher Site

Abstract

Excessive dynamic sleepiness (EDS), the primary complaint of patients seen in sleep clinics, affects up to 12% of the general population. The effects of EDS can be debilitating and even life threatening. Patients with EDS may exhibit psychosocial distress, decreased work or school performance, and increased risk for accidents. The differential diagnosis of EDS requires objective assessments, such as polysomnography and the Multiple Sleep Latency Test. There are four major causes of EDS: (1) central nervous system (CNS) pathologic abnormalities, such as narcolepsy and idiopathic CNS hypersomnia; (2) qualitative or quantitative sleep deficiencies, such as sleep apnea and insufficient nocturnal sleep; (3) misalignments of the body's circadian pacemaker with the environment (eg, jet lag or shift work); and (4) drugs, which can increase sleepiness either therapeutically or as a side effect. Depending on etiology, management strategies for EDS include extension of time in bed, naps, surgery, various medical devices (eg, oral appliances, continuous positive airway pressure), and pharmacotherapy. Pharmacotherapy is generally achieved with stimulants, such as amphetamine sulfate, methylphenidate, and pemoline or newer, safer compounds like modafinil.

Journal

Clinical TherapeuticsElsevier

Published: Jul 1, 1996

References

  • Sleep related vehicle accidents
    Horne, JA; Reyner, LA
  • Daytime sleepiness and alertness
    Roth, T; Roehrs, TA; Carskadon, MA; Dement, WC
  • Narcolepsy syndrome
    Guilleminault, C
  • Self-reported depressive symptomatology, mood ratings, and treatment outcome in sleep disorders patients
    Mosko, S; Zetin, M; Glen, S
  • Narcolepsy in children
    Navelet, Y; Anders, T; Guilleminault, C
  • Sleepiness and ethanol effects on simulated driving
    Roehrs, T; Beare, D; Zorick, F; Roth, T
  • Epidemiology of narcolepsy
    Hublin, C; Partinen, M; Kaprio, J
  • Modafinil, d-amphetamine and placebo during 64 hours of sustained mental work. I. Effects on mood, fatigue, cognitive performance and body temperature
    Pigeau, R; Naitoh, P; Buguet, A
  • Modafinil, d-amphetamine and placebo during 64 hours of sustained mental work. II. Effects on two nights of recovery sleep
    Buguet, A; Montmayeur, A; Pigeau, R; Naitoh, P

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