ABC of sleep disorders. Daytime sleepiness.
Daytime sleepiness (hypersomnia) is a common and serious complaint, although it is less common than insomnia, and many hypersomniac patients are labelled dull, lazy, workshy, or stupid, and if they need treatment are considered to be drug addicts.
Abstract
"Damn the boy, he's fallen asleep again." (Dickens.) Daytime sleepiness (hypersomnia) is a common and serious complaint, although it is less common than insomnia. In a recent community survey in the United States (in Newhaven, Baltimore, St Louis, Durham, and Los Angeles) 102% ofthe sample at the time ofthe interview described insomnia, and 3-2% described hypersomnia. Those most affected were young and unemployed people. The complaint of excessive daytime sleepiness includes inappropriate and undesirable sleep during waking hours; reduced motor and cognitive performance; unavoidable napping; sometimes-but not always-an increase in total 24 hour sleep time; and occasionally states ofincomplete arousal with automatic behaviour and sleep drunkenness, slufted speech, impaired motor control, and difficulty in focusing. The disability caused by severe daytime sleepiness is comparable with that of severe epilepsy. Many hypersomniac patients are labelled dull, lazy, workshy, or stupid, and if they need treatment are considered to be drug addicts. They have considerable problems at school, work, and home. Daytime sleepiness is an important cause ofindustrial and road traffic accidents. Gaps of several years between the start ofsymptoms and the achievement of a definite diagnosis ofthe cause ofthe sleepiness are common.