Daytime sleepiness

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Daytime sleepiness in mean sleep research and sleep medicine "fall asleep", ie the tendency of the brain, from wakefulness to the sleep state to pass. It is characterized by reduced central nervous activation (alertness, sustained attention) with the urge to fall asleep. It is often the result of unrefreshing sleep .

Monotonous , i.e. low-stimulus situations promote actual falling asleep. The term “daytime sleepiness” must be differentiated from “ tiredness ” in the sense of too little sleep. In sleep medicine, a distinction is made between fatigue and drowsiness on the basis of several characteristics. For example, monotonous situations are not a sleep stimulus when you are tired, but they are when you are sleepy.

Diagnostics for daytime sleepiness

The apparatus diagnosis like coming to determine the severity of daytime sleepiness in sleep medicine instruments Multiple Sleep Latency Test (MSLT) and multiple wax Stay Test (MWT) and instruments of nichtapparativen diagnosis as Epworth Sleepiness Scale (ESS) and Stanford Sleepiness Scale (SSS) and many other questionnaires Commitment.

In addition to (MWT) and (MSLT), there is another method of measuring sleepiness: pupillography . The activity of the central sleep / wake regulator in the brain stem, the locus caeruleus , is measured. Its activity can be observed directly in the pupil. These so-called sleepiness waves have been known for 50 years and are standardized for the objective measurement of sleepiness.

Some methods collect subjective assessments from a current or retrospective point of view, while others measure the process of falling asleep in defined, low-stimulus situations using equipment. The procedures therefore take into account partial aspects of daytime sleepiness to a varying extent.

There are indications that patients with chronic daytime sleepiness lose the ability to accurately assess their current level of sleepiness.

Consequences of daytime sleepiness

While wakefulness, increased sleepiness, falling asleep, sleeping and waking up are controlled by the internal clock ( circadian rhythm ) repeat cyclically in the normal course , there are serious changes in sleep disorders.

With extreme daytime sleepiness , which is also referred to in the specialist literature as "Excessive Daytime Sleepiness" (EDS) and occurs as a symptom of various sleep disorders such as narcolepsy , idiopathic hypersomnia and sleep apnea syndrome , there is a constant risk of absent, delayed or incorrect sleep Reactions to rare, unexpected events and the possibility of sudden slipping into sleep (not just microsleep ) with the associated complete loss of control. The consequences can be accidents that endanger yourself and others.

This danger is not only abstract, but is confirmed by the traffic accident statistics, in which the cases are proportionally included along with other sleep-related accidents. For Germany, the ADAC states in its flyer on fatigue in road traffic that drivers who fell asleep were responsible for every fourth fatal car accident and at least every sixth serious traffic accident in which a truck was involved was caused by an overtired professional driver.

See also

Individual evidence

  1. Boris A. Stuck, Joachim T. Maurer, Michael Schredl, Hans-Günter Weeß: Practice of sleep medicine: sleep disorders in adults and children diagnostics, differential diagnostics and therapy . Springer-Verlag, 2013, ISBN 978-3-642-34881-5 , pp. 27 ( limited preview in Google Book search).
  2. S3 guideline for non-restful sleep / sleep disorders of the German Society for Sleep Research and Sleep Medicine (DGSM). In: AWMF online (as of 2009)
  3. Azmeh Shahid, Kate Wilkinson, Shai Marcu, Colin M. Shapiro: STOP, THAT and One Hundred Other Sleep Scales . Springer, New York 2012, ISBN 978-1-4419-9892-7 , doi : 10.1007 / 978-1-4419-9893-4 .
  4. ER Samuels and E. Szabadi: Functional neuroanatomy of the Noradrenergic Locus Coeuleus: Its Roles in the Regulation of Arousal and Autonomic Function Part II: Physiological and Pharmacological Manipulations and Pathological Alterations of Locus Coeruleus Activity in Humans . Current Neuropharmacology 254-285 (2) 2008.
  5. O. Löwenstein, R. Feinberg, I. Loewenfeld: Pupillary movements during acute and chronic fatigue. A new test for the objective evaluation of tiredness . Invest. Ophthal. 1963.
  6. Barbara Wilhelm et al .: Standard values ​​of the pupillographic sleepiness test for women and men between 20 and 60 years . Somnology 5: 115-120 2001.
  7. ^ Murray W. Johns: Daytime sleepiness, snoring, and obstructive sleep apnea. The Epworth Sleepiness Scale . In: Chest . Vol. 103, No. 1 , 1993, p. 30–36 , doi : 10.1378 / chest.103.1.30 (English).
  8. Lamia Afifi, Clete A. Kushida: Clinical Neurophysiology of Sleep Disorders . Ed .: Christian Guilleminault (=  Handbook of Clinical Neurophysiology ). Elsevier, New York 2005, ISBN 978-0-444-51517-9 , Multiple sleep latency test, pp. 51-57 .
  9. ADAC, Flyer Fatigue in Road Traffic ( Memento of the original from November 19, 2012 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. , PDF (508 kB), accessed on January 25, 2013 @1@ 2Template: Webachiv / IABot /