Drowsiness, why should it be taken seriously?

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Drowsiness or fatigue?

Drowsiness is defined as an intermediate state between wakefulness and sleep, which is characterized by falling asleep if the drowsy person is not stimulated.

It reveals a real need to sleep...

It is important to differentiate between drowsiness and fatigue, which results in a feeling of physical or moral weakening occurring after intense activity or sustained effort. It calls for rest, but not necessarily sleep. Thus, one can feel tired but have no desire to sleep!

This distinction between drowsiness and fatigue is essential, because the causes, consequences and treatments of these two symptoms, which are too often confused, can be completely opposite.

We speak of “hypersomnolence” when it occurs excessively and irreversibly and impacts and alters daily life. About 5% of the population would be affected…

Drowsiness and sleep disturbances

Causes and consequences

Daytime sleepiness, when it occurs regularly, is therefore not to be taken lightly. First, it has real consequences on the daily life and quality of life of people who suffer from it: permanent feeling of being badly awake, difficulty concentrating and thinking, lack of attention, increased risk of accidents...

Then she is often symptomatic of health problems and in particular of sleep.

The causes of abnormal drowsiness can be varied: too short nights, drug treatments (sedatives, anxiolytics, etc.), consumption of stimulants (alcohol, caffeine, etc.), but also various chronic psychological, neurological or endocrine diseases such as diabetes. . It can therefore reveal a whole host of sleep disorders such as insomnia, narcolepsy, restless leg syndrome… Or OSAS, sleep apnea and hypopnea syndrome.

Hyper drowsiness and sleep apnea

Sleep apnea causes breathing pauses during sleep and numerous micro-awakenings. The nights are then not very restful and this growing debt of sleep results in hypersomnolence during the day: 30 to 50% of patients with an apnea syndrome suffer from this phenomenon !

It is therefore necessary to look for this pathology when a patient complains of hypersomnolence, especially if it is accompanied by other symptoms such as a feeling of non-restorative sleep, headaches on waking, snoring, nocturnal suffocations, etc.

Because once OSAS (Obstructive Sleep Apnea Syndrome) has been treated, hypersomnolence decreases, or even disappears completely.

Persistent drowsiness

But in some cases, despite good therapeutic management, hypersomnolence persists... This "residual drowsiness" affects 12 to 18% of patients treated for OSAHS, and is most often explained by behavioral causes (sleep deprivation , consumption of toxic substances, etc.) or medical, whether they are directly linked to the apnea syndrome or to another sleep pathology.

Once these avenues have been explored and eliminated, there would still remain 6% of residual drowsiness, without identified causes. New therapies are currently being validated to treat these specific patients… Hope remains!

In any case, whether or not you suffer from sleep apnea, if you feel drowsy too often during the day, do not hesitate to talk to a healthcare professional about it… Because it is very often easy to get over it. rid !

Thank you to Doctor Kelly Guichard, psychiatrist and sleep doctor at the Bordeaux University Hospital (sleep clinic, CRMR Narcolepsies and rare hypersomnias), for his explanations on the subject.

(Photo credit: Antonio Diaz, via Can go)

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