What is Problem Sleepiness?

A person with problem sleepiness exhibits mild to severe impairment of their ability to generally function and perform daily tasks. This can range from poor school or work performance or an inability to concentrate and stay alert. Problem sleepiness can also result in life threatening accidents, such as in a car or work place. Patients suffering from problem sleepiness may complain of difficulty concentrating, fatigue, and emotional labilty. Problem sleepiness occurs when the quantity of sleep is inadequate due to primary sleep disorders, other medical conditions, or lifestyle factors.

Causes and Consequences of Problem Sleepiness

Causes
For all people, sleepiness is physiologically regulated by two primary processes:

1. The body's circadian rhythm causes an increase in sleepiness twice during a 24-hour period. (in general, between midnight and 7 a.m. and in the mid-afternoon between 1 p.m. and 4 p.m.)
2. The physiological need for sleep, which is increased by sleep loss and sleep disruption.

The need for sleep and the circadian rhythm interact to determine the level of sleepiness and alertness. People with disturbances of either of these sleep-regulating mechanisms can exhibit problem sleepiness, with the most common causes being primary sleep disorders, other medical conditions that disrupt sleep, drugs, and lifestyle.

Consequences

The following examples represent the potential hazards which can be contributed to problem sleepiness.

1. Automobile Crashes: The National Highway Traffic Safety Administration estimates that approximately 56,000 police-reported crashes per year result from drivers who were "asleep at the wheel." Individuals with untreated sleep disorders such as sleep apnea, narcolepsy, or insomnia have higher rates of automobile crashes than do other drivers. In a survey of drivers in New York state, approximately 25 percent reported they had fallen asleep at the wheel at some time. Fall-asleep crashes are especially common in young male drivers.
2. Adolescent Development and School Performance: In addition to placing young people at high risk for automobile crashes, problem sleepiness can impair learning, perceptual skills, and memory, which may lead to poor school performance and grades. In adolescents and young adults, mood, attention, and behavior deteriorate when they obtain inadequate sleep. These changes may interfere with a teenager's ability to cope with daily stressors.
3. Work-Related Accidents: Sleepiness in the workplace contributes significantly to performance errors and increases the risk of accidents. Sleepiness has contributed to serious incidents in industrial operations, nuclear power plants, and all modes of transportation.

[Excerpt taken from "Problem Sleepiness in Your Patient" by National Center on Sleep Disorders Research and Office of Prevention, Education and Control.]
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