From wakefulness to excessive sleepiness: What we know and still need to know

Abstract

The epidemiological study of hypersomnia symptoms is still in its infancy; most epidemiological surveys on this topic were published in the last decade. More than two dozen representative community studies can be found. These studies assessed two aspects of hypersomnia: excessive quantity of sleep and sleep propensity during wakefulness excessive daytime sleepiness. The prevalence of excessive quantity of sleep when referring to the subjective evaluation of sleep duration is around 4% of the population. Excessive daytime sleepiness has been mostly investigated in terms of frequency or severity; duration of the symptom has rarely been investigated. Excessive daytime sleepiness occurring at least 3 days per week has been reported in between 4% and 20.6% of the population, while severe excessive daytime sleepiness was reported at 5%. In most studies, men and women are equally affected. In the International Classification of Sleep Disorders, hypersomnia symptoms are the essential feature of three disorders: insufficient sleep syndrome, hypersomnia (idiopathic, recurrent or posttraumatic) and narcolepsy. Insufficient sleep syndrome and hypersomnia diagnoses are poorly documented. The co-occurrence of insufficient sleep and excessive daytime sleepiness has been explored in some studies and prevalence has been found in around 8% of the general population. However, these subjects often have other conditions such as insomnia, depression or sleep apnea. Therefore, the prevalence of insufficient sleep syndrome is more likely to be between 1% and 4% of the population. Idiopathic hypersomnia would be rare in the general population with prevalence, around 0.3%. Narcolepsy has been more extensively studied, with a prevalence around 0.045% in the general population. Genetic epidemiological studies of narcolepsy have shown that between 1.5% and 20.8% of narcoleptic individuals have at least one family member with the disease. The large variation is mostly due to the method used to collect the information on the family members; systematic investigation of all family members provided higher results. There is still a lot to be done in the epidemiological field of hypersomnia. Inconsistencies in its definition and measurement limit the generalization of the results. The use of a single question fails to capture the complexity of the symptom. The natural evolution of hypersomnia remains to be documented.

DSPS-4: a Brief Measure of Perceived Daytime Sleepiness

“…Despite its high prevalence in both community and clinical populations (Ohayon, 2008;Rohers, Carskadon, Dement, & Roth, 2011), no clear consensus exists as to what constitutes sleepiness (Shen et al, 2006;Young, 2004). Traditionally, it has been considered as the physiological tendency to fall asleep (i.e., sleep propensity).…”

Frequência de sonolência diurna e apneia obstrutiva do sono em pacientes submetidos à cirurgia cardíaca participantes de um Programa de Reabilitação Cardiorrespiratória

“…A SDE é frequentemente considerada como reflexo de um sono não reparador, que pode ser causado por distúrbios do sono, bem como pode acarretar a elevação dos níveis de cortisol, responsável pelo agravamento de doenças como hipertensão e diabetes (TEIXEIRA, 2006;BIXLER et al, 2005;BAKSHI, 2003;OHAYON, 2008;STEPANSKI et al, 2002). Além de a SDE ser um importante sintoma dos distúrbios do sono, sua quantificação é um importante método diagnóstico subjetivo que pode discriminar pacientes com distúrbios do sono e indivíduos sem esses distúrbios (FORBES, 1997).…”

Sleep problems, strengths and difficulties in elementary school children

“…The need for prevention and effective treatment instrument has to be emphasized [16][17][18]. It has been shown that daily information and sensation sleep are indispensable [19][20][21], typical signs of sleeplessness are missed and diagnose might be therefore deferred in the pediatric medicine [22][23][24]. Sleeplessness and sleep disturbance influence child's behavior, otherwise behavioral disturbance can influence sleep customs [25][26][27].…”