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14 Mounting evidence suggests that excessive sleepiness among healthcare professionals compromises both employee and patient safety. 9– 16 Men with excessive sleepiness have increased risk of a workplace injury, as compared with non-sleepy subjects. The diminished alertness, attention, and concentration associated with excessive sleepiness may cause substantial morbidity and mortality related to occupational injury and motor vehicle accidents. 8 Half of all respondents felt fatigued or not “up to par” during waking hours at least one day a week and 43 percent had missed work or made errors at work at least one day within the previous three months. In a 2005 National Sleep Foundation poll, 38 percent of adults reported being so sleepy during the day that it interfered with their daily activities at least a few days a month and 21 percent had this level of daytime sleepiness for at least a few days a week. The condition also affects overall wellbeing. 7 This figure may reflect the demands of a 24/7 global economy, in which people work longer hours at the workplace or at home-thanks to technological improvements and the internet. 4– 6 Furthermore, cross-sectional studies suggest that approximately five percent of the general adult population in the United States complain of excessive sleepiness. 3 Among patients with major depressive disorder (MDD), the prevalence of hypersomnia may be as high as 10 to 20 percent. 2 Excessive sleepiness commonly is seen in patients with psychiatric disorders, particularly affective disorders (e.g., depression, atypical depression, seasonal affective disorder) and psychosis (e.g., schizophrenia), and in patients taking certain psychiatric medications (e.g., benzodiazepines, tricyclic antidepressants).
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1 It is one of the most frequently reported symptoms associated with sleep deprivation or sleep disorders. Careful monitoring and follow-up of patients with excessive daytime sleepiness, including counseling and long-term support, are essential to ensure treatment compliance and to maintain improvements over time.Įxcessive sleepiness may interfere with the levels of alertness and wakefulness needed to perform tasks of daily living. In cases where sleep disorders are suspected, a comprehensive treatment program might include nonpharmacologic approaches, pharmacologic approaches, or both may need to be initiated to encompass the complexity of sleep disorder treatments. It is essential to recognize and treat the underlying cause of this disorder. Underdiagnosis and undertreatment of sleep disorders are common in community psychiatric practices because clinicians may not be aware of the different causes and consequences of excessive sleepiness. Although it is an established symptom of certain psychiatric illnesses, abnormal excessive sleepiness in psychiatric patients may be the result of a comorbid disorder of sleep or wakefulness.
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Excessive sleepiness may be the result of a number of extrinsic and intrinsic causes. The reductions in quality of life associated with excessive sleepiness may be substantial, involving compromised cognitive performance and work productivity as well as possible harm to the individual and the public. Excessive sleepiness occurs frequently in the general population and is a common feature of many psychiatric conditions.