Somnolence: Difference between revisions

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'''For patient information, click [[Somnolence (patient information)|here]]
__NOTOC__
 
{{Infobox_Disease |
{{Infobox_Disease |
   Name        = Somnolence |
   Name        = Somnolence |
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}}
}}
{{Search infobox}}
{{Search infobox}}
'''For patient information, click [[Somnolence (patient information)|here]]
{{CMG}} ; {{AE}} {{PB}}
{{CMG}} ; {{AE}} {{PB}}


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It is considered a lesser impairment of consciousness than [[stupor]] or [[coma]].
It is considered a lesser impairment of consciousness than [[stupor]] or [[coma]].


==Hypersomnia of Central Origin==
==Causes==
Hypersomnia of central origin is a disorder of severe sleepiness arising from CNS dysfunction of sleep–wake states.  It does not include OSA, circadian rhythm disorders.
 
* [[Narcolepsy]]
===Causes by Organ System===
* Idiopathic hypersomnia: If excessive daytime sleepiness exists without narcolepsy or other sleep disorders.
{|style="width:80%; height:100px" border="1"
* Recurrent hypersomnia: consists of menstrual-related hypersomnia and Kleine-Levin syndrome
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular'''
* Behaviorally induced insufficient sleep syndrome (Sleep Deprivation)
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No underlying causes
* Hypersomnia due to other conditions: 
|-
**Neurological disorders, including structural, vascular, traumatic, toxic, infectious, and metabolic encephalopathy. Especially when the brain-stem reticular formation or midline diencephalic structures are effected.
|bgcolor="LightSteelBlue"| '''Chemical/Poisoning'''
** [Neuromuscular disorders], [peripheral neuropathies], [myotonic dystrophy] lead to central or obstructive [sleep apnea], pain, or PLMD which in turn can cause somnolence
|bgcolor="Beige"| No underlying causes
**Sleepiness may occur with acute infectious illness, mediated by cytokines, including interferon, interleukins, and tumor necrosis factor
|-
**Psychiatric disorders, like depression, can cause  tiredness, fatigue, and lack of energy  and somnolence.<ref>{{Cite web  | last = | first = | title = http://www.dsm5.org/Pages/Default.aspx | url = http://www.dsm5.org/Pages/Default.aspx | publisher = | date = | accessdate = }}</ref>
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"| [[Aldesleukin]], [[Asenapine maleate]], [[Aminoglutethimide]], [[Amobarbital sodium]], [[Apomorphine hydrochloride]], [[Atropine]], [[bicisate dihydrochloride]],[[Butabarbital]], [[Butorphanol]], [[Carbinoxamine]], [[Clemastine]], [[Clobazam]], [[Cimetidine]], [[Cetirizine hydrochloride]], [[Chlordiazepoxide]],[[Clorazepate Dipotassium]],[[Clozapine]], [[Cycloserine]], [[Cyproheptadine hydrochloride]],  [[Cefaclor]], [[Desloratadine]], [[Desmopressin]], [[Dexchlorpheniramine]], [[Diphenhydramine]], [[Eslicarbazepine acetate]], [[Estazolam]], [[Ezogabine]], [[Felbamate]], [[Flavoxate]], [[Fluphenazine]], [[Flurazepam hydrochloride]], [[Fluvoxamine]], [[Fosphenytoin sodium]], [[Granisetron]], [[Glycopyrrolate]], [[Hydroxyzine]],[[Hydrocodone bitartrate and acetaminophen]], [[Ivermectin]], [[dextromethorphan hydrobromide]], [[Ethosuximide]], [[Loratadine]], [[Meropenem]], [[Mifepristone]], [[Meprobamate]],[[Mepenzolate bromide]], [[Metipranolol]], [[Mitomycin]], [[Mitotane]], [[Nabilone]], [[Nelarabine]], [[Oxazepam]], [[Pergolide]], [[Pentobarbital]], [[Phenobarbital]], [[Polymyxin B]], [[Praziquantel]], [[Pyrantel pamoate]], [[Pyridoxine hydrochloride]], [[Quazepam]], [[Ramelteon]], [[Rilpivirine]], [[riluzole]], [[Rotigotine]], [[Secobarbital sodium]], [[Sodium oxybate]], [[Sulfasalazine]],[[Suvorexant]], [[tasimelteon]],[[Terbutaline]], [[Thioridazine hydrochloride]], [[Thiothixene]], [[Trimethobenzamide]], [[Varenicline]], [[Zopiclone]]
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| No underlying causes
|-
|}


==Sleep Disorders==
===Causes in Alphabetical Order===
*Circadian Rhythm Sleep Disorder
{{columns-list|
** Delayed Sleep-Phase Type
* [[Apomorphine hydrochloride]]
** Jet Lag Type
* [[Butorphanol]]
** Shift Work Type
* [[Cimetidine]]
* Parasomnias
* [[Cycloserine]]
** Nightmare Disorder
* [[Cyproheptadine hydrochloride]]
* Dyssomnias
* [[Desloratadine]]
** Primary Insomnia
* [[Estazolam]]
**Breathing related sleep disorder
*[[Granisetron]]
**Restless legs syndrome
*[[Mifepristone]]
**Periodic Limb Movement Disorder<ref>{{Cite web  | last =  | first =  | title = http://www.dsm5.org/Pages/Default.aspx | url = http://www.dsm5.org/Pages/Default.aspx | publisher =  | date =  | accessdate = }}</ref>
*[[Nabilone]]
*[[Pyrantel pamoate]]
*[[Pergolide]]
*[[Ramelteon]]
*[[Rilpivirine]]
*[[Sodium oxybate]]
*[[Tasimelteon]]
*[[Terbutaline]]
*[[Thioridazine hydrochloride]]
}}


==Other Causes==
==Causes==
* Advanced sleep phase disorder
* [[Advanced sleep phase syndrome|Advanced sleep phase disorder]]
* [[African trypanosomiasis]] ("sleeping sickness")
* [[African trypanosomiasis]] ("sleeping sickness")
* [[Alice in Wonderland syndrome]]
* [[Alice in Wonderland syndrome]]
* [[Cerebral edema|brain edema]]
* [[Cerebral edema|Brain edema]]
* [[Cerebral hypoxia]]
* [[Cerebral hypoxia]]
* [[Chronic fatigue syndrome]]
* [[Chronic fatigue syndrome]]
* [[Clinical depression]], especially [[seasonal affective disorder]] (SAD)
* [[Clinical depression]], especially [[seasonal affective disorder]]
* [[Dehydration]]
* [[Dehydration]]
* [[Delayed sleep phase syndrome]]
* [[Delayed sleep phase syndrome]]
*[[Desmopressin]]
* [[Diabetic ketoacidosis]] as example, but not balanced diabetes mellitus
* [[Diabetic ketoacidosis]] as example, but not balanced diabetes mellitus
* Drug Side Effect- [[Bicisate dihydrochloride]],[[Brompheniramine maleate and Pseudoephedrine hydrochloride]], [[caspofungin acetate]], [[Clozapine]], [[Cyclobenzaprine]], [[Eletriptan]], [[Fesoterodine]], [[Ketorolac tromethamine]], [[Levetiracetam]], [[Loratadine]], [[Naproxen sodium]], [[Oxcarbazepine]], [[Prochlorperazine]], [[Progesterone]]
* [[Encephalitis]] – (viral, bacterial or other agents)
* [[Encephalitis]] – (viral, bacterial or other agents)
* [[Epilepsy]] – after seizure
* [[Epilepsy]]
* [[Fibromyalgia]]
* [[Fibromyalgia]]
* [[Hydrocephalus]]
* [[Hydrocephalus]]
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* [[Increased intracranial pressure]]; for example, [[brain tumors]]
* [[Increased intracranial pressure]]; for example, [[brain tumors]]
* [[Infectious mononucleosis]] (glandular fever)
* [[Infectious mononucleosis]] (glandular fever)
* [[Intracranial hemorrhage]] such as due to ruptured [[aneurysm]]
* [[Intracranial hemorrhage]] such as due to [[Aneurysm natural history, complications and prognosis#Complications|ruptured aneurysm]]
* [[Lyme disease]] (borreliosis)
* [[Lyme disease]]
* [[Medications]]
* [[Medications]]
** [[Analgesics]]: mostly prescribed or illicit [[opiates]] such as [[oxycontin]] or [[heroin]]
** [[Analgesics]]: mostly prescribed or illicit [[opiates]] such as [[oxycontin]] or [[heroin]]
** [[Antiepileptic]]s such as [[phenytoin]], [[carbamazepine]], [[gabapentin]]
** [[Antiepileptic]]s such as [[phenytoin]], [[carbamazepine]], [[gabapentin]], [[topiramate]]
** [[Antidepressants]]: for instance sedating [[tricyclic antidepressants]]<ref name="pmid16832696">{{cite journal |author=Zimmermann C, Pfeiffer H |title=[Sleep disorders in depression. Suggestions for a therapeutic approach] |language=German |journal=Nervenarzt |volume=78 |issue=1 |pages=21–30 |date=January 2007 |pmid=16832696 |doi=10.1007/s00115-006-2111-1 |url=}}</ref> and [[mirtazapine]].  Somnolence is less common with [[SSRI]]<ref name="pmid22161405">{{cite journal |author=Watanabe N, Omori IM, Nakagawa A, ''et al.'' |title=Mirtazapine versus other antidepressive agents for depression |journal=Cochrane Database Syst Rev |volume= |issue=12 |pages=CD006528 |year=2011 |pmid=22161405 |doi=10.1002/14651858.CD006528.pub2 |url=}}</ref> and [[SNRI]] as well as [[MAOI]].
** [[Antidepressants]]: for instance sedating [[tricyclic antidepressants]]<ref name="pmid16832696">{{cite journal |author=Zimmermann C, Pfeiffer H |title=[Sleep disorders in depression. Suggestions for a therapeutic approach] |language=German |journal=Nervenarzt |volume=78 |issue=1 |pages=21–30 |date=January 2007 |pmid=16832696 |doi=10.1007/s00115-006-2111-1 |url=}}</ref> and [[mirtazapine]].  Somnolence is less common with [[SSRI]]<ref name="pmid22161405">{{cite journal |author=Watanabe N, Omori IM, Nakagawa A, ''et al.'' |title=Mirtazapine versus other antidepressive agents for depression |journal=Cochrane Database Syst Rev |volume= |issue=12 |pages=CD006528 |year=2011 |pmid=22161405 |doi=10.1002/14651858.CD006528.pub2 |url=}}</ref> and [[SNRI]] as well as [[MAOI]].
** [[Antihistamines]]: [[diphenhydramine]] and [[doxylamine]]
** [[Antihistamines]]: [[diphenhydramine]], [[doxylamine]], [[Loratadine]] and [[Olopatadine]]
** [[Antipsychotics]]: [[thioridazine]], [[quetiapine]], [[olanzapine]], [[risperidone]], and [[ziprasidone]] but not [[haloperidol]]
** [[Antipsychotics]]: [[clozapine]], [[thioridazine]], [[quetiapine]], [[olanzapine]], [[risperidone]], and [[ziprasidone]] but not [[haloperidol]]
** [[Dopamine agonists]] used in the treatment of [[parkinson's disease]] e.g. [[pergolide]], ropinirole and [[pramipexole]].
** [[Dopamine agonists]] used in the treatment of [[parkinson's disease]] e.g. [[pergolide]], [[ropinirole]] and [[pramipexole]].
** [[HIV]] medications for example, [[efavirenz]]
** [[HIV]] medications for example, [[efavirenz]]
** [[Antihypertensive]] medications like [[amlodipine]]
** [[Antihypertensive]] medications like [[amlodipine]]
** [[Hypnotics]] like [[zopiclone]], or the [[benzodiazepine]] such as [[diazepam]] or [[nitrazepam]] and the [[barbiturate]], such as [[amobarbital]] or [[secobarbital]]
** [[Hypnotics]] like [[zopiclone]], or the [[benzodiazepine]] such as [[diazepam]] or [[nitrazepam]] and the [[barbiturate]], such as [[amobarbital]] or [[secobarbital]]
** Central nervous system agents like [[Carisoprodol]], [[Metaxalone]]
** Other agents impacting the [[central nervous system]] in sufficient or toxic doses
** Other agents impacting the [[central nervous system]] in sufficient or toxic doses
** [[Melatonin]]
**[[Spironolactone]]
* [[Sleep apnea]]
* [[Starvation]]
* [[Starvation]]
* [[Sleep apnea]]
* [[Stroke]]
* [[Stroke]]
* [[Traumatic brain injury]]
* [[Traumatic brain injury]]
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==See also==
==See also==
* [[Sleep Disorders]]
* [[Chronic fatigue syndrome]]
* [[Chronic fatigue syndrome]]
* [[Fibromyalgia]]
* [[Fibromyalgia]]
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==References==
==References==
{{Reflist}}
{{Reflist|2}}
 
{{Cognition, perception, emotional state and behaviour symptoms and signs}}
{{SleepSeries2}}


[[Category:Symptoms and signs: Cognition, perception, emotional state and behaviour]]
[[Category:Symptoms and signs: Cognition, perception, emotional state and behaviour]]
[[Category:Sleep]]
[[Category:Sleep]]
[[Category:Mental processes]]
[[Category:Mental processes]]
{{disease-stub}}
[[fr:Sommeil#Somnolence]]

Latest revision as of 22:54, 10 January 2020

Somnolence
ICD-10 R40.0
ICD-9 780.09

Template:Search infobox

For patient information, click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Pratik Bahekar, MBBS [2]

Overview

Somnolence (or "drowsiness") is a state of near-sleep, a strong desire for sleep, or sleeping for unusually long periods. It has two distinct meanings, referring both to the usual state preceding falling asleep, and the chronic condition referring to being in that state independent of a circadian rhythm. The disorder characterized by the latter condition is most commonly associated with users of prescription hypnotics, such as mirtazapine or zolpidem.

It is considered a lesser impairment of consciousness than stupor or coma.

Causes

Causes by Organ System

Cardiovascular No underlying causes
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect Aldesleukin, Asenapine maleate, Aminoglutethimide, Amobarbital sodium, Apomorphine hydrochloride, Atropine, bicisate dihydrochloride,Butabarbital, Butorphanol, Carbinoxamine, Clemastine, Clobazam, Cimetidine, Cetirizine hydrochloride, Chlordiazepoxide,Clorazepate Dipotassium,Clozapine, Cycloserine, Cyproheptadine hydrochloride, Cefaclor, Desloratadine, Desmopressin, Dexchlorpheniramine, Diphenhydramine, Eslicarbazepine acetate, Estazolam, Ezogabine, Felbamate, Flavoxate, Fluphenazine, Flurazepam hydrochloride, Fluvoxamine, Fosphenytoin sodium, Granisetron, Glycopyrrolate, Hydroxyzine,Hydrocodone bitartrate and acetaminophen, Ivermectin, dextromethorphan hydrobromide, Ethosuximide, Loratadine, Meropenem, Mifepristone, Meprobamate,Mepenzolate bromide, Metipranolol, Mitomycin, Mitotane, Nabilone, Nelarabine, Oxazepam, Pergolide, Pentobarbital, Phenobarbital, Polymyxin B, Praziquantel, Pyrantel pamoate, Pyridoxine hydrochloride, Quazepam, Ramelteon, Rilpivirine, riluzole, Rotigotine, Secobarbital sodium, Sodium oxybate, Sulfasalazine,Suvorexant, tasimelteon,Terbutaline, Thioridazine hydrochloride, Thiothixene, Trimethobenzamide, Varenicline, Zopiclone
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic No underlying causes
Hematologic No underlying causes
Iatrogenic No underlying causes
Infectious Disease No underlying causes
Musculoskeletal/Orthopedic No underlying causes
Neurologic No underlying causes
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic No underlying causes
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal/Electrolyte No underlying causes
Rheumatology/Immunology/Allergy No underlying causes
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order

Causes

Hazards

Somnolence can be dangerous when performing tasks that require constant concentration, such as driving a vehicle. When a person is sufficiently fatigued, he or she may experience microsleeps (loss of concentration).

See also

References

  1. ↑ Zimmermann C, Pfeiffer H (January 2007). "[Sleep disorders in depression. Suggestions for a therapeutic approach]". Nervenarzt (in German). 78 (1): 21–30. doi:10.1007/s00115-006-2111-1. PMID 16832696.
  2. ↑ Watanabe N, Omori IM, Nakagawa A; et al. (2011). "Mirtazapine versus other antidepressive agents for depression". Cochrane Database Syst Rev (12): CD006528. doi:10.1002/14651858.CD006528.pub2. PMID 22161405.
  3. ↑ "http://www.dsm5.org/Pages/Default.aspx". External link in |title= (help)
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