Toxic and metabolic causes of sleepiness

Fabio Cirignotta, Fabio Pizza

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Introduction According to the International Classification of Sleep Disorders (ICSD), excessive daytime sleepiness (EDS) due to toxic and metabolic factors is a hypersomnia that can be diagnosed when the subjective EDS complaint coexists with a “medical or neurological disorder”, and can be evaluated with nocturnal polysomnography possibly coupled with a multiple sleep latency test (MSLT) to exclude other sleep disturbances. Nevertheless, the ICSD states that most of the features of this nosographic category are “not applicable or not known” and that this area is “understudied”. We reviewed the current evidence available on EDS, looking for similarities and differences between different metabolic disturbances and for potential confounders such as daytime fatigue and sleep-disordered breathing (SDB). Infections and inflammatory response Clinical findings It is empirically known since antiquity that during sickness (particularly, infectious) otherwise normal subjects experience increased sleep pressure and daytime sleepiness, along with body temperature elevation and symptoms of malaise in the context of the immune-mediated host defense. EDS is therefore one of the prominent features of the so-called “sickness behavior”, a physiological adaptive response to infection documented in all animal species, that seems to change an individual's priorities to promote recovery following infection. Laboratory investigations and pathophysiological hypotheses EDS during inflammation and infection has been closely linked to the central role of cytokines, the humoral links between the immune and central nervous systems signaling the brain in health and disease.

Original languageEnglish
Title of host publicationSleepiness: Causes, Consequences and Treatment
PublisherCambridge University Press
Pages375-385
Number of pages11
ISBN (Print)9780511762697, 9780521198868
DOIs
Publication statusPublished - Jan 1 2011

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Poisons
Sleep
Infection
Disorders of Excessive Somnolence
Illness Behavior
Polysomnography
Sleep Apnea Syndromes
Nervous System Diseases
Body Temperature
Fatigue
Central Nervous System
Cytokines
Inflammation
Pressure
Health
Brain
Sleep Wake Disorders

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Cirignotta, F., & Pizza, F. (2011). Toxic and metabolic causes of sleepiness. In Sleepiness: Causes, Consequences and Treatment (pp. 375-385). Cambridge University Press. https://doi.org/10.1017/CBO9780511762697.035

Toxic and metabolic causes of sleepiness. / Cirignotta, Fabio; Pizza, Fabio.

Sleepiness: Causes, Consequences and Treatment. Cambridge University Press, 2011. p. 375-385.

Research output: Chapter in Book/Report/Conference proceedingChapter

Cirignotta, F & Pizza, F 2011, Toxic and metabolic causes of sleepiness. in Sleepiness: Causes, Consequences and Treatment. Cambridge University Press, pp. 375-385. https://doi.org/10.1017/CBO9780511762697.035
Cirignotta F, Pizza F. Toxic and metabolic causes of sleepiness. In Sleepiness: Causes, Consequences and Treatment. Cambridge University Press. 2011. p. 375-385 https://doi.org/10.1017/CBO9780511762697.035
Cirignotta, Fabio ; Pizza, Fabio. / Toxic and metabolic causes of sleepiness. Sleepiness: Causes, Consequences and Treatment. Cambridge University Press, 2011. pp. 375-385
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