Somnolence
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| Somnolence | |
| ICD-10 | R40.0 |
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| ICD-9 | 780.09 |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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.
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).
Associated conditions
- sleep apnea
- sleep deprivation / insomnia
- advanced sleep phase syndrome
- narcolepsy
- clinical depression, especially seasonal affective disorder or SAD
- infectious mononucleosis (glandular fever)
- Paget's disease
- increased intracranial pressure for example due to brain tumors
- brain edema
- stroke
- traumatic brain injury
- Intracranial hemorrhage such as due to ruptured aneurysm
- hydrocephalus
- cerebral hypoxia
- encephalitis - (viral, bacterial or other agents)
- Lyme disease (borreliosis)
- hypothyroidism
- starvation
- hypothermia
- medications
- tranquilizers / hypnotics especially benzodiazepines such as temazepam (Restoril®) or nitrazepam (Mogadon®) and barbiturates such as amobarbital (Amytal®) or secobarbital (Seconal®)
- antidepressants - for instance sertraline and venlafaxine.
- antipsychotics - for example: thioridazine, quetiapine, and olanzapine (Zyprexa) but not haloperidol.
- analgesics - mostly prescribed or illicit opiates such as Oxycontin or heroin
- HIV medications - for example: Sustiva and medications containing efavirenz
- anticonvulsants / antiepileptic - such as phenytoin (Dilantin), carbamazepine (Tegretol), lamotrigine (Lamictal) (see article on Epilepsy.com)
- antihistamines - for instance diphenhydramine (Benadryl)
- hypertension medications such as Norvasc
- generally many other agents with impact on central nervous system in sufficient or toxic doses
- certain substances from plants, animals and fungi - from the wild or otherwise. Majority yet to be discovered (rain forest, oceans)
See also
Symptoms and signs: circulatory (R00–R03, 785) | |||||||
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| Cardiovascular |
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| Myeloid/blood |
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Symptoms and signs: respiratory system (R04–R07, 786) | |
|---|---|
| Hemorrhage | * Epistaxis |
| Abnormalities of breathing | ; Respiratory sounds: |
| Other | * Asphyxia |
| Chest, general | * Chest pain |
Symptoms and signs: skin and subcutaneous tissue (R20-R23, 782) | |
|---|---|
| Disturbances of skin sensation | Hypoesthesia - Paresthesia - Hyperesthesia |
| Other | Rash - Cyanosis - Pallor - Flushing - Petechia - Desquamation - Induration - Diaphoresis |
Symptoms and signs: nervous and musculoskeletal systems (R25-R29, 781) | |
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| Abnormal involuntary movements (see also movement disorders) | Tremor - Spasm - Fasciculation - Athetosis |
| Gait abnormality | Scissor gait - Antalgic gait - Cerebellar ataxia - Festinating gait - Pigeon gait - Propulsive gait - Steppage gait - Stomping gait - Spastic gait - Myopathic gait - Magnetic gait - Trendelenburg gait |
| Lack of coordination | Ataxia (Cerebellar ataxia, Sensory ataxia) - Dysmetria - Dysdiadochokinesia - Hypotonia |
| Other | Tetany - Meningism - Hyperreflexia - Opisthotonus - Abnormal posturing - Hemispatial neglect |
Symptoms and signs: urinary system (R30-R39, 788) | |
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| General | Renal colic - Dysuria - Vesical tenesmus - Urinary incontinence - Urinary retention - Oliguria - Polyuria - Nocturia - Extravasation of urine - Extrarenal uremia |
Symptoms and signs: cognition, perception, emotional state and behaviour (R40-R46, 780-781) | |
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| General | Anxiety - Somnolence - Coma - Amnesia (Anterograde amnesia, Retrograde amnesia) - Dizziness/Vertigo |
| Olfaction | Anosmia - Parosmia |
| Taste | Ageusia - Parageusia |
Symptoms and signs: Speech and voice (R47-R49, 784) | |
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| Aphasia/Dysphasia | Expressive aphasia - Receptive aphasia - Conduction aphasia |
| Other speech disturbances | Dysarthria - Schizophasia |
| Symbolic dysfunctions | Dyslexia - Alexia - Agnosia (Prosopagnosia) - Apraxia - Acalculia - Agraphia |
| Voice disturbances | Dysphonia - Aphonia |
Symptoms and signs: general (R50-R69, 780-789) | |
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| General | Fever (Hyperpyrexia) - Headache - Chronic pain - Malaise/Fatigue (Asthenia, Debility) - Fainting (Vasovagal syncope) - Febrile seizure - Shock (Cardiogenic shock) - Lymphadenopathy - Edema (Peripheral edema, Anasarca) - Hyperhidrosis (Sleep hyperhidrosis) - Delayed milestone - Failure to thrive - Short stature (Idiopathic) - food and fluid intake (Anorexia, Polydipsia, Polyphagia) - Cachexia - Xerostomia - Clubbing - Tenderness |
Symptoms and signs: Symptoms concerning nutrition, metabolism and development (R62–R64, 783) | |
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| Ingestion/Weight | |
| Growth | Delayed milestone • Failure to thrive • Short stature (e.g., Idiopathic) |
Articles on Sleep | |
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| Sleep Stages | Rapid eye movement sleep • Beta wave sleep • Gamma wave sleep • Non-rapid eye movement sleep • Slow-wave sleep • Theta wave sleep • Delta wave sleep |
| Sleep disorders | Sleep deprivation • Insomnia • Parasomnia • Sleepwalking • Sleeptalking • Night terror • Dyssomnia • Hypersomnia • Narcolepsy • Sleep apnea • Ondine's curse • Nocturnal myoclonus • Circadian rhythm sleep disorder • Nocturia • Automatic behavior • Sleeping sickness |
| Benign Phenomena | Dream • Nightmare • Exploding head syndrome • Lucid dream • False awakening • Sleep paralysis • Hypnagogia • Hypnic jerk • Nocturnal emission • Somnolence |
| Other Sleep-related Topics | Bed bug • Sleep and learning • Snoring • Jet lag • Sleep debt • Power nap • Polyphasic sleep • Siesta • Bedtime • Bedtime story |
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