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Glutamate, one of the most common neurochemicals in the brain, is an excitatory neurotransmitter involved in many aspects of brain function, including learning and memory. [86] Based upon animal models, exercise appears to normalize the excessive levels of glutamate neurotransmission into the nucleus accumbens that occurs in drug addiction. [21]
While fatigue is often prominent, it is "more than fatigue following a stressor". [6] Other symptoms that may occur during PEM include cognitive impairment, flu-like symptoms, pain, weakness, and trouble sleeping. [6] [4] Though typically cast as a worsening of existing symptoms, patients may experience some symptoms exclusively during PEM. [6]
Treatment of excessive daytime sleepiness (EDS) relies on identifying and treating the underlying disorder which may cure the person from the EDS. Drugs like modafinil , [ 22 ] armodafinil , [ 23 ] pitolisant [ 24 ] (Wakix), sodium oxybate (Xyrem) oral solution, have been approved as treatment for EDS symptoms in the United States.
In the brain, serotonin is a neurotransmitter and regulates arousal, behavior, sleep, and mood, among other things. [9] During prolonged exercise where central nervous system fatigue is present, serotonin levels in the brain are higher than normal physiological conditions; these higher levels can increase perceptions of effort and peripheral muscle fatigue. [9]
Hypersomnia is a pathological state characterized by a lack of alertness during the waking episodes of the day. [3] It is not to be confused with fatigue, which is a normal physiological state. [4] Daytime sleepiness appears most commonly during situations where little interaction is needed. [5]
During intense exercise, lactate has been estimated to provide a third of the brain's energy needs. [39] [42] There is evidence that the brain might, however, in spite of these alternative sources of energy, still suffer an energy crisis since IL-6 (a sign of metabolic stress) is released during exercise from the brain. [26] [34]
The combination of an inappropriate rapid heart rate response to exercise with heavy or rapid breathing is known as an exaggerated cardiorespiratory response to exercise. [3] Due to the confusion between muscle fatigue and muscle weakness, there have been instances of abnormal muscle fatigue being described as exercise-induced muscle weakness.
Excessive daytime sleepiness, characterized by persistent sleepiness throughout the day and often a general lack of energy, even during the day after apparently adequate or even prolonged nighttime sleep. People with EDS nap repeatedly throughout the day and have strong urges to sleep while driving, working, eating, or conversing with others. [13]