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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.
Individuals with IH share common symptoms including excessive daytime sleepiness, sleep inertia, brain fog, and long sleep periods. [10] [11] [12]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.
Patients may complain of difficulty getting to sleep or staying asleep, intermittent wakefulness during the night, early morning awakening, or combinations of any of these. Transient episodes are usually of little significance. Stress, caffeine, physical discomfort, daytime napping, and early bedtimes are common factors.
Chronic kidney disease is commonly associated with sleep symptoms and excessive daytime sleepiness. 80% of those on dialysis have sleep disturbances. Sleep apnea can occur 10 times as often in uremic patients than in the general population and can affect up to 30-80% of patients on dialysis, though nighttime dialysis can improve this.
RLS is over 35% more prevalent in American women than their male counterparts. [80] Restless Leg Syndrome (RLS) is a sensorimotor disorder characterized by discomfort in the lower limbs. Typically, symptoms worsen in the evening, improve with movement, and exacerbate when at rest. [81]
Somnolence is often viewed as a symptom rather than a disorder by itself. However, the concept of somnolence recurring at certain times for certain reasons constitutes various disorders, such as excessive daytime sleepiness, shift work sleep disorder, and others; and there are medical codes for somnolence as viewed as a disorder.
A circadian rhythm is an entrainable, endogenous, biological activity that has a period of roughly twenty-four hours. This internal time-keeping mechanism is centralized in the suprachiasmatic nucleus (SCN) of humans, and allows for the internal physiological mechanisms underlying sleep and alertness to become synchronized to external environmental cues, like the light-dark cycle. [4]
Daytime sleepiness, low energy, irritability, sadness [2] Usual onset: More common with older age [3] Risk factors: Low iron levels, kidney failure, Parkinson's disease, diabetes mellitus, rheumatoid arthritis, pregnancy, certain medications [2] [4] [5] Diagnostic method: Based on symptoms after ruling out other possible causes [6] Treatment