Definition - Frequency - Clinical signs - Assessment / Management
It is a disorder that occurs in an individual who persistently does not obtain sufficient sleep time to allow for a normal level of wakefulness during the day. The individual engages in chronic, voluntary, insidious sleep deprivation without being aware of the risks involved.
Sleep deprivation has always existed, but it is clearly more prevalent today than ever before.
Socio-professional imperatives, the development of shift work and the feeling of not having enough time for oneself lead to chronic sleep insufficiency.
Thus, many otherwise healthy adults accumulate a sleep debt due to chronic sleep deprivation.
Sleep insufficiency syndrome is the cause of about 5-10% of consultations for excessive daytime sleepiness. It mainly concerns men of about 40 years of age, who are active or even hyperactive, with a high cultural level.
It is also found in shift workers and in people who frequently cross several time zones.
The main symptom is excessive, abnormal daytime sleepiness in the afternoon, early evening or after meals. These patients sleep, on average, 5-6 hours per night during the week and 9 hours at weekends.
Waking up in the morning is painful with a feeling of confusion like "sleep drunkenness".
There may be a marked decrease in daytime performance, especially for tasks requiring sustained attention and vigilance.
The disappearance of the symptoms in the event of the possibility of extended night-time sleep at weekends or during holidays reinforces the probability of this diagnosis.
Chronic sleep deprivation syndrome can also be accompanied by fatigue, muscle pain, anxiety or mood disorders, eating disorders, gastrointestinal disorders or even visual disturbances.
Assessment / Management
Assessment to be carried out
The diagnosis is purely clinical, it is even a diagnosis of interrogation.
Polysomnographic recording is rarely indicated. It would show a high sleep efficiency index (> 90%) and a short sleep latency (<10 minutes), signs of a sleep rebound. A morbid association is quite common, especially with sleep-disordered breathing, which may justify this recording.
Patient education and improved sleep hygiene are sufficient to compensate for the sleep debt.