Protocolo diagnóstico de la somnolencia diurna excesiva

Abstract

Excessive daytime sleepiness (EDS) is a common symptom that indicates the inability to remain alert during the day, an irresistible need to sleep, spontaneous daytime sleep, or prolonged nighttime sleep. EDS is a cause of functional impairment in the school, work, social, or family sphere as well as traffic accidents and cardiovascular risk. Therefore, it must be identified and treated. The most common cause of EDS is sleep deprivation. Other causes are toxic, drug, psychiatric disorders (depression), medical problems (obesity, hypothyroidism), primary sleep disorders (obstructive sleep apneas), or central hypersomnias (type 1 and 2 narcolepsy, idiopathic hypersomnia, or Kleine-Levin syndrome). With a detailed case history, it can be verified whether there is a known and treatable cause, although performing a sleep study is usually necessary to confirm the diagnosis. This document proposes an algorithm for an evaluation in the clinic, indications for additional tests in a sleep laboratory, and the management of these disorders.