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The neurophysiological basis of excessive daytime sleepiness: suggestions of an altered state of consciousness

  • P. K. Hitchcott
  • D. Menicucci
  • S. Frumento
  • A. Zaccaro
  • A. GemignaniEmail author
Sleep Breathing Physiology and Disorders • Review
  • 222 Downloads
Part of the following topical collections:
  1. Excessive Daytime Sleepiness

Abstract

Excessive daytime sleepiness (EDS) is characterized by difficulty staying awake during daytime, though additional features may be present. EDS is a significant problem for clinical and non-clinical populations, being associated with a range of negative outcomes that also represent a burden for society. Extreme EDS is associated with sleep disorders, most notably the central hypersomnias such as narcolepsy, Kleine-Levin syndrome, and idiopathic hypersomnia (IH). Although investigation of these conditions indicates that EDS results from diminished sleep quality, the underlying cause for this impairment remains uncertain. One possibility could be that previous research has been too narrow in scope with insufficient attention paid to non-sleep-related aspects. Here, we offer a broader perspective in which findings concerning the impact of EDS on cortical functioning are interpreted in relation to current understanding about the neural basis of consciousness. Alterations in the spatial distribution of cortical activity, in particular reduced connectivity of frontal cortex, suggest that EDS is associated with an altered state of consciousness.

Keywords

Sleep Hypersomnia Excessive daytime sleepiness Altered state of consciousness 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

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Authors and Affiliations

  1. 1.Department of Surgical, Medical and Molecular Pathology and Critical Care MedicineUniversity of PisaPisaItaly
  2. 2.National Research CouncilInstitute of Clinical PhysiologyPisaItaly
  3. 3.Azienda Ospedaliero-Universitaria PisanaPisaItaly

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