Lethargy wikipedia

Lethargy wikipedia DEFAULT

Somnolence

State of strong desire for sleep, or sleeping for unusually long periods

Medical condition

Somnolence (alternatively sleepiness or drowsiness) is a state of strong desire for sleep, or sleeping for unusually long periods (compare hypersomnia). It has distinct meanings and causes. It can refer to the usual state preceding falling asleep,[1] the condition of being in a drowsy state due to circadian rhythm disorders, or a symptom of other health problems. It can be accompanied by lethargy, weakness, and lack of mental agility.[2]

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.

Sleepiness can be dangerous when performing tasks that require constant concentration, such as driving a vehicle. When a person is sufficiently fatigued, microsleeps may be experienced. In individuals deprived of sleep, somnolence may spontaneously dissipate for short periods of time; this phenomenon is the second wind, and results from the normal cycling of the circadian rhythm interfering with the processes the body carries out to prepare itself to rest.

The word "somnolence" is derived from the Latin "somnus" meaning "sleep".

Causes[edit]

Some features of the human circadian (24-hour) biological clock. Click to enlarge

Circadian rhythm disorders[edit]

Main article: Circadian rhythm sleep disorder

Circadian rhythm ("biological clock") disorders are a common cause of drowsiness as are a number of other conditions such as sleep apnea, insomnia, and narcolepsy.[2] The body clock disorders are classified as extrinsic (externally caused) or intrinsic. The former type is, for example, shift work sleep disorder, which affects people who work nights or rotating shifts. The intrinsic types include:[3]

  • Advanced sleep phase disorder (ASPD) – A condition in which patients feel very sleepy and go to bed early in the evening and wake up very early in the morning
  • Delayed sleep phase disorder (DSPD) – Faulty timing of sleep, peak period of alertness, the core body temperature rhythm, hormonal and other daily cycles such that they occur a number of hours late compared to the norm, often misdiagnosed as insomnia
  • Non-24-hour sleep–wake disorder – A faulty body clock and sleep-wake cycle that usually is longer than (rarely shorter than) the normal 24-hour period causing complaints of insomnia and excessive sleepiness
  • Irregular sleep–wake rhythm – Numerous naps throughout the 24-hour period, no main nighttime sleep episode and irregularity from day to day

Physical illness[edit]

Sleepiness can also be a response to infection.[4] Such somnolence is one of several sickness behaviors or reactions to infection that some theorize evolved to promote recovery by conserving energy while the body fights the infection using fever and other means.[5][6] Other causes include:[7][8]

Medicine[edit]

  • Analgesics – mostly prescribed or illicit opiates such as OxyContin or heroin
  • Anticonvulsants / antiepileptics – such as phenytoin (Dilantin), carbamazepine (Tegretol), Lyrica (Pregabalin) and Gabapentin
  • Antidepressants – for instance sedating tricyclic antidepressants,[9] and mirtazapine. Somnolence is less common with SSRIs[10] and SNRIs as well as MAOIs.
  • Antihistamines – for instance, diphenhydramine (Benadryl, Nytol) and doxylamine (Unisom-2)
  • Antipsychotics – for example, thioridazine, quetiapine (Seroquel), olanzapine (Zyprexa), risperidone, and ziprasidone (Geodon) but not haloperidol
  • Dopamine agonists used in the treatment of Parkinson's disease – e.g. pergolide, ropinirole and pramipexole.
  • HIV medications – such as efavirenz
  • Hypertension medications – such as amlodipine
  • Hypnotics, or soporific drugs, commonly known as sleeping pills.
  • Tranquilizers – such as zopiclone (Zimovane), or the benzodiazepines such as diazepam (Valium) or nitrazepam (Mogadon) and the barbiturates, such as amobarbital (Amytal) or secobarbital (Seconal)
  • Other agents impacting the central nervous system in sufficient or toxic doses

Assessment[edit]

Quantifying sleepiness requires a careful assessment. The diagnosis depends on two factors, namely chronicity and reversibility. Chronicity signifies that the patient, unlike healthy people, experiences persistent sleepiness, which does not pass. Reversibility stands for the fact that even if the individual goes to sleep, the sleepiness may not be completely gone after waking up. The problem with the assessment is that patients may only report the consequences of sleepiness: loss of energy, fatigue, weariness, difficulty remembering or concentrating, etc. It is crucial to aim for objective measures to quantify the sleepiness. A good measurement tool is the multiple sleep latency test (MSLT). It assesses the sleep onset latency during the course of one day - often from 8:00 to 16:00.[11] An average sleep onset latency of less than 5 minutes is an indication of pathological sleepiness.[12]

Severity[edit]

A number of diagnostic tests, including the Epworth Sleepiness Scale, are available to help ascertain the seriousness and likely causes of abnormal somnolence.[13][14]

Treatment[edit]

Somnolence is a symptom, so the treatment will depend on its cause. If the cause is the behavior and life choices of the patient (like working long hours, smoking, mental state), it may help to get plenty of rest and get rid of distractions. It’s also important to investigate what’s causing the problem, such as stress or anxiety, and take steps to reduce the feeling.[7]

See also[edit]

References[edit]

  1. ^Bereshpolova, Y.; Stoelzel, C. R.; Zhuang, J.; Amitai, Y.; Alonso, J.-M.; Swadlow, H. A. (2011). "Getting Drowsy? Alert/Nonalert Transitions and Visual Thalamocortical Network Dynamics". Journal of Neuroscience. 31 (48): 17480–7. doi:10.1523/JNEUROSCI.2262-11.2011. PMC 6623815. PMID 22131409.
  2. ^ ab"Drowsiness – Symptoms, Causes, Treatments". www.healthgrades.com. Retrieved 2015-10-31.
  3. ^"Circadian Sleep Disorders Network". www.circadiansleepdisorders.org. Retrieved 2015-11-02.
  4. ^Mullington, Janet; Korth, Carsten; Hermann, Dirk M.; Orth, Armin; Galanos, Chris; Holsboer, Florian; Pollmächer, Thomas (2000). "Dose-dependent effects of endotoxin on human sleep". American Journal of Physiology. Regulatory, Integrative and Comparative Physiology. 278 (4): R947–55. doi:10.1152/ajpregu.2000.278.4.r947. PMID 10749783.
  5. ^Hart, Benjamin L. (1988). "Biological basis of the behavior of sick animals". Neuroscience & Biobehavioral Reviews. 12 (2): 123–37. doi:10.1016/S0149-7634(88)80004-6. PMID 3050629.
  6. ^Kelley, Keith W.; Bluthé, Rose-Marie; Dantzer, Robert; Zhou, Jian-Hua; Shen, Wen-Hong; Johnson, Rodney W.; Broussard, Suzanne R. (2003). "Cytokine-induced sickness behavior". Brain, Behavior, and Immunity. 17 (1): 112–118. doi:10.1016/S0889-1591(02)00077-6. PMID 12615196.
  7. ^ ab"Drowsiness: Causes, Treatments & Prevention". www.healthline.com. Retrieved 2015-10-31.
  8. ^"Drowsiness: MedlinePlus Medical Encyclopedia". www.nlm.nih.gov. Retrieved 2015-10-31.
  9. ^Zimmermann, C.; Pfeiffer, H. (2007). "Schlafstörungen bei Depression". Der Nervenarzt. 78 (1): 21–30. doi:10.1007/s00115-006-2111-1. PMID 16832696.
  10. ^Watanabe, Norio; Omori, Ichiro M; Nakagawa, Atsuo; Cipriani, Andrea; Barbui, Corrado; Churchill, Rachel; Furukawa, Toshi A (2011). "Mirtazapine versus other antidepressive agents for depression". Cochrane Database of Systematic Reviews (12): CD006528. doi:10.1002/14651858.CD006528.pub2. PMC 4158430. PMID 22161405.
  11. ^Kushida, Clete A.; Sullivan, Shannon S. (2008-10-01). "Multiple Sleep Latency Test and Maintenance of Wakefulness Test". Chest. 134 (4): 854–861. doi:10.1378/chest.08-0822. ISSN 0012-3692. PMID 18842919.
  12. ^Roehrs, Timothy; Carskadon, Mary A.; Dement, William C.; Roth, Thomas (2017), "Daytime Sleepiness and Alertness", Principles and Practice of Sleep Medicine, Elsevier, pp. 39–48.e4, doi:10.1016/b978-0-323-24288-2.00004-0, ISBN 
  13. ^Carskadon, M.A.; Dement, W.C.; Mitler, M.M.; Roth, T.; Westbrook, P.R.; Keenan, S. Guidelines for the Multiple Sleep Latency Test (MSLT): a standard measure of sleepiness. Sleep 1986; 9:519–524
  14. ^Johns, MW (March 2000). "Sensitivity and specificity of the multiple sleep latency test (MSLT), the maintenance of wakefulness test and the epworth sleepiness scale: failure of the MSLT as a gold standard". Journal of Sleep Research. 9 (1): 5–11. doi:10.1046/j.1365-2869.2000.00177.x. PMID 10733683. Archived from the original on 2012-12-10.

External links[edit]

Sours: https://en.wikipedia.org/wiki/Somnolence

Fatigue

Range of afflictions, usually associated with physical and/or mental weakness

This article is about the medical term. For other uses, see Fatigue (disambiguation).

Not to be confused with Muscle weakness.

Medical condition

Fatigue
Other namesExhaustion, weariness, tiredness, lethargy, languidness, languor, lassitude, listlessness, injuries
Moods, Ambassador William Foster, Under Secretary of State George Ball, President Lyndon B. Johnson, Secretary of... - NARA - 192609.tif
Long meetings can often be a source of exhaustion, as evidenced by Lyndon B. Johnson in this photograph.
SpecialtyInternal medicine, Family practice, Psychiatry, Psychology

Fatigue is a feeling of tiredness.[1] It may be sudden or gradual in onset. It is a normal phenomenon if it follows prolonged physical or mental activity, and resolves completely with rest. However, it may be a symptom of a medical condition if it is prolonged, severe, progressive, or occurs without provocation.

Physical fatigue is the transient inability of muscles to maintain optimal physical performance, and is made more severe by intense physical exercise.[2][3][4] Mental fatigue is a transient decrease in maximal cognitive performance resulting from prolonged periods of cognitive activity. Mental fatigue can manifest as somnolence, lethargy, or directed attention fatigue.[5]

Fatigue and 'feelings of fatigue' are sometimes confused.[6] Unlike weakness, fatigue can usually be alleviated by periods of rest.

Classification[edit]

See also: Central nervous system fatigue

Physical fatigue[edit]

Main article: Muscle fatigue

Physical fatigue, or muscle fatigue, is the temporary physical inability of muscles to perform optimally. The onset of muscle fatigue during physical activity is gradual, and depends upon an individual's level of physical fitness – other factors include sleep deprivation and overall health. Fatigue can be reversed by rest.[7] Physical fatigue can be caused by a lack of energy in the muscle, by a decrease of the efficiency of the neuromuscular junction or by a reduction of the drive originating from the central nervous system.[8] The central component of fatigue is triggered by an increase of the level of serotonin in the central nervous system.[9] During motor activity, serotonin released in synapses that contact motoneurons promotes muscle contraction.[10] During high level of motor activity, the amount of serotonin released increases and a spillover occurs. Serotonin binds to extrasynaptic receptors located on the axon initial segment of motoneurons with the result that nerve impulse initiation and thereby muscle contraction are inhibited.[11]

Muscle strength testing can be used to determine the presence of a neuromuscular disease, but cannot determine its cause. Additional testing, such as electromyography, can provide diagnostic information, but information gained from muscle strength testing alone is not enough to diagnose most neuromuscular disorders.[12]

People with multiple sclerosis experience a form of overwhelming lassitude or tiredness that can occur at any time of the day, for any duration, and that does not necessarily recur in a recognizable pattern for any given patient, referred to as "neurological fatigue".[13][14]

Mental fatigue[edit]

Mental fatigue is a temporary inability to maintain optimal cognitive performance. The onset of mental fatigue during any cognitive activity is gradual, and depends upon an individual's cognitive ability, and also upon other factors, such as sleep deprivation and overall health. Mental fatigue has also been shown to decrease physical performance.[5] It can manifest as somnolence, lethargy, directed attention fatigue, or disengagement. Research also suggests that mental fatigue is closely linked to the concept of ego depletion. For example, one pre-registered study of 686 participants found that after exerting mental effort, people are likely to disengage and become less interested in exerting further effort.[15] Decreased attention can also be described as a more or less decreased level of consciousness.[16] In any case, this can be dangerous when performing tasks that require constant concentration, such as operating large vehicles. For instance, a person who is sufficiently somnolent may experience microsleep. However, objective cognitive testing can be used to differentiate the neurocognitive deficits of brain disease from those attributable to tiredness.[citation needed]

The perception of mental fatigue is believed to be modulated by the brain's reticular activating system (RAS).[citation needed]

Fatigue impacts a driver's reaction time, awareness of hazards around them and their attention. Drowsy drivers are three times more likely to be involved in a car crash and if they are awake over 20 hours, is the equivalent of driving with a blood-alcohol concentration level of 0.08%.[17]

Causes[edit]

Normal[edit]

Fatigue is a normal result of working, mental stress, overstimulation and understimulation, jet lag, active recreation, boredom, and lack of sleep.

Multiple Sclerosis fatigue may include primary fatigue caused by processes of the disease, such as demyelination.[18][19][20]

Acute[edit]

Causes of acute fatigue include depression; chemical causes, such as dehydration, poisoning, low blood sugar, or mineral or vitamin deficiencies. Fatigue is different from drowsiness, where a patient feels that sleep is required.[citation needed]

Temporary fatigue is likely to be a minor illness like the common cold as one part of the sickness behavior response that happens when the immune system fights an infection.

Prolonged[edit]

Prolonged fatigue is a self-reported, persistent (constant) fatigue lasting at least one month.

Chronic[edit]

Chronic fatigue is a self-reported fatigue lasting at least six consecutive months. Chronic fatigue may be either persistent or relapsing.[21] Chronic fatigue is a symptom of many diseases and conditions. Some major categories of conditions that feature fatigue include:

  • Autoimmune diseases,[22] such as celiac disease, lupus, multiple sclerosis, myasthenia gravis, Sjögren's syndrome, and spondyloarthropathy
  • Blood disorders such as anemia and hemochromatosis
  • Cancer, in which case it is called cancer fatigue
  • Chronic fatigue syndrome (CFS)[23]
  • Substance use disorders including alcohol use disorder[23]
  • Depression and other mental disorders that feature depressed mood
  • Developmental disorders such as autism spectrum disorder[citation needed]
  • Eating disorders, which can produce fatigue due to inadequate nutrition
  • Endocrine diseases or metabolic disorders: diabetes mellitus, hypothyroidism and Addison’s disease[24]
  • Fibromyalgia
  • Gulf War syndrome
  • Heart failure
  • HIV
  • Idiopathic chronic fatigue (ICF), which is chronic fatigue with no known cause that does not meet chronic fatigue syndrome criteria[25][26]
  • Inborn errors of metabolism such as fructose malabsorption.[27][28]
  • Infectious diseases such as infectious mononucleosis or tuberculosis[24]
  • Irritable bowel syndrome
  • Kidney diseases e.g. acute renal failure, chronic renal failure[24]
  • Leukemia or lymphoma
  • Liver failure or liver diseases e.g. Hepatitis[24]
  • Lyme disease
  • Neurological disorders such as narcolepsy, Parkinson's disease, Postural Orthostatic Tachycardia Syndrome and post-concussion syndrome
  • Physical trauma and other pain-causing conditions, such as arthritis
  • Sleep deprivation or sleep disorders, e.g. sleep apnea[24]
  • Spring fever
  • Stroke
  • Thyroid disease such as hypothyroidism
  • Uremia, which is caused by kidney disease

Fatigue may also be a side effect of certain medications (e.g., lithium salts, ciprofloxacin); beta blockers, which can induce exercise intolerance; and many cancer treatments, particularly chemotherapy and radiotherapy.

Inflammation[edit]

Inflammation has been linked to many types of fatigue.[22] Findings implicate neuroinflammation in the etiology of fatigue in autoimmune and related disorders.[22]

Diagnosis[edit]

One study concluded about 50% of people who have fatigue receive a diagnosis that could explain the fatigue after a year with the condition. In those people who have a possible diagnosis, musculoskeletal (19.4%) and psychological problems (16.5%) are the most common. Definitive physical conditions were only found in 8.2% of cases.[29]

If a person with fatigue decides to seek medical advice, the overall goal is to identify and rule out any treatable conditions. This is done by considering the person's medical history, any other symptoms that are present, and evaluating of the qualities of the fatigue itself. The affected person may be able to identify patterns to the fatigue, such as being more tired at certain times of day, whether fatigue increases throughout the day, and whether fatigue is reduced after taking a nap.

Because disrupted sleep is a significant contributor to fatigue, a diagnostic evaluation considers the quality of sleep, the emotional state of the person, sleep pattern, and stress level. The amount of sleep, the hours that are set aside for sleep, and the number of times that a person awakens during the night are important. A sleep study may be ordered to rule out a sleep disorder.

Depression and other psychological conditions can produce fatigue, so people who report fatigue are routinely screened for these conditions, along with substance use disorders, poor diet, and lack of physical exercise, which paradoxically increases fatigue.

Basic medical tests may be performed to rule out common causes of fatigue. These include blood tests to check for infection or anemia, a urinalysis to look for signs of liver disease or diabetes mellitus, and other tests to check for kidney and liver function, such as a comprehensive metabolic panel.[30] Other tests may be chosen depending on the patient's social history, such as an HIV test or pregnancy test.

Comparison with sleepiness[edit]

Fatigue is generally considered a more long-term condition than sleepiness (somnolence).[31] Although sleepiness can be a symptom of a medical condition, it usually results from lack of restful sleep, or a lack of stimulation.[32] Chronic fatigue, on the other hand, is a symptom of a greater medical problem in most cases. It manifests in mental or physical weariness and inability to complete tasks at normal performance.[33] Both are often used interchangeably and even categorized under the description of 'being tired.' Fatigue is often described as an uncomfortable tiredness, whereas sleepiness is comfortable and inviting.

Measurement[edit]

Fatigue can be quantitatively measured. Devices to measure medical fatigue have been developed by Japanese companies, among them Nintendo (cancelled).[34] Nevertheless, such devices are not in common use outside Japan.

See also[edit]

References[edit]

  1. ^"Fatigue". MedlinePlus. Retrieved April 30, 2020.
  2. ^Gandevia SC (February 1992). "Some central and peripheral factors affecting human motoneuronal output in neuromuscular fatigue". Sports Medicine. 13 (2): 93–8. doi:10.2165/00007256-199213020-00004. PMID 1561512. S2CID 20473830.
  3. ^Hagberg M (July 1981). "Muscular endurance and surface electromyogram in isometric and dynamic exercise". Journal of Applied Physiology. 51 (1): 1–7. doi:10.1152/jappl.1981.51.1.1. PMID 7263402.
  4. ^Hawley JA, Reilly T (June 1997). "Fatigue revisited". Journal of Sports Sciences. 15 (3): 245–6. doi:10.1080/026404197367245. PMID 9232549.
  5. ^ abMarcora SM, Staiano W, Manning V (March 2009). "Mental fatigue impairs physical performance in humans". Journal of Applied Physiology. 106 (3): 857–64. CiteSeerX 10.1.1.557.3566. doi:10.1152/japplphysiol.91324.2008. PMID 19131473.
  6. ^Berrios GE (1990). "Feelings of fatigue and psychopathology: a conceptual history". Comprehensive Psychiatry. 31 (2): 140–51. doi:10.1016/0010-440X(90)90018-N. PMID 2178863.
  7. ^"Weakness and fatigue". Healthwise Inc. Retrieved 2 January 2013.
  8. ^Gandevia SC (October 2001). "Spinal and supraspinal factors in human muscle fatigue". Physiological Reviews. 81 (4): 1725–89. doi:10.1152/physrev.2001.81.4.1725. PMID 11581501.
  9. ^Davis JM, Alderson NL, Welsh RS (August 2000). "Serotonin and central nervous system fatigue: nutritional considerations"(PDF). The American Journal of Clinical Nutrition. 72 (2 Suppl): 573S–8S. doi:10.1093/ajcn/72.2.573S. PMID 10919962.
  10. ^Perrier JF, Delgado-Lezama R (August 2005). "Synaptic release of serotonin induced by stimulation of the raphe nucleus promotes plateau potentials in spinal motoneurons of the adult turtle". The Journal of Neuroscience. 25 (35): 7993–9. doi:10.1523/JNEUROSCI.1957-05.2005. PMC 6725458. PMID 16135756.
  11. ^Cotel F, Exley R, Cragg SJ, Perrier JF (March 2013). "Serotonin spillover onto the axon initial segment of motoneurons induces central fatigue by inhibiting action potential initiation"(PDF). Proceedings of the National Academy of Sciences of the United States of America. 110 (12): 4774–9. Bibcode:2013PNAS..110.4774C. doi:10.1073/pnas.1216150110. PMC 3607056. PMID 23487756.
  12. ^Enoka RM, Duchateau J (January 2008). "Muscle fatigue: what, why and how it influences muscle function". The Journal of Physiology. 586 (1): 11–23. doi:10.1113/jphysiol.2007.139477. PMC 2375565. PMID 17702815.
  13. ^Comi G, Leocani L, Rossi P, Colombo B (March 2001). "Physiopathology and treatment of fatigue in multiple sclerosis". Journal of Neurology. 248 (3): 174–9. doi:10.1007/s004150170222. PMID 11355149. S2CID 20769972.
  14. ^Mills RJ, Young CA, Pallant JF, Tennant A (February 2010). "Development of a patient reported outcome scale for fatigue in multiple sclerosis: The Neurological Fatigue Index (NFI-MS)". Health and Quality of Life Outcomes. 8: 22. doi:10.1186/1477-7525-8-22. PMC 2834659. PMID 20152031.
  15. ^Lin H, Saunders B, Friese M, Evans NJ, Inzlicht M (May 2020). "Strong Effort Manipulations Reduce Response Caution: A Preregistered Reinvention of the Ego-Depletion Paradigm". Psychological Science. 31 (5): 531–547. doi:10.1177/0956797620904990. PMC 7238509. PMID 32315259.
  16. ^Giannini AJ (1991). "Fatigue, Chronic". In Taylor RB (ed.). Difficult Diagnosis 2. Philadelphia: W.B. Saunders Co. p. 156. ISBN . OCLC 954530793.
  17. ^"Drowsy Driving is Impaired Driving". National Safety Council. Retrieved 31 January 2019.
  18. ^https://www.frontiersin.org/articles/10.3389/fneur.2015.00021/full
  19. ^https://www.mssociety.org.uk/about-ms/signs-and-symptoms/fatigue/causes-of-fatigue
  20. ^https://practicalneurology.com/articles/2018-july-aug/fatigue-in-patients-with-multiple-sclerosis
  21. ^Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A (December 1994). "The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group"(PDF). Annals of Internal Medicine. 121 (12): 953–9. doi:10.7326/0003-4819-121-12-199412150-00009. PMID 7978722. S2CID 510735.
  22. ^ abcZielinski MR, Systrom DM, Rose NR (August 2019). "Fatigue, Sleep, and Autoimmune and Related Disorders". Frontiers in Immunology. 10: 1827. doi:10.3389/fimmu.2019.01827. PMC 6691096. PMID 31447842. PMCID: PMC6691096 PMID 31447842
  23. ^ abAvellaneda Fernández A, Pérez Martín A, Izquierdo Martínez M, Arruti Bustillo M, Barbado Hernández FJ, de la Cruz Labrado J, et al. (October 2009). "Chronic fatigue syndrome: aetiology, diagnosis and treatment". BMC Psychiatry. 9 Suppl 1 (Suppl 1): S1. doi:10.1186/1471-244X-9-S1-S1. PMC 2766938. PMID 19857242.
  24. ^ abcdeFriedman HH (2001-01-01). Problem-oriented Medical Diagnosis. Lippincott Williams & Wilkins. pp. 4–5. ISBN .
  25. ^Arpino C, Carrieri MP, Valesini G, Pizzigallo E, Rovere P, Tirelli U, et al. (1999). "Idiopathic chronic fatigue and chronic fatigue syndrome: a comparison of two case-definitions". Annali dell'Istituto Superiore di Sanità. 35 (3): 435–41. PMID 10721210.
  26. ^Carrico AW, Jason LA, Witter E, Torres-Harding S (2004). "Disability in Chronic Fatigue Syndrome and Idiopathic Chronic Fatigue". Review of Disability Studies. 1 (1). ISSN 1552-9215.
  27. ^Whitehead WE, Palsson O, Jones KR (April 2002). "Systematic review of the comorbidity of irritable bowel syndrome with other disorders: what are the causes and implications?". Gastroenterology. 122 (4): 1140–56. doi:10.1053/gast.2002.32392. PMID 11910364.
  28. ^Gibson PR, Newnham E, Barrett JS, Shepherd SJ, Muir JG (February 2007). "Review article: fructose malabsorption and the bigger picture". Alimentary Pharmacology & Therapeutics. 25 (4): 349–63. doi:10.1111/j.1365-2036.2006.03186.x. PMID 17217453. S2CID 11487905.
  29. ^Nijrolder I, van der Windt D, de Vries H, van der Horst H (November 2009). "Diagnoses during follow-up of patients presenting with fatigue in primary care". CMAJ. 181 (10): 683–7. doi:10.1503/cmaj.090647. PMC 2774363. PMID 19858240.
  30. ^Davis CP (11 September 2017). Doerr S (ed.). "Fatigue". eMedicineHealth. Archived from the original on 7 March 2010.
  31. ^Shen J, Barbera J, Shapiro CM (February 2006). "Distinguishing sleepiness and fatigue: focus on definition and measurement". Sleep Medicine Reviews. 10 (1): 63–76. doi:10.1016/j.smrv.2005.05.004. PMID 16376590.
  32. ^Hoddes E, Zarcone V, Smythe H, Phillips R, Dement WC (July 1973). "Quantification of sleepiness: a new approach". Psychophysiology. 10 (4): 431–6. doi:10.1111/j.1469-8986.1973.tb00801.x. PMID 4719486.
  33. ^Mayou R (January 1999). "Chronic fatigue and its syndromes". BMJ. 318 (7176): 133A. doi:10.1136/bmj.318.7176.133a. PMC 1114599. PMID 9880310.
  34. ^"Nintendo's first health care device will be sleep and fatigue tracker". The Japan Times. Reuters. 30 October 2014. Retrieved 29 June 2017.

Further reading[edit]

Byung-Chul Han: Müdigkeitsgesellschaft. Matthes & Seitz, Berlin 2010, ISBN 978-3-88221-616-5. (Philosophical essay about fatigue as a sociological problem and symptom).

  • Danish edition: Træthedssamfundet. Møller, 2012, ISBN 9788799404377.
  • Dutch edition: De vermoeide samenleving. van gennep, 2012, ISBN 9789461640710.
  • Italian editions : La società della stanchezza. nottetempo, 2012, ISBN 978-88-7452-345-0.
  • Korean edition: 한병철 지음 | 김태환 옮김. Moonji, 2011, ISBN 9788932023960.
  • Spanish edition: La sociedad del cansancio. Herder Editorial, 2012, ISBN 978-84-254-2868-5.

External links[edit]

Wikiquote has quotations related to: Fatigue
Wikimedia Commons has media related to Fatigue.
Sours: https://en.wikipedia.org/wiki/Fatigue
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Lethargy theorem

In mathematics, a lethargy theorem is a statement about the distance of points in a metric space from members of a sequence of subspaces; one application in numerical analysis is to approximation theory, where such theorems quantify the difficulty of approximating general functions by functions of special form, such as polynomials. In more recent work, the convergence of a sequence of operators is studied: these operators generalise the projections of the earlier work.

Bernstein's lethargy theorem[edit]

Let V_{1}\subset V_{2}\subset \ldots be a strictly ascending sequence of finite-dimensional linear subspaces of a Banach spaceX, and let \epsilon _{1}\geq \epsilon _{2}\geq \ldots be a decreasing sequence of real numbers tending to zero. Then there exists a point x in X such that the distance of x to Vi is exactly \epsilon _{i}.

See also[edit]

References[edit]

Sours: https://en.wikipedia.org/wiki/Lethargy_theorem
Vlad and Nikita had a Fun playing with Mom and Snow in the winter playcenter!

Apathy

State of indifference, or the suppression of emotions

For other uses, see Apathy (disambiguation).

Mental state in terms of challenge level and skill level, according to Csikszentmihalyi's flowmodel.[1](Click on a fragment of the image to go to the appropriate article)

Apathy is a lack of feeling, emotion, interest, or concern about something. It is a state of indifference, or the suppression of emotions such as concern, excitement, motivation, or passion. An apathetic individual has an absence of interest in or concern about emotional, social, spiritual, philosophical, virtual, or physical life and the world. Apathy can also be defined as a person's lack of goal orientation.[2]

The apathetic may lack a sense of purpose, worth, or meaning in their life. People that suffer from severe apathy tend to have a lower quality of life and are at a higher risk for mortality and early institutionalization.[2] They may also exhibit insensibility or sluggishness. In positive psychology, apathy is described as a result of the individuals' feeling they do not possess the level of skill required to confront a challenge (i.e. "flow"). It may also be a result of perceiving no challenge at all (e.g. the challenge is irrelevant to them, or conversely, they have learned helplessness). Apathy is something that all people face in some capacity and is a natural response to disappointment, dejection, and stress. As a response, apathy is a way to forget about these negative feelings.[3] This type of common apathy is usually felt only in the short term, but sometimes it becomes a long-term or even lifelong state, often leading to deeper social and psychological issues. An extreme form of apathy may be someone being numb to different stressful life events such as losing a job.

Apathy should be distinguished from reduced affect display, which refers to reduced emotional expression but not necessarily reduced emotion.

Pathological apathy, characterized by extreme forms of apathy, is now known to occur in many different brain disorders,[4] including neurodegenerative conditions often associated with dementia such as Alzheimer's disease,[5] and psychiatric disorders such as schizophrenia.[6] Although many patients with pathological apathy also suffer from depression, several studies have shown that the two syndromes are dissociable: apathy can occur independently of depression and vice versa.[4]

Etymology[edit]

Although the word apathy was first used in 1594[7] and is derived from the Greekἀπάθεια (apatheia), from ἀπάθης (apathēs, "without feeling" from a- ("without, not") and pathos ("emotion")),[8] it is important not to confuse the two terms. Also meaning "absence of passion," "apathy" or "insensibility" in Greek, the term apatheia was used by the Stoics to signify a (desirable) state of indifference towards events and things which lie outside one's control (that is, according to their philosophy, all things exterior, one being only responsible for one's own representations and judgments).[9] In contrast to apathy, apatheia is considered a virtue, especially in Orthodox monasticism.[citation needed] In the Philokalia the word dispassion is used for apatheia, so as not to confuse it with apathy.[citation needed]

History and other views[edit]

Christians have historically condemned apathy as a deficiency of love and devotion to God and his works.[10] This interpretation of apathy is also referred to as Sloth and is listed among the Seven Deadly Sins. Clemens Alexandrinus used the term to draw to Christianity philosophers who aspired after virtue.

The modern concept of apathy became more well known after World War I, when it was one of the various forms of "shell shock". Soldiers who lived in the trenches amidst the bombing and machine gun fire, and who saw the battlefields strewn with dead and maimed comrades, developed a sense of disconnected numbness and indifference to normal social interaction when they returned from combat.

In 1950, US novelist John Dos Passos wrote: "Apathy is one of the characteristic responses of any living organism when it is subjected to stimuli too intense or too complicated to cope with. The cure for apathy is comprehension."

Technology[edit]

Apathy is a normal way for humans to cope with stress. Being able to "shrug off" disappointments is considered an important step in moving people forward and driving them to try other activities and achieve new goals. Coping seems to be one of the most important aspects of getting over a tragedy and an apathetic reaction may be expected. With the addition of the handheld device and the screen between people, apathy has also become a common occurrence on the net as users observe others being bullied, slandered, threatened or sent disturbing images. The bystander effect grows to an apathetic level as people lose interest in caring for others who are not in their "circle" and may even participate in their harassment.

Social origin[edit]

There may be other factors contributing to a person's apathy.

Apathy has been socially viewed as worse than things such as hate or anger. Not caring whatsoever, in the eyes of some, is even worse than having distaste for something. Author Leo Buscaglia is quoted as saying "I have a very strong feeling that the opposite of love is not hate-it's apathy. It's not giving a damn." Helen Keller stated that apathy is the "worst of them all" when it comes to the various evils in the world.[11] French social commentator and political thinker Charles de Montesquieu stated that "the tyranny of a prince in an oligarchy is not so dangerous to the public welfare as the apathy of a citizen in the democracy." As can be seen by these quotes and various others, the social implications of apathy are great. Many people believe that not caring at all can be worse for society than individuals who are overpowering or hateful.

In the school system[edit]

Apathy in students, especially those in high school, is a growing problem. It causes teachers to lower standards in order to try to engage their students. [12] Apathy in schools is most easily recognized by students being unmotivated or, quite commonly, being motivated by outside factors. For example, when asked about their motivation for doing well in school, fifty percent of students cited outside sources such as "college acceptance" or "good grades". On the contrary, only fourteen percent cited "gaining an understanding of content knowledge or learning subject material" as their motivation to do well in school. As a result of these outside sources, and not a genuine desire for knowledge, students often do the minimum amount of work necessary to get by in their classes.[citation needed] This then leads to average grades and test grades but no real grasping of knowledge.[citation needed] Many students cited that "assignments/content was irrelevant or meaningless" and that this was the cause of their apathetic attitudes toward their schooling. These apathetic attitudes lead to teacher and parent frustration.[13] Other causes of apathy in students include situations within their home life, media influences, peer influences, and school struggles and failures. Some of the signs for apathetic students include declining grades, skipping classes, routine illness, and behavioral changes both in school and at home.

Bystander[edit]

Also known as the bystander effect, bystander apathy occurs when, during an emergency, those standing by do nothing to help but instead stand by and watch. Sometimes this can be caused by one bystander observing other bystanders and imitating their behavior. If other people are not acting in a way that makes the situation seem like an emergency that needs attention, often other bystanders will act in the same way.[14] The diffusion to responsibility can also be to blame for bystander apathy. The more people that are around in emergency situations, the more likely individuals are to think that someone else will help so they do not need to. This theory was popularized by social psychologists in response to the 1964 Kitty Genovese murder. The murder took place in New York and the victim, Genovese, was stabbed to death as bystanders reportedly stood by and did nothing to stop the situation or even call the police.[14]Latane and Darley are the two psychologists who did research on this theory. They performed different experiments that placed people into situations where they had the opportunity to intervene or do nothing. The individuals in the experiment were either by themselves, with a stranger(s), with a friend, or with a confederate. The experiments ultimately led them to the conclusion that there are many social and situational factors that are behind whether a person will react in an emergency situation or simply remain apathetic to what is occurring.

Communication[edit]

Apathy is one psychological barrier to communication. An apathetic listener creates a communication barrier by not caring or paying attention to what they are being told. An apathetic speaker, on the other hand, tends to not relate information well and, in their lack of interest, may leave out key pieces of information that need to be communicated. Within groups, an apathetic communicator can be detrimental. Their lack of interest or passion can inhibit the other group members in what they are trying to accomplish. Within interpersonal communication, an apathetic listener can make the other feel that they are not cared for or about. Overall, apathy is a dangerous barrier to successful communication. Apathetic speakers and listeners are individuals that have no care for what they are trying to communicate, or what is being communicated to them.

Measurement of Apathy[edit]

Several different questionnaires and clinical interview instruments have been used to measure pathological apathy or, more recently, apathy in healthy people.

Apathy Evaluation Scale[edit]

Developed by Robert Marin in 1991, the Apathy Evaluation Scale (AES) was the first method developed to measure apathy in clinical populations. Centered around evaluation, the scale can either be self-informed or other-informed. The three versions of the test include self, informant such as a family member, and clinician. The scale is based around questionnaires that ask about topics including interest, motivation, socialization, and how the individual spends their time. The individual or informant answers on a scale of "not at all", "slightly", "somewhat" or "a lot". Each item on the evaluation is created with positive or negative syntax and deals with cognition, behavior, and emotion. Each item is then scored and, based on the score, the individual's level of apathy can be evaluated.[15]

Apathy Motivation Index[edit]

The Apathy Motivation Index (AMI) was developed to measure different dimensions of apathy in healthy people. Factor analysis identified three distinct axes of apathy: behavioural, social and emotional.[16] The AMI has since been used to examine apathy in patients with Parkinson's disease who, overall, showed evidence of behavioural and social apathy, but not emotional apathy.[17]

Dimensional Apathy Scale[edit]

The Dimensional Apathy Scale (DAS) is a multidimensional apathy instrument for measuring subtypes of apathy in different clinical populations and healthy adults. It was developed using factor analysis, quantifying Executive apathy (lack of motivation for planning, organising and attention), Emotional apathy (emotional indifference, neutrality, flatness or blunting) and Initiation apathy (lack of motivation for self-generation of thought/action). There is a self-rated version of the DAS[18] and an informant/carer-rated version of the DAS.[19] Further a clinical brief DAS has also been developed.[20] It has been validated for use in motor neurone disease, dementia and Parkinson's disease, showing to differentiate profiles of apathy subtypes between these conditions[21]

Medical aspects | Pathological apathy[edit]

Depression[edit]

Main article: Major depressive disorder

Mental health journalist and author John McManamy argues that although psychiatrists do not explicitly deal with the condition of apathy, it is a psychological problem for some depressed people, in which they get a sense that "nothing matters", the "lack of will to go on and the inability to care about the consequences".[22] He describes depressed people who "...cannot seem to make [themselves] do anything", who "can't complete anything", and who do not "feel any excitement about seeing loved ones".[22] He acknowledges that the Diagnostic and Statistical Manual of Mental Disorders does not discuss apathy.

In a Journal of Neuropsychiatry and Clinical Neurosciences article from 1991, Robert Marin, MD, claimed that pathological apathy occurs due to brain damage or neuropsychiatric illnesses such as Alzheimer's, Parkinson's, Huntington's disease, or stroke. Marin argues that apathy is a syndrome associated with many different brain disorders.[22] This has now been shown to be the case across a range of neurological and psychiatric conditions.[4]

A review article by Robert van Reekum, MD, et al. from the University of Toronto in the Journal of Neuropsychiatry (2005) claimed that an obvious relationship between depression and apathy exists in some populations.[23] However, although many patients with depression suffer from apathy, several studies have shown that apathy can occur independently of depression, and vice versa.[4]

Apathy can be associated with depression, a manifestation of negative disorders in schizophrenia, or a symptom of various somatic and neurological disorders.[24][4]

Alzheimer's disease[edit]

Depending upon how it has been measured, apathy affects 19–88% percent of individuals with Alzheimer's disease (mean prevalence of 49% across different studies).[5] It is a neuropsychiatric symptom associated with functional impairment. Brain imaging studies have demonstrated changes in the anterior cingulate cortex, orbitofrontal cortex, dorsolateral prefrontal cortex and ventral striatum in Alzheimer's patients with apathy.[25]Cholinesterase inhibitors, used as the first line of treatment for the cognitive symptoms associated with dementia, have also shown some modest benefit for behavior disturbances such as apathy.[26] The effects of donepezil, galantamine and rivastigmine have all been assessed but, overall, the findings have been inconsistent, and it is estimated that apathy in ~60% of Alzheimer's patients does not respond to treatment with these drugs.[5]Methylphenidate, a dopamine and noradrenaline reuptake blocker, has received increasing interest for the treatment of apathy. Management of apathetic symptoms using methylphenidate has shown promise in randomized placebo controlled trials of Alzheimer's patients.[27][28][29] A phase III multi-centered randomized placebo-controlled trial of methylphenidate for the treatment of apathy is currently underway and planned for completion in August 2020.[30]

Anxiety[edit]

While apathy and anxiety may appear to be separate, and different, states of being, there are many ways that severe anxiety can cause apathy. First, the emotional fatigue that so often accompanies severe anxiety leads to one's emotions being worn out, thus leading to apathy. Second, the low serotonin levels associated with anxiety often lead to less passion and interest in the activities in one's life which can be seen as apathy. Third, negative thinking and distractions associated with anxiety can ultimately lead to a decrease in one's overall happiness which can then lead to an apathetic outlook about one's life. Finally, the difficulty enjoying activities that individuals with anxiety often face can lead to them doing these activities much less often and can give them a sense of apathy about their lives. Even behavioral apathy may be found in individuals with anxiety in the form of them not wanting to make efforts to treat their anxiety.[31]

Other[edit]

Often, apathy is felt after witnessing horrific acts, such as the killing or maiming of people during a war, e.g. posttraumatic stress disorder. It is also known to be a distinct psychiatric syndrome[citation needed] that is associated with many conditions, some of which are: CADASIL syndrome, depression, Alzheimer's disease, Chagas disease, Creutzfeldt–Jakob disease, dementia (and dementias such as Alzheimer's disease, vascular dementia, and frontotemporal dementia), Korsakoff's syndrome, excessive vitamin D, hypothyroidism, hyperthyroidism, general fatigue, Huntington's disease, Pick's disease, progressive supranuclear palsy (PSP), brain damage, schizophrenia, schizoid personality disorder, bipolar disorder,[citation needed]autism spectrum disorders, ADHD, and others. Some medications and the heavy use of drugs such as opiates may bring apathy as a side effect.[32]

See also[edit]

Notes[edit]

  1. ^Csikszentmihalyi M (1997). Finding Flow: The Psychology of Engagement with Everyday Life (1st ed.). New York: Basic Books. p. 31. ISBN .
  2. ^ abFahed M, Steffens DC (May 2021). "Apathy: Neurobiology, Assessment and Treatment". Clinical Psychopharmacology and Neuroscience. 19 (2): 181–189. doi:10.9758/cpn.2021.19.2.181. PMC 8077060. PMID 33888648.
  3. ^Nall R (27 September 2019) [29 October 2013]. Legg TJ (ed.). "What You Should Know About Apathy". Healthline. Retrieved 1 October 2021.
  4. ^ abcdeHusain M, Roiser JP (August 2018). "Neuroscience of apathy and anhedonia: a transdiagnostic approach". Nature Reviews. Neuroscience. 19 (8): 470–484. doi:10.1038/s41583-018-0029-9. PMID 29946157. S2CID 49428707.
  5. ^ abcNobis L, Husain M (August 2018). "Apathy in Alzheimer's disease". Current Opinion in Behavioral Sciences. 22: 7–13. doi:10.1016/j.cobeha.2017.12.007. PMC 6095925. PMID 30123816.
  6. ^Bortolon C, Macgregor A, Capdevielle D, Raffard S (September 2018). "Apathy in schizophrenia: A review of neuropsychological and neuroanatomical studies". Neuropsychologia. 118 (Pt B): 22–33. doi:10.1016/j.neuropsychologia.2017.09.033. PMID 28966139. S2CID 13411386.
  7. ^"Apathy - Definition and More from the Free Merriam-Webster Dictionary". Merriam-webster.com. Retrieved 25 February 2014.
  8. ^"Henry George Liddell, Robert Scott, A Greek-English Lexicon, ἀπάθ-εια". Perseus.tufts.edu. Retrieved 25 February 2014.
  9. ^Fleming W (2006) [1857]. The vocabulary of philosophy, mental, moral, and metaphysical. Kessinger Publishing. p. 34. ISBN . and in hardcover (2007; ISBN 978-0-548-12371-3).
  10. ^"Greek Lexicon :: G543 (KJV)". V3.blueletterbible.org. Archived from the original on 2 October 2017. Retrieved 25 February 2014.
  11. ^Keller H (1994) [1927]. "Chapter 6". Light in My Darkness. West Chester, Pa.: Chrysalis Books. ISBN .
  12. ^Bishop JH (January 1989). "Perspective: Why the Apathy in American High Schools?". Educational Researcher. 18 (1): 6–42. doi:10.3102/0013189X018001006. ISSN 0013-189X. S2CID 145803015.
  13. ^Sanders J, Ticktin R. "Finding the Root Cause of Student Apathy". Pan.intrasun.tcnj.edu. Archived from the original on 24 March 2013. Retrieved 25 February 2014.
  14. ^ abLatané B, Darley JM (1969). "Bystanders "apathy"". American Scientist. 57 (2): 244–68. PMID 5797312. Archived from the original on 4 November 2013.
  15. ^"Apathy Evaluation Scale (Self rated)"(PDF). Dementia-assessment.com.au. Archived from the original(PDF) on 26 January 2014. Retrieved 25 February 2014.
  16. ^Ang YS, Lockwood P, Apps MA, Muhammed K, Husain M (2017). "Distinct Subtypes of Apathy Revealed by the Apathy Motivation Index". PloS One. 12 (1): e0169938. Bibcode:2017PLoSO..1269938A. doi:10.1371/journal.pone.0169938. PMC 5226790. PMID 28076387.
  17. ^Ang YS, Lockwood PL, Kienast A, Plant O, Drew D, Slavkova E, et al. (October 2018). "Differential impact of behavioral, social, and emotional apathy on Parkinson's disease". Annals of Clinical and Translational Neurology. 5 (10): 1286–1291. doi:10.1002/acn3.626. PMC 6186939. PMID 30349863.
  18. ^Radakovic R, Abrahams S (November 2014). "Developing a new apathy measurement scale: Dimensional Apathy Scale". Psychiatry Research. 219 (3): 658–63. doi:10.1016/j.psychres.2014.06.010. PMID 24972546. S2CID 16313833.
  19. ^Radakovic R, Stephenson L, Colville S, Swingler R, Chandran S, Abrahams S (June 2016). "Multidimensional apathy in ALS: validation of the Dimensional Apathy Scale". Journal of Neurology, Neurosurgery, and Psychiatry. 87 (6): 663–9. doi:10.1136/jnnp-2015-310772. PMID 26203157. S2CID 15540782.
  20. ^Radakovic R, Stephenson L, Colville S, Swingler R, Chandran S, Abrahams S (June 2016). "Multidimensional apathy in ALS: validation of the Dimensional Apathy Scale". Journal of Neurology, Neurosurgery, and Psychiatry. 87 (6): 663–9. doi:10.1080/13854046.2019.1621382. PMID 26203157. S2CID 173994534.
  21. ^Radakovic R, Abrahams S (2018). "Multidimensional apathy: evidence from neurodegenerative disease"(PDF). Current Opinion in Behavioral Sciences. 22: 42–49. doi:10.1016/j.cobeha.2017.12.022. S2CID 53173573.
  22. ^ abcMcManamy J. "Apathy Matters - Apathy and Depression: Psychiatry may not care about apathy, but that doesn't mean you shouldn't". Archived from the original on 20 August 2014.".[self-published source?]
  23. ^van Reekum R, Stuss DT, Ostrander L (February 2005). "Apathy: why care?". The Journal of Neuropsychiatry and Clinical Neurosciences. 17 (1): 7–19. doi:10.1176/jnp.17.1.7. PMID 15746478.
  24. ^Andersson S, Krogstad JM, Finset A (March 1999). "Apathy and depressed mood in acquired brain damage: relationship to lesion localization and psychophysiological reactivity". Psychological Medicine. 29 (2): 447–56. doi:10.1017/s0033291798008046. PMID 10218936.
  25. ^Le Heron C, Apps MA, Husain M (September 2018). "The anatomy of apathy: A neurocognitive framework for amotivated behaviour". Neuropsychologia. 118 (Pt B): 54–67. doi:10.1016/j.neuropsychologia.2017.07.003. PMC 6200857. PMID 28689673.
  26. ^Malloy PF (2 November 2005). "Apathy and Its Treatment in Alzheimer's Disease and Other Dementias". Psychiatric Times.
  27. ^Herrmann N, Rothenburg LS, Black SE, Ryan M, Liu BA, Busto UE, Lanctôt KL (June 2008). "Methylphenidate for the treatment of apathy in Alzheimer disease: prediction of response using dextroamphetamine challenge". Journal of Clinical Psychopharmacology. 28 (3): 296–301. doi:10.1097/JCP.0b013e318172b479. PMID 18480686. S2CID 30971352.
  28. ^Rosenberg PB, Lanctôt KL, Drye LT, Herrmann N, Scherer RW, Bachman DL, Mintzer JE (August 2013). "Safety and efficacy of methylphenidate for apathy in Alzheimer's disease: a randomized, placebo-controlled trial". The Journal of Clinical Psychiatry. 74 (8): 810–6. doi:10.4088/JCP.12m08099. PMC 3902018. PMID 24021498.
  29. ^Lanctôt KL, Chau SA, Herrmann N, Drye LT, Rosenberg PB, Scherer RW, et al. (February 2014). "Effect of methylphenidate on attention in apathetic AD patients in a randomized, placebo-controlled trial". International Psychogeriatrics. 26 (2): 239–46. doi:10.1017/S1041610213001762. PMC 3927455. PMID 24169147.
  30. ^Clinical trial number NCT02346201 for "Apathy in Dementia Methylphenidate Trial 2 (ADMET2)" at ClinicalTrials.gov
  31. ^Abraham M (10 October 2020). "Apathy: Anxiety's Unusual Symptom". Calm Clinic. Retrieved 25 February 2014.
  32. ^Baldini A, Von Korff M, Lin EH (14 June 2012). "A Review of Potential Adverse Effects of Long-Term Opioid Therapy: A Practitioner's Guide". The Primary Care Companion for CNS Disorders. 14 (3). doi:10.4088/PCC.11m01326. PMC 3466038. PMID 23106029.

References[edit]

External links[edit]

Wikiquote has quotations related to: Apathy
Sours: https://en.wikipedia.org/wiki/Apathy

Wikipedia lethargy

Springtime lethargy

Springtime lethargy refers to a state of fatigue, lowered energy, or depression associated with the onset of spring. Such a state may be caused by a normal reaction to warmer temperatures, or it may have a medical basis, such as allergies or "reverse" seasonal affective disorder.[1] In many regions, there is a springtime peak in suicide rates.

Psychological and socio-cultural factors also play a role.[2] The opening lines of Eliot's classic poem express some of the complex emotional associations that may be familiar to those who experience dark moods in the spring:[3]

April is the cruellest month, breeding
Lilacs out of the dead land, mixing
Memory and desire, stirring
Dull roots with spring rain.

— T. S. Eliot, The Waste Land

Occasionally, such lethargy or depression may be described as "spring fever", though this term usually relates to an increase in energy and restlessness or to romantic and sexual feelings in the spring.

The German term Frühjahrsmüdigkeit (lit. "Spring fatigue") is the name for a temporary mood or physical condition, typically characterized by a state of low energy and weariness, experienced by many people in springtime. It is not in the category of a diagnosed illness but rather a phenomenon thought to be initiated by a change in the season. Reportedly, an estimated 50–75% of people in Germany have experienced its effect.[4]

Symptoms[edit]

In the northern hemisphere, the symptoms usually arise from mid-March to mid-April, and depending on the person, they may be more or less pronounced. Weariness (despite an adequate amount of sleep), sensitivity to changes in the weather, dizziness, irritability, headaches, and sometimes aching joints and a lack of drive are the most common.

Causes[edit]

Although the causes of this springtime lethargy have not yet been fully resolved, hormone balance may play a role. According to this hypothesis, the body's reserves of the "happiness hormone" serotonin, whose production depends on daylight, become exhausted over the winter, making it especially easy for the "sleep hormone" melatonin to have its effect. When the days become longer in springtime, the body readjusts its hormone levels, and more endorphin, testosterone, and estrogen are released. This changeover puts a heavy strain on the body, which responds with a feeling of tiredness.[citation needed]

In addition, temperatures usually fluctuate greatly in springtime. When temperatures rise, a person's blood pressure drops, since the blood vessels expand. The expansion of blood vessels is called vasodilation. Food also plays a role. In winter, one tends to consume more calories, fat, and carbohydrates than in summer. But during the hormone adjustment period, the body requires more vitamins and proteins instead.[citation needed]

References[edit]

  1. ^Wasmer Andrews, Linda (Mar 28, 2012). "When Spring Brings You Down". Psychology Today. Retrieved November 25, 2016.
  2. ^Hegarty, Stephanie (May 29, 2011). "Reverse Sad: Why springtime can be bad for depression sufferers". BBC World Service. Retrieved November 25, 2016.
  3. ^Borchard, Therese (April 16, 2014). "April Is the Cruelest Month: Why People Get Depressed and Anxious in the Spring". Everyday Health. Retrieved November 25, 2016.
  4. ^Wagner, Beate (2007). "Der verkappte Winterschlaf" [The Undiagnosed Winter Sleep] (in German). Zeit Online. Retrieved November 25, 2016.
Sours: https://en.wikipedia.org/wiki/Springtime_lethargy
Vlad and Nikita had a Fun playing with Mom and Snow in the winter playcenter!

Excessive daytime sleepiness

Symptom characterized by persistent sleepiness during daytime

Medical condition

Excessive daytime sleepiness is characterized by persistent sleepiness and often a general lack of energy, even during the day after apparently adequate or even prolonged nighttime sleep. EDS can be considered as a broad condition encompassing several sleep disorders where increased sleep is a symptom, or as a symptom of another underlying disorder like narcolepsy, circadian rhythm sleep disorder, sleep apnea or idiopathic hypersomnia.

Some persons with EDS, including those with hypersomnias like narcolepsy and idiopathic hypersomnia, are compelled to nap repeatedly during the day; fighting off increasingly strong urges to sleep during inappropriate times such as while driving, while at work, during a meal, or in conversations. As the compulsion to sleep intensifies, the ability to complete tasks sharply diminishes, often mimicking the appearance of intoxication. During occasional unique and/or stimulating circumstances, a person with EDS can sometimes remain animated, awake and alert, for brief or extended periods of time. EDS can affect the ability to function in family, social, occupational, or other settings. A proper diagnosis of the underlying cause and ultimately treatment of symptoms and/or the underlying cause can help mitigate such complications.[1]

Causes[edit]

EDS can be a symptom of a number of factors and disorders. Specialists in sleep medicine are trained to diagnose them. Some are:

  • insufficient quality or quantity of night time sleep;
  • misalignments of the body's circadian pacemaker with the environment (e.g., jet lag, shift work, or other circadian rhythm sleep disorders);
  • another underlying sleep disorder, such as narcolepsy, sleep apnea,[2]idiopathic hypersomnia, or restless legs syndrome;
  • disorders such as clinical depression or atypical depression;
  • tumors, head trauma, anemia, kidney failure, hypothyroidism, or an injury to the central nervous system;
  • drug abuse;
  • genetic predisposition;
  • vitamin deficiency, such as biotin deficiency; and
  • particular classes of prescription and over-the-counter medication.

Diagnosis[edit]

An adult who is compelled to nap repeatedly during the day may have excessive daytime sleepiness; however, it is important to distinguish between occasional daytime sleepiness and excessive daytime sleepiness, which is chronic.

A number of tools for screening for EDS have been developed. One is the Epworth Sleepiness Scale which grades the results of a questionnaire with eight questions referring to situations encountered in daily life. The ESS generates a numerical score from zero (0) to 24 where a score of ten [10] or higher may indicate that the person should consult a specialist in sleep medicine for further evaluation.[3][4][5]

Another tool is the Multiple Sleep Latency Test (MSLT), which has been used since the 1970s. It is used to measure the time it takes from the start of a daytime nap period to the first signs of sleep, called sleep latency. Subjects undergo a series of five 20-minute sleeping opportunities with an absence of alerting factors at 2-hour intervals on one day. The test is based on the idea that the sleepier people are, the faster they will fall asleep.[6][7]

The Maintenance of Wakefulness Test (MWT) is also used to quantitatively assess daytime sleepiness. This test is performed in a sleep diagnostic center. The test is similar to the MSLT as it also relies on a measurement of initial sleep latency. However, during this test, the patient is instructed to try to stay awake under soporific conditions for a defined time.[8][9]

The use of Electroencephalography (EEG) readings is essential for the objective diagnosis of EDS. The initial sleep latency employed in the MSLT and the MWT is mainly derived from EEG recordings.[9] Moreover, power characteristics in the alpha-band of resting-state EEG readings, correlating with somnolence, also showed a correlation with the presence of EDS.[10][11][12]

Treatment[edit]

Treatment of EDS relies on identifying and treating the underlying disorder which may cure the person from the EDS. Drugs like modafinil,[13]Armodafinil,[14]Xyrem (sodium oxybate) oral solution, have been approved as treatment for EDS symptoms in the U.S. There is declining usage of other drugs such as methylphenidate (Ritalin), dextroamphetamine (Dexedrine), amphetamine (Adderall), lisdexamfetamine (Vyvanse), methamphetamine (Desoxyn), and pemoline (Cylert), as these psychostimulants may have several adverse effects[15] and may lead to dependency, especially when illicitly misused.

See also[edit]

References[edit]

  1. ^Guilleminault, C; Brooks, SN (August 2001). "Excessive daytime sleepiness: a challenge for the practising neurologist". Brain : A Journal of Neurology. 124 (Pt 8): 1482–91. doi:10.1093/brain/124.8.1482. PMID 11459741.
  2. ^"How to Stop Snoring". Sleep Apnea. Archived from the original on 4 March 2016. Retrieved 15 August 2015.
  3. ^Johns, Murray W. (November 1991). "A New Method for Measuring Daytime Sleepiness: The Epworth Sleepiness Scale". Sleep. 14 (6): 540–545. doi:10.1093/sleep/14.6.540. PMID 1798888. Retrieved 14 March 2021.
  4. ^Johns, Murray W. (July 1992). "Reliability and Factor Analysis of the Epworth Sleepiness Scale". Sleep. 15 (4): 376–381. doi:10.1093/sleep/15.4.376. PMID 1519015. Retrieved 14 March 2021.
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External links[edit]

Sours: https://en.wikipedia.org/wiki/Excessive_daytime_sleepiness

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Lethargy (band)

Lethargy was an American technical death metal band formed in Rochester, New York in 1992 and active till December 1999. Their last performance was on Christmas night of 1999. Drummer Brann Dailor and guitarist Bill Kelliher would later appear in Today Is the Day and Mastodon. Guitarist and vocalist Erik Burke is currently active in Nuclear Assault, Sulaco, Kalibas, Brutal Truth, and B.C.T. (Blatant Crap Taste).

Members[edit]

Last-known lineup[edit]

Former members[edit]

  • Stephan Nedwetzky − lead guitar (1992−1993)
  • Brian Steltz − guitar (1993−1994)

Discography[edit]

Demos[edit]

  • Lost in This Existence (1993)
  • Tainted (1994)
  • Humor Me, You Funny Little Man (The Red Tape) (1995)

Studio albums[edit]

Compilation albums[edit]

Split albums[edit]

  • Lethargy/Big Hair split (1994)

References[edit]

Sours: https://en.wikipedia.org/wiki/Lethargy_(band)


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