An alteration in mental status refers to general changes in brain function, like confusion, amnesia, loss of alertness, disorientation, poor judgment or thinking, unusual or strange behavior, poor regulation of emotions, and disturbances in perception, psychomotor skills, and behavior. While an altered mental state is characteristic of several psychiatric and emotional conditions, medical conditions and injuries that cause brain damage, including alcohol or drug overdoses and withdrawal syndromes, can also cause changes in the mental state.
What is Altered Sensorium?
The entire brain receives, processes, and interprets sensory stimuli. The sensorium is the supposed seat of sensation, the place to which impressions from the outside world are transmitted and perceived. The sensorium also means the whole sensory apparatus of the body. In medicine, "sensorium" is sometimes used as an umbrella term to refer to intellectual and cognitive functions. The word "sensorium" derives from the Latin sensus, "the faculty of perceiving". The plural of "sensorium" is rarely used, but if necessary you can choose between "sensoriums" and "sensoria".
Causes
There are several possible causes of excessive sleepiness, each with different treatments.
Sleep deprivation:
- Sleep deprivation occurs when there is insufficient sleep. The American Academy of Sleep Medicine (AASM) notes that adults need 7 to 8 hours of sleep each night to feel alert and well-rested the next day.
- However, according to AASM, about 20% of adults don't get enough sleep.
- A person who does not sleep enough during the night may experience excessive drowsiness the following day. People who regularly lack sleep may feel tired all the time.
- Some common causes of sleep deprivation include:
- excessive or inconsistent working hours
- personal obligations
- an underlying medical condition
Insomnia:
- Insomnia is a sleeping condition in which people find it difficult to sleep. People who suffer from insomnia tend to feel excessively drowsy but are unable to fall asleep or stay asleep.
- There are different ways people can experience insomnia. Some common symptoms include:
- be unable to sleep
- continually waking up all night
- Waking up very early in the morning and unable to sleep again
- Insomnia can be difficult to diagnose. The Centers for Disease Control and Prevention (CDC) notes that doctors typically only diagnose insomnia by excluding other potential sleep disorders.
Obstructive sleep apnea:
- Sleep apnea is a disorder in which a person temporarily stops breathing while sleeping. This is a rather common cause of excessive daytime drowsiness.
- There are two types of sleep apnea:
- Obstructive sleep apnea (OSA): Obstructive sleep apnea occurs when the soft tissue behind the throat collapses, blocking the flow of air.
- Central Sleep Apnea (CSA): ASC occurs when the brain does not signal the respiratory muscles to breathe.
- Some people suffer from mixed sleep apnea, which is a combination of OSA and CSA.
- Episodes of sleep apnea can occur dozens or even hundreds of times in a single night. As a result, they can significantly disrupt a person's sleep cycle.
- Common symptoms of sleep apnea include very loud snoring and heavy breathing throughout the night.
- During an episode of sleep apnea, a person's body is temporarily deprived of oxygen. This lack of oxygen can lead to other problems, such as an irregular heartbeat. Over time, this can lead to serious chronic illnesses, such as high blood pressure and heart disease.
- Sleep apnea usually occurs when a person is overweight. In this case, weight loss will be the first recommendation.
Restless Leg Syndrome:
- Restless Leg Syndrome (RLS) refers to an uncontrollable urge to move the legs when they are at rest. The condition also generally causes discomfort in the legs.
- RLS can occur during wakefulness and sleep. People who experience RLS when awake may have difficulty falling asleep.
- If RLS occurs during sleep, it can cause repeated spasms or shake in a person's legs throughout the night. While this is not enough to wake the person up, it can prevent them from reaching the stages of deep, restful sleep. As a result, the person may feel lazy and tired the next day.
- Some scientists believe that RLS is due to abnormalities in the neurotransmitter dopamine, which plays a role in controlling muscle movement.
Narcolepsy:
- Narcolepsy is a neurological disease that causes you to fall asleep suddenly and at inappropriate times.
- People with narcolepsy typically experience extreme and persistent drowsiness throughout the day. Most people suffering from this condition will also experience one or more of the following symptoms:
- sleep disturbances
- sleep paralysis
- hallucinations
Some drugs:
- In some cases, daytime sleepiness can be a side effect of a particular medication, such as:
- antihistamines
- antipsychotics
- antidepressants
- anxiety medications
- blood pressure medications
- You must discuss the side effects of any medication with a physician. If side effects such as drowsiness are too difficult to manage, your physician may recommend that you change your medication or dosage.
Diagnosis
- It is important to correctly diagnose the underlying cause of excessive sleepiness to establish the best treatment.
- During the diagnostic procedure, a doctor may ask questions about a person's lifestyle and the medications they are taking. The physician may also ask questions relating to mental health.
- In some cases, a physician may order the following diagnostic tests:
- A sleep study called polysomnography: This test records a person's brain waves, oxygen levels, and body movements during sleep to assess their sleep cycle.
- Electroencephalogram: This non-invasive test records electrical activity in the brain.
Treatment
Sleep deprivation:
The underlying medical causes require specific treatments. In most other cases, simple lifestyle changes can usually improve the length and quality of a person's sleep.
Insomnia:
- Treatment for insomnia can include a combination of therapies include:
- sedative-hypnotic drugs
- antidepressants
- behavioral techniques to promote regular sleep
Obstructive sleep apnea:
Two common treatments for sleep apnea include:
- Positive airway pressure devices: These devices consist of a machine that attaches to a mask that the person wears on their face. The machine delivers pressurized air to a person's throat while they sleep. The air keeps the throat from collapsing.
- Oral appliances: These are similar to a mouth guard or orthodontic devices. The devices keep the lower jaw slightly forward during sleep. This positioning prevents the soft tissue in the back of the throat from sagging and blocking the airways.
Restless Leg Syndrome:
Some lifestyle changes can benefit individuals with milder RSL cases. These include:
- adopting good sleep habits
- exercise regularly
- stop smoking
People with more severe cases of RLS may need medications to regulate dopamine and iron levels in the body.
Narcolepsy:
- Treatment usually involves stimulant drugs, which help keep the person awake. Antidepressants can help control hallucinations and episodes of sleep paralysis.
- Doctors may also recommend that people take a few good naps throughout the day, as this can improve symptoms of narcolepsy.
Depression:
- Treatment for depression may involve drug therapy, psychotherapy, or a combination of both.
- Several types of antidepressant medications are available. A person can talk to their doctor about which medicine is best for them.
- Common psychotherapy for depression involves cognitive-behavioral therapy (CBT) and interpersonal therapy. According to the Anxiety and Depression Association of America, these therapies seem to be especially effective in the treatment of depression.
Home Remedies
Here are some tips or remedies for excessive sleeping:
- Get up and move around to feel awakened
- Take a nap to relieve drowsiness
- Give your eyes a break to avoid exhaustion
- Eat a healthy snack to increase energy
- Start a conversation to awaken your mind
- Take a breath to feel alert
- If you are driving, stop when you are sleepy
- Change tasks to stimulate your mind
- Drink water to prevent tiredness
- Get some natural light to regulate your sleep cycles
- Exercise to increase energy and reduce fatigue
