Somnolence

Circadian rhythm disorders

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 health

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]

• Hypothyroidism – The body doesn't produce enough hormones that control how cells use energy
• Hypermagnesaemia
• Low blood sodium – Hyponatremia
• Hypercalcemia – Too much calcium in the blood
• Meningitis
• Head Injury
• Concussion – A mild traumatic brain injury
• Narcolepsy – Disorder of the nervous system
• Brain tumor
• Skull fractures
• Chronic pains
• Diabetes
• Fibromyalgia
• Sleeping sickness – caused by a specific parasite
• Mood disorders – Depression, Anxiety, Stress

Medications that may cause drowsiness

• analgesics – mostly prescribed or illicit opiates such as OxyContin or heroin
• anticonvulsants / antiepileptics – such as phenytoin (Dilantin), carbamazepine (Tegretol), Lyrica (Pregabalin), 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
• tranquilizers / hypnotics – 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