title: Sleepiness and human behavior.
abstract: The 24-hour properties of sleepiness affect behavior by reducing performance and increasing the likelihood of accidents. This is important to pulmonary physicians who diagnose and treat sleep apnea, because diagnoses of sleep apnea and narcolepsy are associated with as much as a sevenfold increase in the risk of having a motor vehicle accident. Human abilities throughout the 24-hour day have noticeable ups and downs and are probably causally linked to the same control mechanisms that produce the early morning and midafternoon peaks in the tendency to fall asleep. An important characteristic of this pattern is that increased sleep tendency, regardless of how the increase comes about, does not alter the timing of the peaks. In California, and perhaps other states, current laws can be interpreted as requiring clinicians to report all patients with conditions such as sleep apnea and narcolepsy to the county health officer. Although this policy is at variance with recommendations of the American Thoracic Society, attorneys have advised that, in California, a policy of uniformly reporting all patients with disorders of excessive somnolence is proper. Because ignorance of the law is not a valid defense, it is important for physicians to be aware of all state laws relevant to their patients who may be impaired by sleepiness.
authors.affiliation: Scripps Research Institute, Division of Sleep Disorders Medicine (N209), La Jolla, CA 92037-1093, USA.
authors.forename: M M
authors.initials: MM
authors.lastname: Mitler
mesh_terms: D000063:Accidents, Traffic; D001519:Behavior; D002140:California; D002940:Circadian Rhythm; D018563:Disease Notification; D006291:Health Policy; D006801:Humans; D007603:Jurisprudence; D009290:Narcolepsy / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D011597:Psychomotor Performance / Q000502:physiology; D011635:Public Health Administration; D012307:Risk Factors; D012890:Sleep / Q000502:physiology; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D012894:Sleep Stages / Q000502:physiology*