Psychiatric disorders

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Excessive daytime sleepiness is much less frequently caused by psychiatric problems than is insomnia [50]. It may develop as a protective psychological reaction to circumstances which are difficult to cope with. If it persists it may be difficult to distinguish from idio-pathic hypersomnia but MSLTs are usually normal.

Excessive daytime sleepiness is common in younger subjects with depression, whereas later in life this more frequently causes insomnia. EDS may persist despite adequate treatment of low mood by anti-depressants and may even be worsened by sedative antidepressants. EDS in depression is usually associated with weight gain whereas depression and weight loss often lead to insomnia. EDS is also a feature of the seasonal affective disorder, which is associated with weight gain.

The daytime sleepiness seen in schizophrenia is occasionally due to the disorder itself, but more commonly to sedative medication.

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