WHY YOU CAN’T STAY AWAKE: PSYCHIATRIC DOES – PATHOPHYSIOLOGICAL DOES
Pathophysiological DOES—learned behavior in which the pattern of daytime sleepiness is reinforced by habit—is much less common than the bad sleep habits that may be associated with insomnia. For short intervals of time some people may take to their beds as a minor depressive response to an event, or to escape the pressures of living. They may thus come to depend on such escape on a regular basis, conditioning themselves to expect sleepiness to occur with a certain frequency. Such a pattern seldom extends over the long term, although in some cases it can develop into a persistent complaint of chronic weariness, excessive sleep, and daytime napping. Thorough clinical examination, including a visit to a sleep lab, will usually reveal no objective findings to suggest a cause for the hypersomnia. Supportive counseling to address the initial reason for sleepiness and to change the pattern of behavior is called for.*157\226\8*
