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Jan 16, 2024 · Lethargic: very drowsy, falls asleep in between care. Obtunded: difficult to arouse. Stuporous: very difficult to arouse. Unresponsive/Coma: unarousable. Describing your patient’s LOC correctly is especially important when there are acute changes in condition.
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“Lethargy” is a term that no longer sees widespread use in medical settings. It refers to a decrease in consciousness, but many people use it interchangeably to refer to fatigue, drowsiness or sleepiness. Because it involves a decrease in consciousness, it indicates a disruption in brain activity.
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OverviewPossible CausesCare and TreatmentWhen to Call the Doctor
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What can cause lethargy?
Lethargy can be a sign of many conditions. But what they all have in common is that they involve disruptions in brain function. Conditions that can cause lethargy include (but aren’t limited to): Alcohol intoxication and alcohol poisoning. Blood sugar level extremes (including very low blood sugar [hypoglycemia] and very high blood sugar [hyperglycemia]). Brain bleeds. Chronic fatigue syndrome. Severe dehydration. Delirium. Diseases that affect or cause failure of your kidneys or liver (these cause buildup of toxins that can affect your brain). Electrolyte imbalances (like very low sodium [hyponatremia] or very high calcium [hypercalcemia]). Endocrine disorders (like hypothyroidism and hyperthyroidism). Extreme body temperatures (including very low body temperature [hypothermia] and very high body temperature [hyperthermia]). Head injuries, including concussions and traumatic brain injuries (TBI). Infections (especially encephalitis and meningitis, as well as life-threatening infection-related conditions like sepsis). Intracranial hypertension (like from conditions such as hydrocephalus). Lack of blood flow (like any kind of stroke, especially ischemic stroke). Lack of oxygen (cerebral hypoxia). Medical and nonmedical drug use and overdose. Mental health conditions, especially when they disrupt brain function (major depressive disorder, for example). Seizures. (Lethargy after a seizure is common. If someone is lethargic more than 30 minutes after a seizure, they need immediate medical attention. They could be having status epilepticus from ongoing seizure activity in their brain that isn’t causing other visible symptoms. Status epilepticus is a medical emergency.) Toxins and poisons (like carbon monoxide or heavy metals).
How is lethargy treated?
Treating lethargy almost always involves treating the condition causing it. Because so many conditions can cause or contribute to lethargy, the possible treatments can vary widely.
Can lethargy be prevented?
Lethargy happens unpredictably. The conditions that can cause it generally aren’t preventable. But there are some things you can do to reduce the risk of developing these conditions. Manage your chronic conditions. Following your healthcare provider’s guidance on managing chronic conditions like diabetes and epilepsy can lower your odds of developing a condition that can cause lethargy. Wear safety equipment. Head injuries, especially concussions and traumatic brain injuries, can cause or contribute to lethargy. Helmets, safety restraints, seat belts and other protective gear are essential for reducing your risk. Eat a balanced diet. A balanced diet can reduce the risk of developing electrolyte imbalances and vitamin or mineral deficiencies that could cause lethargy. Your diet also affects your circulatory health, which can help avoid conditions like stroke. Stay physically active and reach and maintain a weight that’s healthy for you. Your weight and activity level can prevent or delay conditions that affect your brain, especially conditions that could cause or contribute to lethargy. Avoid substance and nonmedical drug use, and only use alcohol in moderation. Alcohol and substance use disorders can cause or contribute to lethargy. You should always take prescription medications as directed, as this reduces the risk of developing problems or complications. Get adequate sleep. Most adults require seven to eight hours of sleep every night. Insufficient sleep can worsen your symptoms.
When should this symptom be treated by a doctor or healthcare provider?
Lethargy can be hard to distinguish from drowsiness, even for trained, experienced healthcare providers. An important thing to be aware of when considering if someone has lethargy is the context. Context clues to consider include: Recent events or circumstances. This includes recent injuries, medical procedures, etc. How suddenly they became lethargic. Suddenly becoming drowsy and having trouble thinking without any obvious reason is a red flag. Behavior patterns. If the sudden change in activity level, alertness or behavior is unusual or seems out of character, that’s a reason to seek medical attention. Changes in the moment. If someone seems lethargic but gradually becomes more alert and aware, it’s likely not lethargy. If they stay lethargic or get worse over several minutes, they need medical attention. If they have other symptoms. Some symptoms, like those of a stroke, automatically mean that someone needs emergency care. If these symptoms appear, you should call 911 or your local emergency services number immediately because some conditions that cause lethargy are time-sensitive. Every second counts. In general, it’s best to err on the side of caution when considering whether or not to get medical care for suspected lethargy. A note from Cleveland Clinic It can be hard to tell the difference between fatigue and lethargy. The key difference is that lethargy involves a decrease in consciousness. That means you’re less awake, have diminished awareness or are disoriented. Lethargy happens when there’s a disruption in your brain, and it can be a sign of serious or even life-threatening conditions. If you suspect someone has lethargy, it’s best to err on the side of caution. Get medical attention. Many conditions that can cause lethargy are time-sensitive, so acting out of caution is the wisest course of action. Medically Reviewed Last reviewed by a Cleveland Clinic medical professional on 09/11/2023. Learn more about our editorial process.
The Difference Between Lethargy, Obtundation, Stupor, and Coma. There is a spectrum of impaired consciousness that goes from full arousal to complete unresponsiveness. Coma, which is a state of unarousable unresponsiveness is the worst degree of impairment of a patient’s arousal and consciousness.
Feb 8, 2024 · If you are unfamiliar with common abbreviations, it can make understanding medical notes challenging. We’ve curated a list of medical abbreviations/acronyms to help you understand entries in the medical notes.
Jun 27, 2024 · Levels of consciousness range from normal alertness and attention to gradations of altered states, including confusion, delirium, stupor, and coma. The same conditions may produce mild to severe states of altered LOC. Sometimes, there may be a rapid progression from a mild to a high stage.
- Angela Morrow, RN
Disorders of consciousness are common; these always signify a disorder of the nervous system. Assessment should determine the level of consciousness (drowsy, stuporous, comatose) and/or content of consciousness (confusion, perseveration, hallucinations).
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Jun 29, 2022 · In medical or hospital settings, the term lethargy denotes a patient’s inability to stay awake or engage in any type of interaction, says Paula Zimbrean, MD, a psychiatrist at Yale Medicine. “It is often associated with severe illness or with sedating medications, such as painkillers.”
