"According to some studies, 50% of the hospital beds in France are taken by functional sick people who simply suffer of being tired".

To ensure the good functioning of the body, the brain constantly processes information that it receives from the peripherals, in a silent and automatic manner.
That way, balance, breathing, blood pressure, digestion, (...) are complex functions that are automatically taken care of by the autonomous nervous system (ANS).
The automatic system works silently as long as it can "avoid to have to call the conscious brain for help".
If not, an alarm sign lights up on the control panel.

That "computer" leaves the conscious part of the brain the opportunity to "command" the voluntary nervous system (VNS) to report an illness, a wound, or any kind of danger:
Yet, in general practice of medical consultation, there are many cases where the body « makes a noise » (pain) that no objective lesion can explain.


On the control panel, some warning lights beam up as if there was a danger and draw the operator’s attention. But the intervention of the rescue (police, doctor, firemen) will not solve the problem if the alarm went on due to a simple error of adjustment, like it is the case here.
And still, an alarm that rings all the time is worrying, (it is not normal, it has to stop!)
The automatic functioning of the body is very sensitive to a reduction of the quality of sleep, which we call « hypo-sleep ».
Functional disorders that stand for alarm signs come forward at a very early stage of tiredness, and long before the appearance of real sleep disorders.


The usual language has, unconsciously, been able to show, thanks to a multitude of set phrases, the link that exists between the stressing event, tiredness, and functional disorders.
For example : "This job is a pain in the arse... I’m fed up", really means :
"I notice a disfunction of my intestine, which means that my working conditions have an unacceptable impact on my sleep".
Yet, at that stage, the link with sleep is still unconscious because the subject develops compensation mechanisms to "stand fast".
It is precisely that state of resistance that he/she expresses through these popular set phrases which are true "synonyms of tiredness".
That tiredness is expressed by a functional alarm as soon as the normal mechanisms of adaptation to stress are exceeded.
Clearly, the subject who faces adversity does not yet know that his/her sleep disfunctions and, at the very most, tries to sleep more to recover strength.
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The section for tiredness :
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The section for pain and functional disorder :
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In appearance, sleep remains preserved or even increased (in the start).
Without the lighting of sleep medicine, neither the doctor nor the patient think about making sleep the common denominator between the states of tiredness and functional disorders.
The sick person complains about the symptom but never (spontaneously) about sleep.
The interview must investigate for five symptomatic points of an unefficient sleep, in our opinion :
Their presence, in this context of functional disorders (disabling, worrying, capricious, and without sequellae) should lead to a diagnosis of an "hypo-sleep syndrome".

Some alarm lights start to blink. It is the stage of the passing functional disorders : constipation, abdominal bloatedness, aches, headache, spasms of the eyelids, palpitations, pseudohypoglycemia or low blood pressure...
The doctor has comforting words and prescribes a little "symptomatic" treatment...
Other alarms start to ring.
The symptoms become more insistent and arouse even more worrying, the subject consults for feelings of faintness, colics, chest pains, head aches... He/she fears something bad.
The check-ups are all normal....and people agree to think that this or that organ is "fragile" and that it will be necessary to live with those recurrent "fits" without consulting anymore.

Everything looks as though the system ordered the emergency stop. Handicap becomes major.
The sick person lies in bed : false "flu", false "gastroenteritis", accute dizzy spells, "tetany", lumbago or stiff neck ...
But everything gets back into order (spontaneously or under "symptomatic" treatment without sequellae and until the next time... )

Resistance collapses, the handicap is major (work interruption is sometimes long). Chronic Fatigue Syndrome and Fibromyalgia.
And since all check-ups are still normal (apart from an intercurrent or iatrogenic pathology), it will be left to the care of a psychiatrist as "conversion disorders, somatization, generalized anxiety disorder and/or depression..."
At the opposite of the degenerative diseases (diabetes, arteriosclerosis, polyarthritis...) that become disabling with age;
At the opposite of psychiatric diseases that sometimes evolve very badly;
As time goes by...«arthrosis» and colopathy... , migraine and tinnitus... all those symptoms although so disabling in the past, gradually become more and more discrete.
Even fibromyalgia and chronic fatigue syndrome, which have the reputation of being incurable, are of a good prognosis (heal) on the long term.
It looks as though the subject, who has become too weak, has stopped fighting against him/herself.
Because the body is so old that it has just enough energy to keep on living despite the tiredness, the true one, that of a worn state due to time...
That explains the spectacular (but very often fleeting) results of pseudomedicines, of the tonics’ business, of "miracle" diets, and other "herbalife". [1]
In experimental conditions of "bed rest" (forced prolonged rest), of jet lag or shift work, functional disorders are omnipresent (event with extended sleep time).
In the practice, the (well conducted) "somnological" interview of the patients who suffer of functional disorders (fibromyalgia as well as migraine, palpitation, or spasmophilia) systematically retrieves the notion of an "unrestful" sleep.
The etiologic caretaking
[2]] outward signs of the hypo-sleep in general medicine can only spread with the development of knowledge about sleep (and in particular on the circumstancial use of the nap).
This approach, which we will call "somnicologic", of tiredness and its functional consequences can offer a new pragmatic therapeutic way
to these millions of sick people who clutter up, at all loss (and often putting themselves in danger) the circuits of the medical system.
The sick person would be taken better care of and the (probably huge) savings that would result could be one of the solutions to the real problems of unbalance of health expenses.
Then, it would no more be a matter of saving on the necessary cares to spend less, but to stop the consumption of, in that case, useless resources.
We hope that large campaigns of public health will be launched, one day, on the theme "sleep little, sleep less, sleep better".
While we wait for such a change in mentalities, the «True False-sick» will continue to multiply consultations while the «False True-sick» will continue to consume medications thoughtlessly.
Nb. It is not the purpose, here, to call the role and the efficiency of the medical system into question. It is legitimate and necessary to consult for any abnormal symptom, but the normality of the exploration must lead to take a "somnosomatic disorder" into consideration and, if it is the case, to be able to start a "somnicologic" approach (See the definitions of these neologisms) which means "thought in terms of chronobiology and sleep hygiene".

See also: "Tiredness or sleepiness?"
[1] "herbalife" has been, in the 1990’s, one of these miracle drugs that exploited the naivety of satisfied consumers to develop in a pyramidal sales network.
The advertising message summarized, in itself, the problem of the "hypo-sleep syndrome" : "I am in a good shape now... ask me why..." It was the "typhoon mixture", the panacea that healed everything... except the wallet. It seems like the money, raised that way, ended up into the funds of scientology with which there exist other collusions. Be careful, the actual risk of a return of those "suckertherapies" is high.
[2] A treatment is described as "etiologic" when it takes care of the cause of an illness.
It is "symptomatic" when it takes care of its consequences.
For an infection with bacteria, the antibiotic is etiologic and paracetamol is symptomatic.