Summary and Conclusions

Inability to sleep, excessive sleepiness, and fatigue are common problems that many, if not all, people experience at some time in their lives. Excessive sleepiness and fatigue, particularly when persistent, reduce the quality of life of affected individuals and also cause significant economic loss in terms of diminished productivity and employment capability. Considerable data support strong interactions between the immune response and vigilance states. Furthermore, infectious and inflammatory diseases and/or their therapies are often associated with nonrestorative sleep, excessive daytime sleepiness, and fatigue, and many individuals also suffer from chronic fatigue of unknown etiology. Identifying the mechanisms responsible for poor sleep, chronic fatigue, and excessive sleepiness and developing effective interventions for these disabling symptoms could improve the economic welfare and quality of life of many individuals.

Acknowledgments. This work was supported in part by NIH grants R01-NS40220, R01-HL70522, and K26-RR17543, and by the Southern Illinois University School of Medicine.

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