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The most outstanding symptom of the syndrome of Costen is this feeling to be constantly tired. This tiredness is not only due to a bad quality of sleep. It is accompanied by a loss of will (I mean a lack of enthusiasm). In the middle of the morning, at the time when your energy is still supposed to be at its highest, you have great difficulty to fight against sleeping. This situation is not ideal when you expect to be efficient in your professional activity.

Moreover, this tiredness always coincides with increasing of the muscular tensions: pains in bottom of the back and on the level of the cervical become more and more sharp. If it is added to the banal tiredness that everyone usually feels after lunch, this chronic tiredness seriously decreases the efficiency at work in the afternoon…

One question doctors often ask is: “Are tinnitus stronger in the evening or in the course of the day?” My answer to this question is : “The tonality of the tinnitus depends on the position adopted to sleep. Having no doubt about the fact that tinnitus are caused by some cranial nerves compression, I consider that the fact of sleeping on one side or another has an impact on their intensity - what is perfectly corroborated by my personal experience. Indeed, when I sleep on the right-side with my hand resting against my jaw, my mandible moves towards the left and my tinnitus quickly become intolerable. Under these conditions, it quickly becomes impossible to me to find the sleep.