Hypersomnia

For many people, taking a nap during the day is an exercise in luxury as for them it is a way to relax and be refreshed as the day goes along. But for others, daytime napping is a real problem. It can disrupt everyday tasks without providing any real restorative or restful benefits.

People who struggle with significant daytime sleepiness that isn’t helped by napping may have hypersomnia. This condition can have major impacts on a person’s life, health, and overall well-being. Most people who have daytime fatigue don’t have hypersomnia, but people who have found that they have persistent or worsening issues in this regard may benefit from talking to their doctor about this issue.

In this guide, we’ll go over the important background information about hypersomnia including what it is, what can cause it, how it is diagnosed, how it’s treated, and more.

What is Hypersomnia?

Hypersomnia is a medical condition marked by persistent daytime sleepiness. It is distinct from just being sleepy because of a bad night’s sleep. Instead, hypersomnia causes a feeling of excessive tiredness and need to nap multiple times per day including at inappropriate times. Even if a person with hypersomnia naps several times during the day, it usually does not make them feel less tired. This daytime fatigue may occur even if a person with hypersomnia gets regular sleep during the night.

Narcolepsy is a better-known condition that involves involuntarily and suddenly falling asleep many times during the day. For people with narcolepsy, these are known as sleep attacks. This normally does not occur with hypersomnia. In addition, other symptoms of narcolepsy, such as cataplexy (loss of muscle control), does not typically happen with hypersomnia. Though narcolepsy is not the same as hypersomnia, it can contribute to hypersomnia.

What Are the Symptoms of Hypersomnia?

The most common and most notable symptom of hypersomnia is excessive daytime sleepiness. This sleepiness normally involves numerous daytime naps that do not cause a person to feel more awake or refreshed. These naps may occur during inopportune times such as during meetings, meals, conversations, and work hours. Waking up may be challenging, and a person with hypersomnia may wake up feeling very out-of-sorts or confused.

People who suffer from hypersomnia may also have higher levels of irritability, anxiety, and general feelings of malaise and disorientation. Lack of energy can be both physical and mental. General fatigue can affect appetite and energy levels. Patients may find that their thinking and/or speech is slowed, memory may be impaired, and they may even have hallucinations.

Remember that being sleepy for a day or a few days at a time because of a lack of sleep or an extremely busy schedule is not the same thing as hypersomnia. Hypersomnia tends to be pronounced and prolonged, and for people with this condition, getting more sleep (such as with naps during the day) does not actually make them feel more rested.

What Are the Causes of Hypersomnia?

Hypersomnia does not always have a clearly defined cause. In some cases, it is diagnosed as idiopathic hypersomnia (IH), which means that no cause can be identified. While it can vary by person, some potential causes for hypersomnia include:

  • Other sleep problems: people who deal with other sleep-related problems like obstructive sleep apnea or even narcolepsy may wind up having hypersomnia (although there are usually distinctions between narcolepsy and hypersomnia itself).
  • Drug or alcohol abuse: people who use many drugs or alcohol in significant quantities can suffer from general sleep problems as well as hypersomnia. With alcohol, it can have an especially negative effect when it is consumed later in the evening closer to bedtime.
  • Other physical conditions: people who have had injuries to the head or nervous system may develop hypersomnia as a consequence. Tumors, depression, multiple sclerosis, and even obesity may contribute to hypersomnia.
  • Medications: some medications can cause someone to have hypersomnia, and in addition, withdrawal after taking some medications can cause this issue in certain people.
  • Genetics: though not clearly defined, there is some indication that genetics may influence the risk of hypersomnia.

In many cases, the symptoms of hypersomnia may arise when someone is a teenager or a young adult. They can also arise during adulthood.

Many of these symptoms can be the result of a broad range of health conditions. Often they are caused by something other than hypersomnia. But if you find that you have had many of these symptoms, especially over a consistent period of time, it is important to talk with a doctor or a nurse who can help determine the cause and any appropriate treatment.

What Are the Health Risks of Hypersomnia?

The biggest health risks from hypersomnia relate to the effects of excessive daytime sleepiness. For example, people with this issue are much more likely to be in car accidents or to have injuries from things like trips, falls, or other accidents.

Consistent hypersomnia can also affect a person’s ability to effectively work and maintain social relationships. It can disrupt a person’s overall well-being and feelings of health as well as their ability to maintain their personal and occupational commitments.

How Is Hypersomnia Diagnosed?

If a patient has symptoms of hypersomnia, diagnosis usually begins with a physical exam and history. During the health history, it is normal for the doctor to ask about any medications that you may be taking (prescription or over-the-counter), any prior health issues, and a synopsis of your current symptoms. A physical exam can check for any clear signs of other possible health problems.

Your doctor may ask you to maintain sleep logs or a sleep journal in order to track information about when and how much you are sleeping each day. Other tests can include a test called the multi-sleep latency test, which evaluates the amount of time it takes for you to fall asleep when taking a nap during the day. Another type of sleep study is called polysomnography and usually involves spending a night in a sleep lab. This is more common if the doctor suspects you may have another sleep-related condition.

How Is Hypersomnia Treated?

If the doctor is able to identify an underlying condition that is causing hypersomnia, then treatment will be largely be directed at resolving that underlying condition to the greatest extent possible. In those cases, such treatment may resolve the hypersomnia.

A central part of most treatment for hypersomnia is a focus on managing symptoms. This is true In cases where there is not an apparent underlying condition or when symptoms continue despite resolving another health issue. It may also be initiated at the outset to help someone address ongoing symptoms. Potential treatments include:

  • Medications: medications to treat this often include stimulants, but other types of medications may also be employed. Often the goal of stimulants is to keep a person from falling asleep during the day.
  • Lifestyle changes: some changes that may be suggested involve eliminating alcohol and caffeine from a person’s regular diet, and other dietary changes may be recommended. Avoiding shift work or night shifts and other social engagements that push back a person’s bedtime may be another approach for trying to reduce the severity of hypersomnia.
  • Cognitive Behavioral Therapy (CBT): talk therapy that tries to resolve underlying mental stressors or conditions may prove beneficial for some patients whose hypersomnia may be related to pre-existing mental health issues.

What Medications Are Available for Hypersomnia?

Several different types of drugs may be used to try to address hypersomnia. One class of medications that can be used are stimulants including methylphenidate and amphetamine. These are designed to help avoid daytime napping and to keep a person awake and alert during the day. Modafinil is not a stimulant but also promotes wakefulness during the day.

Antidepressants are sometimes prescribed for treating hypersomnias. These may help by altering the balance of certain chemicals in the brain. Other drugs that can be considered include levodopa, clonidine, bromocripitine, and sodium oxybate.

Overall, because there is not one single cause or manifestation of hypersomnia, there is no one single medication that can be prescribed to manage it or resolve it. Any person who thinks that a medication or supplement may help them with hypersomnia should talk with a health professional before starting to take that medication. A consultation with a trained professional is important to ensure that taking any new medication is safe and will not pose any risks in terms of interactions with other medications that you may take.

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