Hypersomnia

Feeling sleepy is a common experience, but excessive daytime sleepiness can affect the quality of your life. Hypersomnia or Hypersomnolence leads to excessive sleepiness despite having more than 7 hours of good quality sleep.

What Is Hypersomnia?

Hypersomnia is a neurological disorder. This condition is characterized by repeated episodes of excessive and chronic daytime sleepiness. Prolonged sleepiness during the night can also be considered as a part of this disorder. The American Academy of Sleep Medicine characterized Hypersomnia as a “pathological condition recognized by a lack of alertness during the waking episodes of the day”. Although originally known as hypersomnia, it is now mostly identified as hypersomnia or excessive daytime somnolence. This is primarily because the term hypersomnia did not cover all aspects of the condition’s definition.

The American Sleep Association reports that “the condition is more prevalent in men than in women, affecting approximately 5% of the population.” Instead of feeling tired or sleepy at night or enjoying interrupted nighttime sleep, people with this condition feel a compulsion to fall asleep during the daytime. As a result, they often nap during study, work, while having lunch or dinner, during social interactions, and at other inappropriate times. However, sleeping during the day does not help to alleviate the symptoms. Moreover, sufferers often find it challenging to wake up from a long sleep and may even experience dizziness and disorientation.

Hypersomnia can be a problematic disorder since it can greatly affect a person’s ability to perform regular tasks and function on a daily basis. Surveys [mfn] Jean M. Twenge, Zlatan Krizan, Garrett Hisler, Decreases in self-reported sleep duration among U.S. adolescents 2009–2015 and association with new media screen time, Sleep Medicine, Volume 39, 2017, Pages 47-53, ISSN 1389-9457, https://doi.org/10.1016/j.sleep.2017.08.013. [/mfn] conducted by the National Sleep Foundation indicated ”30% of the respondents suffer from Hypersomnia that interferes with their quality of life”.

Types And Stages Of Hypersomnia

According to experts, this condition can be categorized into 2 major types, primary and secondary. The primary form of this disorder is rarer than the secondary type.

1. Primary Hypersomnia

It occurs when there are no other medical conditions present. The only symptom, in this case, is excess fatigue.

2. Secondary Hypersomnia

This occurs due to pre-existing medical conditions. Sleep apnea, Parkinson’s disease, kidney failure, and chronic fatigue syndrome are examples. These underlying conditions can cause poor quality sleep which ultimately makes an individual tired during the day.

Hypersomnia isn’t related to Narcolepsy. Narcolepsy [mfn] Slowik JM, Collen JF, Yow AG. Narcolepsy. [Updated 2021 Jul 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459236/ [/mfn] is a neurological condition that causes sudden uncontrollable sleep attacks during the day. People with Hypersomnia can stay awake and have total control over their sleep. But they usually feel restless and tired.

This condition can be further divided into three main stages:

1. Acute Hypersomnia – This usually lasts for a month.
2. Sub Acute Hypersomnia – Usually lasts between 1 to 3 months
3. Persistent Hypersomnia – Lasts more than 3 months

What Are The Symptoms Of Hypersomnia?

The primary symptom of hypersomnia is excessive sleepiness despite getting quality sleep every day. The Diagnostic and Statistical Manual of Mental Disorders, fifth edition, has a new diagnosis of “hypersomnia disorder (HD),” which is described as “the main sleep disorder most similar to the diagnosis idiopathic hypersomnia (IH) in sleep literature and can be missed in psychiatric settings.”

Here are some of the most common physical and psychological symptoms of hypersomnia:

1. Physical Factors

Common physical symptoms as laid down by the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) [mfn] Substance Abuse and Mental Health Services Administration. Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016 Jun. Table 3.35, DSM-IV to DSM-5 Hypersomnolence Disorder Comparison. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t35/ [/mfn] may include:

• Falling asleep several times during the day
• Not feeling refreshed even after taking naps
• Not feeling well-rested even after sleeping for more than 9 hours
• Having difficulty waking up
• Feeling confused while waking up
• Increased sleep time (up to 14 to 18 hours a day)

Read More About DSM 5 Here

2. Psychological Factors

Psychological factors are the issues that are related to mental health rather than physical ones. There may be some psychological factors causing hypersomnia. They include:

• Anxiety
• Irritation
• Decreased energy
• Restlessness
• Slow thinking
• Slow speech
• Loss of appetite
• Hallucinations
• Difficulties with memory
• Inability to perform at work or home

If symptoms last for more than 3 months, it is considered persistent and requires immediate medical attention. So if you are experiencing any of the symptoms mentioned above, make sure you consult a doctor to address your concerns.

Read More About Anxiety Here

What Causes Hypersomnia?

There is a possibility that an increase in the brain chemicals in an individual can cause this condition. However, researchers are still looking for answers on what interactions in the brain cause hypersomnia. They believe that an unidentified specific substance or molecule that may be involved in Hypersomnia interacts with a substance called y-aminobutyric acid (GABA) [mfn] Trotti, L. M., Saini, P., Bliwise, D. L., Freeman, A. A., Jenkins, A., & Rye, D. B. (2015). Clarithromycin in γ-aminobutyric acid-Related hypersomnolence: A randomized, crossover trial. Annals of neurology, 78(3), 454–465. https://doi.org/10.1002/ana.24459 [/mfn]. GABA is a brain chemical that is responsible for promoting sleep in human beings.

There are several other factors that can cause hypersomnia, such as:

• Stress
• Excess alcohol consumption
• History of viral infection
• History of head trauma
• Family history of hypersomnia or sleep disorders
• Medical history of depression
• Substance Abuse
• Bipolar disorder
• Alzheimer’s disease
• Parkinson’s disease

There are no known risk factors that contribute to this condition. Some people experience it without any reason. When this disorder is experienced without a known cause, it is identified as Idiopathic hypersomnia (IH) [mfn] Idiopathic hypersomnia. (2018, June 13). Genetic and Rare Diseases Information Center (GARD) – an NCATS Program | Providing information about rare or genetic diseases. https://rarediseases.info.nih.gov/diseases/8737/idiopathic-hypersomnia [/mfn] which affects only 0.01 to 0.02 percent [mfn] Nathaniel A. Sowa, Idiopathic Hypersomnia and Hypersomnolence Disorder: A Systematic Review of the Literature, Psychosomatics, Volume 57, Issue 2, 2016, Pages 152-164, ISSN 0033-3182, https://doi.org/10.1016/j.psym.2015.12.006. [/mfn] of the population.

Read More About Alcoholism Here

How Is Hypersomnia Diagnosed?

In order to have a correct diagnosis, a thorough examination is necessary. The doctor usually reviews the patient’s medical history and his symptoms to diagnose Hypersomnia.

The doctors may use several tests to diagnose Hypersomnia, including:

1. Sleep Diary

The doctor recommends the patient maintain a diary where they record their sleep and wake times in order to track sleeping patterns.

2. Epworth Sleepiness Scale

Patients rate their sleepiness in order to determine the severity of the condition.

3. Multiple Sleep Latency Test

Patients take a nap which is monitored during the day. The test is designed to measure the types of sleep the patient experiences.

4. Polysomnogram

The patient is required to stay over at the sleep center. This machine monitors brain activity, eye movements, heart rate, levels of oxygen, and breathing of the patient in order to determine what is causing it.

Your doctor may ask you a set of questions to understand the severity of your disorder. They may include:

• When did you first notice your sleeping pattern?
• Does anything make them worse?
• Is there anything that you do that makes you feel better?
• Are there any medical conditions that you are currently being treated for?
• What are your sleeping patterns?
• What is your sleep environment like?

The doctor may also review your medications so that they can identify if your medications are causing your hypersomnia. They may also recommend that you get a sleep study. The sleep study involves an overnight sleep in a sleep lab where a person is hooked on to various monitors including a pulse oximeter, an electrocardiogram, and a brain wave monitor. This equipment helps the doctor to identify if a person’s daytime sleepiness could be due to a sleep disorder, such as obstructive sleep apnea.

If there are no signs or any underlying disorder, your doctor may diagnose you with Hypersomnia.

How Is Hypersomnia Treated?

The DSM-5 has categorized Hypersomnia as a “sleep-wake disorder”. Treatment for this disorder should be directed towards the cause of onset, if there is any. If it lasts for more than 3 months, then it is recommended that you seek professional help. Hypersomnia, if left untreated, can interfere with the quality of life and have adverse effects on the human body.

There is no evidence on why human beings need to sleep but it is crucial to have quality sleep every day. Not having adequate sleep can make an individual less productive and restless during the day and may even cause physical harm. There are several methods with which hypersomnia can be treated, such as:

1. Medications

Once you visit a doctor, they will start by analyzing your medical history. Here are some of the most common medications that are prescribed to treat this condition:

• Amphetamine
• Methylphenidate
• Modafinil
• Clonidine
• Levodopa
• Bromocriptine
• Antidepressants
• Monoamine oxidase inhibitors (MAOIs)

Read More About Antidepressants Here

2. Lifestyle Changes

Your doctor may recommend some lifestyle modifications in order to cope with hypersomnia and control your sleep pattern. They include:

• Avoiding caffeine and nicotine
• Drinking alcohol in moderation. Consumption of excess alcohol can result in sleep deprivation.
• Avoid foods that cause indigestion and heartburn. Examples can be high-fat creams, carbs, fried food, spicy meals, and carbonated drinks.
• Using visually inducive lights that differentiate between day and night. This can be done by being outdoors and getting exposed to plenty of light during the day and making a dark room during the night.
• Having a relaxing bedtime routine to indicate to your body that it’s time to sleep. You can include reading time or having a warm shower before going to bed.
• Making the sleep environment more comfortable. This may include adjusting the temperature of your room, sleeping on a comfortable mattress, and not using cellphones before going to bed.

3. Scheduled Naps

Taking scheduled naps has proven to reduce daytime sleepiness without interfering with the quality of sleep at night. It is of utmost importance to keep the naps between 15 to 20 minutes to make this method effective. Sleeping for more than 30 minutes can result in sleep inertia.

What Can You Do To Beat Hypersomnia?

According to the National Health Service (NHS) UK, here are some of the things you can do that might make you feel better. It’s not a cure for hypersomnia, but making some changes in your sleeping habits may make a big difference.

Make sure that you try to:

• Every night, go to bed at the same time.
• Avoid alcohol and caffeine
• Create a peaceful environment.
• Avoid medications that make you feel drowsy
• Avoid working late

If you still feel sleepy then it’s best to seek help from a medical professional. Your doctor can conduct tests in order to determine if you have Hypersomnia or excessive sleeping disorder.

Can You Recover From Hypersomnia?

Simple lifestyle changes can significantly improve the condition of a person suffering from Hypersomnia. However, medications prescribed by the doctor also play a crucial role in extreme cases. It is not a life-threatening disorder but has a significant impact on one’s day-to-day life. There is no prevention for excessive sleeping disorder but you can considerably reduce the risk of developing it by creating a calm and peaceful sleeping environment and avoiding drugs and alcohol.

Hypersomnia is very common in the present day due to technological advancements and living in a dynamic environment. If you think you have these symptoms, consult a doctor about your concerns.

Hypersomnia At A Glance

1. Hypersomnia is a neurological disorder.
2. This condition is characterized by repeated episodes of excessive and chronic daytime sleepiness.
3. The primary symptom of hypersomnia is excessive sleepiness despite getting quality sleep every day.
4. There is a possibility that an increase in the brain chemicals in an individual can cause this condition.
5. It’s not a cure for hypersomnia, but making some changes in your sleeping habits may make a big difference.
6. Simple lifestyle changes can significantly improve the condition of a person suffering from Hypersomnia.