Hypersomnia

hypersomnia

Hypersomnia means “excessive sleepiness” and refers to a condition in which a person has trouble staying awake during the day. People suffering from hypersomnia often simply fall asleep at any time and any place: sitting at their desk, driving home from the store or drifting off in conversation. They may also have other sleep-related problems, including an overall lack of energy and trouble thinking clearly.

This sleep disorder can be characterized by regular episodes of excessive daytime sleepiness or extended nighttime sleep. Different from just feeling tired from lack of or interrupted sleep at night, people with hypersomnia may nap throughout the day, often at inappropriate times such as at work in the middle of a meal. But these daytime naps usually don’t provide any relief from symptoms. Patients often have difficulty waking from a long sleep, and may feel disoriented.

According to the National Sleep Foundation, up to 40% of people have some symptoms of hypersomnia from time to time. Other symptoms may include

  • anxiety
  • increased irritation
  • decreased energy
  • restlessness
  • slow thinking
  • slow speech
  • loss of appetite
  • hallucinations, and
  • memory difficulty.

Some patients lose the ability to function well in family, social or work settings.

Some potential causes of hypersomnia include:

  • Sleep disorders such as narcolepsy* (daytime sleepiness) and sleep apnea (interruptions of breathing during sleep)
  • Not getting enough sleep at night (sleep deprivation)
  • Being overweight
  • Drug or alcohol abuse
  • A head injury or a neurological disease, such as multiple sclerosis
  • Prescription drugs, such as tranquilizers
  • Genetics (having a relative with hypersomnia)

* Note that hypersomnia isn’t the same as narcolepsy, which is a neurologic condition that causes sudden unpreventable sleep attacks at any time of day. People with hypersomnia can stay awake, but they feel completely fatigued.

Two Types of Hypersomnia: Primary and Secondary

Primary hypersomnia occurs when no other medical conditions are present. The only symptom is excessive fatigue. It is thought to be caused by problems in the brain systems that control sleep and waking functions.

This type of hypersomnia is unusual, affecting less than one percent of the population and usually associated with a more widely-known diagnosis. It can include diagnoses such as narcolepsy, idiopathic hypersomnia, and Klein-Levin syndrome (recurrent hypersomnia). It also can be associated with genetic disorders including, but not limited to, myotonic dystrophy, Prader-Willi syndrome, and Norrie disease; however, the hypersomnia may be considered a secondary symptom in many of these cases.

Secondary hypersomnia is much more prevalent. The excessive sleepiness describes the condition when it is due to other medical conditions, like sleep apnea, Parkinson’s disease, kidney failure or chronic fatigue syndrome. These conditions cause poor sleep at night which leads you to feel tired during the day. It is common in people with upper airway resistance syndrome, restless leg syndrome, sleep deprivation, and substance abuse. For example, sleep apnea can cause hypersomnia because it can cause trouble breathing at night, forcing people to wake up multiple times throughout the night.

Diagnosing Hypersomnia

If you consistently feel drowsy throughout the day, talk to your doctor. To make a diagnosis, your doctor will ask you about sleep habits, how much sleep you get at night, if you wake up at night, and whether you fall asleep during the day. Your doctor will also want to know if you are having any emotional problems or are taking any drugs that may be interfering with your sleep.

Diagnosing hypersomnia will require some tests, such as bloodwork, computed tomography (CT) scans, and a sleep test called polysomnography. In some cases, an additional electroencephalogram (EEG) is useful to measures the electrical activity of the brain. You might keep a sleep diary for a couple of weeks before scheduling these tests. A diagnosis of hypersomnia will probably not be made unless the offending symptoms have been around for at least three uninterrupted months, and with no apparent cause.

Treatment Options for Hypersomnia

Treatment will depend greatly on the underlying cause of hypersomnia and whether it is a primary or secondary concern. Sometimes, catching up on sleep will alleviate the excessive sleepiness. More often than not, it is more appropriate to treat the underlying cause than it is to treat the symptom. In addition, behavioral therapy, sleep hygiene, and education are usually added to any treatment regimen. Changes in behavior (for example avoiding night work and social activities that delay bed time) and diet may offer some relief.

If you are diagnosed with hypersomnia, your doctor can prescribe various drugs to treat it, including stimulants, antidepressants, as well as several newer medications (for example, Provigil and Xyrem). If you are diagnosed with sleep apnea, your doctor may prescribe a treatment known as continuous positive airway pressure, or CPAP.  (Learn more about CPAP.)

If you are taking a medication that causes drowsiness, ask your doctor about changing to one that is less likely to make you sleepy. You may also want to go to bed earlier to try to get more sleep at night, and eliminate alcohol and caffeine.

If you or someone you love are suffering from excessive sleepiness and need help, …

…please give us a call at 847-674-3600 to schedule an appointment with one of our sleep specialists.

 

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