Hypersomnia - Know About It

Introduction

Hypersomnia may pose a challenge to one’s work, social, and home life. An individual experiencing hypersomnia may feel sleepy during the day despite sleeping adequately or more than adequately at night. Hypersomnia could be a result of certain medical conditions or neurological factors. Hypersomnia is also referred to as excessive daytime sleepiness or hypersomnolence. Since these individuals have trouble staying awake during the day, their concentration and energy levels may be affected. A major danger associated with hypersomnia is the increased risk of accidents.

What Are the Different Types of Hypersomnia?

The different types of hypersomnia are as follows:

1. Idiopathic Hypersomnia: In this condition, an individual may feel extremely sleepy for no clear reason.

2. Primary Hypersomnia: Primary hypersomnia occurs when hypersomnia is the main condition and manifests as a symptom of narcolepsy (excessive, uncontrollable sleepiness during the day) or due to neurological causes. One theory that is proposed for the occurrence of primary hypersomnia is that in a few individuals, there could be excessive production of a certain small molecule in the cerebrospinal fluid whose action mimics that of an anesthetic or a sleeping pill. However, further research is necessary to validate this.

3. Secondary Hypersomnia: In this condition, hypersomnia could be a consequence of another medical condition like:

• Depression.

• A tumor.

• Alcohol or drug use.

• Nerve damage due to head trauma.

• Medication use.

• Sleep apnea (a serious type of sleep disorder in which there is repeated cessation and initiation of breathing).

• Damage to the central nervous system.

• Multiple sclerosis (an autoimmune condition in which the immune system engulfs the protective covering of the nerves).

A few of these conditions may affect one’s sleep at night, which results in tiredness during the day.

Why Does One Experience Hypersomnia?

The reason for most cases of hypersomnia is not known. Researchers have researched the potential roles of neurotransmitters (chemical messengers) present in the brain and spinal cord, like dopamine, histamine, hypocretin or orexin, gamma-aminobutyric acid (GABA), and serotonin. A genetic link may also contribute to hypersomnia since a family history has been present in about 39 percent of individuals with idiopathic hypersomnia. There is ongoing research about the role of certain genes in circadian rhythm that may differ in individuals with idiopathic hypersomnia. Other causes include:

Who Is at Risk of Experiencing Hypersomnia?

People with the following conditions that make them feel sleepy during the day are at an increased risk of experiencing hypersomnia:

• Depression.

• Sleep apnea.

• Heart, kidney, and nervous system conditions.

• Encephalitis (inflammation of the brain).

• Low thyroid function.

• Epilepsy (a brain disorder that results in recurrent seizures).

• Those who drink or smoke regularly.

• Medications that induce drowsiness.

Hypersomnia can usually manifest between mid-teens and early twenties (mean age is 17 to 24 years) but can happen at any time. Symptoms may aggravate at intervals. In females, the symptoms may worsen just prior to menstruation. According to the Hypersomnia Foundation, symptoms may go off in about 10 to 15 percent of individuals for no obvious reasons. Hypersomnia has a female predominance. It is believed to affect about 5 percent of the population.

What Are the Signs and Symptoms of Hypersomnia?

The signs and symptoms of hypersomnia are as follows:

• Constantly and repeatedly experiencing episodes of extreme daytime sleepiness.

• Sleep drunkenness (difficulty waking up in the morning) or difficulty waking up after daytime naps, sometimes appearing confused.

• Despite sleeping longer than usual (10 hours or more), one might feel very sleepy during the day and find it difficult to stay awake during the day.

• Daytime naps do not seem to improve alertness.

• Restlessness.

• Decreased energy.

• Anxiety, irritability.

• Headache.

• Loss of appetite.

• Hallucinations.

• Slow speech, slow thinking, memory problems, difficulty focusing or concentrating.

How Can Hypersomnia Be Diagnosed?

A doctor will assess the medical history and symptoms of the individual to diagnose hypersomnia. One is said to be diagnosed with hypersomnia if they experience the following for a minimum of three months:

• An uncontrollable urge to sleep.

• Excessive daytime sleepiness.

• Long, unrefreshing naps.

• Difficulty waking up from sleep even after sleeping for long hours at night.

A physical examination may be done to check for alertness. The following may be suggested by a physician to diagnose hypersomnia:

• A Sleep Diary: One might be asked to record their sleep and wake times through the night to assess their sleeping patterns.

• Multiple Sleep Latency Test: One is allowed to take a nap during the day, and the nap is monitored using a device that measures the types of sleep that one experiences.

• Epworth Sleepiness Scale: This scale rates sleepiness to evaluate the severity of the condition.

• Polysomnogram: In this method, one is asked to stay at a sleep center overnight, and a device is used to monitor the activity of the brain, oxygen levels, breathing function, and heart rate.

In What Ways Can Hypersomnia Be Treated?

The treatment of hypersomnia depends on the cause and type of hypersomnia. The following are some of the treatment options for treating hypersomnia:

1. Stimulant drugs used for treating narcolepsy can be used such as:

• Amphetamines like Methylphenidate.

• Modafinil (Provigil), a drug used to stimulate wakefulness.

• Pitolisant (Wakix), a stimulant drug.

• Flumazenil (Romazicon) which reverses the action of benzodiazepines.

• Sodium oxybate (Xyrem), which prevents sleepiness and muscle weakness with narcolepsy.

• Narcolepsy differs from hypersomnia in that narcolepsy is linked with abrupt sleep attacks, but this is not a symptom of hypersomnia. In hypersomnia, an individual may have long naps that last longer than an hour, but the individual may not find it refreshing. However, in narcolepsy, an individual may feel refreshed after a short nap.

2. Lifestyle changes can help individuals manage their sleep or deal better with hypersomnia, which is as follows:

• Refraining from doing certain activities like eating or working in bed. By doing this, one’s sleep quality will be improved.

• Joining a support group.

• Following a regular sleep routine, like waking and going to bed at the same time daily.

• Following a diet rich in whole foods may aid in maintaining energy levels naturally.

Is There a Possibility to Prevent Hypersomnia?

Some forms of hypersomnia cannot be prevented. One can minimize the risk of hypersomnia by refraining from alcohol consumption and intake of certain medications and by establishing a peaceful sleeping environment. One must not ignore seeking treatment for the underlying conditions, as neglecting these may result in complications.

Conclusion

Hypersomnia is a condition in which an individual finds it challenging to stay awake during the day despite sleeping sufficiently at night. This could have a dangerous consequence, especially when one drives, uses machinery, or performs other works that mandate full alertness. One’s social and academic life may also be affected. Hypersomnia may also be associated with some underlying conditions like depression, alcohol use, and so on. Those who sleep for long hours in the day for most days may be exposed to an elevated risk of developing high blood pressure (also known as hypertension), cardiovascular disease, or stroke. Hence, if one experiences symptoms of hypersomnia, one must consult a physician and should not ignore the symptoms.