Hypersomnia is a rare condition that affects 10% of individuals that experience excessive daytime sleepiness. This sleeping disorders almost never occurs in children or adults older than 30 years, however, it is most common among adolescents and can cause a lot of problems for a regular, daily functioning.
Whatever might be causing the sleepiness throughout the day should be properly addressed in order to maintain a healthy circadian rhythm and provide our body and brain with effective rest that will make us feel more energized.
If you have slept for more than 11 hours a day without feeling restored by it in a period longer than 3 months and have felt drowsy and exhausted throughout the day, you might need to check if you’re at risk of developing hypersomnia.
You might have dealt with sudden crashes of energy followed by an urge to fall asleep during the day, in which case you should read this article and discover what hypersomnia is and how to cure it.
What Is Hypersomnia?
Hypersomnia is a condition of excessive sleeping time during the day. Another name for this condition is excessive daytime sleepiness (EDS).
The word itself is derived from “hyper” meaning “too much” and “somnia” meaning “sleep”. Often, today’s medical terminology uses the term “hypersomnolence” to define broadly the long sleep durations, while hypersomnia is rather used to describe a specific condition.
While this condition may sound as if it isn’t as hard and exhausting as insomnia, it disables a person in quite the same way. People with hypersomnia have problems in functioning normally throughout the day because of the constant feeling of being tired.
Hypersomnia, however, has two types: primary and secondary hypersomnia. What is the difference between these two?
The main symptom being only excessive daytime fatigue, medical experts had to think of ways to classify hypersomnia in order to make the diagnosis and future treatment easier and more efficient.
Primary Hypersomnia VS Secondary Hypersomnia
Hypersomnia that is a primary condition occurs when the only symptom is constant fatigue. Idiopathic hypersomnia is a hypersomnia of a primary condition.
This kind of hypersomnia is diagnosed by the symptoms of excessive fatigue and too much daytime sleepiness. Idiopathic means that the causes of the condition are not clear or known, which is why treating this type of excessive sleep is more difficult.
Patients with idiopathic hypersomnia often sleep for a very long time. This hypersomnia is diagnosed after a sleep testing reveals that the patients sleep at least 11 hours in a day. This is the main criteria in diagnosing this sleeping condition.
On the other hand, secondary hypersomnia is when the symptoms of excessive sleep and daytime sleepiness are caused by another condition. According to the International Classification of Sleep Disorders (ICSD) secondary forms of hypersomnia include:
- 1. Hypersomnia due to a medical condition
- 2. Hypersomnia due to a medication or substance
- 3. Hypersomnia associated with a psychiatric disorder
Hypersomnia due to a medical condition
This type of hypersomnia is when excessive sleep is caused by an injury or a disease. For example, if a person suffers from sleep apnea,(1) Parkinson’s disease, kidney failure, or myotonic dystrophy, hypersomnia can develop as a result of poor sleep at night and the feeling of excessive fatigue during the day.
Hypersomnia due to a medication or substance
This type of excessive sleepiness is caused by a prescription or non-prescription drug. It can usually be overcome with a change in treatment.
Hypersomnia associated with a psychiatric disorder
Hypersomnia is often associated with depression, but in this case, it’s hard to establish if the depression causes hypersomnia, the other way around or the two are just related in some way. However, a psychiatry research has found that hypersomnia is a usual symptom of depression.(2)
Hypersomnia vs Narcolepsy
Even if they can sometimes look alike and present some same symptoms, hypersomnia and narcolepsy are not the same. The main difference is in the way of controlling the falling asleep momentum. Patients with narcolepsy experience unpreventable sleep attacks all of a sudden during the day, while people with hypersomnia can manage to stay awake, but will feel very tired.
Some patients with narcolepsy experience cataplexy too, which is a medical condition in which a strong emotion such as anger or laughter causes a person to experience a sudden episode of weakness. This does not occur with hypersomnia.
REM sleep is also more common in narcolepsy than in hypersomnia. It might not even occur in hypersomnia, or it would occur only rarely.
What makes these two conditions similar is the fact that patients suffering from any of these two will fall asleep in less than 8 minutes on average.
How Do You Know If You Have Hypersomnia?
The most common symptoms of hypersomnia include:
- Excessive drowsiness and fatigue
- Excessive daytime sleepiness
- Falling asleep in under 8 minutes on average
- Sleeping 11 hours or more in a 24-hour period
- Sleeping often during the day
- Not feeling refreshed after regular naps
- Sleeping long hours at night despite falling asleep during the day
- Drowsiness and sleepiness affecting your life
If you’re fighting with the constant feeling of drowsiness during the day, you might be dealing with hypersomnia. Talk to your doctor in order to determine what’s causing your sleepiness.
Before telling you the diagnosis and the treatment plan, your doctor will likely ask you about several things. First of all, the doctor will want to know more about your sleeping habits, the medications you take, as well as emotional problems. In some cases, a sleep diary might be needed too.
Your doctor might require additional tests and checkups in order to rule out any other potential conditions that might be causing your daytime sleepiness. These can include blood tests, computed tomography or MRI scans, and electroencephalogram (EEG). These will help in ruling out anemia, multiple sclerosis or problems related to brain activity.
Polysomnography will most likely be used, as it is a sleep test used to determine the cause of most sleep problems.
Your sleep specialist might also recommend a Multiple Sleep Latency Test (MSLT) which measures how quickly you fall asleep.
Why Do I Have Hypersomnia?
Hypersomnia can be a result of another medical condition so certain people might be at a higher risk of experiencing hypersomnia.
Here are some risk factors that can make the occurrence of hypersomnia more likely:
- Suffering from Parkinson’s disease
- Suffering from Sleep Apnea
- Suffering from Myotonic Dystrophy
- Intake of some prescription or non-prescription drugs
- Suffering from a Psychiatric disorder
- Suffering from Depression
- Alcohol or drug abuse
- Being overweight
Hypersomnia can also sometimes come as a result of sleep deprivation. So if you’ve experienced sleep deprivation first, excessive sleeping might be your body’s way of getting enough sleep. However, sleeping too much during the day is not good and people that tend to sleep a lot in an extended period of time should see a doctor.
Some people can also be more prone to developing hypersomnia due to genetics. If you have a relative that has suffered from excessive daytime sleeping, this condition might be passed onto you through genes.
Is Hypersomnia A Disability?
Dealing with any sleep disorder can affect your life and, of course, your work. The fact that hypersomnia will make you fall asleep several times a day will reduce your productive hours and will make you fear getting fired or not being able to maintain your employment.
Therefore, symptoms of idiopathic hypersomnia or any sleep disorders are indeed considered as disabilities which will likely make you eligible for short-term or long-term disability benefits. If you feel you can’t cope anymore with your sleepiness and lack of focus at work, talk to your employer and discuss the long-term or short-term leave that will let you deal with your condition better.
Can Hypersomnia Be Cured?
When talking about curing and treating hypersomnia we have to make one thing clear. Secondary hypersomnia is cured by treating the condition that led to forming the sleeping problem. On the other hand, treating primary, idiopathic hypersomnia is quite different.
Hypersomnia can be cured, but there is no known cure for it. In fact, doctors often prescribe medication used in narcolepsy treatments to fight sleepiness and promote daytime wakefulness.
What Is The Cure For Hypersomnia?
So far three major classes of medications were approved for the treatment of sleepiness associated with narcolepsy and hypersomnia. These include stimulant medications, non-stimulant wake-promoting medications, and sodium oxybate. Let’s explain each of them more thoroughly.
Stimulant medications, derivatives of amphetamines, that are commonly used in treating sleepiness include dextroamphetamine and methylphenidate (Ritalin). These medications were shown to be quite effective in decreasing the excessive need for sleep, but they may also bring potential adverse events such as dependence, aggressive behavior or even heart problems.
Non-stimulant medications that are used in treating hypersomnia and narcolepsy are usually Modafinil and Armodafinil. Modafinil proved to be among the best cures for increasing wakefulness by influencing brain chemistry (3). However, the mechanism of these medications is not completely clear. When taken with hormonal birth control, non-stimulants become less effective in treating sleepiness and might result in headaches or even life-threatening rashes.
Although this medication is mostly created for patients with narcolepsy, it is still prescribed to people suffering from hypersomnia. Sodium oxybate is taken before bedtime and during the night in order to promote deep sleep. By doing so, it also decreases daytime sleepiness.
There have been more researches about the best way to treat and cure hypersomnia, and one of them suggests that Mazindol is quite good in supporting a healthier sleep on a long-term basis for people with hypersomnia. (4) Mazindol is a tricyclic, anorectic, non-amphetamine stimulant that is also efficient in eliminating cataplexy.
How Do You Overcome Hypersomnia?
Hypersomnia is not something that you can cure and treat overnight. It is a condition that develops and is affected by many factors that have to be addressed accordingly in order to completely overcome it.
First of all, it will be necessary to have a good doctor that you can rely on. In most cases, getting in touch with a sleep specialist, neurologist or psychiatrist is also crucial in order to cure hypersomnia for good. Sleeping disorders are often caused by our emotional and mental states that we’re not aware of.
Before getting any of the prescription drugs mentioned above, your doctor will try to see if any medication you are currently taking is causing the drowsiness. If that seems to be the case, you might have to try taking another drug instead. Sometimes this simple modification might help in eliminating excessive sleepiness throughout the day.
If that doesn’t seem to improve your situation, your doctor will probably advise you to make certain lifestyle changes. Usually, these changes include quitting alcohol and coffee, as these substances affect notably our circadian rhythms and ruin our healthy sleep.
When associated with depression, the cure to your hypersomnia might lay in using antidepressants. This will only be the case if your hypersomnia is caused by depression and not the other way around. If this is the case, make sure you have a good psychiatrist that will help you resolve your problem properly.