Hypersomnia: Types, Symptoms, Causes, Risks, Complications, Diagnosis, Treatment, Outlook and Prevention

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A man who suffer from hypersomnia and try to keep his eyes open during the day

1Overview

Sleep is an important factor in overall health and wellness. Sleep plays an important role in the physical health since it’s involved in the repair and healing of important organs such as the heart and blood vessels. When a person lacks sleep, he or she is at a greater risk of kidney disease, high blood pressure, diabetes, heart disease and stroke.

However, sleep disorders can affect the quantity and quality of sleep person has. One of the sleep disorders people may experience is hypersomnia.
This is the excessive sleep or sleepiness that can interfere with daily life.

It’s characterized by the insatiable need for sleep even if the person had a full night’s sleep. This condition may be caused by sleep apnea, narcolepsy or restless legs syndrome, depression, some medications and severe sleep deprivation, among others.

According to the National Sleep Foundation, about 40 percent of people may experience some hypersomnia in their lifetime.

2Types

Primary or idiopathic hypersomnia – This condition has no explanation or underlying cause

Secondary hypersomnia – This condition is caused by the factors stated above.

Primary hypersomnia is less common than secondary hypersomnia, affecting about less than 1 percent of the population. This type of hypersomnia includes idiopathic hypersomnia, narcolepsy, and the Klein-Levin syndrome or recurrent hypersomnia.

On the other hand, secondary hypersomnia is more common with causes ranging from depression, multiple sclerosis, obesity, and epilepsy. An underlying health problem causes this type of hypersomnia.

3Symptoms

Individuals with hypersomnia struggle to stay awake during the day and they tend to sleep frequently, causing problems at work and school. The symptoms include:

  • Feeling extra sleepy or falling asleep at inappropriate times such as a meal, during a conversation and even while driving.
  • Sleeping for more than 10 hours at night
  • They feel confused or drowsy upon waking up in the morning (sleep drunkenness)
  • Have low energy
  • Restless and irritable
  • Respond, move or talk slowly
  • Trouble concentrating
  • Trouble remembering things
  • Restlessness
  • Fatigue or extreme tiredness
  • Anxiety or depression
  • Agitation

The signs and symptoms of the disease first appear in the mid-to-late teens or early adulthood, but they can also appear in childhood or older adults. The sleep of a person with hypersomnia is deep and the arousal from sleep can be hard, sometimes requiring various alarm clocks.

Idiopathic hypersomnia usually affects younger people, those aged less than 30 years old. The condition tends to progress slowly over a couple of months to years. The patients affected may have a problem with being able to work normally. This is because of the extreme sleepiness and tiredness.

For some people, they are mistaken to show lack of interest or motivation to work or study, or they are just lazy. However, the social support of the patient, particularly his or her friends and family members should understand how hard it is having the condition of always being sleepy. In some cases, the condition may lead to depression. Also, patients are barred from driving or operating heavy machinery.

4Causes

In idiopathic hypersomnia, the exact cause is still unclear. However, some experts believe that the condition is caused by the overproduction of a small element in the brain that resembles the effects of a sleeping pill. However, the exact composition of this molecule remains unknown.

Like insomnia, hypersomnia has many causes such as head injuries, hypersomnia, hypersomnolence and brain tumors. Here are the common causes of hypersomnia.

  • Other sleep disorders such as sleep apnea (breathing interruptions during sleep) and narcolepsy (daytime sleepiness)
  • Not getting enough sleep (sleep deprivation)
  • Obesity or being overweight
  • Prescription drugs like tranquilizers or sleeping pills
  • Family history
  • Head injury
  • Neurological diseases like multiple sclerosis or Parkinson’s disease
  • Brain tumor
  • Anemia
  • Another sleeping disorder such as narcolepsy
  • Impairment of the autonomic nervous system
  • Drug abuse

5Risk Factors

Hypersomnia affects about 5 percent of the general population. In fact, regarding gender, men are more affected than women. The reason behind this is, men are at a higher risk of having sleep apnea, a common cause of hypersomnia.

Moreover, studies have shown that hypersomnia appears to have a genetic component. As a matter of fact, approximately 50 to 60 percent of the cases run in families.

The other risk factors include:

6Complications

If the condition is left untreated, it may lead to various complications including:

  • Problems with relationships
  • Impaired ability to work and function in school
  • Can’t operate heavy machinery
  • Impaired ability to drive
  • Impaired ability to concentrate at work

Other complications:

Accidents – People with hypersomnia are at a higher risk of accidents because he or she might fall asleep while driving.

Obesity – People who are deprived of sleep may also exercise less and eat more, making them prone to gaining weight and obesity.

Hypertension – When a person has hypersomnia, he or she is at a higher risk of hypertension, which will also increase the tendencies of other medical conditions such as heart failure, kidney disease, stroke and heart attack.

7Diagnosis

If you are experiencing the symptoms of hypersomnia, you should contact a sleep doctor immediately. The common symptoms include increased daytime sleepiness and sleeping more than ten hours.

The doctor will conduct a complete physical examination and medical history. In this interview, the doctor will ask about your sleeping habits, how long you sleep at night and the many factors that may increase the risk of hypersomnia.

The doctor will also refer you to a specialist or a psychiatrist, especially if you have emotional problems such as depression. The medicines you are taking will also be taken into account.

Blood tests can also be requested to determine any underlying health conditions that may aggravate sleepiness or hypersomnia. Other tests include:

Polysomnography – This test is done during the night. Also called night-time sleep test, it helps rule out sleep disorders such as sleep apnea and narcolepsy. The patient will sleep in a bedroom and will be observed from another room throughout the night. During sleep, the patient will have electrodes attached to his body, head and face to help record brain waves, eye movement, snoring, brain activity and breathing.

Multiple sleep latency tests – This test is done the next day after a polysomnography. The patient will be asked to take many naps throughout the day. The doctors will take note of how long the naps took and if the patient falls asleep easily.

CT scan or MRI of the head – The doctors can also request for brain imaging tests to see if there are any abnormalities that may be causing the hypersomnia.

8Treatment

Medicine

There are no drugs specifically designed to treat hypersomnia. However, the drugs used to treat narcolepsy may help. The main drugs to treat hypersomnia include stimulants like amphetamine, modafinil, and methylphenidate.

Antidepressants may also be prescribed if the cause of the condition is an emotional problem such as depression. The other drugs used to treat hypersomnia include levodopa, clonidine, bromocriptine and monoamine oxidase inhibitors.

A new drug has been made available today, called flumazenil. This has shown promise and has been observed to produce positive effects in some patients. Make sure that your doctor will prescribe the medicines first before taking them.

The promising drug has been seen to treat sleep problems and even anxiety.

 

Lifestyle changes

Changing some habits may help a person manage hypersomnia, especially if the cause is known such as sleep deprivation, working night shifts or having emotional problems such as depression.

  • Avoid alcohol, medications, and caffeine that can make sleeping a problem
  • Shift to a morning shift work
  • Adapt to good sleeping habits
  • Stick to a bedtime routine
  • Avoid activities at night that may delay bedtime
  • Go to bed at the same time each night and wake up the same time every morning.

For sleep apnea patients

If you are diagnosed with sleep apnea, the doctor may recommend treatments to curb the condition. This includes a treatment option dubbed as continuous positive airway pressure or CPAP. In this treatment, the patient will wear a mask over the nose during sleep. A machine will provide a continuous flow of air into the nose to keep the airways open and reduce obstruction.

9Outlook

The prognosis of hypersomnia depends on the severity of the symptoms or manifestations. Those who have mild symptoms may have a good and positive outlook compared to those with severe symptoms.

Also, the outcome for hypersomnia depends on the treatment and compliance of the patient. Many of the treatment options entail prolonged treatment, some people may not comply.

10Prevention

At present, there are no ways to prevent idiopathic hypersomnia because the reason behind the condition is unknown. However, for secondary hypersomnia, here are the preventive measures for hypersomnia.

  • Avoiding food and beverages that may interfere with sleep such as alcohol and caffeine.
  • Get about 7 to 8 hours of sleep daily.
  • Exercise regularly
  • Eat a well-balanced diet
  • Reduce stress