Hypersomnia

Hypersomnia – Research & Treatments

Hypersomnia, or hypersomnolence, means “excessive sleepiness,” and it is characterized by an individual having a hard time staying awake throughout the day…

What is hypersomnia?

People with hypersomnia can fall asleep at any time and in any condition, even while driving or at work.  The primary symptoms of hypersomnia are prolonged nighttime sleep and excessive daytime sleepiness, with the desire to take several long naps during the day.  This condition is more prevalent in men than in women, affecting approximately 5% of the population.

What Are The Symptoms Of Hypersomnia (EDS)

Hypersomnnia, or excessive daytime sleepiness (EDS), is usually a symptom of a larger condition.

Those with hypersomnia suffer from constant, recurrent episodes of extreme sleepiness and symptoms of sleep deprivation.  It can be caused by other disorders such as narcolepsy, obstructive sleep apnea, and the use of some types of medications.

There are several tests that can be done to diagnose hypersomnia, which will determine whether the individual has primary (originating in the brain) or secondary (originating as a result of another disease) hypersomnia.

Hypersomnia is a symptom of a bigger condition

First, the physician will look for other obvious sleep disorders that could be causing the excessive sleepiness, with the primary goal being to determine if there are treatable medical conditions present.  These tests could include polysomnography, subjective scales such as the Epworth Sleepiness Scale and the Stanford Sleepiness Scale, as well as objective tests like the multiple sleep latency test.  The physician will usually make the diagnosis when symptoms have been present for three consecutive months and there are no other underlying diseases.

Differences Between Primary Hypersomnia & Secondary Hypersomnia

Primary hypersomnia is rarer than secondary hypersomnia, affecting less than 1% of the population and usually associated with a more widely known diagnosis.  Primary hypersomnia includes diagnoses such as narcolepsy, idiopathic hypersomnia, and Klein-Levin syndrome (recurrent hypersomnia). 

 It is notable that primary hypersomnia is often 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.

Neurological disorders may also resemble hypersomnia.  Problems like brain tumors, lesions, and dysfunctional thalamus, hypothalamus, or brainstem may lead to excessive sleepiness.  Further, diseases like Alzheimer’s and Parkinson’s may have symptoms that look like primary hypersomnia as well.

 Secondary hypersomnia is much more prevalent.  The excessive sleepiness can be a result of other conditions such as depression, obesity, epilepsy, or multiple sclerosis.  It is common in those with upper airway resistance syndrome, restless leg syndrome, sleep deprivation, and substance abuse.  Some people may be genetically predisposed to the condition as well.

Common Conditions That Lead To Hypersomnia

There are a host of conditions that could lead to hypersomnia; however, the most common cause is Sleep Apnea, affecting approximately 4% of the population.

Real Stories from Real People – visit the ASA Page on The Mighty

Natural & Prescribed Treatments

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; however, more often than not, it is more appropriate to treat the underlying cause than it is to treat the symptom.  Most common treatments include the use of stimulant medications like amphetamines to help the individual stay awake throughout the day.  In addition, behavioral therapy, sleep hygiene, and education are usually added to a treatment regimen.

Sleep Conditions Related to Hypersomnia AKA Excessive Daytime Sleepiness (EDS)

Idiopathic hypersomnia & narcolepsy are related to EDS. Hypersomnia is a sleep symptom defined as excessive daytime sleepiness.

Primary Hypersomnia is a sleep disorder that shares many similarities with narcolepsy in terms of symptoms. However, it lacks the classic ‘triad of narcolepsy symptoms.

People with primary hypersomnia will often sleep in excess of 10 hours, and are very difficult to wake during this time. Despite what would be considered an abundance of sleep for most people, they will still feel tired during the day, and may feel compelled to nap multiple times, even at times or in places that would not be considered socially acceptable. Like the prolonged sleep periods, these naps often provide only short periods of relief from the chronic tiredness, and another desired nap session will quickly approach.

Hypersomnia may be caused by other sleeping disorders, though these would generally be categorized as such , and not as hypersomnia. It may also be a case of genetics in some people, and could also be the cause of certain drugs or medications, brain damage, or other medical disorders like fibromyalgia. In some cases, hypersomnia has no directly attributable cause and these cases are classified as idiopathic hypersomnia.

Primary Hypersomnia is a relatively rare sleeping disorder, affecting under 1% of the population. It is slightly more common in females than in males, and typically starts in early adulthood. It is very rarely found in children.

Diagnosing hypersomnia will require some tests to make ensure there aren’t any other medical conditions or sleeping disorders causing the excessive sleepiness. A doctor may want you to maintain a sleep diary for one or more weeks before setting up these tests, and will also want to know the length of time the excessive daytime sleepiness has afflicted you for. 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.

Tools To Detect Hypersomnia

Polysomnogram and multiple sleep latency tests are both good tools in detecting hypersomnia or other sleeping disorders. The multiple sleep latency test measures the speed at which a person enters deep sleep over numerous 2 hour intervals. People with hypersomnia and other related disorders like narcolepsy tend to fall asleep very quickly, and this is considered the best test for detected these sleeping disorders. A multiple sleep latency test of less than 10 minutes may indicate one of the above sleeping disorders. The polysomnogram test measures the subject’s brain waves and bodily movements during sleep phases, and this is good for detecting other sleep disorders that may be leading to the daytime sleepiness. If nothing abnormal is detected during this test, you may be asked to come back for a 2nd test to validate the data, and barring changes in the results, it may be determined that you have hypersomnia.

Primary Hypersomnia is most commonly treated with stimulants like amphetamine and modafinil. Other treatments could include antidepressants. Behavioural changes are also instituted in most cases, and for those with idiopathic hypersomnia, this is one of the only treatment methods available at present.

Proper sleep hygiene is the most important behavioral change that must be implemented. This includes setting a regular sleeping schedule, having a sleeping environment that is well suited to quality sleep, a comfortable bed and pillow, and avoiding caffeine or other stimulants near bedtime.

Natural Treatments

Some treatment plans may include an attempt at avoiding naps completely through the use of daytime stimulants, others will attempt to remove naps systematically, while others will encourage naps in balanced doses and at proper times and locations. How hypersomnia gets treated, and with what ultimate goal(s) in mind is up to the patient, and these should be ambitious yet realistic.

Summary

Hypersomia, or excessive daytime sleepiness, is a very common finding in our society that has many causes and many treatment options.

Hypersomnia

The American Sleep Association (ASA) was founded in 2002 by a group of Sleep Professionalsseeking to improve Public Health by increasing awareness of the importance of Sleep in ensuring a high quality of life, as well as the dangers of Sleep Disorders. Through our own Research, and investing in the Research of others, the ASA Members and Board are committed educating millions of people on the importance of sleep health and to resolving Sleep DisordersInsomnia and Sleep Apnea.

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13 Replies to “Hypersomnia”

  1. Karen Ammons

    My daughter is 15 years old and has problems since end of elementary school. It continues to get worse. She has been diagnosed with IH and sleep wake disorder. Every medicine she has tried has not worked. She is using a blue light and taking Modanifil 200 mg but if she is sleepy enough she will fall asleep and stay asleep for a whole day. Then the cycle starts over. There are a few times during the week she will stay up but is still fatigued and then fall asleep early. She has had her sleep studies done with MSLT test and all the other tests there are. She doesn’t eat well and eats one meal a day. Are there any treatments that are not the normal but works on teens? I am really worried about her health.
    Thanks

  2. BG

    Karen — I’ve had sleep issues (among other health problems) since i was 15, but was not diagnosed with narcolepsy until my mid-20’s. To stay awake during the day i now take 250mg of Nuvigil (the only med that keeps me able to function) and (when needed) supplement that with caffeinated energy drinks such as Starbucks Doubleshot or Monster Coffee. When i was in high school, before i was diagnosed (and before the advent of energy drinks) my neurologist would allow me to drink an entire pot of coffee, espresso or several bottles of mountain dew a day to give me the caffeine needed to stay awake. This, of course, is just a suggestion, and something i would first discuss with your daughter’s doctor, but caffeine has always helped me and it continues to help me today even on the rare days my Nuvigil falls short. Good luck to you both, and i hope your daughter finds something that works for her soon!

  3. SH

    I am a 34-year-old female. My excessive sleepiness is ruining my relationship. I fall asleep for long periods of time during the day when im off and then still fall asleep once I try to watch a movie with my “fiancé”.He gets mad at me because of it. I have to take caffeine pills to stay awake with him but I don’t like taking them because they have me up the entire night.So does anyone eles have this problem?? I would love some advice

    • TMT

      Dear SH,

      I am someone with I.H. for over 10 years now. During my life I definitely had similar experiences before being regulated on Modafinil. Unfortunately, I don’t have a specific answer solving your movie time situation. I can only suggest analyzing the factors that do keep you awake currently and try applying them during movie time with your fiancé if possible. Though my advice is a bit vague, I hope to create an opportunity that may spark a possible solution through our conversation.

      At the end of the day you know your dilemma best with all the background situational variables and boundaries.

      On a side note, though it won’t solve your movie time problem, I do have another suggestion if you are interested to discuss further.

      Just let me know! I will check back on this website at a later time.

      • Ki

        I am 32 and have hypersomnia and I fall asleep during anything. I have created a new sleeping method which includes me not having caffeine hours before bed and taking melatonin gummies before bed and using calming body washes and scents.

    • James F Moore jr

      Look into light therapy, they have devices on Amazon. Usually the devices are used in the morning, I would try that first. If not then I would try using it while you are watching the movie. Look for something 10,000 lux. I hope this helps!

  4. Nicole

    I have a super hard time staying awake around the summer months, and sleep for 10-14 hours, wake up groggy and angry. But I also have periods where I don’t sleep for two days, I get so tired I’m not tired anymore. It’s so strange. Should I still get checked for IH?

    • Jennifer Kramer

      Hi Nicole,

      Without much other info, I would suggest you schedule a psychiatric evaluation. Please don’t take offense! The symptoms you described sound like you could have a type of bipolar disorder which very commonly impacts sleep! I don’t have that, but I do have depression and anxiety. I know that many people don’t want to consider psych issues as culprits for their problems, but with so very many people suffering with them one would think the bad stigma would cease already! I hope that you get help for whatever is ailing you!

  5. DB

    I have a problem. I can’t sleep. I have difficulty falling asleep at night. I take antianxiety medication that makes me drowsy, and it helps me to fall asleep. I then sleep for about 14 hours. Everyone says that it’s the medicine, but it’s not. The thing is, if I don’t take them, after a day or two, I can’t sleep at all. I’m awake for about 36 hours before I crash and sleep for 16 hours. Then I start to hallucinate and hear voices. But I can take other antianxiety medications that don’t make me drowsy, but I can’t sleep at all until I crash. Once I stop taking the medicine, after about a week I sleep everyday for 18 hours. Nothing helps, and it’s extremely difficult to wake me. What’s wrong with me? My doctor says I just don’t get enough vitamin c.

  6. Jen

    DB,
    I’ve never heard of vitamin C deficiency causing that! Vitamin D deficiency can keep a person fatigued, and many people say they feel much better after they start taking it. Before anything though, the Dr should do blood work to see if there’s anything underlying the symptoms you’re having! If they won’t, find a different Dr. Also, quitting anxiety meds cold turkey can be a very scary situation!! Please don’t do that! I’m not sure what you’re taking, but the typical benzos need to be tapered down extremely slowly, and even then you are likely to have withdrawal symptoms. After I learned that taking Xanax can cause dementia (I’ve been having terrible memory problems!) I started taking myself off of it but it took a couple of months. I was only taking .5mg twice per day, and I still had problems sleeping and was rather angry for no real reason as well.

    I’m sorry to hear you too are suffering. I think a different Dr might be a good place to start off the one you have isn’t listening. Good luck!!

  7. Cheryl Jensen

    I have a diagnosis of OSA and then hypersomnia for lack of a better diagnosis. The CPAP did not fix the hypersomnia. I had the 24 hr test, but I don’t think it was done correctly since it was only a daytime test, not 24 hrs, and they did not monitor in between naps. I also have Fibromyalgia, Vit D and folic acid deficiencies and periodic bouts of insomnia and increased hypersomnia.

    However, the biggest problem is none of the medications have been effective. The Dr finally ordered a pharmacological genetics test that showed I rapid metabolize most stimulants and am inefficient at processing anything that affects Seritonin. However, other medications it did not show a problem with or that should be affective haven’t worked either. I have extreme reactions to Effexor, Gabapentin, and Topamax, and Concerta is only sporadically effective. We had already eliminated Modafinil, Adderall, and Vyvanse. Vyvanse worked ok for a couple of months, but it became less and less effective at the highest dose and never did more than help me stay awake. I have never experienced jitters, euphoria, or any real increase in my energy level. I took both my Concerta today 36 mg, total 72; it’s 6:51 and I’ve fallen asleep 3 times while typing this. This is a huge disruption to my life, and I am at a loss.

  8. CJC

    I was diagnosed with Idiopathic Hypersomnia without long sleep time about 12yrs ago. I have used Nuvigil or Povigil with some improvement but not much. Today: my Sleep Doc tells me that she cannot treat me for IH until I fulfill the ‘requirement” of getting at least 7 hrs sleep/night. This is the first time ever I have been told this. I started a log and find that I get from 6 – 7.5 hrs sleep/night with a rare exception. The computer says it is about 5.5 hrs sleep/night and the computer, of course, wins. If she treats me without my meeting the minimal sleep requirement, she will lose the Accredidation for the Clinic. Thus: she says she can no longer write refills for the Nuvigil or Provigil. Is this for real? Has anyone else run into this? Please advise.

  9. Jitin

    The issue of sleep has infected my life pervasively. Although I know that I am a mental health patient, still I face memory problems and need for caffieniated drinks to survive. In any interesting profession, you’ve to have a good memory atleast. I am tired of it and this further depresses me. My life has turned into s**tstorm. I consulted psychiatrists and also my physician, but nothing helps. Psychiatric anti anxiety pills, mood stabilizers and modafin don’t help me at all. What to do? Please help me.

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