Hypersomnia: Symptoms, causes, and treatments

Excessive daytime sleepiness and prolonged nighttime sleep (over 11 hours) are signs of a chronic condition called hypersomnia. Additionally, sleep does not help to alleviate the fatigue and exhaustion of individuals with hypersomnia. Symptoms of this condition can range from anxiety and irritability to hallucinations, memory problems, and an inability to function in certain social or occupational settings. Though it is not life-threatening, this disorder can still lead to serious repercussions, such as accidents from falling asleep while driving. It can be classified as either primary or secondary depending upon the underlying cause. Primary hypersomnia, which occurs independently of any other medical condition, is classified by the Sleep Foundation as a disorder that is not caused by any known factor or condition. On the other hand, secondary hypersomnia is caused by other medical conditions, medications, substances, psychiatric disorders, or insufficient sleep.

The most common cause of hypersomnia is chronic or acute sleep deprivation and falls in the category of secondary hypersomnia. This often occurs due to poor sleep hygiene, such as in the case of shift workers, like doctors, nurses and carers, as their circadian rhythms - the brain's natural way of regulating the body's sleep cycle - are disturbed by their night shifts. In these cases, the body's natural response is to try and make up for the lost sleep during the day, leading to increased sleepiness.

Excessive sleepiness can also be a sign of an underlying medical condition like hypothyroidism, brain injuries, and certain illnesses of the nervous system, such as Parkinson's disease, epilepsy, and multiple sclerosis. It may also be caused by certain medications, drinking alcohol, or withdrawing from stimulants.

Primary hypersomnia disorders, as identified by the National Institute of Neurological Disorders and Stroke (NINDS), include narcolepsy type 1, narcolepsy type 2, Kleine-Levin syndrome, and idiopathic hypersomnia. These conditions are often linked to abnormal sleep patterns, excessive sleeping during the day, and other sleep-related symptoms.

It is estimated that 10-20% of adults around the world suffer from this disorder Dr. Abhinav Singh, the medical director of the Indiana Sleep Center explained. In Addition, Dr. Anita Raja, a general practitioner in the U.K., told Live Science that the symptoms of insomnia can have an adverse effect on a person's mood, concentration, relationships, and energy levels, thus making it imperative that individuals who notice the signs of the disorder go to a medical professional and seek treatment

Hypersomnia can be diagnosed when a person experiences daily periods of excessive sleepiness or falls asleep during the day for at least three months, and when the results of a multiple sleep latency test (MSLT) show a sleep latency of fewer than 8 minutes or a total sleep time of 11 or more hours. Additionally, cataplexy (sudden loss of muscle tone triggered by strong emotions) or sudden muscle weakness should not be present. The cause of idiopathic hypersomnia should also be ruled out, such as insufficient sleep syndrome, medical conditions, medications, substances, or psychiatric disorders.

Treatment for hypersomnia may include the drug Xywav, the only Food and Drug Administration-approved medication specifically for this disorder, as well as stimulants such as amphetamine, methylphenidate, and modafinil. Non-drug options may also be used, such as short naps and caffeine intake to help increase wakefulness. Furthermore, lifestyle modifications are often recommended, such as avoiding night work, reducing alcohol intake, keeping a healthy weight, eating a balanced diet, and practicing relaxation techniques like meditation and yoga.

References

Gora, A. (2023, January 23). Hypersomnia: Symptoms, causes and treatments. Live Science. Retrieved January 25, 2023, from https://www.livescience.com/hypersomnia-symptoms-causes-treatments