What Is Hypersomnia - Featured

What Is Hypersomnia and How to Cope With It

by Dr. Lina Velikova, MD

Numerous scientific papers emphasize the importance of getting adequate sleep every night. At the same time, insomnia’s catastrophic effects on the body can be seen both in the short and long term. Fortunately, after sleeping an adequate number of hours, we can replenish our energy—our mind and body recover enough to maintain a healthy state of alertness. 

But then what is hypersomnia? There are people whose sleep patterns change in a manner that’s the complete opposite of insomnia. In the case of hypersomnia, we know that this condition accompanies a change in one’s quality and quantity of sleep, meaning they’ll sleep for an excess of over nine hours. When someone gets this much sleep, they’ll usually feel tired and even experience increased sleepiness throughout the day.

Why Am I Sleeping So Much All of a Sudden? 

There’s evidence that between 4% and 6% of the global population is affected by the condition known as hypersomnia. It also has adverse effects on the body’s overall health, which shouldn’t be overlooked. These effects can be associated with the development of neurological diseases such as Alzheimer’s disease, Parkinson’s disease, stroke, and other issues. 

If you wonder, “Why do I sleep for 12 hours and still feel tired?” then it’s time to change your sleep cycle. It’s best to consult a specialist who will help you learn to cope with the condition. A sleep expert will follow your sleeping habits, do the necessary research, and help you deal with this severe problem. 

Nevertheless, hypersomnia is sometimes a real challenge for doctors to diagnose. In some cases, hypersomnia can be truly insidious, keeping you from your daily duties, even your work, and potentially ruining your life. Be careful and seek medical help when you feel that something in your sleep routine isn’t right.

What Is the Hypersomnia Definition?

Increased sleepiness, or so-called hypersomnia, is the state of having a disturbed sleep model, which is manifested by the following:

  • Sleeping 10–12 hours
  • Having difficulty waking
  • Feeling fatigued during the day

Hypersomnia as a sleep disorder is characterized by the presence of excessive drowsiness during the day, even though the previous sleep period lasted more than seven hours. Hypersomnia and insomnia are both types of sleep disorders that affect the schedule, quantity, and quality of your sleep—but in opposite ways.

In the case of hypersomnia, patients remain drowsy for most of the day, usually after an average sleep of at least nine hours or more. Most importantly, that sleep may not allow people to actually get enough rest. A person with hypersomnia can sleep for long periods, as well as during the day. The condition can even include falling asleep in a manner similar to narcolepsy. 

Hypersomnia vs. Narcolepsy and the Types of Hypersomnia

What Is Hypersomnia - Types

We can identify different types of hypersomnia depending on the underlying cause. It is essential to note that although narcolepsy can also cause episodes of sudden sleep, it’s an entirely separate pathology with its own specific characteristics and therefore should not be confused as a type of hypersomnia.

Primary or Idiopathic Hypersomnia

With this type of hypersomnia, the condition’s causes aren’t known, although the primary type of hypersomnia can be observed as part of a condition called Klein-Levin’s syndrome. The latter manifests as continuous periods of intense sleep (for several days or weeks), altered behavior, and a decreased understanding of the world.

This condition is the opposite of primary insomnia in terms of where it falls on the sleep disorder spectrum. Instead, it’s characterized by sleeping as much as 20 hours in a row, while still remaining tired for the rest of the day. Other accompanying symptoms include high irritability, hyperphagia, and hypersexuality. It’s not uncommon to have hallucinations and speech and memory problems. These episodes of hypersomnia often occur with regularity.

Secondary Hypersomnia

Unlike primary hypersomnia, the act of sleeping for a prolonged period of time with difficulty waking up may instead have specific reasons that explain it. For example, some of the people with secondary hypersomnia are sleep deprived because their sleep is interrupted. Otherwise, they might take various drugs or medications or have a concurrent medical or psychiatric disorder. In these cases, hypersomnia would not be the primary disorder, but a symptom of an underlying condition.

Alternating insomnia and hypersomnia define this variation of the sleep disorder. It’s possible for the affected person to sleep for 18 hours a day in order to meet their physiological needs after not sleeping enough. These episodes may appear chaotic, lasting for a few weeks or even months. Once they finish, patients are able to establish a standard sleep pattern. Other symptoms typical of this type of hypersomnia include overeating, sexual hesitancy, and irritation.

One unusual type of this condition is recurrent hypersomnia. It’s characterized by recurrent episodes of excessive drowsiness, which may last for several days.

What Are the Most Common Hypersomnia Symptoms?

What Is Hypersomnia - Symptoms

Along with the three main symptoms—prolonged sleeping (usually lasting over 10 hours), trouble waking up, and extreme fatigue during the day—there are other signs that suggest the condition:

  • Constant drowsiness
  • Yawning often
  • A high probability of falling asleep again after waking up
  • Profound sleep
  • Needing a longer time to adapt after waking

Besides the lack of energy, this disorder can cause emotional disturbances. It isn’t rare to observe hypersomnia and anxiety, irritability, demotivation, or apathy together. People who suffer from hypersomnia usually have memory problems, and sometimes they’ll suffer from intellectual disabilities and physical challenges. Additionally, at the systemic level, this condition can weaken the immune system.

If you’re verifying the presence of this disorder, the somnolence episodes should occur at least three times a week (although it can happen practically every day) for at least a month. It’s worth noting that the symptoms for hyposomnia, despite how it first sounds, are in direct contrast with hypersomnia.

Other less common symptoms include decreased appetite, memory problems, and delayed speech. Moreover, hypersomniac people usually suffer from a significant dysfunction, reducing their capacity and results at work, home, and in society. In fact, a patient can fall asleep in high-risk situations, such as when they’re driving or bicycling.

What Is the Cause of Hypersomnia? 

Increased sleepiness may be due to an impaired circadian rhythm, a chronic sleep deficiency, overwork, another sleep disorder, or certain medications. However, the most likely causes of this condition are largely unknown today. When hypersomnia is diagnosed as a primary disorder, the symptoms won’t be explained in the context of another pathology, drug use, or sleep deprivation. 

When we exclude all of the previously mentioned causes, we can establish a diagnosis of primary hypersomnia as the ICD 10 describes (that being the 10th revision of the International Statistical Classification of Diseases). Thus, diagnoses based on the consumption of medications or another medical problem will fall under secondary hypersomnia.

Even if the causes aren’t fully understood, the possible changes in the limbic system may explain the behavioral changes related to Klein-Levin’s syndrome. The deficiency in synthesis and transmission of noradrenaline may also play a role in understanding this disorder. In addition, a possible injury in the areas of the brain responsible for sleep regulation may cause severe idiopathic hypersomnia.

Common Medical Causes

The following conditions or diseases lead to an increased risk of hypersomnia:

  • Chronic fatigue syndrome
  • Sleep apnea – This is characterized by spontaneous night seizures of respiratory arrest. They can occur sometimes dozens of times a night. This severely debilitates a patient’s oxygen supply to the brain and can have life-threatening complications: myocardial infarction, stroke, or sudden death during sleep.
  • Narcolepsy –This is a genetically mediated disease characterized by disturbed sleep, catalepsy (muscular atony) and paralysis, and increased drowsiness. Patients may fall asleep during the day multiple times.
  • Insomnia
  • Brain trauma can cause post-traumatic hypersomnia, as well as an epidural hematoma, brain tumor, stroke, transient ischemic attack, meningitis, encephalitis, or migraine with aura.
  • Gastroesophageal reflux disease (GERD)
  • Hypovolemic and cardiogenic shock
  • Hyponatremia, hypercalcemia, and hypothyroidism
  • Acute mountain sickness
  • Restless legs syndrome – This is a neurological disorder that leads to insomnia and increased daily drowsiness. It’s characterized by nighttime numbness, tingling, and leg pain.

However, more severe illnesses could be linked to hypersomnia: depression, bipolar disorder, Parkinson’s, Alzheimer’s disease, diseases of the musculoskeletal system and connective tissue, disruptions in the endocrine system, and others. At the same time, certain single, concentrated events have also been known to lead to hypersomnia.

Temporary Causes

What Is Hypersomnia - Symptoms

The following covers some common temporary hypersomnia causes:

  • Long journeys that include crossing time zones, which can lead to jet lag 
  • Prolonged stress
  • A permanent lack of sleep that exhausts the nervous system
  • Taking certain medications

The pathophysiological cause of hypersomnia could be an alteration in the reticular formation in the brain. This is a network of neurons located in the brainstem next to the hypothalamus. If there’s a problem in this part of the brain, the balance between wakefulness and drowsiness could be disturbed.

Is It Okay to Sleep a Lot?

Diagnosing this condition may be a challenge for doctors. Here are some signs that are grounds for seeking medical help for yourself or a loved one:

  • You suddenly start to sleep more than usual.
  • You experience an unexpected, uncommon desire for sleep.
  • It’s hard to keep your wits.
  • You notice other symptoms such as headaches, forgetfulness, a feeling of distraction, etc.

Because the underlying cause of this condition may be a medical problem, your doctor should examine your heart and lungs, and order any other necessary laboratory tests before making a proper diagnosis.

How Do You Treat Hypersomnia?

What Is Hypersomnia - Treatment

Hypersomnia is a tedious and worrying problem for those who suffer from it, and it can significantly deteriorate the quality of their lives. Worse, the disorder can lead to terrible accidents. Therefore, if you’re diagnosed with it, it’s essential that you receive treatment.

Firstly, it’s best to avoid driving or using heavy machinery. Secondly, try to maintain the best possible sleep hygiene. Sports are also a great way to stay active and reduce any sense of tiredness. In fact, physical activities are typically included in hypersomnia treatment.

It’s a good idea to establish and follow an individual sleep and wake schedule. To facilitate getting regular sleep, try to avoid any technological distractions or noise before going to bed.

Cognitive-behavioral techniques can also be used to address any problems arising from the disorder and to help patients maintain focus. Patients are also trained in detecting the first signs of sleepiness. They can then apply several physical and mental exercises to raise their level of consciousness and physiological activity.

The hypersomnia treatment guidelines also advise avoiding the use of depressants like alcohol, as well as any medicines with the same effect. At the same time, your doctor might prescribe the use of certain drugs or stimulants. Some antidepressants such as imipramine or MAOIs have been used as a treatment, although caution should be exerted due to certain adverse effects, such as increased blood pressure.

If you’re experiencing excessive sleepiness quite suddenly, your doctor will likely ask about your mood, the current events in your life, and the medications you’re taking. Only then will they suggest any treatment options.

FAQ

What is idiopathic hypersomnia?

Those experiencing this type of hypersomnia sleep for about 25% longer than what’s usual. In this case, the condition isn’t linked to another disorder. This includes temporary hypersomnia, which often occurs in healthy people and lasts for several days or nights after a severe lack of sleep or physical overload.

If hypersomnia is a symptom of other conditions, then we’re talking about secondary hypersomnia.

How do you get rid of hypersomnia?

Hypersomnia is an unpleasant condition that requires a medical examination. If the underlying cause is known, and it can be eliminated, then this should also resolve the symptoms and consequences of hypersomnia. However, if the condition lasts too long, it can cause neurovegetative or nervous system disturbances. Therefore, it’s essential you take action to get rid of this condition.

Is hypersomnia a disability?

Hypersomnia can severely impact a patient’s work capacity and lifestyle. Moreover, about 30% of the people suffering from hypersomnia also complain of permanent headaches, and 15% to 20% have symptoms of depression. Too much sleep can deteriorate a patient’s concentration, learning, and work, as well as their relationships with others. People with this disorder often find themselves carelessly looking off into space without paying attention to what’s happening around them.

While we should define hypersomnia by its ICD 10 classification, all of the reasons mentioned here, and more, could justify considering the condition a disability.

Conclusion

When it comes to hypersomnia, we imagine sleeping peacefully for 10 to 14 hours without interruption. However, even after such a long rest, waking up is quite tricky. More importantly, hypersomnia isn’t always explained away by a lifestyle change or the use of medication—it’s usually caused by mental or neurological illnesses. Because of this, it requires further medical examinations and treatment to avoid complications. However, if you’re only now asking, What is hypersomnia? the good news is that eliminating its underlying cause (if there is one) increases the chance of getting rid of it and developing a healthy sleep routine.

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