Hypersomnia: Causes, Symptoms, Diagnosis and Treatments

Hypersomnolence or hypersomnia is a common condition for those experiencing excessive or chronic sleep deprivation. Unlike insomnia, hypersomnia is characterized by excessive daytime sleepiness or excessive time spent sleeping.

This reduces the alertness required to perform daily tasks. Unlike common tiredness, hypersomniac patients feel tired and exhausted regardless of the amount of time they sleep.

Let’s have a deep look at this condition.

What Is Hypersomnia?

Hypersomnia is

a sleep disorder associated with frequent episodes of excessive sleepiness regardless of nocturnal sleep. It is not considered a disorder but a symptom of any other underlying medical health condition.

People with hypersomnia
constantly feel

a strong desire to rest or nap during the day. It affects their professional and personal life to a great extent.

If the condition persists for a long time period, it can open the doors for mental disorders and other neurological disorders.

What Qualifies as Oversleeping?

Oversleeping refers to sleeping longer than your body’s natural sleep requirements. However, how much sleep is considered excessive varies between individuals.

Most adults need 7 to 9 hours of sleep per night. Sleeping more than 9 hours consistently could indicate oversleeping. However, some people may naturally require more prolonged nighttime sleep.

Oversleeping for more than 10 hours nightly or napping for over an hour daily on a regular basis likely indicates a sleep disorder or other health condition, unless you are one of the rare long sleepers who need to sleep this much.

While occasional oversleeping may just mean you need to catch up on sleep, chronic oversleeping can signify an underlying issue.

Signs of oversleeping include needing an alarm to wake up, feeling groggy after waking, needing to nap frequently, reduced productivity, and consistently sleeping more than 9 hours.

Sleeping more than 12 hours per night could signify a sleep disorder like hypersomnia, obstructive sleep apnea, or narcolepsy. Oversleeping needs medical evaluation if it occurs often and interferes with daily life.

The cause of oversleeping can range from lack of exercise, stress, depression, sleep deprivation, to side effects of medication. Determining the trigger will allow proper treatment.

Causes of Hypersomnia

Hypersomnia

is a multi-faceted condition and requires thorough medical evaluation.

Primary hypersomnia lacks a clear cause but involves issues in the brain system that regulate sleep and wakefulness. It is also called idiopathic hypersomnia, as idiopathic refers to the lack of an apparent cause or trigger. Those who have it
wake up unrefreshed

despite long periods sleeping.

Primary hypersomnia is a diagnosis of exclusion after testing rules out other sleep disorders.

Evidence suggests

those diagnosed with idiopathic hypersomnia constitute approximately 1% of the patient population observed in neurological sleep centers.

Secondary hypersomnia

can be associated with a range of underlying medical conditions. It can be associated with neurological diseases—such as Parkinson’s disease, epilepsy, or brain tumors—which disrupt the brain’s ability to regulate sleep-wake cycles.

Psychiatric disorders or mood disorders can trigger excessive sleepiness, such as depression or bipolar disorder.

Chronic diseases, particularly those that cause inflammation or hormonal imbalances, are also associated with secondary hypersomnia. Examples include
hypothyroidism

or another thyroid dysfunction,
chronic fatigue syndrome,

and
fibromyalgia.

Certain prescription medications used for mental health, allergies, hypertension, and pain can also
induce hypersomnia

as a side effect.

For effective treatment, it is important to identify the specific cause as it directs the approach to managing the excessive sleepiness and associated symptoms.

Primary hypersomnia is managed through lifestyle changes and stimulant medications. Secondary hypersomnia involves treating the root cause, like adjusting medications or using CPAP for sleep apnea.

Identifying triggers for secondary hypersomnia can be complex. A comprehensive evaluation by a sleep specialist is key to pinpointing the factors leading to excessive sleepiness. This facilitates proper management.

Symptoms of Hypersomnia

Symptoms of hypersomnia can vary and interfere with daily life. The most prominent symptom is daytime sleepiness (EDS), where individuals find it difficult to stay awake and alert during daytime activities.

This condition persists despite adequate or extended nocturnal sleep. People with hypersomnia sleep for extended hours and wake up feeling tired, unrefreshed, and disoriented. They also feel difficulty in waking up after sleep, including naps.

Hypersomniac patients often feel confused or groggy—a
state referred

to as sleep drunkenness and more prolonged than the usual sleep inertia experienced by the average sleeper on waking up.

These groggy feelings can be accompanied by anxiety, irritability, decreased energy, restlessness, slow thinking, slow speech, loss of appetite, and memory difficulties.

These symptoms of hypersomnia can be chronic and can occur daily over a period of at least three months for a diagnosis. These symptoms are often severe enough to cause distress and impair work, social, and other vital functions—differentiating hypersomnia from normal sleepiness or the occasional difficulty waking up.

Hypersomnia vs. Insufficient Sleep Syndrome

Hypersomnia and insufficient sleep syndrome both involve excessive daytime sleepiness. However, the underlying causes and characteristics differ.

With hypersomnia, individuals experience recurrent episodes of extreme sleepiness and require lengthy sleep durations. This persists regardless of getting sufficient or even extended sleep time at night. It is a neurological disorder where the sleep-wake regulating mechanisms are impaired.

In contrast,
insufficient sleep syndrome

is caused by consistent inadequate nighttime sleep. The individual is unable to get the 7-9 hours of sleep at night needed on a chronic basis. This sleep deprivation accumulates and leads to increased daytime sleepiness.

People with insufficient sleep syndrome will feel better after catching up on lost sleep. However, those with hypersomnia will still experience sleepiness despite recovery sleep.

Also, poor sleep is a consequence of external factors like occupational, family, or lifestyle demands. Hypersomnia typically arises from an internal biological dysfunction.

Distinguishing between the two is important for treatment. Addressing sleep debt and improper sleep hygiene can resolve insufficient sleep syndrome. But hypersomnia requires a more clinical approach to managing an underlying disorder.

Impact of Hypersomnia

Hypersomnia impacts the affected person’s life in various ways. It often impairs cognitive functions, diminishes concentration and memory, and adversely affects academic and work performance.

The inability to stay alert during the day poses significant safety risks, especially when driving or operating machinery.

On the social front, people with hypersomnia may withdraw from activities or social interactions due to fatigue or embarrassment about their condition. They might face misunderstandings or misconceptions about their state—and often get labeled as lazy or unmotivated.

People with hypersomnia also find it challenging to maintain the quality of relationships in their lives. The condition hinders one’s ability to perform daily routines or household tasks.

In the long run, this condition can contribute to the onset or worsening of mental health issues, such as depression or anxiety, due to chronic stress and frustration. Moreover, mental health disturbances can also exacerbate hypersomnia.

Diagnosing Hypersomnia

Getting an accurate diagnosis of hypersomnia requires a comprehensive medical evaluation by a sleep specialist. The doctor will review your medical history, sleep patterns, and symptoms. They may order several tests to help determine the cause and severity of excessive daytime sleepiness.

The multiple sleep latency test (MSLT)
measures how quickly you fall asleep

during daytime naps. It assesses your sleep propensity and likelihood of dozing off.

An overnight polysomnogram or sleep study tracks your brain waves, heart rate, breathing, and movements during sleep. It helps identify other issues like sleep apnea.

You may be asked to maintain a
sleep diary

for 1-2 weeks, noting sleep and wake times, naps, medications, and daily fatigue levels. This provides insight into your sleep-wake cycles.

The Epworth Sleepiness Scale is a common questionnaire
that evaluates

your likelihood of falling asleep in various situations. It quantifies daytime sleepiness levels from normal to pathological.

These diagnostic tests help clinicians pinpoint the specific factors contributing to your hypersomnia. The results guide them in developing an effective treatment plan tailored to your condition. Accurate diagnosis is key to properly managing symptoms and improving your quality of life.

Managing Hypersomnia in Daily Life

Living with hypersomnia is challenging and requires careful management to reduce its impact on daily life. Maintaining a conducive sleep environment and a regular sleep schedule are foundational steps.

Though the condition is challenging, patients are still advised to avoid stimulants or any other substance that interferes with sleep quality. Engaging in relaxing activities before bedtime can also help improve sleep hygiene.

You can also try strategic power naps with limited short durations. However, avoid getting a nap late in the day as it can potentially disrupt nighttime sleep.

Try to move or exercise regularly for better sleep. It helps regulate sleep patterns and improve alertness during the day, helping you fend off fatigue or grogginess.

It is crucial to address any underlying medical condition that may contribute to hypersomnia. Consult with a medical healthcare professional to help manage symptoms.

FAQs

What is the main cause of hypersomnia?

The main cause of hypersomnia is unknown. It can stem from various sources, including sleep disorders like narcolepsy, sleep apnea, or the disruption of normal sleep patterns. Some other conditions like neurological diseases and side effects of certain medications of prolonged sleep deprivation can also cause hypersomnia.

What is the most common treatment for hypersomnia?

The most common treatment for hypersomnia often involves lifestyle modifications. These include establishing a consistent sleep schedule, improving sleep hygiene, and creating a sleep-healthy environment. In some cases, stimulant medications may be prescribed to help manage excessive sleepiness.

Which deficiency causes hypersomnia?

Hypersomnia can be caused by various factors, and sometimes it’s present in an individual with no clear cause. While specific vitamin and mineral deficiencies have been linked to excessive daytime sleepiness, no definitive single deficiency has been identified as the direct cause of hypersomnia.

However, deficiencies in vitamins such as vitamin D, iron, and vitamin B12 are known to potentially contribute to daytime sleepiness.

Is hypersomnia serious?

Severe or prolonged hypersomnia can be serious as it affects several aspects of your life. The affected person finds it challenging to maintain cognitive functions, work performance, and social relationships. This is why diagnosis and treatment is important.

Is hypersomnia a mental disorder?

Hypersomnia is not classified as a mental disorder. However, it can be associated with or contribute to various neurological and mental health conditions. However, it can be associated with or contribute to various neurological and mental health conditions and can potentially worsen or lead to the onset of mental health problems.

If left untreated, it can open the door to several neurological and mental illnesses, such as depression and bipolar disorder, either as a symptom or a comorbid condition that exacerbates the mental health issues.

Conclusion

Hypersomnia involves excessive sleepiness and profoundly affects one’s quality of life, productivity, and mental health. Though there’s no known cause of hypersomnia, there are underlying health conditions that may cause it.

Understanding the causes, recognizing symptoms, and seeking appropriate treatment are vital steps toward managing this challenging condition.

The most common treatment option involves lifestyle adjustments and sleep hygiene practices. Pharmacological inventions targeting underlying conditions can also be used. However, it is crucial to consult with a healthcare professional for accurate diagnosis and tailored treatment plans.