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Are You Feeling Sleepy? Understanding Hypersomnia

Do you often find yourself fighting (or perhaps giving in to) excessive sleepiness during the day, despite getting a good night’s sleep? Is daytime sleepiness having a negative effect on your everyday activities — at work or on the home front? Do you sleep longer than most people but often wake up disoriented and groggy?

If you answered yes to any of these questions, you may be living with a condition called hypersomnia, which the National Institutes of Health describes as “characterized by recurrent episodes of excessive daytime sleepiness or prolonged nighttime sleep.”

People with hypersomnia can be irresistibly drawn to napping repeatedly throughout the day, sometimes at the most inappropriate, inconvenient or even dangerous times. When driving, for instance.

And they may have difficulty waking from an extra-long nighttime sleep. Other possible effects of hypersomnia include depression, restlessness, slow thinking, loss of appetite, memory problems and hallucinations. Any of these can seriously impair your ability to navigate the challenges of day-to-day life.

People with hypersomnia can be irresistibly drawn to napping repeatedly throughout the day, sometimes at the most inappropriate, inconvenient or even dangerous times.

What Causes Hypersomnia?

Hypersomnia describes a set of symptoms that can show up in various sleep disorders. It can be caused by conditions such as narcolepsy or sleep apnea, for instance. Other possible contributors to hypersomnia may include:

• A problem with the autonomic nervous system, which controls functions like breathing, heartbeat and digestion that you don’t have conscious control of
• Drug or alcohol abuse
• Head trauma, tumor or injury to the central nervous system
• Certain medications (or medication withdrawal)
• Medical conditions such as depression, multiple sclerosis, encephalitis, epilepsy or obesity

Narcolepsy and Other Hypersomnias

The most well-known cause of hypersomnia is narcolepsy, a neurological disorder that interferes with the brain’s ability to regulate the sleep-wake cycles. People with narcolepsy can feel sleepy throughout the day and may fall asleep even while engaging in daily activities, including eating and driving. Other symptoms of narcolepsy may include:

• Cataplexy – the sudden loss of muscle tone and voluntary muscle control, ranging from minor (a drooping eyelid, for instance) to major (a total body collapse). These episodes usually don’t last long and resolve on their own.
• Sleep paralysis – the temporary inability to move while falling asleep or waking up
• Hallucinations – seeing or perceiving vivid, sometimes frightening images. Hallucinations are sometimes accompanied by sleep paralysis.

Other sleep disorders under the hypersomnia classification include:

• Idiopathic hypersomnia — an irrepressible need for daily periods of sleep, typically totaling 12 to 14 hours in a 24-hour period
• Klein-Levin Syndrome — recurrent episodes (usually more than once a year) of excessive sleepiness and sleep duration, with each episode persisting for two days to five weeks
• Insufficient sleep syndrome — regularly failing to get enough sleep at night, perhaps due to a work schedule or personal habits, resulting in sleep deprivation that makes you sluggish throughout the day

How Is Hypersomnia Diagnosed and Treated?

Your health care provider will typically perform a physical examination and discuss your medical history with you. She will ask about your symptoms, your sleep habits and how your sleep problems are affecting your daily activities. Your doctor may suggest that you take part in a sleep study and keep a diary of your sleep habits.

Depending on the results of the examination and testing, your treatment could involve:

• A prescription of stimulants, such as amphetamine, methylphenidate or modafinil
• Antidepressant medications and/or behavioral therapy
• Changes in your habits and behavior (including exercise and nap therapy) to promote a more regular sleep schedule and help you maintain daytime alertness
• Dietary changes such as avoiding alcohol and caffeine

Source: American Academy of Sleep Medicine; National Sleep Foundation; National Institute of Neurological Disorders and Stroke; MedlinePlus