DO you have difficulty staying awake during the day, despite having had more than enough sleep at night? If so, you may be suffering from hypersomnia, a condition where you feel sleepy and fall asleep during the day despite adequate night-time sleep.
If you have hypersomnia, you experience extreme sleepiness during the day and fall asleep several times during the day, despite having had sufficient or more than sufficient sleep during the night.
Seven to nine hours is normally considered adequate night-time sleep. If you have nine hours sleep every night and still have difficulty staying awake during the day, you are almost certainly suffering from hypersomnia.
If you only sleep for six hours or less per night, you are probably not having enough sleep and may have a higher risk of hypertension, stroke or cardiovascular disease.
Hypersomnia affects your ability to be alert and function as you should at work and socially. It increases your chances of having an accident, as you may fall asleep, for instance, while driving.
It usually starts between the mid-teens and early twenties, though it can start at any time. It is commoner in females than males. Symptoms may become more intense at intervals. In women, the symptoms may worsen just before a period.
Types and causes
There are three types of hypersomnia.
Primary hypersomnia is where extreme sleepiness is a condition in itself. It is not caused by another condition. Secondary hypersomnia is due to another medical condition or to medication.
Idiopathic hypersomnia is where the cause of the condition is unknown. Narcolepsy, which makes you drowsy during the day and unable to stay awake for long periods of time, comes under primary hypersomnia. If you suffer from narcolepsy, you may fall asleep suddenly even in the middle of a task.
There are numerous medical conditions that can cause secondary hypersomnia. They include depression, bipolar disorder, multiple sclerosis, nerve damage due to a head trauma, epilepsy, encephalitis, hypothyroidism, encephalitis, Parkinson’s disease, sleep apnoea, damage to the central nervous system or a tumour.
Medication that can cause secondary hypersomnia includes sedatives, hypertension drugs, medicines for epilepsy or Parkinson’s and anti-psychotic medicines. Alcohol and recreational drugs can also cause it.
Causes of idiopathic hypersomnia are unknown. If you suffer from it, you may find it difficult to wake up. After a nap you generally do not feel refreshed. You may wake up confused and disorientated.
Risk factors
People with conditions that make them sleepy during the day are most at risk of hypersomnia. These conditions include sleep apnoea, kidney conditions, heart conditions, nervous system conditions, depression, low thyroid function, encephalitis and epilepsy. People who smoke or drink alcohol regularly are also at risk of developing hypersomnia. Medications that cause drowsiness may have side effects similar to hypersomnia.
Complications
Hypersomnia can be dangerous if you drive, use machinery or do other work that requires full alertness. It can also affect your studies and social life. Ignoring hypersomnia may mean you are not receiving treatment for another condition which has caused it.
Symptoms
The main symptom of hypersomnia is constant sleepiness. If you have hypersomnia, you may find that you are sleeping more than 11 hours in every 24 hours. You may even be taking naps throughout the day but still feel sleepy. Other symptoms include difficulty waking from a long sleep, slow thinking and speech, difficulty remembering things, irritability, anxiety, low energy and, in some cases, experiencing hallucinations.
Diagnosis
To tell whether or not you have hypersomnia, your doctor will review your symptoms and medical history. You will likely be diagnosed with hypersomnia if for the last three months you have experienced excessive daytime sleepiness, an uncontrollable need to sleep, long unrefreshing naps and difficulty waking up from sleep, even after typically adequate or longer periods of night time sleep.
To assess hypersomnia, your doctor may also ask you to keep a sleep diary in which you record your sleep and awake at times during the night to track your sleeping patterns. An Epworth sleepiness scale may be used to rate your sleepiness and determine the severity of the condition.
A multiple sleep latency test can be done to monitor your naps during the day using a device that measures the types of sleep you experience. A polysomnogram can also be used to monitor your brain activity, eye movements, heart rate, oxygen levels and breathing function.
Treatment
Treatment depends on the cause and type of hypersomnia. Options include stimulant drugs to promote wakefulness typically used for treating narcolepsy and drugs to prevent muscle weakness and sleepiness.
Successful treatment of the condition causing secondary hypersomnia is likely to also cure the hypersomnia. Lifestyle changes may help you either manage your sleep patterns or cope better with hypersomnia.
You can consider working on a regular sleep schedule such as waking up and sleeping at the same time each day. Avoid certain activities such as eating or working in bed. Start eating a healthy diet that is rich in whole foods. This may help maintain energy levels naturally.
Prevention
There is no way to prevent some forms of hypersomnia. You can, however, reduce the risk of hypersomnia by creating a peaceful sleeping environment and avoiding alcohol and certain medications. It is essential to seek treatment for any underlying conditions as ignoring these may lead to complications that are related to hypersomnia.
Outlook You can reduce or improve your hypersomnia symptoms with the right lifestyle changes and medication. The effectiveness of this varies with different people. Some may never obtain full relief. Hypersomnia is not a life-threatening condition but may have an impact on the quality of your life.
It may make it difficult to work, study and do other everyday activities. If you suffer from hypersomnia or have symptoms related to this condition, inform your doctor as soon as possible to find out if you can be given treatment, including that for any other condition that may be causing the hypersomnia.
Outlook
You can reduce or improve your hypersomnia symptoms with the right lifestyle changes and medication. The effectiveness of this varies with different people. Some may never obtain full relief. Hypersomnia is not a life-threatening condition but may have an impact on the quality of your life. It may make it difficult to work, study and do other everyday activities. If you suffer from hypersomnia or have symptoms related to this condition, inform your doctor as soon as possible to find out if you can be given treatment, including that for any other condition that may be causing the hypersomnia.
