What does hypersomnia mean
National Institute of Neurological Disorders and Stroke
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The National Heart, Lung, and Blood Institute (NHLBI), a component of the National Institutes of Health (NIH), is the leading federal funder of research on sleep disorders and operates the National Center on Sleep Disorders Research (NCSDR).
What is hypersomnia?
Hypersomnia refers to medical conditions in which you repeatedly feel excessively tired during the day (called excessive daytime sleepiness) or sleep longer than usual at night. It is different from feeling tired due to lack of or interrupted sleep at night. If you have hypersomnia, you might fall asleep repeatedly during the day, often at inappropriate times such as at work or during a meal. These daytime naps usually provide no relief from symptoms. Hypersomnia can occur on its own or be caused by:
- Another sleep disorder (such as insomnia or sleep apnea)
- Another medical condition (including multiple sclerosis, depression, encephalitis, epilepsy, or obesity)
- Drug or alcohol abuse
- Dysfunction of part of the nervous system
It can also result from a physical problem, such as a tumor, head trauma, or injury to the central nervous system.
Symptoms include:
- Difficulty waking from a long sleep
- Slow thinking
- Slow speech
- Memory difficulty
- Anxiety
- Increased irritation
- Decreased energy
- Hallucinations
Medications are available to treat one form of hypersomnia. Other medicines may be used to treat symptoms. Lifestyle changes can include avoiding caffeine or alcohol, avoiding night work and social activities that delay bedtime, and going to bed at a regular time. Counseling and support groups can also help you learn to cope with hypersomnia.
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Learn About Clinical Trials
Clinical trials are studies that allow us to learn more about disorders and improve care. They can help connect patients with new and upcoming treatment options.
How can I or a loved one help improve care for people with hypersomnia?
Consider participating in a clinical trial so clinicians and scientists can learn more about hypersomnia and related disorders. Clinical research uses human volunteers to help researchers learn more about a disorder and perhaps find better ways to safely detect, treat, or prevent disease.
All types of volunteers are needed—those who are healthy or may have an illness or disease—of all different ages, sexes, races, and ethnicities to ensure that study results apply to as many people as possible, and that treatments will be safe and effective for everyone who will use them.
For information about participating in clinical research visit NIH Clinical Research Trials and You. Learn about clinical trials currently looking for people with hypersomnia at Clinicaltrials.gov.
Where can I find more information about hypersomnia?
Information may be available from the following resources:
American Sleep Apnea Association
Phone: 888-293-3650Hypersomnia Foundation, Inc.
Phone: 678-842-3512National Sleep Foundation
Phone: 703-243-1697
Excessive daytime sleepiness (hypersomnia) - NHS
Excessive daytime sleepiness (hypersomnia) is a condition where people fall asleep repeatedly during the day.
Check if it's hypersomnia
Excessive daytime sleepiness (hypersomnia) is different from feeling tired all the time.
If you have hypersomnia, you may:
- regularly nap during the day and not feel refreshed
- fall asleep during the day, often while eating or talking
- still sleep for long hours at night
Non-urgent advice: See a GP if:
- you often fall asleep during the day
- sleepiness is affecting your life
What happens at your appointment
To find out why you're sleeping excessively, a GP might:
- ask you about possible causes of your sleepiness, such mental or physical health problems, or any medicines you may be taking
- suggest you keep a diary of when you sleep
- refer you to a doctor who specialises in sleep disorders
Treatment for excessive sleepiness will depend on what's causing it. It may include medicine to help keep you awake.
Causes of hypersomnia
Sometimes other conditions may be related to excessive sleepiness (hypersomnia). These conditions can have additional symptoms.
Additional symptoms | Possible cause |
---|---|
Falling into a deep sleep anywhere, without warning | Narcolepsy |
Loud snorting, breathing and snoring at night | Sleep apnoea |
An unusual feeling in your legs, particularly at night | Restless legs syndrome |
Low mood, little interest in things and feeling irritable | Depression |
Mood swings that range from extreme highs (mania) to extreme lows | Bipolar disorder |
Some medicines, drinking too much alcohol and taking drugs can also cause excessive daytime sleepiness.
Sometimes there is no known cause. This is called idiopathic hypersomnia.
Things you can try to help your sleeping habits
Changing your sleep habits may not cure excessive daytime sleepiness (hypersomnia), but it might help you feel better.
Try to:
- go to bed at the same time every night
- avoid drinking alcohol and caffeine
- create a peaceful sleeping environment
- if possible, avoid medicines that can cause drowsiness
- avoid working late into the night
It might also help to talk to your family and friends about your excessive daytime sleepiness so they're aware of it.
Page last reviewed: 04 August 2020
Next review due: 04 August 2023
Hypersomnia.
What is Hypersomnia? IMPORTANT
The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
Hypersomnia is a significant increase in the duration of sleep, usually accompanied by daytime sleepiness. The main signs of hypersomnia are: the duration of nighttime sleep for more than 10 hours, constant or paroxysmal daytime sleepiness, the absence of a significant improvement in the condition after daytime sleep, difficult and prolonged waking up, often with the symptom of “sleep drunkenness”. Hypersomnia is diagnosed based on clinical findings, test results, and polysomnography. Therapy of hypersomnia consists in observing a certain sleep regimen, treating the causative disease and using stimulant drugs.
ICD-10
G47. 1 F51.1
- Classification of hypersomnia
- Causes of hypersomnia
- Clinical signs of hypersomnia
- Diagnosis of hypersomnia
- Treatment of hypersomnia
- Prognosis of hypersomnia
- Prices for treatment
General
Hypersomnia is a sleep disorder in the form of an increase in its duration and increased drowsiness. It should be noted that the normal duration of sleep varies greatly and in different people can be from 5 to 12 hours. Therefore, when talking about hypersomnia, the duration of sleep is assessed individually in comparison with the period before the onset of sleep problems. It is necessary to distinguish hypersomnia from increased daytime sleepiness with insufficient nighttime sleep due to life circumstances or insomnia.
In clinical practice, hypersomnia is much less common than insomnia (insomnia). It is not always noticed by the patient himself, but can be detected when he passes a special test. Hypersomnia can be observed with lack of sleep and overwork; be a side effect of certain drugs, enter the clinical picture of narcolepsy and mental disorders; accompany sleep apnea syndrome, trauma and organic brain damage, somatic diseases.
hypersomnia
Hypersomnia classification
In clinical neurology, hypersomnia is classified mainly according to the etiological principle. In accordance with the cause of the occurrence, hypersomnia is divided into psychophysiological, post-traumatic, narcolepsy, psychopathic, idiopathic, associated with breathing disorders during sleep and caused by somatic diseases.
According to the features of the manifestation, permanent and paroxysmal hypersomnia are distinguished. Permanent hypersomnia is accompanied by constant drowsiness and drowsiness throughout the day. Paroxysmal hypersomnia is characterized by sudden attacks of an irresistible desire to sleep, leading to falling asleep even in the most inappropriate conditions for this. Paroxysmal hypersomnia is noted in narcolepsy and cataplexy.
Causes of hypersomnia
The mode of sleep and wakefulness in the human body is regulated by a complex system of mutual activating and inhibitory effects occurring between the cerebral cortex, subcortical structures, the limbic system and the reticular formation. Hypersomnia develops as a result of a malfunction of this system, which can be due to a number of different reasons.
Psychophysiological hypersomnia can occur in healthy people after prolonged lack of sleep, physical and mental overwork, and stress. The development of this type of hypersomnia may be associated with the intake of certain medications, for example, antipsychotics, tranquilizers, antihistamines, hypoglycemic and antihypertensive drugs.
Post-traumatic hypersomnia is caused by functional disorders of the central nervous system that occur after a traumatic brain injury. Along with trauma, hypersomnia can be caused by organic brain damage: intracerebral tumor, brain abscess, intracerebral hematoma, infectious diseases (neurosyphilis, meningitis, encephalitis), vascular disorders (hemorrhagic stroke, chronic ischemia, ischemic stroke). The development of hypersomnia in patients with sleep-related breathing disorders is most likely due to chronic hypoxia of the brain tissue.
Hypersomnia is the main clinical symptom of narcolepsy and is often noted in cataplekia. Hypersomnia can also be observed in mental disorders (neurasthenia, hysteria, schizophrenia) and somatic diseases (hypothyroidism, diabetes mellitus, heart failure, liver cirrhosis, chronic renal failure). In cases where increased drowsiness occurs without a specific cause and without connection with any disease, it is referred to as idiopathic hypersomnia.
Clinical signs of hypersomnia
The main symptom of hypersomnia is periodic or constant daytime sleepiness with a long duration of night sleep. Often, hypersomnia is accompanied by an increase in the duration of night sleep up to 12-14 hours. Characterized by difficulty waking up, the inability to get up on an alarm clock, an increase in the transition time from sleep to wakefulness. Patients with hypersomnia may remain lethargic and not fully awake for some time after waking up. At the same time, their condition resembles intoxication, for which this symptom was called “drunk sleep”.
Daytime sleepiness in various forms of hypersomnia can be permanent or paroxysmal. It lowers attentiveness and efficiency, interferes with the full-fledged work activity, complicates the normal rhythm of life and forces patients to take breaks for daytime sleep. In some cases, after a daytime sleep, patients report relief, but more often the state of drowsiness persists even after prolonged or repeated daytime sleep.
Narcoleptic hypersomnia is characterized by the presence of attacks of forced falling asleep, in which the desire to sleep is so irresistible that patients fall asleep in the most unsuitable places for sleep and positions. Over time, patients with narcolepsy develop a premonition of an upcoming attack and try to advance into a more comfortable sleeping position. Narcoleptic hypersomnia can be accompanied by the appearance of hallucinations during falling asleep and awakening, as well as awakening cataplexy - a significant decrease in muscle tone, which does not allow the patient to make any voluntary movements in the first minutes after sleep.
Psychopathic hypersomnia is characterized by an unpredictable clinical picture of daytime sleepiness. For example, in patients with hysteria after a traumatic situation, a "sleep" lasting several days may be observed. However, polysomnography during the daytime does not find real signs of sleep in them, but on the contrary, the EEG demonstrates a state of intense wakefulness. Often it turns out that patients simply lie with their eyes closed.
Post-traumatic hypersomnia often develops after injuries that are not accompanied by significant damage to brain tissue, and is most likely associated with stress experienced during trauma. In such cases, its clinical picture may be similar to manifestations of psychopathic hypersomnia.
Idiopathic hypersomnia occurs more often in young people (15-30 years). Patients complain of constant drowsiness, difficulty waking up from sleep, a feeling of lack of sleep in the morning with a sufficient duration of night sleep. There may be a symptom of "drunk sleep". Daytime sleep in such patients brings some relief, but does not completely relieve them of drowsiness. In some cases, idiopathic hypersomnia may be accompanied by episodes of ambulatory automatism lasting several seconds. Most often, a similar symptom is observed in patients who refuse daytime sleep.
The state of uninterrupted sleep lasting more than a day is called lethargic sleep. Such hypersomnia is often a manifestation of epidemic lethargic encephalitis or various lesions of the reticular formation.
Diagnosis of hypersomnia
Since patients themselves cannot always objectively assess their sleep problems, generally accepted tests are used to diagnose hypersomnia: the Stanford sleepiness scale and the sleep latency test.
Polysomnography is of great diagnostic value. In the case of narcoleptic hypersomnia, polysomnography reveals a shortening of the period of falling asleep, frequent nocturnal awakenings, and an early onset of the REM phase, while normally REM sleep occurs an average of 80 minutes after falling asleep. A similar sleep pattern can be observed with hypersomnia associated with sleep apnea syndrome. In this case, the correct diagnosis can be made by identifying concomitant respiratory disorders during polysomnography. For idiopathic hypersomnia, as well as for narcolepsy, a shortening of the period of falling asleep is characteristic, however, at the same time, a normal ratio of sleep phases and nocturnal sleep without frequent awakenings is maintained.
Hypersomnia requires differentiation from asthenia, depression, chronic fatigue syndrome. To exclude the organic nature of pathological drowsiness, a thorough neurological examination is performed, an ophthalmologist's consultation with ophthalmoscopy, echo-EG, MRI or CT of the brain. Identification of the relationship of hypersomnia with the presence of a somatic disease may require additional consultation with a therapist, endocrinologist, cardiologist, gastroenterologist, nephrologist.
The diagnosis of hypersomnia is usually established by a neurologist if its symptoms have been observed for at least 1 month and are not associated with sleep disturbance or medication. If, after the disappearance of hypersomnia for up to 2 years, its symptoms reappear, then they speak of a recurrent form of the disease.
Treatment of hypersomnia
Successful treatment of hypersomnia is closely related to the effective treatment of the disease of which it is one of the symptoms. If a complete cure of the underlying disease is not possible (for example, in the case of narcolepsy), then the treatment of hypersomnia is aimed at maximizing the patient's quality of life.
Sleep is essential in the treatment of hypersomnia. The patient must exclude work in the evening and night shifts, adhere to the same time for going to bed, and be sure to include 1-2 daytime sleeps in your routine. It is desirable that the duration of a night's sleep does not exceed 9h. With idiopathic hypersomnia, the recommended duration of daytime sleep is 45 minutes. Along with sleep hygiene, you should avoid drinking alcoholic beverages and overly heavy meals, as well as eating just before bedtime.
To eliminate daytime sleepiness in hypersomnia, stimulants are used: pemoline, dexamphetamine, modafinil, mazindol, propranolol. If the patient has cataplexy, then he is shown taking antidepressants: protriptyline, imipramine, clomipramine, fluoxetine, viloxazine. The dosages of these drugs are selected individually, trying to achieve maximum therapeutic efficacy with minimal side effects.
Prediction of hypersomnia
Symptoms of post-traumatic hypersomnia are often reversible. The situation is worse with hypersomnia, which develops with narcolepsy or as a result of an organic brain lesion. And although hypersomnia in itself does not pose a threat to the patient's life, it significantly increases the risk of death from an accident at work or while driving a car.
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IMPORTANT
The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
Hypersomnia: causes of the disease, main symptoms, treatment and prevention
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Constant drowsiness with a sufficient duration of night sleep, may be due to injuries and pathologies of the brain, side effects of drugs.
Causes of hypersomnia
The occurrence of the disease may be a reaction to taking certain medications. Also, disorders of the central nervous system (central nervous system) can manifest themselves in this way. Increased drowsiness can occur against the background of already existing diseases (pathological conditions of the brain, vascular disorders, infections).
Symptoms of hypersomnia
The disease is characterized by one main feature - drowsiness during the day, which occurs periodically, bursts, or constantly during the normal duration of night sleep.
Diagnosis of hypersomnia
The diagnosis is established after a comprehensive examination and consultations with several specialists in order to exclude the presence of other pathologies or to identify the disease leading to hypersomnia. An MRI or CT scan of the brain, examination by an ophthalmologist and ophthalmoscopy are recommended. You may need to consult an endocrinologist, cardiologist, nephrologist. The main commonly used tests are the Stanford Sleepiness Scale and the sleep latency test. Polysomnography is also important in the diagnosis of the disease. Provided that all examinations are completed, and the patient's condition remains the same for a month, the neurologist establishes the diagnosis of hypersomnia.
Treatment of hypersomnia
As a rule, hypersomnia is a companion of the underlying disease and therapy is aimed at eliminating its manifestations. Be sure to strictly adhere to the regime of sleep and wakefulness, as well as eat rationally, do not abuse alcohol and fatty, heavy foods in the evening hours before bedtime. Night sleep should not exceed nine hours. If possible, evening work and night shifts should be avoided. It is possible to use stimulants to combat daytime sleepiness (Pemoline, Modafinil, Propranolol). It is recommended to exclude the management of personal transport for the period of treatment.