Hypersomnia is a disorder that causes excessive daytime sleepiness or sleeping for unusually long periods at night. It can also cause low energy, trouble concentrating, irritability, and intense fatigue throughout the day.
This disorder may be caused by genetic factors, in which case it is called idiopathic or primary hypersomnia. It can also be caused by other health conditions, such as anemia or hypothyroidism, in which case it is called secondary hypersomnia.
Hypersomnia can greatly affect quality of life and performance at school or work. It is important to see a healthcare provider, such as a sleep specialist or neurologist, for diagnosis and appropriate treatment.
Main symptoms
The main symptoms of hypersomnia are:
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Constant tiredness during the day, even after a good night’s sleep
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Difficulty waking up after long periods of sleep
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Low energy
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Excessive sleepiness
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Disorientation or trouble paying attention and staying focused
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Slow speech
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Difficulty thinking and making decisions
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Loss of concentration or memory
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Irritability, restlessness, and anxiety
In addition, it is very common for the person to need to sleep for very long periods, take several naps during the day, or sleep for more than 24 hours straight.
If symptoms of hypersomnia are present, a primary care provider or sleep specialist should be consulted for a detailed evaluation, diagnosis, and appropriate treatment.
Confirming a diagnosis
Hypersomnia is diagnosed by a sleep specialist, often a neurologist with training in sleep disorders. Diagnosis is based on symptoms, medical history, and blood tests to check whether hypersomnia may be related to other health conditions, such as anemia or hypothyroidism.
The doctor may also ask the person to complete a questionnaire that evaluates daytime sleepiness, called the Epworth Sleepiness Scale. This helps assess how sleepiness affects daily life.
Other tests may also be ordered, such as polysomnography or a multiple sleep latency test. Polysomnography monitors brain activity, eye and leg movements, breathing, and oxygen levels during sleep, while the multiple sleep latency test measures how quickly a person falls asleep during scheduled daytime naps.
Possible causes
Hypersomnia is classified into two different types according to its cause:
1. Idiopathic hypersomnia
The exact cause of idiopathic hypersomnia, also called primary hypersomnia, is not fully known. However, some studies suggest it may be related to changes in brain chemicals involved in sleep and wakefulness.
Idiopathic hypersomnia can also be classified into two different types, which include:
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Idiopathic hypersomnia with long sleep time, which involves sleeping for more than 24 hours straight.
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Idiopathic hypersomnia without long sleep time, which is characterized by sleeping an average of 10 hours straight, but needing several short naps throughout the day to feel refreshed. Even so, the person may still feel tired and sleepy all the time.
This type of hypersomnia is generally linked to a genetic predisposition, such as a family history of hypersomnia.
2. Secondary hypersomnia
Secondary hypersomnia is caused by other disorders or diseases that can lead to excessive sleepiness, such as sleep apnea, Parkinson’s disease, hypothyroidism, iron deficiency, or depression.
In addition, the use of medications such as anti-anxiety medications, antidepressants, or mood stabilizers, which can cause excessive sleepiness as a side effect, may also lead to secondary hypersomnia.
Treatment options
Treatment for hypersomnia should be guided by a neurologist or sleep specialist and usually varies depending on the type of hypersomnia.
In cases of idiopathic, or primary, hypersomnia, the doctor may recommend wake-promoting medications. According to the American Academy of Sleep Medicine, modafinil is strongly recommended for adults with idiopathic hypersomnia, while methylphenidate may be considered conditionally. These medications help improve wakefulness during the day, increase alertness, and reduce excessive sleepiness.
In cases of secondary hypersomnia, treatment focuses on managing the underlying condition causing excessive sleepiness, such as sleep apnea, hypothyroidism, or depression, according to medical guidance.