Hypersomnias

Hypersomnia is a sleep disorder characterized by excessive sleepiness during wakefulness, regardless of how many hours of sleep the person has had. The person feels very sleepy throughout the day in situations where it is not normal. It is considered hypersomnia when this condition persists daily for at least three months.

Depending on its origin, two types of hypersomnia are distinguished:

Primary or idiopathic hypersomnia: no known cause. This group includes narcolepsy and Kleine-Levin syndrome.

Secondary hypersomnia: sleepiness is a symptom of an underlying disorder. This is the most common type.

Although hypersomnia is not dangerous in itself, it affects the daily life of patients and can put their lives at risk when, for example, they fall asleep in dangerous situations.

Symptoms

The common symptoms of hypersomnia are as follows:

• Constant or excessive feeling of sleepiness, tiredness, and heaviness.
• Increased daily sleep time.
• Extreme difficulty in waking up and staying awake.
• Disorientation upon waking.
• Amnesia episodes may occur.
• Feeling like not having rested after sleeping for several hours.
• Long naps throughout the day that are not restorative.
• Clumsiness in movement and thinking.
• Decreased concentration and memory.
• Irritability or anxiety.

Causes

The main cause of secondary hypersomnia is insufficient or fragmented rest, which may be due to various reasons:

Other sleep disorders, such as insomnia, sleep apnea, or restless leg syndrome.

Diseases that cause fragmented sleep, such as arthritis, epilepsy, asthma, chronic obstructive pulmonary disease, urinary dysfunction, gastrointestinal disorders, or chronic pain.

Other factors that lead to hypersomnia include:

• Drug or medication use that causes drowsiness, such as sedatives, hypnotics, antidepressants, antihistamines, antiepileptics, antihypertensives, or neuroleptics, among others.
• Psychiatric disorders such as post-traumatic syndrome, major depression, dysthymia, or bipolar disorder.
• Neurological and neurodegenerative diseases, such as encephalopathies or dementias.
• Metabolic disorders, such as hypothyroidism, iron deficiency, or vitamin D deficiency.
• Infectious diseases, especially those with high fever.

Risk Factors

The likelihood of suffering from idiopathic hypersomnia increases in the following cases:

• Irregular sleep cycles, generally due to work or lifestyle.
• Age: it usually starts in adolescence or early adulthood.
• Family history.

Complications

Hypersomnia has a very negative effect on the quality of life of those who suffer from it, and the constant feeling of sleepiness can be very limiting. Concentration and memory problems reduce work and academic performance, and along with motor coordination issues, they increase the risk of accidents. Moreover, mood changes caused by sleepiness affect the patient's social relationships. Additionally, the lack of restorative sleep is one of the risk factors for multiple heart, vascular, metabolic, and neurological diseases, such as hypertension, heart failure, obesity, metabolic syndrome, dementia, depression, anxiety, or chronic fatigue syndrome, among others.

Prevention

Hypersomnia can be prevented by maintaining proper sleep hygiene that guarantees rest:

• Keep the same sleep schedule every day.
• Aim for eight hours of sleep daily, either all at once or with a daytime nap.
• Engage in relaxing activities or relaxation exercises before bedtime.
• Avoid heavy meals and intense physical activity before bedtime.
• Do not take sedative or hypnotic medications.

Which doctor treats hypersomnias?

Hypersomnia is evaluated and treated by specialists in the Sleep Unit, including doctors from various specialties, such as neurology, neurophysiology, pulmonology, and psychiatry.