Hypersomnia is the inability to stay awake and alert during the day despite having more than an adequate amount of nighttime sleep. Hypersomnia challenges work life, social life and home life. Treatments include medications, non-drug options and education and support groups.
Hypersomnia is a condition in which you feel extreme daytime sleepiness despite getting sleep that should be adequate (or more than adequate). If you have hypersomnia, you fall asleep several times during the day. Hypersomnia affects your ability to function at work and socially, affects your quality of life and increases your chance of accidents.
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Hypersomnia is more common in females than males. It's thought to affect about 5% of the population. It’s usually diagnosed in adolescence or young adulthood (mean age is 17 to 24 years).
Signs and symptoms of hypersomnia include:
The cause of most cases of hypersomnia remains unknown. Researchers have looked at the potential roles of neurotransmitters in the brain and cerebrospinal fluid including hypocretin/orexin, dopamine, histamine, serotonin and gamma-aminobutyric acid (GABA). A genetic link may be possible since a family history is present in up to 39% of people with idiopathic hypersomnia. Researchers are also exploring the role of certain genes in circadian rhythm that may be different in people with idiopathic hypersomnia.
Your sleep specialist will ask about your symptoms, medical history, sleep history and current medications. You may be asked to keep track of your sleep and wake patterns using a sleep diary. You may be asked to wear an actigraphy sensor, which is a small, watch-like device worn on your wrist that can track disruptions in your sleep-wake cycle over several weeks.
Other tests your sleep specialist may order include:
According to diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders, you would be diagnosed with hypersomnia if you:
Different sleep organizations and psychiatric organizations have different classification systems and subcategories for hypersomnia. Complicating matters, these classifications continue to evolve.
More commonly accepted criteria is that there are two main types of hypersomnia: secondary hypersomnia and primary hypersomnia.
Secondary hypersomnia means your excessive sleepiness is due to some other known cause. Causes include:
Primary hypersomnia means that hypersomnia is its own condition. It’s not caused by other medical conditions or a symptom of another medical condition. Four conditions are classified as primary hypersomnias:
Treatment depends on what’s causing your hypersomnia. There are both medication approaches and lifestyle changes.
Wakefulness-promoting agents include modafinil (Provigil®), armodafinil (Nuvigil®) and pitolisant (Wakix®) and solriamfetol (Sunosi®). One of these medications is usually tried first.
It’s important to see your sleep specialist for follow-up appointments. Your healthcare provider will need to find out how you’re feeling and determine how well your medication is working, if dose adjustment is needed or if a switch to another medication should be made.
Maintain good sleep habits. This includes things like establishing a regular sleeping schedule, having an environment that allows for sleep (cool, dark room; comfortable pillows and bed) and limiting caffeine and exercise before bedtime.
There’s no way to prevent most types of hypersomnia. Hypersomnia is a chronic illness without a cure.
Consider making some lifestyle changes to help improve the quality of your sleep and keep you safe and avoid injuries and accidents.
Things you can try include:
It may be helpful to talk to a psychologist or counselor and find a support group to learn to cope with the challenges of having hypersomnia. Ask your sleep specialist for referrals and names of support groups. Bring loved ones with you to these sessions. People with hypersomnia are often misunderstood as being lazy or incompetent and educating them on this condition will help your relationships.
Your outcome depends on the cause of the disorder. Although hypersomnia is not life-threatening, it can have a significant impact on the quality of your life. It can cause you to lose your ability to function around your family, in social situations, at work or in other settings. It can cause vehicle accidents if you fall asleep while driving. Medications and lifestyle changes can help improve some symptoms in some people with hypersomnia. Other people may not achieve full relief.
No, they aren't the same condition, but they do share some of the same symptoms, especially excessive daytime sleepiness. One of the main differences is that narcolepsy is associated with abrupt sleep attacks. This isn't a symptom of hypersomnia. Also, naps in a person with hypersomnia often are longer than an hour and aren't refreshing. A person with narcolepsy may feel refreshed after a short nap. Narcolepsy can be clearly diagnosed according to polysomnographic testing.
No. Anxiety doesn’t cause hypersomnia. However, having hypersomnia can cause anxiety.
A note from Cleveland Clinic
Not being able to stay awake and alert during the day despite an adequate amount of sleep at night can have a major impact on the quality of your life and even be dangerous to yourself and the people around you. If these symptoms sound like something you're experiencing, seek help from your primary healthcare provider or directly from a sleep specialist. There may be some medications and non-drug therapies that can help improve your symptoms. Learning about hypersomnia, joining a support and educating family, friends and work colleagues can help with adjustments that may need to be made to help you better function and cope with this sleep disorder.
Last reviewed by a Cleveland Clinic medical professional on 10/27/2021.
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