Hypersomnia

What is hypersomnia?

Hypersomnia is any condition that makes you feel extremely sleepy during the day. This happens even though you get a healthy amount of sleep (or more than enough).

Everyone wishes they could take a midday nap once in a while. But hypersomnia is more serious. It’s more than feeling drained after a long meeting or double-block class period. If you have hypersomnia, you can’t control when you feel sleepy. You may fall asleep several times during the day, usually without meaning to.

Hypersomnia can affect your ability to go to school or work. It can make it hard to maintain relationships with loved ones. You’ll also have a higher risk of accidents and injuries.

Talk to a healthcare provider if you feel tired all the time or feel like you can’t control when you fall asleep.

What are the symptoms of hypersomnia?

Symptoms of hypersomnia can include:

• Anxiety, irritability
• Constant or repeated episodes of extreme sleepiness during the day
• Decreased energy
• Difficulty waking up in the morning or after daytime naps (“sleep drunkenness”)
• Feeling confused or angry when waking up
• Hallucinations
• Headaches
• Loss of appetite
• Memory problems
• Restlessness
• Sleep paralysis
• Sleeping much longer than usual (11 hours or more) but still feeling very sleepy and having trouble staying awake during the day
• Daytime naps not making you feel more alert or rested
• Trouble focusing or concentrating

What causes hypersomnia?

Experts aren’t always sure what causes hypersomnia. Some types have a known cause. But most cases don’t (they’re idiopathic).

Researchers are still studying possible causes, including:

• An overactive immune system after some viral infections
• Changes in your brain’s size or thickness
• Genetic variations
• Issues with neurotransmitters in your brain

Types of hypersomnia

Healthcare providers sort hypersomnia into two categories — primary and secondary hypersomnia

Primary hypersomnia

Primary hypersomnia is hypersomnia that happens on its own without another condition causing it. There are three types of primary hypersomnia:

• Idiopathic hypersomnia. Idiopathic hypersomnia is hypersomnia that happens without any known cause. It’s the most common type.
• Kleine-Levin syndrome (KLS). KLS makes you sleep for an unusually long time. People with KLS often sleep for 16 to 20 hours a day during an episode. This is very rare.
• Narcolepsy. Narcolepsy happens when your brain can’t control your ability to sleep or stay awake.

Secondary hypersomnia

Secondary hypersomnia happens when a health condition or another issue causes you to feel extreme sleepiness. Causes can include:

• Alcohol or recreational drugs. Drinking alcohol or using cannabis or opiates can affect your sleep and lead to hypersomnia.
• Health conditions. Conditions that affect your muscles, brain or central nervous system can all cause hypersomnia. Mental health conditions like depression may also trigger it.
• Injuries. Head injuries or traumatic brain injuries may cause hypersomnia or increase your risk.
• Not getting enough sleep (insufficient sleep syndrome). Not sleeping long enough can eventually build up and cause hypersomnia. Most adults need seven to nine hours of sleep every night.
• Not getting enough high-quality sleep. Getting interrupted a lot when you sleep can cause issues. Everything from light and noise disturbances to health conditions like sleep apnea can affect your sleep’s quality.
• Side effects from medications or alcohol. Some medications might cause hypersomnia as a side effect. Sedatives, muscle relaxers or antipsychotics may cause hypersomnia. Withdrawal from stimulants (like medications used to treat ADHD) can also cause it.

What are the risk factors?

Anyone can experience hypersomnia, but some groups may be more likely to. This includes people:

• Between age 17 and 24 (late adolescence or young adulthood)
• Recorded female at birth
• Who have a biological family member with a hypersomnia

How is hypersomnia diagnosed?

A healthcare provider will diagnose hypersomnia based on the symptoms you’re experiencing and how they’re affecting your health. Tell your provider how you’ve been sleeping and if you’ve noticed any changes. They might suggest you visit a sleep specialist.

You might need to keep a sleep journal where you’ll write down when you fall asleep and wake up. Your provider may have you wear an actigraphy sensor on your wrist. This device looks like a smartwatch and will track disruptions in your sleep-wake cycle over several days.

Your provider can use a few tests to diagnose hypersomnia, including:

• A sleep study
• Multiple sleep latency test (MLST)
• Sleep questionaries (like the Epworth Sleepiness Scale)

How is hypersomnia treated?

Your provider will suggest a combination of medications and tweaks to your sleep habits to help manage hypersomnia. You might need:

• Medications to help you stay awake. Your provider will suggest the right kind of medicine for the type of hypersomnia you have.
• Improved sleep hygiene. Having a consistent bedtime routine and sleep environment can help you get a healthy amount of sleep every night. Try to avoid alcohol, caffeine and exercising for a few hours before you go to bed.
• Therapy for anxiety, stress or other mental health issues. Talking to a mental health professional can help you manage depression and other conditions that may cause hypersomnia. It can also help you process your feelings if you’re worried hypersomnia is affecting your relationships.
• Treatments for a specific cause. If you have secondary hypersomnia, your provider will suggest treatments that manage its cause.

Can hypersomnia be prevented?

Other than trying to get a healthy amount of sleep each night, there’s usually no way to prevent hypersomnia. That’s especially true for idiopathic hypersomnia. Because we don’t know what causes it, it’s impossible to prevent it.

Managing hypersomnia may not prevent it, but it can reduce how often you experience symptoms. Talk to your provider about what to expect. They’ll help you set realistic goals and expectations based on your sleep and health.

Is there a cure for hypersomnia?

There isn’t currently a cure for hypersomnia. Your provider will help you reduce how much it impacts your day-to-day routine. Some people with hypersomnia experience it less often once they find the right combination of treatments.

Ask your provider if it’s safe for you to drive. They’ll tell you what’s OK based on the symptoms you’re experiencing.

When should I see my healthcare provider?

You’ll need follow-up visits with your provider after starting hypersomnia treatments. They’ll tell you when you should make another appointment. You may need sleep studies and other tests in the future.

Call your provider if you notice any new or changing symptoms — especially if you’re falling asleep without meaning to more often.

Which questions should I ask my doctor?

Questions you may want to ask your provider include:

• Are there medications that can help me?
• Is it safe for me to drive?
• Which tests will I need?
• Which type of hypersomnia do I have?

Is narcolepsy the same as hypersomnia?

Hypersomnia is a group of conditions that share symptoms. Most importantly, they all make you feel extremely tired during the day. Narcolepsy is one form of hypersomnia.

Narcolepsy causes abrupt sleep attacks. You’ll fall asleep suddenly, usually for less than an hour. When you wake up, you may feel refreshed.

Other forms of hypersomnia can make you fall asleep for longer than an hour. And often, you won’t feel refreshed or energized when you wake up.

See a healthcare provider if you’re falling asleep without meaning to. They’ll diagnose it, no matter which type of hypersomnia you have.