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There are three types of hypersomnia: Recurrent Hypersomnia, Idiopathic Hypersomnia and Posttraumatic Hypersomnia. Here is the difference between the three, courtesy of the World Sleep Foundation:
Sufferers have repeated extreme sleepiness and big sleep requirements. They've been known to sleep as much as 16 to 20 hours a day.
Sufferers complain of excessive sleepiness and prolonged sleep at night. The difference between this disorder from normal long sleepers and narcoleptics is these individuals suffer numerous episodes of non-REM sleep that can last for up to two hours. That is why this disorder is sometimes called non-REM narcolepsy. However, it is different from narcolepsy in that idiopathic hypersomnia does not involve suddenly falling asleep or losing muscle control associated with strong emotions as in narcolepsy.
Excessive sleepiness that develops as the result of physical injury or disease in the central nervous system. For example, a brain injury, neurosurgery, infection, or spinal cord injury can cause this. Typcially, this type of hypersomnia usually goes away over weeks or months.
Hypersomnia refers to either excessive sleepiness during the day or extended, overly long periods of nighttime sleep. This common sleep disorder affects nearly 5 percent of the US population with a focus on teenagers and young adults between the ages of 15 and 30 years old.
The reasons for hypersomnia can include: work changes, family demands (such as a new baby), study or social life. Other causes include sleep disorders, medication and medical and psychiatric illnesses. However, doctors agree that hypersomnia can be helped or cured with a few adjustments to lifestyle habits.
Some symptoms of hypersomnia may include:
- Feeling unusually tired all the time
- The need for daytime naps
- Feeling drowsy, despite sleeping and napping
- Difficulty thinking and making decisions: the mind feels "foggy"
- Memory or concentration difficulties
- An increased risk of accidents, especially motor vehicle accidents
You just can't seem to feel awake during the day. All you want to do is nap. If you feel an overwhelming urge to sleep all day, but realize you are already getting an excessive amount of sleep, here are some possible diagnosis:
- Insufficient or inadequate sleep - long working hours and overtime can be tolerated for months or years before the symptoms of sleepiness take effect. Teenagers may stay out until the early hours of the morning on weekends and be tired during the week.
- Environmental factors - a snoring partner, a baby that wakes, noisy neighbours, heat, cold or sleeping on an uncomfortable mattress.
- Shift work - it is very difficult to get good sleep while working shift work, especially night shift. As well as the problem of trying to sleep, there is also the effect of being out of sync with the body's internal clock (or circadian rhythm).
- Mental states - anxiety can keep people awake at night, which makes them prone to sleepiness during the day. Depression depletes energy.
- Medications - alcohol, caffeinated drinks, tranquilizers, sleeping pills and antihistamines can disrupt sleeping patterns.
- Medical conditions - hypothyroidism (underactive thyroid gland), oesophageal reflux, nocturnal asthma and chronic painful conditions.
- Changes to time zone - jet lag. Sleep is regulated by an internal biological clock that responds to light.
- Sleep disorders - such as sleep apnoea, Restless Legs Syndrome, sleep walking, narcolepsy, idiopathic hypersomnia and insomnia.
In some cases, you can help yourself with your hypersomnia by making some simple changes in your lifestyle. Always check with your doctor first, but here are some tips from the SleepDisordersGuide.com:
- Changes in behavior (for example avoiding night work and social activities that delay bed time) and diet may offer some relief. Patients should avoid alcohol and caffeine.
- Go to bed at a set time each night and get up at the same time each morning.
- Try to exercise 20 to 30 minutes a day.
- Daily exercise often helps people sleep, although a workout soon before bedtime may interfere with sleep. For maximum benefit, try to get your exercise about four to five hours before going to bed.
- Smokers tend to sleep very lightly and often wake up in the early morning due to nicotine withdrawal. Alcohol robs people of deep sleep and REM sleep and keeps them in the lighter stages of sleep.
- A warm bath, reading, or another relaxing routine can make it easier to fall sleep. Sleep until sunlight.
- Maintain a comfortable temperature in the bedroom. Extreme temperatures may disrupt sleep or prevent you from falling asleep.
- If you have trouble falling asleep night after night, or if you always feel tired the next day, then you should see a physician.
Napping has a negative stigma - most think napping should be reserved for the very young, very old or very sick. Yet many healthy adults nap and are not negatively affected by it. However, those who find themselves needing excessive sleep - naps many times a week along with a good night's rest - should have their napping habits studied by a medical professional. According to the National Sleep Foundation, nappers should follow the following rules to ensure that their nap is a healthy event.
- The right length: a short nap is usually recommended (20 to 30 minutes) for short-term alertness. This type of nap provides significant benefit for improved alertness and performance without leaving you feeling groggy or interfering with nighttime sleep.
- The right environment: your surroundings can greatly impact your ability to fall asleep. Make sure that you have a restful place to lie down and that the temperature in the room is comfortable. Try to limit the amount of noise heard and the extent of the light filtering in.
- The right time: if you take a nap too late in the day, it might affect your nighttime sleep patterns and make it difficult to fall asleep at your regular bedtime.
- Post-nap impairment and disorientation is more severe, and can last longer, in people who are sleep deprived or nap for longer periods. When you wake up from a nap you may feel sleep inertia, defined as a feeling of grogginess and disorientation that can come with awakening from a deep sleep. While this state usually only lasts for a few minutes to a half hour, it can be detrimental to those who must perform immediately after waking from a napping period.
- Napping can have a negative effect on other sleeping periods. A long nap or a nap taken too late in the day may adversely affect the length and quality of nighttime sleep. If you have trouble sleeping at night, a nap will only amplify problems.
According to the National Sleep Foundation's 2005 Sleep in America poll, poor sleep, excessive sleepiness and lack of sleep cause disruptions in nearly every facet of one's life.
Here is what the foundation found:
- Sixty percent of adults licensed to drive say they have driven drowsy in the past year, an increase over recent years. Of those, 4 percent have had an accident or near accident because they were too tired or actually dozed off while driving.
- Sleep-related issues are cited as the most common reason people are late for work. Almost three in 10 working adults say they have missed work, events/activities or made errors at work because of sleep-related issues in the past three months
- For partnered adults, sleep problems are extra disruptive, as one partner's sleep problem can cause the other to lose, on average, nearly an hour of sleep a night.
- One or both partners are often too sleepy for sex, and many couples sleep apart because of a sleep problem.
If you think a sleep disorder is effecting your daily work, family and sex life, talk to a doctor.
Hypersomnia is sometimes misdiagnosed as narcolepsy. In many ways the two are similar. One significant difference is that people with narcolepsy experience a sudden onset of sleepiness, while people with hypersomnia experience increasing sleepiness over time. Also, people with narcolepsy find daytime sleep refreshing, while people with hypersomnia do not.
If you think you might have hypersomnia, experts say you can help your condition by following these lifestyle adjustments:
- Avoid cigarettes, alcohol and caffeinated drinks near bed time
- Relaxation to prevent night time anxiety
- Exercise regularly and maintain a normal weight for your height
- Eat a well-balanced diet to prevent nutritional deficiencies
- If possible, changes your environment to reduce disturbances
- Be comfortable; make sure you don't overheat or feel too cold in bed
Have a regular sleeping routine so that your body "knows" it is time to sleep
- Only go to bed when you feel sleepy
- Avoid daytime napping
Excessive sleep is a symptom of bipolar disorder. Bipolar disorder, or manic-depression, is characterized by moods that swing between two opposite poles - periods of mania and episodes of depression. Excessive sleep is also a symptom of major depression. So if you are experiencing excessive sleep, talk to your physician about both of these possibilities.
Here is a list of the symptoms of bipolar disorder depression:
- Sad mood
- Fatigue or loss of energy
- Sleep problems (insomnia, excessive sleeping, or shallow sleep with frequent awakenings)
- Appetite changes (either an increase or decrease)
- Diminished ability to concentrate or make decisions
- Agitation or markedly sedentary behavior.
- Feelings of guilt, pessimism, helplessness, or low self-esteem
- Loss of interest or pleasure in life
- Thoughts of, or attempts at, suicide
Hypersomia can be treated professionally or self-treated. Talk with your doctor about which methods will work best for you. In most cases of professional treatment, your doctor can prescribe various drugs to treat hypersomnia. Stimulants, antidepressants and monoamine oxidase inhibitors are useful in treating sleep paralysis, cataplexy and hypnagogic hallucinations.
It's important to note that that hypersomnia patients taking both imipramine and stimulants risk developing hypertension and should be closely monitored.
Kleine-Levin Syndrome (KLS) is a rare sleep disorder described by repeated and long episodes of hypersomnia. It can also be associated with behavioral/cognitive disturbances, binge eating, and, more rarely, hypersexuality. KLS primarily strikes adolescents and typically stops when the person reaches adulthood to middle age.
The cause of KLS is unknown, however nearly half of the patients experience a non-specific, mainly flu-like infectious disease few days before the onset of their first KLS episode. Since KLS is rare, but the onset triggers the very common flu-like symptoms, researchers think genetics might play a part in who gets KLS.
Studies show that Kleine-Levin Syndrome may be an autoimmune disease, which means your immune system attacks itself by mistake and you can get sick. In KLS, the association of an infection before the onset of a disease, a recurrence of symptoms and possible genetic predisposition is suggestive of an autoimmune disease. More studies are being conducted on this theory.
|Jennifer Mathes, Ph.D.|