Hypersomnia

Hypersomnia is the opposite of insomnia. People with hypersomnia sleep too much. Of course, "too much" is a subjective evaluation. You can always argue that the person "needs" that much sleep, and in reality, there is no fixed amount of sleep that's right for everyone.

But serious health professional try to define hypersomnia as a real medical phenomenon. It is an excessively deep or prolonged major sleep period. Persons with hypersomnia are compelled to nap repeatedly during the day, often at inappropriate times such as at work, during a meal, or in conversation. These daytime naps usually provide no relief from symptoms.

When patients are evaluated with the Multiple Sleep Latency Test, a finding of a sleep latency lasting less than eight minutes is support for hypersomnia. The difference between hypersomnia and narcolepsy on the MSLT is that the narcoleptics will have two or more sleep-onset rapid eye movements. Hypersomniacs also tend to take longer daytime naps than narcoleptics, although neither experience much refreshment from daytime napping. People who suspect they have hypersomnia often overestimate the amount of time they spend sleeping; a sleep study is really the best way to determine for sure if the condition is present.

"Even were sleep is concerned, too much is a bad thing" - Homer

Like insomnia, hypersomnia can have many causes. Head injuries often result in hypersomnia (also called hypersomnolence). Hypersomnia may be caused by dysfunction of the autonomic nervous system, or drug or alcohol abuse. In some cases it results from a physical problem, such as a tumor, head trauma, or injury to the central nervous system. Certain medications, or medicine withdrawal, may also cause hypersomnia. . Post-traumatic stress disorder sometimes includes hypersomnia as a symptom.

In many cases, the cause is unknown: this is called idiopathic hypersomnia. The International Classification of Sleep Disorders distinguishes between two types of hypersomnia based on length of nightime sleep: more than 10 hours continuously at night is called Idiopathic Hypersomnia with long sleep and a period between 6 and 10 hours is called Idiopathic Hypersomnia with short sleep. Although the nocturnal sleep time for those with short sleep is in the normal range, a diagnosis of hypersomnia may be given if the patient has a sleep latency of less than six minutes, excessive daytimes sleepiness, and unrefreshing daytime naps.

A person with hypersomnia may sleep up to twelve hours a night, and still need frequent daytime naps. Many people experience hypersomnia periodicly with episodes occuring weeks or months apart. If the condition is diagnosed as recurrent hypersomnia, this is also called Kleine-Levin Syndrome.

Patients often have difficulty waking from a long sleep, and may feel disoriented and experience sleep inertia. Polysomnograms show some hypersomniacs experience sleep-onset REM - that is, they enter into REM very early after going to bed, while normal people do not enter REM for several hours. Other symptoms may include anxiety, increased irritation, decreased energy, restlessness, slow thinking, slow speech, loss of appetite, hallucinations, and memory difficulty. Some patients lose the ability to function in family, social, occupational, or other settings.

The onset is insidious (gradually, so you are not aware of it at first). Hypersomnia typically affects adolescents and young adults and continues through life. It is very rare when the onset happens past age 40, except in case of brain injuries. There is some tendency for hypersomnia to run in families.

Treatment

Treatment for idiopathic hypersomnia attacks the symptoms, not the underlying cause, because the underlying cause is unknown or no treatment for the causes exist. So doctors often prescribe stimulants just to keep people awake, including dexamphetamine, methylphenidate (Ritalin), and modafini (Nuvigil or Provigil)l. Other drugs used to treat hypersomnia include clonidine, amphetamine, levodopa, bromocriptine, antidepressants, and monoamine oxidase inhibitors. Specialists also recommend sleep hygiene practices similar to those for other sleep disorders.

"Even were sleep is concerned, too much is a bad thing." - Homer

The prognosis for persons with hypersomnia depends on the cause of the disorder. The disorder itself is not life threatening, but in our modern society falling asleep at the wrong time can be dangerous, such as in drowsy driving. The attacks usually continue indefinitely.

Kleine-Levin syndrome is a recurrent form of hypersomnia. It is also called recurrent hypersomnia. Some clinicians distinguish between Kleine-Lein syndrome with and without compulsive eating. There is also menstrual-related hypersomnia. Narcolepsy could also be classified as a form of hypersomnia.

See also: Idiopathic Hypersomnia: Clinical Features and Response to Treatment

"Like all other forms of pleasure, sleep may become a passion" – Jean-Anthelme Brillat-Savarian – The Pyschology of Taste, 1825

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