Hypersomnia: Causes, Treatment, and How It's Linked to OSA

The sleep disorder called hypersomnia is associated with sleeping too much during the day and night. When people have hypersomnia they get excessive daytime sleep in the daylight hours. However, they are still tired at night and need a full night of sleep. It is the opposite of insomnia in which people cannot go to sleep. Hypersomnia is also associated with other sleep disorders including Sleep Apnea. Learn more about hypersomnia causes, tests, and treatments.

The basic hypersomnia definition is extreme tiredness. People will ask themselves, “Why am I sleepy all the time,” even though they sleep through the night and take naps during the day. According to the National Institute of Neurological Disorders and Stroke (NINDS), hypersomnia can also refer to people who sleep too long at nighttime exclusively.

There are two main types of hypersomnia:

• Primary hypersomnia
• Secondary hypersomnia

The Hypersomnia Foundation states that primary hypersomnia is solely associated with excessive fatigue. This type of sleep disorder is believed to be caused by misfires in the part of the brain that controls sleep functions.

Examples of primary forms of hypersomnia include:

• Idiopathic Hypersomnia
• Kleine-Levin Syndrome
• Narcolepsy Type 1 and Type 2

Secondary forms of hypersomnia include conditions caused by medical conditions or injuries. For example, an individual diagnosed with Sleep Apnea may also suffer from hypersomnia. In this case, secondary hypersomnia refers to being unable to sleep due to Obstructive Sleep Apnea that blocks the airways. As a result, the individual sleeps more during the day to make up for a lack of quality deep sleep at night.

Other causes of secondary hypersomnia include:

• Neuromuscular disorders
• Neurodegenerative diseases, such as Parkinson’s disease
• Substance use or abuse
• Insufficient sleep syndrome
• Psychiatric disorders, such as depression

A common symptom associated with hypersomnia is:

Hallucinations caused by long periods of sleep and disorientation

The following symptoms are a result of not having a regular daily schedule, i.e., meal times and periods of activity:

• Loss of appetite
• Decreased energy
• Increased restlessness
• Anxiety

People with hypersomnia can also suffer from the following conditions:

• Slow thinking
• Slurred speech
• Loss of short term or long term memory

These conditions are due to the mental fog associated with waking that can affect these individuals at any time.

When comparing hypersomnia vs narcolepsy, the main difference is in the ability to control sleep. For people who are diagnosed with hypersomnia, they feel compelled to nap when they should be eating, sleeping, or doing some other activity. Narcolepsy is defined as uncontrollable daytime sleepiness. People with narcolepsy fall asleep unexpectedly throughout the day.

According to a study published in the Dialogues in Clinical Neuroscience, there is a strong connection between sleep disorders and depression:

Approximately 40 percent of young depressed adults are diagnosed with hypersomnia. In addition, 10 percent of seniors diagnosed with depression also have hypersomnia.

The study also reports that females are more likely to have a dual diagnosis of sleep disorders and depression. People diagnosed with both a sleep disorder and depression are noted as having an increased risk of suicide. This is associated with the majorly distressing symptoms related to hypersomnia or insomnia and depression.

The causes of hypersomnia can be divided according to lifestyle factors and co-occurring conditions or disorders. In terms of lifestyle factors that cause this sleep disorder, the most common conditions include:

• Being overweight or obese
• Having a history of drug or alcohol abuse
• Sleep deprivation
• Taking prescription drugs for sleep

As for medical conditions and disorders that are associated with hypersomnia causes, these include:

• Genetics and having a family history of hypersomnia
• Clinical depression
• Sleep Apnea
• Narcolepsy
• Depression
• Suffering from a head injury
• Having a neurological disease

For people who have a sudden onset of hypersomnia, this condition may be a sign of an underlying health issue or change in lifestyle.

Fortunately for people who are concerned that they are suffering from this sleep disorder, there is a hypersomnia test available. A doctor will discuss a patient’s medical history including their sleep habits. A sleep test may also be prescribed in order to see if Sleep Apnea or other sleep disorders are involved.

A doctor will also discuss any substances including alcohol or drugs that may be involved in the sleep condition. Other methods of a hypersomnia test can include:

• Computed Tomography (CT) scans
• A polysomnography sleep test
• Electroencephalogram (EEG) test

Following a hypersomnia diagnosis, the next step is to consider the various forms of hypersomnia treatment. For mild cases of hypersomnia associated with lifestyle, a doctor will likely prescribe lifestyle changes. These include eliminating alcohol, tobacco, or caffeine from the patient’s diet. Other lifestyle changes may include:

• Regular exercise
• Walking outdoors
• Having a set routine
• Avoiding napping whenever possible

Another treatment that can effective for individuals living in northern states includes the use of a sun lamp. Regions with shorter days experience a decrease in vitamin D that can be associated with depression and hypersomnia. This treatment allows the body's circadian clock to stay on balance.

For patients diagnosed with moderate or severe hypersomnia, prescription drugs may be prescribed. These may include:

• Modafinil or Provigil, which is used to reduce extreme sleepiness and narcolepsy
• Sodium Oxybate or Xyrem, which is used to treat severe daytime sleepiness and narcolepsy

Other prescription drugs prescribed for hypersomnia can include stimulants. These are used to increase stimulation and help the patient stay awake for longer periods of time. Antidepressants may be prescribed for patients with co-occurring depression or anxiety.

A common question among patients with hypersomnia is how this is linked to OSA or Obstructive Sleep Apnea disorder. As previously noted, secondary hypersomnia can be caused by Sleep Apnea. There are three main types of Sleep Apnea:

• Obstructive Sleep Apnea, the most common type of this sleep disorder, associated with overly relaxed throat muscles
• Central Sleep Apnea, caused by short-circuiting brain signals that fail to tell muscles to relax
• Complex Sleep Apnea Syndrome, or Treatment-Emergent Central Sleep Apnea, that is a combination of both other types of this condition

For individuals suffering from Sleep Apnea, the most common symptoms include:

• Hypersomnia
• Insomnia
• Gasping for air while asleep
• Not breathing while asleep
• Waking up with a dry mouth and/or a sore throat on a regular basis without a cold
• Snoring loudly
• Unable to pay attention during the day
• Irritability
• Anxiety
• Depression
• Fatigue

Patients who are diagnosed as having hypersomnia with Sleep Apnea will need to find treatment for Sleep Apnea first. This is the primary medical condition leading to secondary hypersomnia. In this case, people who get treatment for Sleep Apnea will most likely also treat their hypersomnia successfully.

At the same time, treatment for hypersomnia may also help patients who are diagnosed with one of the types of Sleep Apnea. By treating both of these sleep disorders, an individual can correct their excessive daytime sleepiness and insomnia. This can enable the individual to improve their quality of life while reducing the likelihood of associated medical problems. Medical issues caused by long-term untreated sleep disorders can include:

• Heart disease
• High blood pressure
• High cholesterol
• Mental health issues including depression

Treatment for sleep disorders including Sleep Apnea and hypersomnia is essential to reducing these health concerns.

Learn more here with this Sleep Apnea article to determine if you are suffering from this sleep disorder, as well as hypersomnia. Subscribe to our newsletter for more useful CPAP and Sleep Apnea information, as well as savings on equipment for hypersomnia treatment.

https://www.ninds.nih.gov/Disorders/All-Disorders/Hypersomnia-Information-Pagehealthblog.uofmhealth.org/health-management/6-ways-obstructive-sleep-apnea-can-harm-your-healthwww.ncbi.nlm.nih.gov/pmc/articles/PMC3181883/