Hypersomnia: Types, Symptoms, Causes And Treatments

Sleep is an essential process for our survival and maintaining our capabilities. When we are tired or sleepy, our energy level and motivation suffer and we lose the desire to do things. We cannot concentrate and our judgment and analytical skills decrease, as well as our performance.

Fortunately, after sleeping an adequate number of hours we regain our energy and regain our energy and maintain a state of normative wakefulness and attention. However, there are people whose sleep periods are altered in terms of time and quality of sleep. This is the case of insomnia or its opposite, hypersomnia.

hypersomnia

It is understood as hypersomnia sleep disorder characterized by excessive sleepiness despite having maintained a previous sleep period of at least seven hours in duration. It is a dyssomnia, a type of sleep disturbance that affects the schedule, quantity and quality of sleep.

In hypersomnia, the subject in question remains sleepy for much of the day and it is usually difficult for him to wake up after a period of normative sleep or one that can even last nine or more hours, and this sleep may not be restorative and may not allow him real rest. It may involve falling asleep similar to narcolepsy. Thus, someone with hypersomnia may both sleep for long periods of time and be sleepy during the day.

To consider the existence of this disorder, episodes of drowsiness must occur at least three times a week (although it can occur practically every day) for at least a month. Hypersomnia usually leads to great dysfunction for those who suffer from it, reducing their abilities and performance at both a work and personal and social level. In fact, a person can fall asleep in high-risk situations, such as when driving a vehicle.

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Apart from the lack of energy, this disorder can cause emotional disturbances such as anxiety and irritability problems, demotivation and apathy. They also tend to have memory problems and a certain mental and physical slowdown. At an organic level it can generate changes and weakening of the immune system.

Types of hypersomnia

Depending on whether or not there is a known cause, we can establish different types of hypersomnia. It is important to keep in mind that although episodes of sudden sleep also occur in narcolepsy, it is another pathology with its own and differentiated characteristics, so we would not be talking about a type of hypersomnia.

Primary or idiopathic hypersomnia

This is known as hypersomnia disorder. In this case the causes that produce this alteration are not known, there being a period of normative rest and without the excessive sleep being explained by organic causes. The symptoms are those previously described.

Among primary hypersomnias, one can also find what is known as Kleine-Levine syndrome, which acts recurrently and persistently, causing periods of several days or weeks of intense sleep.

It is common for those who suffer from it to sleep up to 20 hours straight and stay tired the rest of the time, with high instability, irritability and disinhibition of impulses that leads to hyperphagia and hypersexuality. It is not uncommon for hallucinations and speech and memory problems to appear. These episodes will occur recurrently, but in the periods of time that elapse between sleep and behavior they are normative.

Secondary hypersomnia

The presence of persistent sleep during the day or difficulties waking up may also have a concrete and specific cause that explains it.

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Among secondary hypersomnias we can find those due to sleep deprivation. for not having slept enough or because it is frequently interrupted, the effect of different drugs or the existence of some medical or psychiatric disorder that explains it. In these cases, hypersomnia would not be a disorder but a symptom of said alteration.

Causes of this problem

The causes of hypersomnia are largely unknown Today. For the diagnosis of hypersomnia as a primary disorder, it is necessary that the symptoms are not better explained by the presence of another pathology or as a result of substance use or sleep deprivation, or that although they may occur together, they do not justify hypersomnia.

Thus, although it is possible to present sleep problems due to the persistent absence of sleep, substance use or certain problems of medical origin, in this case we would be talking about hypersomnia secondary to these and not hypersomnia as a disorder. per se.

Even if the cause is not completely known, the possibility of the presence of alterations in the limbic system that may explain the presence of behavioral alterations in cases of Kleine-Levine syndrome. A deficit in the synthesis and transmission of norepinephrine could also be an element to take into account when trying to explain this disorder. A possible injury to the brain areas responsible for regulating sleep could also cause this problem.

To do? Treatment

Hypersomnia is an annoying and disabling problem for those who suffer from it and that can greatly limit their life and even precipitate accidents that are dangerous for their own survival. Your treatment is essential.

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In this sense, it is recommended that at a behavioral level you try to avoid operating heavy machinery or vehicles, as well as try to maintain sleep hygiene as correct as possible. Sport is also a great help to stay active and reduce the feeling of drowsiness in the moments after exercise. In sleep hygiene it is recommended set specific times to sleep and wake up as well as facilitating entry into sleep at normative moments such as avoiding elements that require attention or noises.

At a psychological level, cognitive-behavioral techniques are also used that can be used to confront the problems derived from the disorder and to increase and help focus attention. The subject is also trained in detecting the first signs of sleep, and applying various exercises to them, both physically and mentally, to increase the level of consciousness and physiological activity.

It is very useful avoid the consumption of depressant substances such as alcohol and other drugs with the same effects. Exciting drugs and substances may be prescribed. Some antidepressants such as imipramine or MAOIs have also been used as treatment, although caution must be taken with other health aspects such as blood pressure.

Bibliographic references:

  • Guilleminault, C. & Brooks, S. N. (2001). Excessive daytime sleepiness. A challenge for the practicing neurologist. Brain; 124: 1482-1491.