Hypersomnia (excessive sleepiness)
Idiopathic hypersomnia (IH) is a sleep disorder in which a person is excessively sleepy (hypersomnia) during the day and has great difficulty being awakened from sleep.
Most people do not even realize they oversleep when they have the condition called IH, that is due in part to recurring episodes of excessive daytime sleeping and prolonged nighttime sleep.
This is different from the average person taking that midday nap. When a person with IH falls asleep, it may be at the most inappropriate times, like at work, during meals, or even during conversations with people.
Idiopathic Hypersomnia is similar to narcolepsy in that the person is extremely sleepy. It is different from narcolepsy because IH does not usually involve suddenly falling asleep (sleep attacks) or losing muscle control due to strong emotions (cataplexy). Also, unlike narcolepsy, naps in IH are usually not refreshing.
This can be quite dangerous because some individuals are behind the wheel of cars or even cooking in their home and are not aware that they fall asleep. Some hypersomniacs and narcoleptics can fall asleep and then wake up and resume where they left off in conversations with people.
Usually daytime naps provide no relief or symptoms to the problems and will result in the individuals having increased difficulty in waking from a long extended period of sleeping, disorientation, anxiety, decreased energy, increased fatigue, restlessness, slow thinking, slow speech, loss of appetite, hallucinations, and problems with memory functions.
Some individuals also experience losing the ability to function in normal family, social, occupational, and other settings familiar to that person.
Symptoms
Symptoms often develop slowly during the teens or young adulthood. They include:
Daytime naps that do not relieve drowsiness
Difficulty waking from a long sleep — may feel confused or disoriented (”sleep drunkenness”)
Increased need for sleep during the day — even while at work, or during a meal or conversation
Increased sleep time — up to 14 to 18 hours a day
Other symptoms may include:
Anxiety
Feeling irritated
Loss of appetite
Low energy
Restlessness
Slow thinking or speech
Trouble remembering
Causes
Idiopathic means there is not a clear cause.
It has also been noted that some hypersomniacs are genetically predisposed to this problem, whereas in others there is no known or documented cause. Hypersomnia typically affects adolescents and young adults in their 20s and 30s. Although the most common causes of this disorder differs in the age brackets.
Hypersomnia can be triggered by sleep apnea or narcolepsy, where it can lead to dysfunction of the autonomic nervous system. Symptoms can be brought on by acute alcohol and/or drug abuse. In some cases it can also be triggered from physical problems such as tumors, head trauma or injuries to the nervous system. Specific medications or withdrawal of medications and/or drugs may contribute to someone having hypersomnia.
Medical conditions such as multiple sclerosis, depression, encephalitis, epilepsy, and obesity can contribute to hypersomnia as well.
Discuss your condition with your provider if you have repeated episodes of daytime sleepiness. They may be due to a medical problem that needs further testing.
Exams and Tests
The health care provider will ask about your sleep history. The usual approach is to consider other possible causes of excessive daytime sleepiness. A mental health evaluation for depression may also be done.
Tests that may be ordered include:
Multiple-sleep latency test (a test to see how long it takes you to fall asleep during a daytime nap)
Sleep study (polysomnography, to identify other sleep disorders)
Treatment
Your provider will likely prescribe stimulant medicines such as amphetamine, methylphenidate, or modafinil. These drugs may not work as well for this condition as they do for narcolepsy.
Lifestyle changes that can help ease symptoms and prevent injury include:
Avoid alcohol and medicines that can make the condition worse
Avoid operating motor vehicles or using dangerous equipment
Avoid working at night or social activities that delay your bedtime
More Information
Information can be located on the National Institute of Neurological Disorders and Strokes website if you are seeking a more thorough clinical explanation to this problem.
https://www.ninds.nih.gov/
This is not a substitute for medical advice from a licensed physician so it is ideal to educate yourself, but leave the diagnosing and treatment to a doctor so that you condition can be monitored closely.