Hypersomnia: types, symptoms, causes and treatments

Sleep is an essential process for our survival and maintain our capabilities. When we are tired or sleepy, our energy levels and motivation suffer and we lose the urge to do things. We cannot concentrate and our judgment and analytical skills diminish, as does our performance.

Fortunately, after having slept a sufficient number of hours, we regain our energy and regain our energies and maintain a state of awakening and regulating attention. However, there are people whose sleep periods change over time and the quality of sleep. This is the case with insomnia or its opposite, hypersomnia.

    Hypersomnia

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

    In hypersomnia, the subject in question remains drowsy for a good part of the day. and it is often difficult to wake up after a period of normative sleep or it can even last for nine hours or more, and this dream may not be restful and will not allow you a real rest. This may involve falling asleep in a manner similar to narcolepsy. Thus, a person with hypersomnia can both sleep for long periods of time and sleep 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 almost every day) for at least a month. Hypersomnia usually leads to severe dysfunction for those who suffer from it, reducing their abilities and performance both at work and personally and socially. In fact, the person can fall asleep in high risk situations, such as when driving a vehicle.

    Apart from the lack of energy, this disorder it can cause emotional alterations such as anxiety and irritability, demotivation and apathy issues. They also often have memory problems and a certain mental and physical sluggishness. At the organic level, it can cause 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 narcolepsy also has sudden episodes of sleep, this is another pathology with its own differentiated characteristics, so we would not speak of a type of hypersomnia.

    Primary or idiopathic hypersomnia

    This is known as hypersomnia disorder. In this case, the causes which produce this alteration are not known, and there is a period of normative rest and without being able to explain the excess sleep due to organic causes. The symptoms are as described above.

    In primary hypersomnia, we also find what is called Kleine-Levine syndrome, which works recurrently and persistently causing periods of several days or weeks of intense sleep.

    It is common that those who suffer from it can sleep up to 20 hours in a row and stay tired the rest of the time, With a strong instability, irritability and disinhibition of the impulses which lead them to overeating and hypersexuality. It is not uncommon for hallucinations and problems with speech and memory to appear. These episodes were recurring, but the time periods between sleep and behavior were normative.

    secondary hypersomnia

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

    In secondary hypersomnias, we can find those due to sleep deprivation either to not get enough sleep or because it is frequently interrupted, the effect of different drugs or medications, or the existence of a medical or psychiatric disorder that explains it. In these cases, hypersomnia would not be a disorder but a symptom of this disorder.

    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 warrant hypersomnia.

    So, although it is possible to have problems with sleep due to its persistent absence, substance use or some medical problem, but in this case we would speak of secondary hypersomnia. To those – here and not hypersomnia as a disorder in itself.

    Although the cause is not fully known, the possibility of the presence of alterations in the limbic system which may explain the presence of behavioral alterations in Kleine-Levine syndrome. A deficiency in the synthesis and transmission of norepinephrine could also be an element to consider in trying to explain this disorder. Possible damage to the areas of the brain responsible for regulating sleep could also cause this problem.

      What to do? treatment

      Hypersomnia is a troublesome and crippling problem for those who suffer from it and it can greatly limit their life and even precipitate accidents dangerous for their own survival. Its treatment is essential.

      In this sense, it is recommended at the behavioral level to try to avoid the use of machinery or heavy vehicles, as well as to try to maintain as good sleep hygiene as possible. Sport is also a great help in staying active and reducing the feeling of sleep in the moments following exercise. Sleep hygiene is recommended establish specific sleep and wake timesIn addition to facilitating the entry into sleep in normative moments such as the avoidance of elements that require attention or noise.

      At the psychological level, cognitive-behavioral techniques are also used which can be used to treat problems arising from the disorder and to increase and help focus attention. The subject is also trained in the detection of the first signs of sleep, and applies various exercises to them both physically and mentally to increase the level of consciousness and physiological activity.

      It’s very useful avoiding the use of depressants such as alcohol and other drugs with the same effects. The use of drugs and excitatory substances may be prescribed. Some antidepressants such as imipramine or MAOIs have also been used as treatment, although caution should be taken with other aspects of health such as blood pressure.

      Bibliographical references:

      • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth edition. DSM-V. Masson, Barcelona.
      • Bassetti, CL and Dauvilliers, Y. (2011). Idiopathic hypersomnia. A: Kryger MH, Roth T, Demented WC, eds. Principles and practice of sleep medicine. 5th ed. Philadelphia, PA: Elsevier Saunders.
      • Erro, ME and Zandio, B. (2007). Hypersomnias: diagnosis, classification and treatment. Annals of the Navarra Health System; 30. Hospital of Navarre. Pamplona.
      • Guilleminault, C. and Brooks, SN (2001). Excessive daytime sleepiness. A challenge for the practicing neurologist. Brain; 124: 1482-1491.

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