Excessive sleepiness, also known as hypersomnia, is a condition in which an individual has problems staying awake during the day. It may occur even after long stretches of sleep.
People with excessive sleepiness can fall asleep in any condition and at any time, even while at work or driving. The age groups most affected by excessive sleepiness are teenagers and young adults.
There are two main categories of hypersomnia:
- primary hypersomnia (also known as idiopathic hypersomnia) – this type of excessive sleepiness is similar to narcolepsy in that the patient falls asleep at inappropriate times, is excessively sleepy, sleeps at night for more than 10 hours, and frequently takes naps;
- recurrent hypersomnia (also known as current primary hypersomnia) – it is characterized by recurrent, reversible episodes of hypersomnia commonly linked with other symptoms which usually occur months or weeks apart. Recurrent hypersomnia may or may not be accompanied by other symptoms, like – hypersexuality and overeating (also known as compulsive hyperphagia).
- an increased risk of accidents, particularly vehicle accidents;
- feeling unusually tired all the time;
- concentration or memory difficulties;
- difficulty thinking and making decisions;
- feeling drowsy, despite sleeping;
- the need for daytime naps.
There are several potential causes of excessive sleepiness, such as:
- genetics (having a relative with excessive sleepiness);
- sleep apnea (interruptions of breathing during sleep);
- narcolepsy (daytime sleepiness);
- the use of prescription drugs, like – tranquilizers;
- not getting sufficient sleep at night (sleep deprivation);
- a neurological disease, like – multiple sclerosis;
- a head injury;
- being overweight or obese;
- sleeping pills;
- caffeine (found in energy drinks, some sodas, coffee, chocolate, and some teas);
Your healthcare professional can use a few tests to diagnose excessive sleepiness, such as:
- multiple sleep latency test;
- Epworth sleepiness scale;
- sleep diary.
Treatment usually includes:
- the avoidance of alcoholic beverages and caffeine from all sources;
- regular moderate physical exercise;
- meditation, yoga, or Tai Chi to reduce stress levels.
Note – prescribed stimulants may be used to treat the disorder, however, these medications may be less effective for excessive sleepiness than they are for narcolepsy.
While the disorder itself is not life-threatening, excessive sleepiness can have serious consequences, like – car accidents caused by falling asleep while driving.
It is a sleep disorder that causes severe daytime sleepiness. Narcolepsy can have negative and serious repercussions on a sufferer’s psychological, physical, emotional, cognitive, and social functioning if it is not identified and treated correctly.
This condition affects an estimated 1 out of every 2,000 people. Females and males are equally likely to suffer from the sleep disorder. About fifty percent of affected adults retrospectively report symptoms starting in their teenage years.
Excessive daytime sleepiness is present in 100 percent of people with narcolepsy and is the main symptom. Other symptoms of the sleep disorder include:
- inability to move or talk (sleep paralysis) – it affects about 60 percent of patients;
- disrupted nighttime sleep — it occurs in 60 to 90 percent of affected individuals;
- distorted perceptions (hypnagogic hallucinations);
- cataplexy (loss of muscle control) – it may cause you to have a sudden loss of muscle control while being awake.
Most patients with this sleep disorder have low levels of the chemical hypocretin, an essential neurochemical in the brain which helps regulate REM sleep (happens 90 minutes after you fall asleep) and wakefulness.
Healthcare professionals use the following methods to diagnose the sleep disorder:
- spinal fluid analysis;
- multiple sleep latency test;
- nocturnal polysomnogram.
There’s no cure for this sleep disorder, however, symptoms can be kept under control with medications and lifestyle changes.
- selective serotonin reuptake inhibitors, like – fluoxetine (Prozac), can help improve your mood and regulate sleep;
- serotonin-norepinephrine reuptake inhibitors, like – venlafaxine (Effexor), Duloxetine (Cymbalta), or Desvenlafaxine (Pristiq) can help regulate sleep and mood since these medications can be useful in treating hallucinations, cataplexy, and sleep paralysis;
- tricyclic antidepressants – these medications can have unpleasant side effects, like – dry mouth, constipation, and urinary retention, but, they can reduce sleep paralysis, cataplexy, and hallucinations. Some of the prescribed tricyclic antidepressants include -Trimipramine (Surmontil), Protriptyline (Vivactil), Nortriptyline (Pamelor), Imipramine (Tofranil), Doxepin, Desipramine (Norpramin), Amoxapine, and Amitriptyline;
- stimulants like modafinil (Provigil), armodafinil (Nuvigil), and methylphenidate (Ritalin) may also be used to improve wakefulness.
Lifestyle changes include:
- avoiding bright lights before bedtime, like those from a computer or a smartphone;
- avoiding large meals and beverages just before bedtime;
- avoiding alcoholic beverages, tobacco, energy drinks, colas, coffee, green and black tea, and chocolate, since they contain caffeine (a central nervous system stimulant) for a minimum of 5 hours before bedtime;
- exercising regularly, however, not within three hours before bedtime;
- allowing yourself about twenty minutes to fall asleep or fall back asleep after waking up;
- keeping your sleep area or bedroom comfortable, quiet, dark, and free from distractions, like a computer, laptop, tablet, or a TV;
- doing something relaxing before bedtime, like practicing mindfulness meditation or taking a warm bath;
- going to bed and waking up at the same time every day.
Narcolepsy can interfere with an individual’s capacity to play, drive, work, socialize, and perform other daily activities. Moreover, in severe cases, this sleep disorder prevents affected individuals from living a normal life, leading to a loss of independence and depression.
Bottom Line – Hypersomnia vs Narcolepsy
Hypersomnia is a sleep condition in which you feel excessive sleepiness during the day. Up to 40 percent of people experience some symptoms of hypersomnia from time to time, according to the National Sleep Foundation. This sleep disorder is more prevalent in males than in females.
There are many causes of hypersomnia, including:
- psychiatric illnesses;
- sleep disorders;
- insufficient or inadequate sleep.
Chronic patients may sleep up to 18 hours a day or more.
Narcolepsy is a chronic sleep disorder which is characterized by sudden attacks of sleep and daytime drowsiness. In a patient without narcolepsy, rapid eye movement sleep only occurs when that individual has been asleep for some time. After obstructive sleep apnea, narcolepsy is the 2nd-leading cause of excessive daytime sleepiness.