Hypersomnia: types, symptoms, causes and treatments

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

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

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Hypersomnia

It is understood by hypersomnia a sleep disorder characterized by the presence of excessive sleepiness despite having had a previous sleep period of at least seven hours. It is a dysomnia, a type of sleep disturbance that affects the timing, quantity and quality of sleep.

In hypersomnia, the subject in question remains drowsy for most of the day

And it tends to be difficult for you to wake up after a normative period of sleep or that may even last nine or more hours, and this sleep may not be restorative and not allow you a real rest. It may involve falling asleep in a way similar to narcolepsy. Thus, someone with hypersomnia can 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 involves great dysfunction for those who suffer from it, decreasing their capacities and performance both at work, personal and social level. In fact, the person can fall asleep in high-risk situations, such as when they are behind the wheel of a vehicle.

Apart from the lack of energy, this disorder can cause emotional disturbances What anxiety problems and irritability, 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 bear in mind that although episodes of sudden sleep also occur in narcolepsy, it is about another pathology with its own and differentiated characteristics, so that we would not be talking about a type of hypersomnia

Primary or idiopathic hypersomnia

It is known as hypersomnia disorder. In this case the causes that produce this alteration are not known, there is a regulatory rest period and Without being able to explain excessive sleep due to organic causes. The symptoms are those previously described.

Within the primary hypersomnias can also be found the so-called syndrome of Kleine-Levine, which acts in a recurrent and persistent way 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 the rest of the time tired, with high instability, irritability and impulse disinhibition that leads to hyperphagia and hypersexuality. It is not uncommon for them to appear hallucinations and speech and memory problems. These episodes will recur recurrently, but the periods of time that elapse between sleep and behavior are normative.

Secondary hypersomnia

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

Among the secondary hypersomnias we can find those due to sleep deprivation, either for not having slept enough or because it is frequently interrupted, the effect of different drugs or drugs 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 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 have sleep problems due to the persistent absence of sleep, substance use or certain problems of medical origin, but in this case we would be talking about hypersomnia secondary to these and not hypersomnia as disorder itself.

Even if the cause is not fully known, the possibility of the presence of disturbances 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 noradrenaline It 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.

• Related article: "Limbic system: the emotional part of the brain"

To do? Treatment

Hypersomnia is an annoying and disabling problem for the sufferer and that can greatly limit their life and even precipitate accidents that are dangerous for their own survival. Its treatment is essential.

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

On a psychological level, they are also used cognitive-behavioral techniques that can serve to face 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 both physically and mentally to increase the level of consciousness and physiological activity.

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

Bibliographic references:

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth edition. DSM-V. Masson, Barcelona.

• Bassetti, C.L. & Dauvilliers, Y. (2011). Idiopathic hypersomnia. In: Kryger MH, Roth T, Dement WC, eds. Principles and Practice of Sleep Medicine. 5th ed. Philadelphia, PA: Elsevier Saunders.

• Erro, M.E. and Zandio, B. (2007). Hypersomnias: diagnosis, classification and treatment. Annals of the Navarra Health System; 30. Navarra Hospital. Pamplona.

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