What is hypersomnia and what causes it?
Idiopathic hypersomnia is a sleep condition where you have extreme tiredness during the day, despite adequate or even excessive sleep at night. Patients can often sleep 10+ hours a night and still feel unrefreshed. This drowsiness often makes day-to-day activities difficult for patients, as they often fall asleep during awake hours. They have the urge to nap, and can easily, yet the naps classically do not help them be more functional during the day. While more women than men are diagnosed with idiopathic hypersomnia, the actual cause of the condition remains unknown.
What are the symptoms of idiopathic hypersomnia?
They symptoms of hypersomnia can include
- Extreme drowsiness or sleepiness during the day
- Longer than average sleep times
- Irritability
- Anxiety
- Brain fog or inability to focus
- Sleep drunkenness or difficulty waking in the morning
- Not feeling refreshed, despite daytime naps
- Headache
- Restlessness
- Hallucinations
How is idiopathic hypersomnia diagnosed?
Definitive testing is done with a sleep study at a sleep center. Not in the US, but sometimes a sleep center will allow a patient to demonstrate they can sleep 11+ hours in one night, which could establish the diagnosis with the right correlating symptoms and absence of drugs or other medical conditions that could explain those symptoms otherwise.
In the US though, a multiple sleep latency test (please see narcolepsy section above on MSLT format) is required to establish the diagnosis. Adequate sleep time the night before and the rapid ability to take naps through the day will provide the diagnosis. The structure of sleep at night and during the naps is what distinguishes idiopathic hypersomnia from narcolepsy on a sleep study.
What are the treatment options for hypersomnia?
At the present, the only FDA approved treatment for idiopathic hypersomnia is Xywav. Xywav is an oxybate sedative. Again, like in narcolepsy, it promotes restorative sleep to where the brain does not feel sleepy the next day. Historical treatments of idiopathic hypersomnia include stimulants and other wake promoting agents that can be quite effective in controlling symptoms as well.