Hypersomnia: Why Not To Ignore Over-Sleepiness during the Day

The normal tendency is to ignore the feeling of sleepiness during the day. After all, don't we all feel sleepy after consecutive late nights or even after doing some hard work the previous couple of days? But when such chronic sleepiness overpowers and starts to interfere with daytime activities, then one should take it seriously, as it is a medical condition called hypersomnia that needs therapy.

This is a type of sleep disorder that sets in between 15 and 30 years of age and usually remains for life, responding poorly to any kind of therapy. Statistics mention that only 25% have chances of full recovery.

When should one seek therapy?

There are some tell-tale signs that one cannot miss:

- Tendency to sleep for long hours - stretching to over 10 hours.
- Days filled with short naps that are far from refreshing.
- Confusion and disorientation on waking up
- Gradually shying away from most social interactions
- Likelihood of going off to sleep at the most inappropriate times and places
- Parallel mood disorders and behavioral changes including irritability, depression, tiredness and restless.

Diagnosis could be late and wrong

Late diagnosis is common since most patients and family tend to ignore excessive daytime sleepiness without realizing what it could mean or what the long term consequences are. National Sleep Foundation mentions that close to 40% people show early signs but they remain unattended.

The other important aspect of this condition is the chance of it being misdiagnosed since over-sleepiness during the day is common with several other sleep disorders like obstructive sleep apnea as well as narcolepsy. In fact, it is one of the prime narcolepsy symptoms.

How to get it right?

There are two ways this kind of diagnostic confusion can be cleared:

- Get confirmation from results of sleep apnea test, also called polysomnogram examination. This is one of the most reliable and objective diagnostic examinations that not only assess the severity of the condition but also provide critical clues regarding the nature of illness the patient is suffering from. This is done with the help of studying various physical and physiological parameters during sleep, which otherwise the patient cannot report as symptoms.
- The second way is to study the other prominent and characteristic features of other sleep disorders. For example:

1. Narcolepsy is a disorder that is of neurological origin that is characterized by sudden sleep attacks. Patients however go off to sleep gradually, when suffering from other sleep disorders.
2. Age of onset is another clear indicator of the type of disorder the patient could be suffering from. While sleep apnea sets in around 50 years of age, most of the other sleep disorders set in earlier.
3. Sleep apnea treatment is based on severity of the condition. For managing mild to moderate conditions, doctors rely on CPAP along with weight loss, special exercises for toning and strengthening breathing muscles, abstinence from alcohol, changing sleeping position, etc. Surgery is also a possible option in case the condition is serious.
4. Treating hypersomnia takes another route. It is 'idiopathic' in nature, that is, there is 'no known cause' for the onset; doctors provide drugs that merely provide symptomatic relief. These include amphetamine or methylphenidate. Some doctors prefer to put their patients on levodopa, bromocriptine, clonidine, monoamine oxidase inhibitors and antidepressants like Provigil and Xyrem.