Hypersomnolence – What is it?
Hypersomnolence is recognized as extreme daytime sleepiness even though a quality recommended amount of sleep at night is being obtained consistently. Narcolepsy type 1, narcolepsy type 2, and idiopathic hypersomnia are all different types of hypersomnolence. One cannot be diagnosed with hypersomnolence until they have experienced the excessive daytime sleepiness symptoms of narcolepsy 1, narcolepsy 2, or idiopathic hypersomnia for at least three months. Excessive daytime sleepiness (EDS) is recognized as having multiple sleep attacks a day after getting an appropriate amount of sleep the night before.
A couple of key associations with narcolepsy are cataplexy and hypocretin levels in the brain. Cataplexy is when someone falls asleep suddenly and can even happen mid-conversation. They could be asleep for just a minute or fifteen. This can vary greatly. Typically their head will drop suddenly, and they will be asleep just like that. Research has shown that cataplexy occurs when hypocretin levels in the brain are low or non-existent. Hypocretin regulates wakefulness, alertness, and REM sleep. Dreamlike hallucinations can occur when patients are awake due to poor control over REM.
Narcolepsy type 1 is present if you have cataplexy, have low levels of hypocretin, experience sleep attacks, nap multiple times a day, and enter into REM sleep for at least two naps a day, and you may experience dream-like hallucinations.
Narcolepsy type 2 is present if you nap multiple times a day, experience sleep attacks, and enter into REM sleep for at least two naps out of the day. The clear distinctions between narcolepsy 1 and narcolepsy 2 are that people with narcolepsy two do not experience cataplexy and they have normal hypocretin levels.
Idiopathic hypersomnia is present if they nap multiple times a day, experience sleep attacks, and sleep for at least 11 hours per day. They do not experience cataplexy and have normal hypocretin levels. The major difference between idiopathic hypersomnia and both narcolepsy 1 and narcolepsy 2 are that people with idiopathic hypersomnia sleep more in a 24 hour period. They don’t necessarily fall asleep suddenly, but they do take many naps and nap for longer periods of time, never waking up feeling refreshed, but always tired.
What causes it?
There could be many causes of narcolepsy, but as of right now any specific causes are unknown. However, there are some links to narcolepsy that have been made. As mentioned before, hypocretin is a chemical in your brain that regulates when you are awake and when you are asleep, specifically REM sleep. Studies have found that most individuals who suffer from narcolepsy also have low levels of hypocretin.
In certain cases, family history of narcolepsy and genetics have played a role in the development of narcolepsy.
Research has also shown a possible connection between the development of narcolepsy and exposure to the H1N1 virus, commonly known as swine flu. However, it is undetermined whether exposure to the virus may increase your chances of getting narcolepsy or if in some cases the virus may directly cause narcolepsy.
Physicians are unsure as to what exactly causes idiopathic hypersomnia, but believe it could be that some people suffer from an influx of chemicals in the brain responsible for causing sleepiness. There are, however, different risk factors causing people to be more susceptible to idiopathic hypersomnia including:
- stress
- excessive alcohol consumption
- previous history of viral infection
- previous history of head trauma
- a family history of hypersomnolence
- medical history of depression, substance abuse, bipolar disorder, Alzheimer’s disease, or Parkinson’s disease
Possible solutions
Treatments for all of the central disorders of hypersomnolence are aimed to relieve symptoms of EDS. Treatment options for hypersomnolence include the use of medications and lifestyle and sleep hygiene changes. The goal of these treatments is to help your body understand the appropriate sleep-wake cycle and minimize the factors that disrupt good sleep.
Stimulants are the most often prescribed medication to treat hypersomnolence. They help to combat the excessive tiredness and keep those struggling with the problem awake during the day. Other commonly prescribed medications include:
- Modafinil – a eugeroic
- Clonidine – a centrally acting alpha-agonist hypotensive agents
- Bromocriptine – a dopamine receptor agonists
- Sodium Oxybate
- antidepressants
Treatment methods to facilitate restful sleep beyond medications are commonly prescribed for hypersomnolence. These treatments typically include light-based therapy as well as recommendations for sleep hygiene and lifestyle changes. Examples of these recommendations include:
- Avoiding caffeine, nicotine, and all stimulant substances before bedtime
- Drinking alcohol only in moderation – although alcohol can make a person feel drowsy, drinking it in excess will result in poorer sleep quality
- Avoiding eating fatty, fried, and spicy foods that cause heartburn or impact digestion
- Avoid eating within a couple of hours of bedtime or late at night
- Using lighting to help your body understand when it is time to sleep and when it is time to be awake
- Establishing a relaxing bedtime routine and winding down an hour before its time to sleep by turning off electronics and reading or taking a relaxing bath
- Making your bed and bedroom more comfortable – keep the room dark and cool and make sure the bed, linens, and pillows are comfortable
Why get treatment?
All three conditions categorized as hypersomnolence are very treatable conditions using lifestyle and sleep hygiene changes and medications when necessary. Treatment allows you to get the sleep you need at appropriate times of the day and finally feel refreshed and satisfied with your sleep. Check out our Sleep Wellness Packages and get insights into your sleeping problems and treatment options so you can finally feel refreshed and get back to enjoying life again!