Hypersomnia can be a nightmare

Imagine what it would be like if you could fall asleep anywhere at any time. What if this included difficulty staying awake while driving, talking to someone or working?

At any given time, 4 to 6 percent of people face this problem. They have a condition called hypersomnia. Hyper means something that is more than what is normal and somnia means sleep.

According to the National Institute of Neurological Disorders and Stroke, “Hypersomnia is characterized by recurrent episodes of excessive daytime sleepiness or prolonged nighttime sleep.”

If you suffer from hypersomnia, you may get a full night’s sleep and yet feel compelled over and over to sleep again during the day. You may also sleep for more than 10 hours at night and be very difficult to wake during this time.

Hypersomnia has many causes: sleep apnea, narcolepsy, insufficient sleep syndrome, major depression or major mood disorder, brain tumor, stroke, Alzheimer’s, Parkinson’s and metabolic and endocrine diseases. The presence of other symptoms, such as anxiety and irritability in the case of some psychiatric disorders and weakness or loss of coordination in the case of some neurologic disorders, can help physicians figure out the cause of hypersomnia.

If you are experiencing symptoms of hypersomnia, the first step is to discuss your sleep habits and hygiene with your health care provider. You will probably need to keep track of how often and how long you sleep during the day and whether these naps leave you feeling refreshed. To uncover the cause, your health care provider may run blood tests to check for metabolic disorders and other problems, or order a brain scan for neurological problems. You may also have tests during daytime or nighttime sleep to monitor your heart or to measure your oxygen levels, breathing, leg movements, electrical brain activity, electrical muscle activity or eye movements.

Your treatment will depend on the fundamental cause of your hypersomnia; in many cases you may have to continue with treatment indefinitely.

Sleep apnea – repeatedly stopping and starting breathing during sleep – is one of the more common causes of hypersomnia. Mild cases often respond to lifestyle changes such as losing weight or quitting smoking. More serious cases may require sleeping with a device to keep your upper airway passages open while you sleep. Surgery may be recommended when all other treatments fail.

Cases caused by narcolepsy can respond to antidepressants, stimulants and other medications. Lifestyle modifications can also help manage symptoms.

Chronic sleep loss that leads to hypersomnia may be both the easiest and most difficult cause of hypersomnia to treat. Treatment means allowing enough time for sleep each night, practicing good sleep hygiene and setting a regular sleep schedule. These things are not easy to achieve in our 24/7 society. I wrote some tips about how to get better sleep in this column in July 2009 ( www.spokesman.com/ stories/2009/jul/21/ sleeping-tips-from- a-to-zzzs/).

Rarely, a cause for hypersomnia isn’t found. When that happens, treatment with stimulants can help with daytime sleepiness, but there is no effective solution when no underlying cause is known.

Good sleep helps us to avoid depression, keep our immune system healthy, remember things better, concentrate (making us safer drivers), improve our sex drive, maintain a healthy weight and even digest our food better. If you or someone you know suffers from hypersomnia, seeking an answer will do more than just get you a good night’s rest. It may improve or save a life.

Dr. Alisa Hideg is a family medicine physician at Group Health’s Riverfront Medical Center in Spokane. Her column appears every other Tuesday in the Today section.

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