Hypersomnia Causes and Treatment

Hypersomnia is characterized by episodes of excessive daytime sleepiness, even with adequate nighttime sleep, or prolonged nighttime sleep. This condition is different from the daytime sleepiness and sleep episodes of narcolepsy or feeling tired due to occasional insomnia. People with hypersomnia feel driven to nap, often for long periods of time, but the naps usually are not refreshing. Hypersomnia sufferers also often have difficulty awakening from a long sleep, and they may feel disoriented. Other symptoms may include anxiety, irritability, lack of energy, restlessness, slowed thinking and speech, appetite loss, and memory problems. These symptoms can be severe and interfere with daytime functioning. Although hypersomnia usually affects adolescents and young adults, it also can occur later in life and may be mistakenly attributed to aging.

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Hypersomnia may be caused by another sleep disorder, such as sleep apnea, drug or alcohol abuse, medication withdrawal (or by some medications themselves), head trauma, or a tumor. Some medical conditions, such as depression, epilepsy, and multiple sclerosis, as well as obesity, may contribute to hypersomnia. Some people may have a genetic predisposition to hypersomnia. Not surprisingly, hypersomnia can lead to drowsy driving and auto accidents.

How Hypersomnia Is Treated

Hypersomnia is treated by addressing the underlying cause. If no cause is found, the disorder may be treated with medications and behavioral changes.

Daytime stimulants such as methylphenidate or modafinil may be tried. Those who do not respond may find relief with flumazenil (Romazicon), a gamma-aminobutyric acid (GABA)-A receptor antagonist, that is given sublingually (under the tongue) or transdermally (through the skin). In a study published in the Journal of Clinical Sleep Medicine, GABA helped relieve symptoms in 63 percent of the 153 patients in the study. Overall, flumazenil provided a lasting benefit to 39 percent of patients who had failed to achieve satisfactory symptom control with more conventional medications.

Drugs that may be used to increase alertness by improving sleep include sodium oxybate (Xyrem), monoamine oxidase inhibitors (MAOIs), antidepressants, clonidine (Catapres), and bromocriptine (Parlodel).

Currently, no FDA-approved medications are available for the treatment of hypersomnia, since this condition has been poorly studied. The Hypersomnia Foundation is creating patient-centered databases that will help advance research and foster collaborative approaches for evaluating and treating this condition.

Behavioral changes, including avoiding caffeine, alcohol, and activities that delay bedtime, may help in cases of sleep fragmentation.

To learn about other disorders that can affect your sleep, purchase Improving Sleep from www.UniversityHealthNews.com.

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