A sleep disorder in which a person feels unrested after sleeping through the night is called idiopathic hypersomnia (IH). People who develop it may feel exhausted, disoriented, or unable to function properly during the day.
In other words, IH is a condition in which people have an excessive need to sleep. Those who develop it often wake up very tired even after getting enough amount of sleep. The medical term “idiopathic” means that the cause is not known. Furthermore, people with IH may need several alarms and may take afternoon naps to feel more alert. Fortunately, doctors can manage the symptoms of this condition.
In general, this condition occurs rarely, and it affects about 10 out of 100,000 people in the U.S.
What Are The Symptoms of Idiopathic Hypersomnia?
Usually, people with this type of hypersomnia experience the following symptoms. Examples include:
- Daytime sleepiness
- Sleeping more than 8 hours per day
- Taking naps
- Difficulty waking up
- Disorientation
The previous symptoms can make daily routine extremely difficult. To confirm this condition, a person should experience these symptoms a few times a week or daily, for at least 3 months in a row. Check below some symptoms that often occur during daytime:
It is recommended to visit a doctor if any of the symptoms listed above occur. Otherwise, it may lead to serious complications.
Causes and Risk Factors
While doctors do not know the exact cause of this type of hypersomnia, they think the following factors could play a role. These include:
- Genetic mutations – There is a gene change that may negatively affect the signaling and cell regulation within the brain. As a result, it affects the sleep-wake cycle.
- Immune system response – Sometimes, the immune system mistakenly attacks healthy cells of the nervous system instead of bacteria, viruses, and other germs that can make you ill.
While anyone can develop this condition, doctors have identified some factors that may increase your risk. Examples include a family history of hypersomnia, genetic predisposition, sex (according to some data, females are more likely to develop this condition than males), age (most people who develop this condition are between the ages of 10 and 30), and neurochemical factors. Some research has shown that possible central nervous system dysfunction, particularly how the brain processes neurotransmitters (such as GABA), may also contribute to idiopathic hypersomnia.
What Are The Triggers of Idiopathic Hypersomnia?
There are some things and conditions that may trigger symptoms of this condition. Check some of them below:
- Viral infections
- Head trauma
- Overexertion
- General anesthesia
- Sudden changes to the sleep-wake cycle
What Are The Long-Term Effects of Idiopathic Hypersomnia?
Those who ignore the symptoms and do not get treatment for this condition may also experience some complications. Check some examples below:
- Severe sleep inertia – It causes extreme grogginess and confusion upon walking that may last for a few hours.
- Job and school loss – Long-term (chronic) lateness and poor concentration may negatively affect your career.
- Accidents – Excessive daytime sleepiness significantly increases your risk for accidents.
- Cognitive impairment – These include problems with focus, short-term memory, and word-finding.
- Mood disorders
- Autonomic problems – For example, dizziness, abnormal body temperature regulation, headaches, and others.
- Increased risk for hypertension (high blood pressure) and cardiovascular disease
- Relationship problems
The previous list does not contain all possible idiopathic hypersomnia complications. In any case, your doctor may help reduce the risk or even prevent the previous complications. Unfortunately, there is no way to prevent this condition because doctors do not fully understand what exactly causes it.
Diagnosis
First, doctors will perform a physical examination in which they will learn more about your symptoms. In some cases, they may rank how sleepy you are by using the Epworth Sleepiness Scale. Some people may also need to keep a sleep journal for a few weeks and track where they fall asleep and wake up. It may help get more clues about your disease. However, doctors may also perform a polysomnography or a multiple sleep latency test to rule out other sleep disorders that cause similar symptoms.
Treatment
This type of hypersomnia cannot be treated, and that’s why the treatment goal is to ease the symptoms and improve your quality of life. Most of the time, medicines help treat symptoms. Doctors often prescribe:
- Central nervous system (CNS) stimulants (including Amphetamines)
- Non-amphetamine CNS stimulants (such as Modafinil)
- CNS depressants, including FDA (Food and Drug Administration)-approved Sodium oxybate
- GABA receptor antagonists (such as Flumazenil)
You should administer these medicines exactly as recommended by your doctor. Inform your physician about any adverse reactions you experience or if the treatment does not help.
Sometimes, doctors may also recommend cognitive behavioral therapy for hypersomnia (CBT-H), which is a type of psychotherapy (also known as talk therapy). This treatment helps a lot of people with idiopathic hypersomnia perform their daily tasks and improve sleep quality.
Frequently Asked Questions
Is idiopathic hypersomnia the same as narcolepsy?
No. Idiopathic hypersomnia and narcolepsy are different sleep disorders. Both can cause excessive daytime sleepiness, but people with idiopathic hypersomnia typically have prolonged sleep, difficulty waking up, and severe sleep inertia. Narcolepsy may involve sudden sleep attacks, cataplexy, sleep paralysis, and hallucinations around sleep.
How many hours do people with idiopathic hypersomnia sleep?
Usually, people with idiopathic hypersomnia sleep more than 9 or 10 hours in a 24-hour period. However, the amount of sleep alone does not determine whether someone has IH. A key feature is persistent excessive sleepiness or difficulty waking despite getting adequate or extended sleep.
Why is it so difficult to wake up with idiopathic hypersomnia?
People with IH may experience severe sleep inertia, meaning they remain extremely groggy, confused, or disoriented after waking. This can make getting out of bed, starting daily activities, or becoming fully alert take much longer than usual.
Can naps improve idiopathic hypersomnia symptoms?
Naps may not provide the same level of relief that they provide for people with ordinary sleep deprivation. Some people with IH find that naps are long but unrefreshing and still feel sleepy afterward. Doctors may recommend other strategies and medications to improve daytime alertness.
How is idiopathic hypersomnia diagnosed?
Doctors usually review a person’s sleep history, symptoms, medications, and other health conditions. They may use a sleep diary, actigraphy, overnight polysomnography, and sometimes a multiple sleep latency test. These tests can help rule out conditions such as narcolepsy, sleep apnea, and insufficient sleep.
Can idiopathic hypersomnia go away on its own?
Symptoms may change over time, and some people experience periods when their symptoms improve. However, idiopathic hypersomnia is generally considered a chronic sleep disorder. Anyone experiencing persistent excessive sleepiness should work with a healthcare professional rather than assuming the condition will resolve on its own.
Can idiopathic hypersomnia affect work or school?
Yes. Excessive sleepiness, brain fog, difficulty concentrating, and problems waking up can interfere with school, work, relationships, and other daily responsibilities. Treatment and appropriate accommodations may help people manage these challenges.
Can people with idiopathic hypersomnia drive safely?
Excessive daytime sleepiness can impair alertness and increase the risk of motor vehicle accidents. People who are very sleepy should avoid driving or operating machinery until they can safely maintain alertness and have discussed their symptoms with a healthcare professional.
Is there a cure for idiopathic hypersomnia?
There is currently no established cure that eliminates idiopathic hypersomnia in everyone. Treatment focuses on reducing excessive daytime sleepiness, improving wakefulness, and helping people function more effectively. Medications and behavioral strategies may help manage symptoms.
When should someone see a doctor for excessive daytime sleepiness?
A person should talk with a healthcare professional if excessive sleepiness persists despite getting enough sleep, interferes with daily activities, causes difficulty waking, or creates safety concerns. Evaluation is especially important when sleepiness is frequent or lasts for several months. If you have any other questions, ask your healthcare provider.
