Hypersomnia is a disorder characterized by prolonged sleep at night, lack of alertness upon waking, and persistent sleepiness during the day.
A normal night’s sleep of a healthy person lasts from 5 to 12 hours, on average, 8 hours. The pathological condition occurs when the sleep duration is 12 hours and more. It is very difficult to wake a person up. During the day, he feels lethargic and weak, unable to concentrate. The performance is sharply reduced. Hypersomnia can recur periodically or be present constantly.
What causes hypersomnia ?
Hypersomnia can be due to the following reasons:
- regular lack of sleep;
- imbalance in neurotransmitters (congenital or acquired);
- stress, entailing psycho-emotional overstrain, exhaustion;
- increased physical and mental stress;
- tumors, organic, traumatic diseases of the brain;
- chronic somatic and endocrine diseases;
- infections, drug intoxication, alcohol;
- mental and neurological pathologies;
- some medications that affect brain function;
- as part of sleep apnea syndrome – sleep disorders, with periodic stops of breathing for 10 or more seconds. It is characterized by snoring, superficial night sleep, daytime sleepiness, decreased performance.
According to the frequency of manifestations, hypersomnia is constant (permanent) and episodic (paroxysmal).
Depending on the etiological factor, there is idiopathic, hysterical, post-traumatic, lethargic, medicinal, iatrogenic, psychopathic hypersomnia :
- Idiopathic (psychophysiological) – occurs against the background of chronic stress, lack of sleep in healthy people 15-30 years old. It may be accompanied by signs of outpatient automatism (involuntary continuation of some actions, wandering followed by amnesia) lasting several seconds. Daytime sleep relieves the condition, but the person does not feel sleepy and vigorous.
- Hysterical is the result of psychotrauma. It is impossible to wake up a person. The reaction to light is preserved, the patient resists a violent attempt to open his eyes. Skin sensitivity is reduced, muscle tone is increased, blood pressure is normal. Often accompanied by a rapid heartbeat, increased sweating of the extremities. The electroencephalogram (EEG) shows signs of wakefulness.
- Lethargic – develops suddenly or against the background of lethargic encephalitis, lesions of the reticular formation of the brain. Lethargic sleep lasts at least a day. There are known cases of lethargy lasting for decades. It is characterized by a slowdown in metabolism, a weakening of the reaction to light, sound, touch. Outwardly, a person is in a state of deep sleep. The picture may resemble an imaginary death: the skin is pale, cold, there is no pupillary reaction to light, the pulse cannot be felt. The person does not eat or drink, there is no excretion of urine and feces. People with lethargy were often buried alive.
- Iatrogenic – occurs after the use of certain drugs.
- Psychopathic – develops against the background of mental disorders.
- Post-traumatic – against the background of brain injuries.
- Medicinal – after taking medication with a sedative effect.
Clinical features distinguish:
- Narcolepsy is a paroxysmal course of the disorder, the patient cannot resist the desire to fall asleep, he does it anywhere, at any time (during classes, at work, in a store, cafe). The person does not even have time to take a comfortable sleeping position. Gradually, the patient can feel the onset of an attack and prepare: choose a suitable place and posture. The condition is often accompanied by hallucinations during falling asleep and waking up. Catalepsy is characteristic – the patient cannot move for several minutes after awakening as a result of a sharp hypotonia of the muscles.
- Pickwick syndrome is a combination of daytime hypersomnia , obesity and respiratory failure. After a night’s sleep, a person feels overwhelmed, complains of a headache.
- Kleine-Levin syndrome – bulimia joins hypersomnia (the patient eats everything in huge quantities indiscriminately before or during an attack). Typical for young people. Before bouts of drowsiness, pschomotor agitation and insomnia are observed . The duration of one attack can last for several weeks. Self-awakening is accompanied by confusion, forced – aggression.
- Syndrome of hypersomnia and drowsiness – characterized by confusion after waking up for 15 minutes. – 2 hours. During the day, there is increased sleepiness.
Treatment of hypersomnia aims to eliminate the etiological factor (pathogenetic therapy), signs of the disease (symptomatic therapy), to prevent the recurrence of attacks, the development of complications.
Apply medication, psychotherapy, treatment with folk remedies. The correct daily routine is of great importance.
Drug therapy includes:
- drugs that restore the balance of neurotransmitters;
- correction of somatic, endocrine, neuropsychic, oncological diseases;
- detoxification therapy in a hospital for intoxication;
- antibiotic therapy for infections;
- nootropic drugs – to improve brain function in organic pathologies;
- drugs that calm the nervous system in psychogenic etiology;
- psychostimulants to eliminate daytime sleepiness;
- antidepressants for symptoms of catalepsy;
- vitamin therapy and immunostimulants in order to strengthen the body.
With medicinal and iatrogenic forms, the dosage of the drugs that caused the hypersomnia is adjusted .
It must be remembered that the use of medicines should only take place under the supervision of a doctor! Doses are prescribed strictly individually, depending on the condition, patient’s age, duration and frequency of hypersomnia , and the presence of concomitant diseases.
How to treat hypersomnia without medication? Since the leading trigger mechanism in the etiology of the disease is psychotrauma, an important role in treatment is assigned to psychotherapy aimed at teaching:
- combating stress;
- managing emotions;
- constructive problem solving;
- conflict-free communication;
- relieving stress with the help of music, painting, dancing, modeling, sand exercises (art, sand therapy).
Traditional medicine is used in addition to medicines. These are herbal infusions and decoctions, which have a sedative (with nervous tension) or tonic (with constant daytime sleepiness) effect.
What to do with hypersomnia ?
Treatment of hypersomnia at home will not be complete without strict adherence to the daily regimen. It is necessary:
- Distribute sleep and wakefulness – sleep no more than 9 hours at night, try to allocate time for daytime sleep (no more than an hour). Go to bed and wake up at the same time.
- Refuse evening and night work.
- 2 hours before bedtime, do not use a mobile phone, computer, or watch TV.
- Before going to bed, take walks in the fresh air every day.
- Do not eat 2 hours before bedtime. The last meal should be digestible, low in calories.
- Do not abuse alcohol and smoking.
- Avoid stressful situations.
- It is enough to move, play sports, do exercises, but not overwork.
- Regularly undergo medical examinations, treat chronic pathologies in a timely manner.
Hypersomnia is not a sentence. Its symptoms can be completely eliminated by strictly adhering to the doctor’s recommendations, observing the sleep and wakefulness regime.