Thursday, 19 June 2014
Hypersomnolence (hypersomnia) Symptoms
Hypersomnia
(termed hypersomnolence in DSM-5) is characterized by recurrent
episodes of excessive daytime sleepiness or prolonged nighttime sleep.
Different from feeling tired due to lack of or interrupted sleep at night, persons
with hypersomnolence are compelled to nap repeatedly during the day, often at
inappropriate times such as at work, during a meal, or in conversation. These
daytime naps usually provide no relief from symptoms. Patients often have
difficulty waking from a long sleep, and may feel disoriented. Other symptoms
may include anxiety, increased irritation, decreased energy, restlessness, slow
thinking, slow speech, loss of appetite, hallucinations, and memory difficulty.
Some patients lose the ability to function in family, social, occupational, or
other settings. Some people appear to have a genetic predisposition to
hypersomnolence; in others, there is no known cause.
Hypersomnolence typically affects adolescents and young adults.
Specific Diagnostic Criteria
for Hypersomnolence
The predominant complaint is excessive sleepiness for at least 1
month (in acute conditions) or at least 3 months (in persistent conditions) as
evidenced by either prolonged sleep episodes or daytime sleep episodes that
occur at least 3x per week.
The excessive sleepiness causes clinically significant distress
or impairment in social, occupational, or other important areas of functioning.
The excessive sleepiness is not better accounted for by insomnia
and does not occur exclusively during the course of another Sleep Disorder
(e.g., Narcolepsy, Breathing-Related Sleep Disorder, Circadian Rhythm Sleep
Disorder, or a Parasomnia) and cannot be accounted for by an inadequate amount
of sleep.
The disturbance is not due to the direct physiological effects
of a substance (e.g., a drug of abuse, a medication) or a general medical
condition.
Hypersomnolence can co-occur with another mental or medical
disorders, though this condition cannot adequately explain the predominant
complaint of hypersomnolence; in other words, the hypersomnolence is
significant enough to warrant its own clinical attention and treatment. In
some cases it results from a physical problem, such as a tumor, head trauma, or
injury to the central nervous system. Medical conditions including multiple
sclerosis, depression, encephalitis, epilepsy, or obesity may also contribute
to the disorder.
Treatments for
Hypersomnolence
Treatment for hypersomnolence is based upon the symptoms a
person has. Stimulants, such as amphetamine, methylphenidate, and modafinil,
may be prescribed. Other drugs used to treat hypersomnia include clonidine,
levodopa, bromocriptine, antidepressants, and monoamine oxidase inhibitors.
Changes in behavior (for example avoiding night work and social activities that
delay bed time) and diet may offer some relief. Patients should avoid alcohol
and caffeine.
