Hypersomnia and narcolepsy are associated however distinct medical phrases. Narcolepsy is a particular neurological dysfunction that causes sudden assaults of deep sleep, whereas hypersomnia is a symptom, and refers to extreme daytime sleepiness extra typically.
Hypersomnia, or hypersomnolence, is a symptom of narcolepsy. It’s due to this fact not doable to check and distinction hypersomnia and narcolepsy, since they don’t seem to be separate medical situations.
However there are different causes for hypersomnia apart from narcolepsy, and these situations do have separate, distinctive options.
On this article, we’ll have a look at hypersomnia and narcolepsy in additional element, together with what the phrases imply and the way they’re associated. We may also have a look at narcolepsy as compared with another causes of intense sleepiness.
Hypersomnia, or hypersomnolence, is a medical time period that describes extreme daytime sleepiness. It’s a symptom moderately than a medical situation.
An individual with hypersomnia might must sleep throughout the day or sleep for longer than common at night time. Folks with this symptom might expertise:
- drowsiness or disorientation after waking up
- the necessity for frequent napping
- issue concentrating
- issue remembering
- sluggish speech
There are two classes of hypersomnia: main and secondary. Major hypersomnia happens attributable to an underlying situation that instantly impacts the sleep-wake cycle, similar to narcolepsy.
Secondary hypersomnia happens when one thing else causes extreme tiredness, similar to a drugs, head harm, or well being situation that disrupts sleep in different methods. For instance, sleep apnea causes somebody to quickly cease respiratory of their sleep, which lowers sleep high quality and may trigger daytime sleepiness.
Narcolepsy is a particular neurological dysfunction that causes sudden assaults of overwhelming sleepiness that may happen at any time. They might occur when somebody is speaking, consuming, or driving. These assaults final a few seconds to a few minutes.
Narcolepsy is likely one of the causes of main hypersomnia. However between assaults, folks can have typical vitality ranges. Folks with narcolepsy additionally usually expertise:
- sleep paralysis, which causes a short lived incapability to maneuver or converse as an individual falls asleep or wakes up
- hallucinations, which might accompany sleep paralysis and could also be horrifying
- issue staying asleep at night time, which can trigger frequent waking or insomnia
Folks with type 1 narcolepsy additionally expertise cataplexy, which has similarities to fainting. Cataplexy causes a sudden lack of muscle tone and management when an individual feels robust feelings. It might lead to a complete physique collapse, or milder signs, similar to sudden weak spot or cataplexy in just one a part of the physique.
Folks with kind 2 narcolepsy don’t expertise cataplexy.
What causes narcolepsy?
Scientists don’t totally perceive what causes narcolepsy. There could also be totally different causes for varieties 1 and a couple of.
Nearly all folks with kind 1 narcolepsy have very low levels of hypocretin, a chemical that retains the physique awake and regulates the rapid eye movement (REM) section of sleep. This may occasionally clarify why folks with narcolepsy enter REM sleep a lot quicker than most individuals, and why they’ll expertise vivid goals and sleep paralysis.
Researchers consider that individuals might develop kind 1 narcolepsy if the cells that produce hypocretin die. This might occur attributable to an autoimmune illness, genetics, or environmental elements.
However those that have narcolepsy with out cataplexy are inclined to have ordinary ranges of hypocretin. The reason for kind 2 is presently unknown.
Narcolepsy is likely one of the potential causes of main hypersomnia, however there are others.
Regardless of the title, idiopathic hypersomnia (IH) is a definite medical situation named after its most outstanding symptom. It’s a dysfunction of the nervous system. Scientists don’t perceive what causes it, however the extreme tiredness and unrefreshing sleep it causes could be debilitating.
The signs embody:
- sleeping more than 10–11 hours a day
- sleep that doesn’t scale back tiredness
- issue waking up, which can trigger disorientation
- psychological fogginess and issue concentrating
One other explanation for main hypersomnia is Kleine-Levin syndrome, a rare situation that causes episodes of extreme sleep that happen in cycles. The signs embody:
- sleeping as much as 20 hours a day
- extreme consuming
- conduct adjustments, similar to having an unusually excessive intercourse drive or a scarcity of emotion
- feeling confused, disorientated, or torpid when awake
Between episodes, folks can go for weeks or months with no signs. The situation usually improves with age, however generally comes again when an individual will get older. The reason for Kleine-Levin syndrome is unknown.
The next desk compares narcolepsy with IH and Kleine-Levin syndrome:
The situations that trigger main hypersomnia, together with narcolepsy, are pretty uncommon. In lots of instances, extreme daytime sleepiness is the results of one thing else.
Another causes for intense sleepiness embody:
- situations that disrupt or decrease sleep high quality, similar to sleep apnea
- situations that have an effect on the mind or nervous system, similar to Parkinson’s disease or mind accidents
- situations that impression psychological well being, similar to despair
- medicines that trigger sleepiness, similar to antihistamines, opiates, and benzodiazepines
Docs can start diagnosing the reason for extreme sleepiness by taking a medical historical past and asking questions on an individual’s signs. They might additionally ask somebody to maintain a sleep diary for a number of days, in order that they’ll get a greater sense of how a lot an individual sleeps, whether or not it’s refreshing or not, and the way this impacts their life.
Docs additionally must rule out different potential causes for the tiredness. They might have a look at any prescription or leisure medicine an individual takes and order medical exams. If there is no such thing as a clear trigger, they’ll refer somebody to a sleep laboratory.
There are two key exams a sleep laboratory can run:
A polysomnogram (PSG) data muscle and mind exercise, eye motion, and respiratory throughout sleep. This enables docs to find out if REM sleep happens earlier in somebody’s sleep cycle than it ought to. It might probably additionally detect different causes for daytime sleepiness, similar to sleep apnea.
A number of sleep latency check
A a number of sleep latency check seems to be at daytime sleepiness. The day after a PSG, an individual should take 5 brief naps, every separated by 2 hours. On common, falling asleep in 8 minutes or much less is a sign of extreme daytime sleepiness.
For narcolepsy testing, in some instances, a health care provider can also measure the extent of hypocretin within the fluid surrounding the mind and spinal twine. However as a result of low hypocretin ranges are usually not attribute of kind 2 narcolepsy, it isn’t at all times helpful.
The remedy for hypersomnia depends upon the trigger. For hypersomnia brought on by narcolepsy, docs might prescribe medicines to assist stop daytime sleep assaults. This may occasionally include:
- Wake-promoting medicines: Modafinil (Provigil) is the first-line remedy for narcolepsy. It’s a non-stimulant wake-promoting remedy. This class of drug is derived from amphetamines, however causes fewer uncomfortable side effects and is much less more likely to trigger addiction.
- Stimulants: Generally, docs might prescribe stimulants. However these amphetamine-like medicine could cause numerous uncomfortable side effects, and could be addictive. Examples embody dextroamphetamine (Dexedrine) and methylphenidate (Ritalin).
- Antidepressants: A number of varieties of antidepressant are efficient for controlling cataplexy. These embody tricyclic antidepressants, selective serotonin reuptake inhibitors, and serotonin and norepinephrine reuptake inhibitors.
- Sodium oxybate: This drug may also deal with cataplexy and hypersomnia in folks with narcolepsy. Sodium oxybate is a extremely managed substance due to how potent it’s.
In 2021, the Meals and Drug Administration (FDA) authorized sodium oxybate to be used in folks with IH. Presently, it’s the solely drug formally authorized for the situation. However as a result of the therapies for narcolepsy may also assist with IH, many docs prescribe them for off-label use.
Managing hypersomnia usually entails making life-style adjustments. These might embody:
- sustaining a constant schedule for exercise, relaxation, and sleep
- exercising each day for no less than 20 minutes, and no less than 4–5 hours earlier than sleep
- avoiding heavy meals earlier than sleep
- working towards rest earlier than bedtime
- stopping smoking, particularly at night time
- avoiding caffeine and alcohol
Folks with main hypersomnia may also search further assist within the office, at residence, and for his or her mental health. This may occasionally embody:
- office changes to permit for naps and a versatile schedule, which individuals with narcolepsy are entitled to beneath the People with Disabilities Act
- remedy with a therapist to assist with the impression hypersomnia has on an individual’s temper
- assist teams for others experiencing the identical signs or situations
- a service animal who can wake somebody up in emergencies or assist with duties
It’s also vital for folks with hypersomnia to take security precautions. This may occasionally imply avoiding sure actions when feeling sleepy, similar to driving, strolling up or down stairs, or working equipment.
Hypersomnia refers to extreme daytime sleepiness. In folks with narcolepsy, this manifests as brief, sudden sleep assaults, which trigger an amazing urge to sleep throughout each day actions. Folks with narcolepsy may also expertise cataplexy, sleep paralysis, vivid goals, and hallucinations.
Different causes for hypersomnia embody IH, Kleine-Levin syndrome, sure medicines, and different medical situations that not directly have an effect on sleep. Solely a health care provider or sleep specialist can diagnose the trigger.
Extreme sleepiness has a major impression on high quality of life, however therapies and techniques will help decrease the signs. If somebody is experiencing persistent sleepiness throughout the day, and getting sufficient sleep doesn’t assist, they need to converse with a medical skilled.