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.
This entry has been updated according to DSM-5 criteria; diagnostic code 307.44.
Medina, J. (2014). Hypersomnolence (hypersomnia) Symptoms. Psych Central. Retrieved on September 15, 2014, from http://psychcentral.com/disorders/hypersomnia-symptoms/
Symptom criteria summarized from:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, fifth edition. Washington, DC: American Psychiatric Association.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.
Last reviewed: By John M. Grohol, Psy.D. on 13 May 2014
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