Understanding Hypersomnia: Symptoms, Risks & Disorders

If you find yourself feeling unusually tired during the day, even after getting a full night’s sleep, it could be more than just fatigue. These persistent feelings of tiredness may point to a condition known as hypersomnia, which causes excessive daytime sleepiness and can significantly impact daily activities, potentially raising the risk of accidents and injuries. Continue reading to learn more about the causes and effects of hypersomnia.

What is Hypersomnia?

Hypersomnia is a sleep disorder characterized by excessive daytime sleepiness. People with this condition feel tired and sleepy during the day, despite getting enough sleep at night. 

Hypersomnia and oversleeping are often used interchangeably, but they are not exactly the same. 

Oversleeping, also known as "long sleeping," refers to sleeping for more than 9 hours within a 24-hour period. Hypersomnia, on the other hand, is a condition in which a person oversleeps and also experiences excessive sleepiness during the day. 

While long sleeping may be harmless in some cases, hypersomnia implies functional impairment and often requires clinical evaluation. 

In other words, oversleeping can be a symptom of hypersomnia.

Types of Hypersomnia

Sometimes, there is no underlying cause for hypersomnia – this is called idiopathic hypersomnia or primary hypersomnia. 

In other cases, an underlying health problem or lifestyle factor causes excessive sleepiness, a strong need to sleep, sudden sleep attacks, and difficulty staying awake even after adequate sleep at night - this is called secondary hypersomnia.

Distinction From Other Sleep Disorders  

There are more than a hundred types of sleep disorders. They are classified into four main categories:

• Problems falling asleep or staying asleep (for example, insomnia)

• Problems staying awake (for example, hypersomnia or excessive daytime sleepiness)

• Problems sticking to a regular sleep schedule (for example, circadian rhythm disorders)

• Problems with unusual or disruptive behaviors during sleep (for example, parasomnias)

An expert in clinical sleep medicine can help diagnose and differentiate between different sleep disorders. 

Examples of some sleep disorders that should be differentiated from hypersomnia include:

• Sleep paralysis is a type of parasomnia or abnormal sleep behavior where you have a temporary inability to move or speak while falling asleep or waking up, resulting in fear and anxiety. 

• Sleep drunkenness or confusional arousal is a parasomnia in which your brain is slow to make the transition from sleep to wakefulness. This phenomenon is known as sleep inertia, characterized by confused behavior or difficulty speaking for several minutes to an hour after waking up.

• Sleep onset latency is the time it takes for you to fall asleep after turning the lights out. The average is 10-20 minutes. A sleep onset latency of less than 8 minutes points to sleep deprivation or poor sleep quality due to an underlying sleep disorder.

How Much Sleep is Too Much?

Anything more than 9 hours of sleep a night can be too much. If you regularly need to sleep 10 or more hours every night or if you are tired and sleepy despite sleeping at least 7 hours at night, there may be an underlying cause for your symptoms. Make an appointment to see your doctor and find out what’s going on.

Symptoms of Hypersomnia 

The symptoms of hypersomnia can vary from person to person, depending on the cause. They may include:

• Feeling tired all the time

• Needing to take daytime naps

• Feeling drowsy during the daytime despite sleeping enough hours at night and taking naps during the day

• Feeling unrefreshed upon awakening in the mornings

• Foggy thinking 

• Difficulty making decisions

• Memory problems

• Difficulty concentrating

• Lack of enthusiasm or energy

• Automatic behavior (performing tasks without awareness)

What Does It Feel Like To Have Hypersomnia?

Having hypersomnia usually feels like being tired and sleepy all the time. However, hypersomnia can feel different to different people depending on age, lifestyle, and other factors. For example, you may sleep well at night for 12 hours or more (oversleeping) but still feel the need to take daytime naps. Despite napping in the daytime, you may continue to have mental fog and drowsiness. 

The International Classification of Sleep Disorders defines hypersomnia or excessive daytime sleepiness as “the inability to stay awake and alert during the major waking episodes of the day, resulting in unintended lapses into drowsiness or sleep.”

Causes of Hypersomnia

Potential causes of secondary hypersomnia disorders are listed below.

Environmental and Lifestyle Factors

• Insufficient sleep syndrome, where you regularly fail to get enough sleep at night, leads to sleep deprivation and sleep debt, which can prevent you from feeling well-rested and being fully alert during the day.

• Environmental factors that prevent you from getting restful sleep due to the lack of a comfortable and peaceful sleeping environment, for example:

  • A partner who snores.

  • A new baby.

  • Noisy neighbors.

  • A room that’s too hot or too cold.

  • An uncomfortable mattress.

• Shift work, where working non-traditional hours affects your circadian rhythm and causes problems falling asleep, staying asleep, and excessive sleepiness at unwanted times.

• Jet lag and changes in time zones can disrupt the body’s internal clock, which responds to light and darkness.

Medical Conditions

Chronic Conditions

Certain health conditions can disrupt sleep and lead to hypersomnia (oversleeping or excessive sleep), for example:

• Chronic pain

• Hypothyroidism (underactive thyroid gland)

• Gastroesophageal reflux disease (GERD)

• Bruxism (grinding teeth at night)

• TMJ (temporomandibular joint disorder)

• Cardiovascular disease 

• Type 2 diabetes

• Hormonal fluctuations during the menstrual cycle or menopause

• Traumatic brain injury

• Neurological disorders such as epilepsy, dementia, Parkinson’s disease, and multiple sclerosis

• Genetic disorders such as Kleine-Levin syndrome, Prader-Willi syndrome, and myotonic dystrophy (progressive muscle weakness)

Mental Health Conditions

Hypersomnia is not a mental illness. However, it can be a symptom of mental illnesses such as stress, anxiety, depression, seasonal affective disorder, and other mood disorders and psychiatric disturbances. These conditions can cause sleep disturbances, resulting in excessive daytime sleepiness, low energy, and reduced alertness.

Vitamin and Mineral Deficiencies

Iron deficiency, vitamin B12 deficiency, and vitamin D deficiency have been linked to excessive daytime sleepiness and oversleeping.

Sleep Disorders

Hypersomnia (excessive daytime sleepiness or oversleeping) can be a symptom of sleep disorders such as:

• Insomnia

• Obstructive sleep apnea

• Restless legs syndrome

• Sleepwalking and other parasomnias

• Primary and secondary narcolepsy

Medications  

Certain medications can disrupt sleeping patterns and lead to excessive sleep, for example:

• Sedatives and tranquilizers

• Antihistamines

• Antihypertensives (for high blood pressure)

• Opioids (narcotic painkillers)

• Antiepileptic drugs

• Psychotropic drugs (anti-anxiety medications, antidepressants, antipsychotics, mood stabilizers, and stimulant drugs)

Health Risks of Hypersomnia  

Yes, you should be concerned if you sleep a lot. Oversleeping or excessive sleepiness can be a sign of an existing medical condition. In addition, hypersomnia can contribute to health problems such as:

• Heart disease

• Type 2 diabetes

• Headaches

• Obesity

• Depression

• Increased risk of death from medical conditions

Risk of Accidents

One of the biggest concerns with hypersomnia is an increased risk of accidents and injuries, especially motor vehicle accidents if you fall asleep suddenly during the daytime. 

Cognitive Impacts 

Similar to the effects of sleep deprivation, oversleeping can lead to mental fatigue or brain fog, decreased alertness, and difficulties with concentration and memory.

Impact on Daily Life 

Hypersomnia can affect work performance, social interactions, daily functioning, and overall quality of life.

Diagnosis

Doctors can make a diagnosis of hypersomnia in clinical practice by asking questions about your lifestyle, medications, physical and mental health, and other symptoms. In addition, some tests and procedures can be used to diagnose people with hypersomnia and other sleep disorders, for example:

• Epworth Sleepiness Scale is a short questionnaire that assesses your level of daytime sleepiness. 

• Stanford Sleepiness Scale, which asks the individual to rate their current level of sleepiness from 1 (feeling active and vital) to 7 (almost in a daydream)

• Sleep study or polysomnography is a diagnostic test that measures various bodily functions during sleep.

• Multiple sleep latency test, a diagnostic test that measures how quickly a person falls asleep during daytime naps. MSLT is used to diagnose conditions such as idiopathic hypersomnia and narcolepsy.

• Maintenance of wakefulness test, which measures a person’s ability to stay awake in a quiet, non-stimulating environment.

Treatment Options

Treatment of hypersomnia depends on the underlying cause. For example, if the lack of a peaceful sleeping environment is making you excessively sleepy in the daytime, then making lifestyle adjustments may resolve the problem.

If disturbed sleep due to obstructive sleep apnea is leading to oversleeping and excessive daytime sleepiness, then your doctor may recommend treatments such as a CPAP machine.

Lifestyle Changes

Lifestyle adjustments can help many people with hypersomnia:

• Ensure sufficient sleep at night, but avoid oversleeping. Experts recommend 7-9 hours per night of sleep for adults.
• Practice good sleep hygiene. Sleep research indicates that establishing a consistent sleep schedule and calming bedtime routine can help you develop healthy sleep habits. 
• Avoid looking at screens for at least 2 hours before bedtime. 
• Maintain a cool, quiet, dark bedroom to avoid sleep disruption and improve sleep quality.
• Avoid cigarettes, alcohol, and caffeinated beverages before bedtime.
• Keep a sleep diary to identify trends and get timely care for potential sleep problems.
• Eat a healthy, balanced diet and get regular exercise. 

Can Hypersomnia Be Cured?

Yes, hypersomnia can be cured by making lifestyle changes and treating the underlying condition causing excessive sleepiness.

What Are The Benefits of Oversleeping?

Oversleeping may be beneficial for short periods of time, for example, during:

• Recovery from an illness or accident.

• Physical recovery from intense exercise.

• Emotional recovery during periods of high stress.