What is hypersomnia?The central symptom of hypersomnia is daytime sleepiness. The tiredness during the day is very pronounced and does not occur once, but regularly or permanently.
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Hypersomnia manifests itself in an increased need for sleep during the day, with no frequent or long-lasting, consciously awakening phases during the night's sleep.
The daytime sleep can vary greatly, ranging from short sleep attacks that plague the victim to a constant fatigue throughout the day. Those affected suffer greatly from the disease because it affects performance. For example, participation in road traffic is usually no longer possible.
Hypersomnia is classified by severity in terms of mild, moderate and severe hypersomnia. At a slight hypersomnia involuntary sleep does not happen every day, at an average hypersomnia daily and at a heavy hypersomnia several times a day.
The causes of the drowsiness are not yet clearly known. Remarkable, however, are the frequent simultaneous occurrence of other diseases, such as depression, schizophrenia, cancer, Parkinson's or multiple sclerosis.
In addition, a link has been observed between drug and alcohol abuse and somnolence. The most common cause - as various records in sleep laboratories have shown - is sleep apnea. If a patient suffers from scapulae, breathing often ceases during sleep. This can happen several times an hour and last for several minutes.
The suspension of breathing leads to an oxygen deficiency in the body. The night sleep is then, without the affected person noticing it, little restful. The constant wake-up situation also causes enormous stress.
Symptoms, complaints & signs
The central symptom of hypersomnia is daytime sleepiness. The tiredness during the day is very pronounced and does not occur once, but regularly or permanently. Affected persons often can not or only with difficulty keep awake.
In addition, concentration disorders may be an indication of hypersomnia. As a result, work performance may decrease and the probability of errors increases. The lack of concentration and tiredness can also be expressed in motor insecurity.
Another possible symptom of hypersomnia is memory problems. These are partly related to the concentration difficulties. Depending on the underlying disease of hypersomnia, sleep may be considered as restful or non-restorative. Narcoleptics typically feel refreshed during the day when they sleep a short while, but other forms of hypersomnia do not.
Daytime sleepiness often affects drivers' ability to drive. Depending on the type of hypersomnia, the spectrum ranges from general carelessness and lack of concentration to narcoleptic attacks. Even with other hypersomnia than narcolepsy motorists can fall into a microsleep.
They fall asleep for a few seconds at the wheel, sometimes without noticing. Furthermore, mental symptoms such as [depressive moods] may occur. Conversely, hypersomnia can also be due to depression, schizophrenia or other mental illness.
Diagnosis & History
In order to be able to make a reliable diagnosis, a stay in a sleep laboratory is advisable. In a sleep laboratory, the night sleep of the patient is monitored. For this purpose, it is connected to EEG and ECG, which allows the monitoring of brain waves and heart activity.
In addition, the movement activity and the respiratory flow are recorded. In addition, the patient receives several questionnaires and is subjected to different tests - for example, the pupil width during the night or the ability to concentrate in monotonous activities is measured - which also provide information about his night and daytime sleep. If all results are available, an experienced sleep specialist can diagnose "hypersomnia".
If an organic cause is considered, the tests in the sleep laboratory are followed by an internal or psychiatric diagnosis. The course of a hypersomnia is very different. In mild hypersomnia, the patient usually does not suffer from somnolence, often he does not even perceive it as a disease.
Only when the individual's daily rhythm of the affected person is disturbed or after a disturbance at night, secondary diseases - such as cardiovascular problems - have occurred, the person affected will perceive the disease.
In most cases, hypersomnia occurs in middle-aged men. The affected people are suffering from a real somnolence. If a high need for sleep is not met daily, it leads to a feeling of sickness or to increased irritability of the patient. Hypersomnia also has a negative effect on the psyche of the patient and is usually associated with other mental health problems.
The sleep of the patient is very deep and lasts for a long time. Often getting up is difficult. Not infrequently sufferers also suffer from sleep disorders and therefore need sleep at other irregular times. Everyday life is confused by hypersomnia and made more difficult for the patient. In many cases it is no longer possible to do a job or a regular job.
Furthermore, it can also cause discomfort to the heart or the patient's circulation, which in the worst case can lead to death. The treatment of hypersomnia is usually causal and does not lead to any special complications. However, it can not be predicted how easily the underlying disease can be treated. In most cases, life expectancy is not reduced.
When should you go to the doctor?
In periods of higher physical or emotional demands, an increased need for sleep is natural. A visit to a doctor is not necessary in these cases, as normally a normal sleep behavior automatically occurs after the successful coping with the situation. If sleep requirements do not exceed nine to ten hours a day, there is no cause for concern. A visit to a doctor is necessary if the need for sleep increases or if it occurs without any comprehensible reason.
If, despite a sufficient night's sleep, the affected person already feels chipped off and tired by performing light tasks, a doctor should be consulted. If the symptoms of sleep persist for several months, a doctor's visit is also recommended. If there is a sudden sleep attack, this is considered unusual. If the performance of everyday or professional tasks is interrupted by an unexpected fall asleep, the person concerned needs help.
If the person affected is dizzy, he shows a depressed mood, he suffers from persistent attention deficits or he takes environmental influences only vague true, a doctor's visit must be made. If there are disturbances of the breathing, it comes to more sleep interruptions or feels the person concerned, despite a good sleep hygiene never really fit, are recommended to check-ups. In addition to a nutritional deficiency, results of a sleep laboratory can help to find the cause.
Treatment & Therapy
Since the drowsiness is usually the result of another disease, it is important to treat the cause. Sleep apnea, one of the most common causes of hypersomnia, is usually caused by obesity or narrowed airways.
If this is the cause of the drowsiness, it usually helps to lose weight or to surgically correct or expand the airway. In addition, it can help the sufferer to wear a breathing mask during nighttime sleep, which aids breathing and thus prevents the suspension of breathing.
In very rare cases of severe hypersomnia, medications may be given. The drugs - all amphetamines - can overcome the drowsiness, but they have an extremely high addictive potential. Self-medication is strongly discouraged.
Outlook & Forecast
The prognosis of hypersomnia is tied to the present cause as well as overall diagnosis of the patient. If the person suffering from a mental disorder such as anxiety, coercion, depression or an addiction, there is a risk of a chronic disease. Relief of the symptoms usually occurs only when the mental illness is treated and an improvement in emotional stability occurs.
In the case of cancer, the healing of the triggering tumor is necessary to reduce or completely relieve hypersomnia. Often a recovery occurs after several years of therapy and is accompanied by periods of relapse. If the patient suffers from a chronic or progressive disease such as Parkinson's disease or multiple sclerosis, there is little chance of a cure for hypersomnia. As the underlying disease progresses, it manifests as a manifestation of the accompanying symptoms. In severe cases, the patient is threatened with an increase in symptoms.
If the hypersomnia is triggered by existing living and accompanying circumstances, a change in the everyday processes or the environmental influences can lead to a patient's freedom from symptoms. The sleep hygiene must be revised and optimized in these situations. Often it is necessary to adapt the daily routine to the needs of the human person as well as to change mental attitudes to the everyday challenges in order to alleviate the symptoms of sleep.
Hypersomnia itself can not be predicted. Since it is usually the result of another disease - often sleep apnea due to obesity - it is advisable to pay attention to a low body weight. Avoiding excessive alcohol consumption is just as helpful as consequent abstinence from drugs and a healthy diet.
For patients with hypersomnia care should be taken in the aftercare that the sleep hygiene rules are adhered to. This includes above all a controlled course of the day-night rhythm in connection with the observance of the sleep-wake rhythm. Sleep deprivation and sleep deprivation are to be avoided. The sleep-wake-up-rhythm has to be adjusted to the respective patient.
Thus, optimal sleep and waking phases in the 24-hour daily routine can be firmly established. Sleep periods during the daytime phase should be exceptions and should also be consistent with the patient's behavior and habits. A sleep-wake or fatigue-wake diary is recommended. This makes it easier for the patient to accommodate his activities in the daily routine meaningful and effective.
For example, activities and tasks that are part of the routine can then be transferred to the phases of daytime tiredness. In addition, a healthy lifestyle is extremely important for patients with hypersomnia. Alcohol should be completely avoided due to the tiring effect. A rather light, low-carbohydrate diet spread over several small meals throughout the day makes sense.
Aftercare also includes the education of the immediate family members as well as the social environment. The further life planning of the patient, for example with regard to training, retraining or work plays a crucial role in living with a hypersomnia.
You can do that yourself
With a strong need for sleep, the person concerned should take various precautions to avoid complications or an increased risk of accidents. The need for sleep reduces the usual efficiency and leads to a reduction of participation in social life. In order to reduce conflicts in professional and social life, the people from the surrounding area should be informed of the problems.
The symptoms of the disease are often due to increased stress and dissatisfaction. The general lifestyle should be reviewed and optimized. The intake of food should be improved and should be rich in vitamins and fiber. Obesity is to be avoided and adequate exercise or sports activities promote general well-being. The consumption of alcohol or nicotine should be avoided. Stimulants in the form of drugs or excessive drug use should also be avoided.
The sleep hygiene is to be changed according to the needs of the person concerned. Helpful and very informative is a visit to the sleep laboratory. Sources of interference during the resting and recovery phases are to be eliminated. The daily routine should, if possible, be well structured and regularly structured. If sudden sleep bouts occur, sources of danger must be eliminated. Traffic should not take place without an escort. Activities that pose a high risk of injury are also not carried out without supervision and protective clothing.