Hypersomnie

Hypersomnie, or hypersomnia, is a sleep disorder characterized by excessive daytime sleepiness despite adequate nocturnal sleep or by prolonged sleep episodes that are difficult to wake from. It can be primary (idiopathic hypersomnia) when no clear cause is found, or secondary to another condition, such as a sleep disorder, medical illness, medication, or psychiatric condition. Some cases are linked to circadian rhythm disturbances or to syndromes such as Kleine–Levin.

Causes include obstructive sleep apnea, poor sleep quality, insomnia, depression, thyroid disease, neurological injury, infections, and certain drugs or substances. Idiopathic hypersomnia lacks an identifiable cause after evaluation. Narcolepsy, a related disorder with sleep attacks and often cataplexy, is diagnosed separately but is part of the differential when excessive daytime sleepiness is present.

Diagnosis relies on history and objective testing to exclude other causes. Tools include sleep diaries or questionnaires (for example, the Epworth Sleepiness Scale), overnight polysomnography to assess sleep quality, and, when indicated, a multiple sleep latency test. The goal is to identify or rule out disorders such as sleep apnea, narcolepsy, or insufficient sleep.

Treatment focuses on underlying conditions and reducing daytime sleepiness. Non-pharmacologic measures include regular sleep schedules, planned daytime naps, exercise, and good sleep hygiene. Pharmacologic options are wake-promoting agents such as modafinil or armodafinil; traditional stimulants may be used if needed. In selected cases, sodium oxybate has been used. Ongoing management and treatment adjustment are important.

Prognosis varies; some individuals have persistent symptoms requiring long-term management, while others respond to treatment and lifestyle changes.