hipersomnia

Hypersomnia, also called hipersomnia in some languages, is a sleep disorder defined by persistent excessive daytime sleepiness and, in some cases, prolonged nighttime sleep. It is not simply fatigue. Hypersomnia can be primary, arising from intrinsic sleep disorders such as narcolepsy, idiopathic hypersomnia, or Kleine-Levin syndrome, or secondary, resulting from other conditions or factors such as insufficient sleep, sleep apnea, circadian rhythm disorders, depression, neurological disease, or certain medications.

Diagnosis involves clinical history, sleep diaries, and reports of sleepiness. Objective testing typically includes overnight polysomnography and a multiple sleep latency test (MSLT). The Epworth Sleepiness Scale is commonly used to quantify daytime sleepiness. The ICSD-3 criteria are used to classify primary hypersomnias and to distinguish them from secondary causes.

Common secondary causes include untreated obstructive sleep apnea, poor sleep hygiene, irregular work schedules, and mood disorders. Narcolepsy features may include sudden sleep attacks, cataplexy, sleep paralysis, and hypnagogic hallucinations. Idiopathic hypersomnia is characterized by long nocturnal sleep and daytime sleepiness without SOREM periods on diagnostic testing.

Treatment focuses on underlying causes and symptom control. For sleep apnea, continuous positive airway pressure (CPAP) therapy improves daytime alertness. Pharmacologic options include wake-promoting agents such as modafinil, armodafinil, solriamfetol, and pitolisant; sodium oxybate is used for narcolepsy with cataplexy. Behavioral strategies, scheduled daytime naps, and good sleep hygiene are important components.

Prognosis varies by cause and treatment response. Hypersomnia is relatively uncommon; with proper management, many patients experience reduced daytime sleepiness and improved functioning, though some conditions persist chronically. Safety considerations, including driving assessments, are an important aspect of care.