Sleep Disorders > Hypersomnias

Disorders of Excessive Sleepiness

Recall that Dyssomnias include disorders of excessive sleepiness – also known as Hypersomnias:
Narcolepsy - characterized by extreme sleepiness
- Sleep attacks - sleep at inappropriate times (such as during a conversation, while driving)
- Cataplexy - loss of muscle tone during the day (often occurs during experiencing of strong emotions, causes collapse)
- Hypnagogic hallucinations - seeing or hearing things while falling asleep
- Sleep paralysis - when waking from sleep, having sensation of paralysis (usually a frightening experience)
There are different forms of Narcolepsy of lesser severity, such as Idiopathic Hypersomnia
Must first tease out medical problems (e.g., hypothyroidism), psychological problems (e.g., depression) and potential medication issues

Hypersomnias - Diagnosis & Treatment

To diagnose a hypersomnia, one must have a normal overnight PSG, followed by a Multiple Sleep Latency Test (MSLT) the following day. A MSLT involves a series of nap trials throughout day (~ 20 minutes, every two hours). A diagnosis of Narcolepsy requires that one fall asleep on average within five minutes during the nap trials, and that REM sleep is observed on at least two of the nap trials. Other hypersomnias are diagnosed similarly, with different criteria.

One in two thousand Americans have Narcolepsy. The onset of Narcolepsy usually occurs by adolescence and often takes years to diagnose. This disorder is likely under-diagnosed. Narcolepsy and other hypersomnias are treated most often with stimulant medication. Behavioral treatments are also utilized, such as scheduling naps.

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Disorders of Excessive Sleepiness

Hypersomnias - Diagnosis & Treatment

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