Hypersomnia is a condition where people sleep excessively, have trouble waking up after a complete night of sleep and are abnormally tired throughout the day. Excessive sleepiness can often cause people to fall asleep at inopportune times during the day, such as at work or school. There are treatments for hypersomnia to help people achieve optimal levels of sleep at night and avoid struggles with daytime drowsiness.
A combination of medication and behavioral interventions often result in the best outcomes. A sleep diary is a behavioral intervention that is used to help people better understand their sleep patterns. Other behavioral techniques can include limiting naps, staying away from heavy meals, avoiding alcohol, and exercising to promote alertness and quality sleep. Keeping a regular sleep schedule, going to bed and rising at consistent times, and using stress-reduction and relaxation techniques can promote healthy sleep behaviors.
The frequent awakenings associated with sleep apnea prevent people from getting a healthy amount of sleep each night. Hypersomnia generally occurs when an individual does not obtain restorative sleep. CPAP, or continuous positive airway pressure, is a treatment for obstructive sleep apnea where the air is continually released into a person’s nostrils. The pressure from the steady airflow allows a person’s airways to stay open during sleep. This method addresses pauses in breathing that are linked to sleep apnea and the treatment approach can lessen hypersomnia symptoms.
Medications are generally the first-line treatment option for many of the hypersomnia disorders. It is important to consider the benefits and potential side effects when contemplating beginning medication. There are three classes of hypersomnia medications used to treat the disorder, including non-stimulant wake-promoting medications, sodium oxybate, bupropion and stimulant medications.
- Non-stimulant wake-promoting medications: Medications such as Modafinil and Nuvigil, can be used to induce wakefulness by impacting brain chemistry and increasing dopamine. Stimulants, or derivatives of amphetamines, may be used to increase alertness but can have potentially harmful side effects, including building tolerance and becoming addicted to the substance.
- Sodium oxybate: Sodium oxybate is a medication taken before the person goes to sleep and during the night to help them enter deep sleep. The restorative sleep can address symptoms of hypersomnia by reducing excessive fatigue during the day.
- Bupropion: Most anti-depressants have not been found to be effective in treating hypersomnia. However, bupropion has been shown to have wake-promoting properties and is sometimes prescribed for hypersomnia. Bupropion elevates levels of norepinephrine and dopamine in the brain.
- Stimulants: There are several stimulant medications for hypersomnia that are approved by the Federal Drug Administration (FDA), including methylphenidate and dextroamphetamine. Stimulants encourage dopamine release in the brain and are believed to be the key component for wake-promotion. While stimulants are effective in lessening sleepiness in the short term, they do not address the core problem. Also, individuals tend to become resistant to a stimulant’s effects as time goes on. Stimulants may have unpleasant and detrimental side effects, such as dependence, insomnia, cardiac issues and violent or physically harmful behavior.
Treating Hypersomnia and Co-Occurring Conditions
People who have hypersomnia commonly have co-occurring mental health conditions, other sleep disorders and substance use disorders. Depression and mood disorders are frequently associated with hypersomnia. Other sleep disorders, such as insomnia, obstructive sleep apnea, circadian rhythm disorders and restless legs syndrome, also frequently co-occur with hypersomnia disorder.
Stimulants are the first-line treatment for hypersomnia and carry the risk of dependence, which can be problematic for an individual with hypersomnia and a history of substance abuse.
Despite the type of co-occurring conditions, it is always important to use an integrated treatment model to manage the symptoms of both conditions at the same time. If a person has hypersomnia and depression, treating depression will often help sleeping issues while treating sleeping issues may also have a positive impact on mood disturbance.
If you have a substance use disorder and a co-occurring mental health disorder that has caused insomnia, consider contacting The Recovery Village, a network of rehab facilities with trained mental health professionals that can assist you in treating both your sleep disorder and substance use disorder at the same time.