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. The 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. Treatment for hypersomnia when joined by another mental illness and substance use disorder can be personalized and generally linked to the main cause of the disorder.
Treatment Options for Hypersomnia
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 air flow 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, stimulant medications and sodium oxybate.
Non-stimulant wake-promoting 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 a tolerance and becoming addicted to the substance.
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.
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.
There are several stimulant medications for hypersomnia that are approved by the Federal Drug Administration (FDA), including methylphenidate and dextroamphetamine. Stimulant medications used to treat hypersomnia are derivatives of amphetamines and can encourage daytime wakefulness. Stimulants encourage dopamine release in the brain and are believed to be the key component for wake-promotion.
Stimulants are effective in lessening sleepiness in the short term but are not usually effective in the long term. Stimulants treat a person’s symptoms but not 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. Treatment options for a person with co-occurring hypersomnia and a substance use disorder would depend on the nature of the substances the person abuses.
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 the mood disturbance.
Hypersomnia and Addiction
As hypersomnia is often treated with stimulant medications, it is important to tailor treatment based on a person’s specific substance use disorder. Treatment should address an individual’s hypersomnia and addiction simultaneously to effectively manage both conditions.
Hypersomnia disorder can present differently in various people. Treatment for hypersomnia should be individualized and linked to symptoms and underlying causes of the disorder. Treatment options can include medication, therapy or a combination of both. If a co-occurring condition is present, both disorders should be addressed and treated at the same time.
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.