109 Sentences With "hypersomnia" | Random Sentence Generator

Sufferers experience hypersomnia, low mood, and a pervasive sense of futility during the bleaker months.

I was exhausted and often actually couldn't make it into work because I was so burnt out from everything along with my hypersomnia and chronic fatigue.

Narcolepsy is one, and it's related to a condition called hypersomnia, which is where where people might sleep for upwards of 16 hours a day and still feel sleepy.

That could be a specific sleep disorder (such as narcolepsy or idiopathic hypersomnia), a medical condition (such as sleep apnea), or a medication (such as antihistamines or beta-blockers).

The American Academy of Sleep Medicine and Sleep Research Society recommends adults get seven to nine hours of sleep a night, so sleeping more than that regularly may indicate hypersomnia, or "excessive daytime sleepiness that is usually not relieved by a nap," Nowakowski says.

There is a very low level of public awareness of idiopathic hypersomnia, which often leads to stigma for those who suffer from it. There is currently no cure, but there are several off-label treatments, which are primarily FDA-approved narcolepsy medications. In the medical literature, idiopathic hypersomnia may also be referred to as IH, IHS, primary hypersomnia, central hypersomnia, or hypersomnia of brain origin. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) defines idiopathic hypersomnia as EDS without narcolepsy or the associated features of other sleep disorders.

" Paraneoplastic syndromes can also cause insomnia, hypersomnia, and parasomnias. Autoimmune diseases, especially lupus and rheumatoid arthritis are often associated with hypersomnia, as well. Morvan's syndrome is an example of a more rare autoimmune illness that can also lead to hypersomnia. Celiac disease is another autoimmune disease associated with poor sleep quality (which may lead to hypersomnia), "not only at diagnosis but also during treatment with a gluten-free diet.

Hypersomnia can be primary (of central/brain origin), or it can be secondary to any of numerous medical conditions. More than one type of hypersomnia can coexist in a single patient. Even in the presence of a known cause of hypersomnia, the contribution of this cause to the complaint of excessive daytime sleepiness needs to be assessed. When specific treatments of the known condition do not fully suppress excessive daytime sleepiness, additional causes of hypersomnia should be sought.

Since the underlying disease mechanism is not yet fully understood, treatment efforts have usually focused on symptom management. There are no FDA-approved medicines for idiopathic hypersomnia. The wake-promoting medications used in narcolepsy are also commonly used off-label to help manage the excessive daytime sleepiness of idiopathic hypersomnia. However, the medications currently used for idiopathic hypersomnia are far from satisfactory.

Unlike narcolepsy with cataplexy, which has a known cause (autoimmune destruction of hypocretin-producing neurons), the cause of idiopathic hypersomnia has, until recently, been largely unknown, hence its name. However, researchers have identified a few abnormalities associated with IH, which with further study may help to clarify the etiology. Destruction of noradrenergic neurons has produced hypersomnia in experimental animal studies, and injury to adrenergic neurons has also been shown to lead to hypersomnia. Idiopathic hypersomnia has also been associated with a malfunction of the norepinephrine system and decreased cerebrospinal fluid (CSF) histamine levels.

KLS should also be distinguished from very rare cases of menstruation-caused hypersomnia.

Although there has been no cure of chronic hypersomnia, there are several treatments that may improve patients' quality of life, depending on the specific cause or causes of hypersomnia that are diagnosed. Because the causes of hypersomnia are unknown, it is only possible to treat symptoms and not directly the cause of this disorder. Behavioral treatments as well as sleep hygiene have to be discussed with the patient and are recommended, however, they might have only few beneficial outcomes. There are several pharmacological agents that have been prescribed to patients with hypersomnia, but few have been found to be efficient.

For one patient, daily administration of flumazenil by sublingual lozenge and topical cream has proven effective for several years. A 2014 case report also showed improvement in idiopathic hypersomnia symptoms after treatment with a continuous subcutaneous flumazenil infusion. Clarithromycin, an antibiotic approved by the FDA for the treatment of infections, was found to return the function of the GABA system to normal in patients with idiopathic hypersomnia. In the pilot study, clarithromycin improved subjective sleepiness in GABA-related hypersomnia.

The crash following the use of methamphetamine in this manner is very often severe, with marked hypersomnia.

Daytime naps are generally very long (up to several hours) and are also unrefreshing. Some studies have shown increased frequencies of other symptoms in patients with idiopathic hypersomnia, although it is not clear whether these symptoms are caused by the idiopathic hypersomnia. These symptoms include palpitations, digestive problems, difficulty with body temperature regulation, and cognitive problems, especially deficits in memory, attention, and concentration. Anxiety and depression are often increased in idiopathic hypersomnia, most likely as a response to chronic illness.

The true primary hypersomnias include these: narcolepsy (with and without cataplexy); idiopathic hypersomnia; and recurrent hypersomnias (like Klein-Levin syndrome).

It occurs in the absence of medical problems or sleep disruptions, such as sleep apnea, that can cause secondary hypersomnia.

Secondary hypersomnias are extremely numerous. Hypersomnia can be secondary to disorders such as clinical depression, multiple sclerosis, encephalitis, epilepsy, or obesity. Hypersomnia can also be a symptom of other sleep disorders, like sleep apnea. It may occur as an adverse effect of taking certain medications, of withdrawal from some medications, or of drug or alcohol abuse.

Nearly every day, the person may sleep excessively, known as hypersomnia, or not enough, known as insomnia. Insomnia is the most common type of sleep disturbance for people who are clinically depressed. Symptoms of insomnia include trouble falling asleep, trouble staying asleep, or waking up too early in the morning. Hypersomnia is a less common type of sleep disturbance.

Mild schizophrenic signs may be withdrawing socially, agitation or hostility, and irregular sleep such as in the case of insomnia and hypersomnia.

In 2013, a retrospective review evaluating longer-term clarithromycin use showed efficacy in a large percentage of patients with GABA-related hypersomnia.

Idiopathic hypersomnia is a rarity in the public eye and has a very low level of public awareness. Because of this low awareness, patients with idiopathic hypersomnia often need significant support because they are at risk of being isolated and misunderstood. Therefore, the education of relatives, friends, and colleagues helps the patient to function much better with this incurable disease.

Sodium oxybate is an orphan drug which was designed specifically for the treatment of narcolepsy. Common side effects include nausea, dizziness, and hallucinations. A 2016 study by Leu-Semenescu et al. found sodium oxybate improved daytime sleepiness in idiopathic hypersomnia to the same degree as in patients with narcolepsy type 1, and the drug improved severe sleep inertia in 71% of the hypersomnia patients.

There are also several genetic disorders that may be associated with primary/central hypersomnia. These include the following: Prader-Willi syndrome; Norrie disease; Niemann–Pick disease, type C; and myotonic dystrophy. However, hypersomnia in these syndromes may also be associated with other secondary causes, so it is important to complete a full evaluation. Myotonic dystrophy is often associated with SOREMPs (sleep onset REM periods, such as occur in narcolepsy).

There are many neurological disorders that may mimic the primary hypersomnias, narcolepsy and idiopathic hypersomnia: brain tumors; stroke- provoking lesions; and dysfunction in the thalamus, hypothalamus, or brainstem. Also, neurodegenerative conditions such as Alzheimer's disease, Parkinson's disease, or multiple system atrophy are frequently associated with primary hypersomnia. However, in these cases, one must still rule out other secondary causes. Early hydrocephalus can also cause severe excessive daytime sleepiness.

A genetic predisposition may also be a factor. In some cases it results from a physical problem, such as a tumor, head trauma, or dysfunction of the autonomic or central nervous system. Sleep apnea is the second most frequent cause of secondary hypersomnia, affecting up to 4% of middle-aged adults, mostly men. Upper airway resistance syndrome (UARS) is a clinical variant of sleep apnea that can also cause hypersomnia.

Hypersomnia can also develop within months after viral infections such as Whipple's disease, mononucleosis, HIV, and Guillain–Barré syndrome. Behaviorally induced insufficient sleep syndrome must also be considered in the differential diagnosis of secondary hypersomnia. This disorder occurs in individuals who fail to get sufficient sleep for at least three months. In this case, the patient has chronic sleep deprivation although he or she is not necessarily aware of it.

Modafinil has been found to be the most effective drug against the excessive sleepiness and has even been shown to be helpful in children with hypersomnia. The dosage is started at 100 mg per day and then slowly increased to 400 mg per day. In general, patients with hypersomnia or excessive sleepiness should only go to bed to sleep or for sexual activity.McWhirter, D., Bae, C., & Budur, K. (2007).

The first book on sleep was published in 1830 by Robert MacNish; it described sleeplessness, nightmares, sleepwalking and sleep-talking. Narcolepsy, hypnogogic hallucination, wakefulness and somnolence were mentioned by other authors of the nineteenth century. Westphal in 1877 described first case of narcolepsy, the name coined later by Gelineu in 1880 in association with cataplexy. Lehermitte called it paroxysmal hypersomnia in 1930 to differentiate it from prolonged hypersomnia.

Idiopathic hypersomnia is a neurological disorder which is characterized primarily by excessive sleep and excessive daytime sleepiness (EDS).Narcolepsy and hypersomnia: review and classification of 642 personally observed cases. Roth B. Schweiz Arch Neurol Neurochir Psychiatr. 1976;119(1):31-4 It has historically been rarely diagnosed and is often very difficult to diagnose at an early stage; it is usually a lifelong chronic disease, which is often debilitating.

Just as other sleep disorders (like narcolepsy) can coexist with sleep apnea, the same is true for UARS. There are many cases of UARS in which excessive daytime sleepiness persists after CPAP treatment, indicating an additional cause, or causes, of the hypersomnia and requiring further evaluation. Sleep movement disorders, such as restless legs syndrome (RLS) and periodic limb movement disorder (PLMD or PLMS) can also cause secondary hypersomnia. Although RLS does commonly cause excessive daytime sleepiness, PLMS does not.

Mood disorders, like depression, anxiety disorder and bipolar disorder, can also be associated with hypersomnia. The complaint of excessive daytime sleepiness in these conditions is often associated with poor sleep at night. "In that sense, insomnia and EDS are frequently associated, especially in cases of depression." Hypersomnia in mood disorders seems to be primarily related to "lack of interest and decreased energy inherent in the depressed condition rather than an increase in sleep or REM sleep propensity".

A case series in 2010 found that peripheral vascular symptoms, such as cold hands and feet (Raynaud's-type phenomena) were more common in people with idiopathic hypersomnia than in controls. In addition to difficulty with temperature regulation and Raynaud's type symptoms, other symptoms associated with autonomic dysfunction were noted to occur in idiopathic hypersomnia. These included: fainting episodes (syncope); dizziness upon arising (orthostatic hypotension); and headaches (possibly migrainous in quality). Food cravings and impotence have also been reported.

In fact, "the most severe cases of daytime somnolence are found in patients affected by narcolepsy or idiopathic hypersomnia." Surprisingly, excessive daytime sleepiness is even more handicapping than the cataplectic attacks of narcolepsy. Due to the consequences of their profound EDS, both idiopathic hypersomnia and narcolepsy can often result in unemployment. Several studies have shown a high rate of unemployment in narcoleptics (from 30–59%), which was felt to be related to the severe symptoms of their illness.

Section 6 measures, by direct questions, whether the respondent is depressed, by items relating to feeling low, uncontrolled crying, anhedonia, loss of feeling, suicidal tendencies, social withdrawal, insomnia or hypersomnia, dysthymia, etc.

Modafinil used alone has been reported to be effective in a subgroup of individuals with depersonalization disorder (those who have attentional impairments, under- arousal and hypersomnia). However, clinical trials have not been conducted.

In some cases, hypersomnia can be caused by a brain injury.Guilleminault, C., Faull, K. F., Miles, L., & Van den Hoed, J. (1983). Posttraumatic excessive daytime sleepiness: A review of 20 patients. Neurology, 33(12), 1584–1584.

Sleep disturbances (insomnia or hypersomnia) are not a necessary diagnostic criterion but one of the most frequent symptoms of individuals with major depressive disorder (MDD). Insomnia and hypersomnia have prevalence rates of 88% and 27%, respectively, among individuals with MDD whereas individuals with insomnia have a threefold increased risk of developing MDD. Depressed mood and sleep efficiency strongly co-vary, and while sleep regulation problems may precede depressive episodes, such depressive episodes may also precipitate sleep deprivation. Fatigue as well as sleep disturbances such as irregular and excessive sleepiness are linked to symptoms of depression.

Typically, the symptoms of idiopathic hypersomnia begin in adolescence or young adulthood, although they can begin at a later age. After onset, hypersomnia often worsens over several years, but it is often stable by the time of diagnosis and appears to be a lifelong condition. Spontaneous remission is only seen in 10–15% of patients. According to the limited epidemiological data that exists, IH "has more of a female preponderance (1.8/1)." Family cases are frequent, in a range from 25% to 66% without any clear mode of inheritance.

Hypersomnia affects approximately 5% - 10% of the general population, Geddes, J., Gelder, M., Price, J., Mayou, R., McKnight, R. Psychiatry. 4th ed. Oxford University Press; 2012. p365. "with a higher prevalence for men due to the sleep apnea syndromes".

Given the possible role of hyper-active GABAA receptors in the primary hypersomnias (narcolepsy and idiopathic hypersomnia), medications that could counteract this activity are being studied to test their potential to improve sleepiness. These currently include clarithromycin and flumazenil.

Researchers found that the level of sleepiness is correlated with the severity of the injury.Watson, N. F., Dikmen, S., Machamer, J., Doherty, M., & Temkin, N. (2007). Hypersomnia following traumatic brain injury. Journal of Clinical Sleep Medicine, 3(04), 363–368.

Researchers have recently found an abnormal hypersensitivity to GABA (the major brain chemical responsible for sedation) in a subset of patients with central hypersomnia i.e.: idiopathic hypersomnia, narcolepsy without cataplexy and long sleepers. They have identified a small (500 to 3000 daltons) naturally occurring bioactive substance (most likely a peptide as it is trypsin-sensitive) in the CSF of afflicted patients. Although this substance requires further identification of its chemical structure, it is currently referred to as a "somnogen" because it has been shown to cause hyper-reactivity of GABAA receptors, which leads to increased sedation or somnolence.

Reversed vegetative symptoms include only oversleeping (hypersomnia) and overeating (hyperphagia), as compared to insomnia and loss of appetite. These features are characteristic of atypical depression (AD). However, there have been studies claiming that these symptoms alone are sufficient to diagnose the condition of AD.

The diagnosis of a bipolar disorder is linked to various sleep disorders. Mainly it is very comorbid with Insomnia and Hypersomnia. Other related sleep disturbances are for e.g. a delayed sleep phase syndrome, circadian-rhythm sleep disorder, sleep apnea, REM sleep abnormalities and Irregular sleep-wake schedules.

A single case report study indicates that high-frequency repetitive transcranial magnetic stimulation (HF rTMS) over the left dorsolateral prefrontal cortex (DLPFC) might represent an alternative choice for symptom control in narcoleptic patients with cataplexy. rTMS may also exert intrinsic effects on hypersomnia in depressed adolescents.

It is used to diagnose disorders of excessive somnolence, such as hypersomnia, narcolepsy or obstructive sleep apnea.Sangal, R. B., Thomas, L., & Mitler, M. M. (1992). Maintenance of wakefulness test and multiple sleep latency test: Measurement of different abilities in patients with sleep disorders. Chest, 101(4), 898–902.

Furthermore, unlike the polysomnography, it is less expensive and non-invasive. An actigraphy over several days can show longer sleep periods, which are characteristic for idiopathic hypersomnia. Actigraphy is also helpful in ruling out other sleep disorders, especially circadian disorders, leading to an excess of sleepiness during the day, too.

The MSLT measures, by several nap opportunities in one day, how long it takes a person to fall asleep. It also determines whether REM sleep appears upon falling asleep. It is usually performed immediately after an overnight study. This test is the standard to test for narcolepsy and idiopathic hypersomnia.

Secondary damage involves the damage of neurotransmitter release, inflammatory responses, mitochondrial dysfunctions and gene activation, occurring minutes to days following the trauma. Patients with sleeping disorders following TBI suffer specifically from insomnia, sleep apnea, narcolepsy, periodic limb movement disorder and hypersomnia. Furthermore, circadian sleep-wake disorders can occur after TBI.

Presentation of symptoms and signs varies considerably by form (DM1/DM2), severity and even unusual DM2 phenotypes. DM1 symptoms for DM2 include problems with executive function (e.g., organization, concentration, word-finding) and hypersomnia. Conduction abnormalities are more common in DM1 than DM2, but all people are advised to have an annual ECG.

Excessive daytime sleepiness is characterized by persistent sleepiness and often a general lack of energy, even during the day after apparently adequate or even prolonged nighttime sleep. EDS can be considered as a broad condition encompassing several sleep disorders where increased sleep is a symptom, or as a symptom of another underlying disorder like narcolepsy, circadian rhythm sleep disorder, sleep apnea or idiopathic hypersomnia. Some persons with EDS, including those with hypersomnias like narcolepsy and idiopathic hypersomnia, are compelled to nap repeatedly during the day; fighting off increasingly strong urges to sleep during inappropriate times such as while driving, while at work, during a meal, or in conversations. As the compulsion to sleep intensifies, the ability to complete tasks sharply diminishes, often mimicking the appearance of intoxication.

Patients with Kleine–Levin syndrome (KLS) experience recurring episodes of prolonged sleep (hypersomnia). In most cases, patients sleep 15 to 21 hours a day during episodes. Excessive appetite (hyperphagia) and unusual cravings are present in half to two thirds of cases. About half of patients, mainly male patients, experience dramatically increased sexual urges (hypersexuality).

Others are sleep apnea, narcolepsy and hypersomnia (excessive sleepiness at inappropriate times), sleeping sickness (disruption of sleep cycle due to infection), sleepwalking, and night terrors. Management of sleep disturbances that are secondary to mental, medical, or substance abuse disorders should focus on the underlying conditions. Primary sleep disorders are common in both children and adults.

Some studies have shown negative effects of hypnotics, such as an increased risk of dementia. In patients with hypersomnia, Modafinil, Armodafinil, Methylphenidate and amphetamines are often used as a treatment for day time sleepiness. Medication should always be prescribed by an expert to make sure that the correct medicament is taken in an appropriate dose.

Kleine–Levin syndrome (KLS) is a rare disorder characterized by persistent episodic hypersomnia and cognitive or mood changes. Many patients also experience hyperphagia, hypersexuality and other symptoms. Patients generally experience recurrent episodes of the condition for more than a decade and may return at a later age. Individual episodes generally last more than a week, sometimes lasting for months.

Even with medication, patients may struggle with these activities. Many patients are chronically tardy to work, school or social engagements and, over time, may lose the ability to function in family, social, occupational or other settings altogether. Idiopathic hypersomnia profoundly affects work, education, and quality of life. Patients often need to drastically adapt their lifestyle after diagnosis.

Hypocretin-1 has been shown to be strongly wake-promoting in animal models, but it does not cross the blood- brain barrier. Suvorexant, a hypocretin receptor antagonist, has been developed to limit the natural effects of hypocretin in patients with insomnia. It is therefore possible that a hypocretin agonist may be similarly developed for the treatment of hypersomnia.

One of the main behavioral symptoms of bipolar disorder is abnormal sleep, and studies have suggested that 23-78% of individuals with bipolar disorders consistently report symptoms of excessive time spent sleeping, or hypersomnia. The pathogenesis of bipolar disorder, including the higher risk of suicidal ideation, could possibly be linked to circadian rhythm variability, and sleep disturbances are a good predictor of mood swings. The most common sleep-related symptom of bipolar disorder is insomnia, in addition to hypersomnia, nightmares, poor sleep quality, OSA, extreme daytime sleepiness, etc. Moreover, animal models have shown that sleep debt can induce episodes of bipolar mania in laboratory mice, but these rodent models are still restricted in their potential to explain bipolar disease in humans with all its multifaceted symptoms, including those related to sleep disturbances.

Diagnostic criteria for KLS was established by Schmidt in 1990, and the International Classification of Sleep Disorders further refined them. KLS is classified as a sleep disorder, specifically one of recurrent hypersomnia. Before 2005, hyperphagia and hypersexuality were thought to occur in all cases. That was changed with the guidelines published that year, which noted that they did not always occur.

Psychosocial studies of the individual's changing perspectives in Alzheimer's disease (Premier Reference Source). Hershey, PA: Medical Information Science Reference. As well as in PD population, insomnia and hypersomnia are frequently recognized in AD patients, which are associated with accumulation of Beta-amyloid, circadian rhythm sleep disorders (CRSD) and melatonin alteration. Additionally, changes in sleep architecture are observed in AD too.

It may include sleeping for prolonged periods at night or increased sleeping during the daytime. The sleep may not be restful, and the person may feel sluggish despite many hours of sleep, which may amplify their depressive symptoms and interfere with other aspects of their lives. Hypersomnia is often associated with an atypical depression, as well as seasonal affective disorder.

The Epworth Sleepiness Scale has been validated primarily in obstructive sleep apnea, though it has also shown success in detecting narcolepsy and idiopathic hypersomnia. It is used to measure excessive daytime sleepiness and is repeated after the administration of treatment (e.g., CPAP) to document improvement of symptoms. In narcolepsy, the Epworth Sleepiness Scale has both a high specificity (100%) and sensitivity (93.5%).

Abnormally low levels of acylcarnitine have been observed in people with narcolepsy. These same low levels have been associated with primary hypersomnia in general in mouse studies. “Mice with systemic carnitine deficiency exhibit a higher frequency of fragmented wakefulness and rapid eye movement (REM) sleep, and reduced locomotor activity.” Administration of acetyl-L-carnitine was shown to improve these symptoms in mice.

Competence in sleep medicine requires an understanding of a plethora of very diverse disorders, many of which present with similar symptoms such as excessive daytime sleepiness, which, in the absence of volitional sleep deprivation, "is almost inevitably caused by an identifiable and treatable sleep disorder," such as sleep apnea, narcolepsy, idiopathic hypersomnia, Kleine-Levin syndrome, menstrual-related hypersomnia, idiopathic recurrent stupor, or circadian rhythm disturbances. Another common complaint is insomnia, a set of symptoms that can have many causes, physical and mental. Management in the varying situations differs greatly and cannot be undertaken without a correct diagnosis. ICSD, The International Classification of Sleep Disorders, was restructured in 1990, in relation to its predecessor, to include only one code for each diagnostic entry and to classify disorders by pathophysiologic mechanism, as far as possible, rather than by primary complaint.

This situation is becoming more prevalent in western society due to the modern demands and expectations placed upon the individual. Many medications can also lead to secondary hypersomnia. Therefore, a patient's complete medication list should be carefully reviewed for sleepiness or fatigue as side effects. In these cases, careful withdrawal from the possibly offending medication(s) is needed; then, medication substitution can be undertaken.

In the typical pattern, a person wakes very early and cannot get back to sleep. Hypersomnia, or oversleeping, can also happen. Some antidepressants may also cause insomnia due to their stimulating effect. A depressed person may report multiple physical symptoms such as fatigue, headaches, or digestive problems; physical complaints are the most common presenting problem in developing countries, according to the World Health Organization's criteria for depression.

Late on 25 December Chornovol was prepared for a series of reconstructive surgeries on her nose and right eye orbit, and was recovering from severe concussion. By 30 December, Chornovol was transferred out of intensive care but remained in hospital due to severe hypersomnia. On 7 January 2014, she was ready to be discharged from hospital, though still requiring outpatient treatment. However she refused to leave.

It may also be effective in reducing excessive daytime sleepiness while improving vigilance in primary hypersomnias, such as idiopathic hypersomnia. The drug has also been used in hepatic encephalopathy. It may have beneficial short‐term effects in people with cirrhosis, but there is no evidence for long-term benefits. The onset of action is rapid, and effects are usually seen within one to two minutes.

Somnolence (alternatively "sleepiness" or "drowsiness") is a state of strong desire for sleep, or sleeping for unusually long periods (compare hypersomnia). It has distinct meanings and causes. It can refer to the usual state preceding falling asleep, the condition of being in a drowsy state due to circadian rhythm disorders, or a symptom of other health problems. It can be accompanied by lethargy, weakness, and lack of mental agility.

A 1999 study found that sleep deprivation resulted in reduced cortisol secretion the next day, driven by increased subsequent slow-wave sleep. Sleep deprivation was found to enhance activity on the hypothalamic-pituitary-adrenal axis (which controls reactions to stress and regulates body functions such as digestion, the immune system, mood, sex, or energy usage) while suppressing growth hormones. The results supported previous studies, which observed adrenal insufficiency in idiopathic hypersomnia.

CSF samples from KLS patients indicate that the condition has a different cause than influenza-associated encephalopathy. Triggers of KLS may also affect the blood-brain barrier, which could play a role in the condition. There is limited evidence of what role hypocretin may play, although it often influences hypersomnia. Androgen might (indirectly) block melatonin receptors, possibly by means of vasodilation, and cause cholinergic abnormalities in some cases of Kleine–Levin syndrome.

In the Putumayo department of southwestern Colombia, the Inga people treat chronic pain and other conditions with a drink by simmering the root of the plant in water for several hours. For myalgia (body ache), low energy/motivation, and hypersomnia, the patient drinks an infusion of chichaja. The infusion is also said to cleanse the blood and to help prevent disease. In cases of rheumatism, chronic fatigue, or hemorrhoids, the patient drinks the infusion hot.

There are different kinds of TBI that cause different brain dysfunctions. Research suggests that TBI results in damage to sleep-regulation centers including the reticular activation system, specifically damage to the suprachiasmatic nuclei (SCN) which leads to disturbances in the circadian rhythm. Considering hypersomnia, mostly areas involving the maintenance of wakefulness are damaged, such as the rostral pons, caudal midbrain and thalamus. Sleep disorders are more frequently reported when patients suffer from mild TBI (mTBI).

Cocaine withdrawal isn't as severe as the withdrawal from other substances. For example, substances like alcohol and benzodiazepines can involve severe physical withdrawal symptoms while cocaine results in mostly psychological symptoms. Physiological changes caused by cocaine withdrawal include vivid and unpleasant dreams, insomnia, hypersomnia, anger, increased appetite, weight gain, psychomotor retardation, agitation, depression, and anxiety. According to a study done by Gawin and Kleber in 1986, there are three phases in the withdrawal process.

Roger in 1932 coined the term parasomnia and classified hypersomnia, insomnia and parasomnia. Kleitman in 1939 recognized types of parasomnias as nightmares, night terrors, somniloquy (sleep-talking), somnambulism (sleepwalking), grinding of teeth, jactatians, enuresis, delirium, nonepileptic convulsions and personality dissociation. Broughton in 1968 developed classification of the arousal disorders as confusional arousals: night terrors and sleep walking. Insomnias were classified as primary and secondary till 1970 when they were recognized as symptoms of other disorders.

In her later years, Tubman was an activist in the movement for women's suffrage. Born enslaved in Dorchester County, Maryland, Tubman was beaten and whipped by her various masters as a child. Early in life, she suffered a traumatic head wound when an irate overseer threw a heavy metal weight intending to hit another enslaved person, but hit her instead. The injury caused dizziness, pain, and spells of hypersomnia, which occurred throughout her life.

Dysthymia characteristics include an extended period of depressed mood combined with at least two other symptoms which may include insomnia or hypersomnia, fatigue or low energy, eating changes (more or less), low self-esteem, or feelings of hopelessness. Poor concentration or difficulty making decisions are treated as another possible symptom. Mild degrees of dysthymia may result in people withdrawing from stress and avoiding opportunities for failure. In more severe cases of dysthymia, people may withdraw from daily activities.

The syndrome causes Delien to sleep for 18–19 hours a day on average and to sleep for longer stretches of time as well, including a 64-day block of time in 2012. The disorder is characterized by episodic periods of hypersomnia and lethargy. These episodes can last anywhere from days to weeks and can last in the patient from eight to twelve years before disappearing altogether. Delien's parents and siblings do not suffer from the disorder.

For one person, daily administration of flumazenil by sublingual lozenge and topical cream has proven effective for several years. A 2014 case report also showed improvement in primary hypersomnia symptoms after treatment with a continuous subcutaneous flumazenil infusion. The supply of generic flumazenil was initially thought to be too low to meet the potential demand for treatment of primary hypersomnias. However, this scarcity has eased, and dozens of people are now being treated with flumazenil off-label.

Evolutionary approaches to postpartum depression examine the syndrome from the framework of evolutionary theory. Postpartum (or postnatal) depression refers to major and minor episodes of depression within the first 12 months after delivery. Depression during pregnancy is referred to as prenatal (or antenatal) depression. Symptoms of postpartum depression include sad or depressed mood, feelings of worry, anxiety, guilt, or worthlessness, hypersomnia or insomnia, difficulty concentrating, anhedonia, somatic pain, changes in appetite, weight loss or weight gain, moodiness, irritability, restlessness, and fatigue.

Bourne A, Reid D, Hickson F, Torres Rueda S, Weatherburn P (2014) The Chemsex study: drug use in sexual settings among gay & bisexual men in Lambeth, Southwark & Lewisham. London: Sigma Research, London School of Hygiene & Tropical Medicine. www.sigmaresearch.org.uk/chemsex The crash following the use of methamphetamine in this manner is very often severe, with marked hypersomnia. Ketamine is very different from the main chemsex drugs, as it is a dissociative hallucinogen that distorts perceptions and creates a sense of detachment.

In individuals with psychiatric illnesses, sleep disorders may include a variety of clinical symptoms such as excessive daytime sleepiness, difficulty falling asleep, difficulty staying asleep, nightmares, sleep talking, sleep walking, and poor quality sleep, among various others. Sleep disturbances - insomnia, hypersomnia and delayed sleep-phase disorder - are quite prevalent in severe mental illnesses such as psychotic disorders. In those with schizophrenia sleep disorders contribute to cognitive deficits in learning and memory. Sleep disturbances often occur before the onset of psychosis.

Orexin-A ( hypocretin-1) has been shown to be strongly wake-promoting in animal models, but unfortunately it does not cross the blood-brain barrier. Therefore, companies have developed orexin receptor antagonists, like suvorexant, for the treatment of insomnia. It is also likely that an orexin-A receptor agonist will be found and developed for the treatment of hypersomnia. In August 2015, Nagahara et al published their work in synthesizing the first HCRT/OX2R agonist, compound 26, with good potency and selectivity.

" "Planned naps are unhelpful, as they are both long and unrefreshing." Although behavioral approaches have not been shown to improve EDS, the goal, as in CBT (cognitive behavioral therapy), is often to help patients learn to reduce their negative emotional responses (e.g. frustration, anger, depression) to their disease symptoms. Furthermore, because idiopathic hypersomnia "may lead to marriage breakdown, extensive counseling for the patient's partners, educating them about the symptomatology and treatment options, must be part of a comprehensive management plan.

Idiopathic hypersomnia is a lifelong disorder (with only rare spontaneous remissions) whose symptoms typically begin in adolescence or young adulthood. It is initially progressive, but may stabilize, and its main consequences are professional and social. The disorder is chronic, and the symptoms can be relentless. If an effective medication to control symptoms cannot be found, it can be extremely difficult for people with IH to hold down jobs, remain in school, maintain marriages, and fully engage with their family and friends.

Avoiding situations that might be dangerous while sleepy, such as driving. It is not safe to drive a car unless the symptoms are under control with medication. Patients are often too sleepy to work or attend school regularly, and they are predisposed "to develop serious performance decrements in multiple areas of function as well as to potentially life- threatening domestic, work-related and driving accidents." Furthermore, these risks are higher for idiopathic hypersomnia patients than for those with sleep apnea or severe insomnia.

Physical withdrawal is not dangerous. Physiological changes caused by cocaine withdrawal include vivid and unpleasant dreams, insomnia or hypersomnia, increased appetite and psychomotor retardation or agitation. Physical side effects from chronic smoking of cocaine include coughing up blood, bronchospasm, itching, fever, diffuse alveolar infiltrates without effusions, pulmonary and systemic eosinophilia, chest pain, lung trauma, sore throat, asthma, hoarse voice, dyspnea (shortness of breath), and an aching, flu-like syndrome. Cocaine constricts blood vessels, dilates pupils, and increases body temperature, heart rate, and blood pressure.

Given the possible role of hyperactive GABAA receptors in idiopathic hypersomnia, medications that could counteract this activity are being studied to test their potential to improve sleepiness. These currently include clarithromycin and flumazenil. Flumazenil, a GABAA receptor antagonist is approved by the FDA for use in anesthesia reversal and benzodiazepine overdose. Research has shown that flumazenil provides relief for most patients whose CSF contains the unknown "somnogen" that enhances the function of GABAA receptors, making them more susceptible to the sleep-inducing effect of GABA.

Eugeroics (originally, "eugrégorique" or "eugregoric"), also known as wakefulness-promoting agents and wakefulness-promoting drugs, are a class of drugs that promote wakefulness and alertness. They are medically indicated for the treatment of certain sleep disorders including excessive daytime sleepiness (EDS) in narcolepsy or obstructive sleep apnea (OSA). They generally have a very low addictive potential. Eugeroics are also often prescribed off-label for the treatment of EDS in idiopathic hypersomnia, a rare and often debilitating sleep disorder which currently has no official treatments approved by the Food and Drug Administration (FDA).

The symptoms of physical withdrawal from stimulants can include fatigue, dysphoric mood, increased appetite, vivid or lucid dreams, hypersomnia or insomnia, increased movement or decreased movement, anxiety, and drug craving, as is apparent in the rebound withdrawal from certain substituted amphetamines. Physical withdrawal from some sedatives can be potentially lethal, for instance benzodiazepine withdrawal syndrome. Opioid withdrawal is very uncomfortable, often described as a bad case of the flu, with possibly severe abdominal cramps and diarrhoea as central symptoms, but it is rarely lethal unless the user has a comorbid condition.

Dyssomnia is a class of sleep disorders which includes Primary insomnia, primary hypersomnia, narcolepsy, breathing-related sleep disorders, circadian rhythm sleep discorer, and other conditions. Primary insomnia is a disorder in which a patient has difficulty initiating and maintaining sleep. Behavior modification and a reduction in neurologically active substances such as caffeine and alcohol seem to be among the most promising treatments. Although the mechanism is unknown, brain plasticity and behavior modification are utilized to train patients to only go to bed when tired, associating the bed itself with a sleepy state.

Atypical depression as it has been known in the DSM IV, is depression that shares many of the typical symptoms of the psychiatric syndromes of major depression or dysthymia but is characterized by improved mood in response to positive events. In contrast to atypical depression, people with melancholic depression generally do not experience an improved mood in response to normally pleasurable events. Atypical depression also features significant weight gain or an increased appetite, hypersomnia, a heavy sensation in the limbs, and interpersonal rejection sensitivity that results in significant social or occupational impairment.American Psychiatric Association. (2000).

In general, atypical depression tends to cause greater functional impairment than other forms of depression. Atypical depression is a chronic syndrome that tends to begin earlier in life than other forms of depression—usually beginning in the teenage years. Similarly, patients with atypical depression are more likely to suffer from personality disorders and anxiety disorders such as borderline personality disorder, avoidant personality disorder, generalized anxiety disorder, obsessive-compulsive disorder, and bipolar disorder. Recent research suggests that young people are more likely to suffer from hypersomnia while older people are more likely to suffer from polyphagia.

This would lead the investigator to observe what they want to observe in subjects, and to render conclusions in line with their expectations. Also, the imprecise diagnostic criteria for psychiatric illnesses inevitably lead to problems modeling the condition; e.g., since a person with major depressive disorder may experience weight loss or weight gain, insomnia or hypersomnia, we cannot with any certainty say that a rat with insomnia and weight loss is depressed. Furthermore, the complex nature of psychiatric conditions makes it difficult/impossible to translate human behaviors and deficits; e.g.

Some independent risk factors associated with confusional arousals have been identified. According to studies, they are shift work, hypnagogic hallucinations (also known as hypnagogia), excessive daytime sleepiness, insomnia and hypersomnia disorder, circadian rhythm sleep disorder, restless legs syndrome, obstructive sleep apnea syndrome (OSAS), bipolar disorder, daily smoking, and age of 15–24 years. These risk factors of confusional arousals are somehow related to mental disorders and medical conditions and affecting mostly younger subjects regardless of gender. Precipitating factors include sleep deprivation, use of hypnotics or tranquilisers before bedtime, and sudden awakening from sleep (e.g.

Recurrent brief depression (RBD) defines a mental disorder characterized by intermittent depressive episodes, not related to menstrual cycles in women, occurring between approximately 6–12 times per year, over at least one year or more fulfilling the diagnostic criteria for major depressive episodes (DSM-IV and ICD-10) except for duration which in RBD is less than 14 days, typically 5–7 days. Despite the short duration of the depressive episodes, such episodes are severe, and suicidal ideation and impaired function is rather common. The majority of patients with RBD also report symptoms of anxiety and increased irritability. Hypersomnia is also rather frequent.

Signs and symptoms depend on the targeted antigen, but the features in patients with different antibodies often overlap. The most characteristic feature found in a case series was cognitive impairment and seizures in anti-LGI-1 positive patients, and peripheral motor hyperexcitability in anti-CASPR2 positive patients. Some patients have other coexisting autoimmune diseases. anti-LGI-1 encephalitis: Patients with anti-LGI1 encephalitis have limbic encephalitis with amnesia and/or confusion (100%) and seizures (84-92 %) Other reported features include hyponatremia (in 60%), movement disorders (myoclonus/dyskinesia), sleep disorders (hypersomnia, insomnia, REM sleep behavior disorder, sleep reversal) and ataxia.

Nonpharmacological treatments involve different interventions, starting with sleep hygiene, which includes sleep promoting activities such as maintaining a regular and strict sleep schedule and avoiding heavy meals before bedtime in order to restore the natural sleep-wake cycle. Further treatments options are phototherapy and infrared light therapy, which both, aim to treat circadian rhythm disorders such as delayed sleep phase disorder. Especially in patients with hypersomnia, bright light therapy in the morning has been proven to be effective. A prolongation of slow-wave sleep increases glymphatic clearance of metabolic waste products, which can lead to improvements of sleep disorders.

A major depressive episode (MDE) is a period characterized by the symptoms of major depressive disorder. Sufferers primarily have a depressed mood for two weeks or more, and a loss of interest or pleasure in everyday activities, accompanied by other symptoms such as feelings of emptiness, hopelessness, anxiety, worthlessness, guilt and irritability, changes in appetite, problems concentrating, remembering details or making decisions, and thoughts of suicide. Insomnia or hypersomnia, aches, pains, or digestive problems that are resistant to treatment may also be present. The description has been formalized in psychiatric diagnostic criteria such as the DSM-5 and ICD-10.

In 2005, Mark Taylor (Chris Nelson), an American Christian firefighter married to a fire dispatcher named Mary Jo (Karen Boles), carries a dead young boy (Landon Starns) out of a crackhouse fire. He has had fever dreams relating to the incident since then, which prompts his doctor (Todd McLaren) to diagnose him as having post-traumatic stress disorder. However, he is not taking his prescribed medication and retires his position as firefighter. Taylor spends the next six years descending into his PTSD-infused situation, facing hypersomnia and nightmares about being taken hostage by a fire demon from hell (Darrell Nelson) while watching television to numb the illness.

MdDS sufferers may have hypersomnia and can sleep up to 12 or more hours a day, depending on their symptom levels. Research reveals MdDS is not migraine-related and many sufferers have never had migraine symptoms prior to the onset of the disorder. However, for some MdDS sufferers there maybe have been a correlation between migraine and some pathophysiological overlap or even some other precipitating illness. The condition may be masked by a return to motion such as in a car, train, plane, or boat; however, once the motion ceases, the symptoms rebound or return, often at much higher levels than when the journey first commenced.

Hospital Anxiety and Depression Scale (HADS) was originally developed by Zigmond and Snaith (1983) and is commonly used by doctors to determine the levels of anxiety and depression that a person is experiencing. The HADS is a fourteen item scale that generates: Seven of the items relate to anxiety and seven relate to depression. Zigmond and Snaith created this outcome measure specifically to avoid reliance on aspects of these conditions that are also common somatic symptoms of illness, for example fatigue and insomnia or hypersomnia. This, it was hoped, would create a tool for the detection of anxiety and depression in people with physical health problems.

Atomoxetine (or reboxetine in Europe) is an adrenergic reuptake inhibitor which increases wakefulness (generally less strongly than the medications which act on dopamine) and which has been argued to have a "clear use in the therapeutic arsenal against narcolepsy and hypersomnia although undocumented by clinical trials." Ritanserin is a serotonin antagonist that has "been shown to improve daytime alertness and subjective sleep quality in patients on their usual narcolepsy medications." It is intended as an adjunct (supplement to another main therapeutic agent), and although it is not available in the US, it is available in Europe. Pitolisant, a selective histamine 3 (H3) receptor antagonist/inverse agonist, was approved by FDA during August 2019.

People around them often describe the sufferer in words similar to "just a moody person". Note the following diagnostic criteria:, ICD9, Accessed 2009 May 2 # During a majority of days for two years or more, the adult patient reports depressed mood, or appears depressed to others for most of the day. # When depressed, the patient has two or more of: ## decreased or increased appetite ## decreased or increased sleep (insomnia or hypersomnia) ## Fatigue or low energy ## Reduced self-esteem ## Decreased concentration or problems making decisions ## Feelings of hopelessness or pessimism # During this two-year period, the above symptoms are never absent longer than two consecutive months. # During the duration of the two-year period, the patient may have had a perpetual major depressive episode.

Sleep deprivation can also produce hallucinations, delusions and depression. A 2019 study investigated the three above-mentioned sleep disturbances in schizophrenia- spectrum (SCZ) and bipolar (BP) disorders in 617 SCZ individuals, 440 BP individuals, and 173 healthy controls (HC), sleep disturbances being identified using the Inventory for Depressive Symptoms - clinician rated scale (IDS-C). Results suggested that at least one type of sleep disturbance was reported in 78% of the SCZ population, in 69% individuals with BD, and only in 39% of the healthy controls. The SCZ group reported the most number of sleep disturbances, compared to the BD and HC group, specifically hypersomnia was more frequent among individuals with SCZ and delayed sleep phase disorder was 3 times more common in the SCZ group compared to the BD group.

Those who suffer from idiopathic hypersomnia seems to have some common symtoms like Excessive daytime sleepiness, which is characterized by persistent sleepiness throughout the day and often a general lack of energy, even during the day after apparently adequate or even prolonged nighttime sleep. People with EDS are compelled to nap repeatedly during the day; fighting off increasingly strong urges to sleep during inappropriate times such as while driving, while at work, during a meal, or in conversations. Sleep inertia (also known as sleep drunkeness), which is characterized by having extreme difficulty waking up and feeling an uncontrollable desire to go back to sleep. Clouding of consciousness (also known as brain fog or mental fog), which is characterized by inattention, thought process abnormalities, comprehension abnormalities, and language abnormalities.

Other depressive symptoms include significant weight loss or weight gain without trying to diet (an increase/decrease in appetite can provide clues as well), insomnia or hypersomnia, psychomotor agitation or psychomotor retardation, fatigue or loss of energy, and feelings of worthlessness or excessive guilt. All of these signs can compound on each other to create the last major symptom group of minor depressive disorder: thoughts of death, suicidal thoughts, plans to commit suicide, or a suicide attempt. Minor depressive disorder differs from major depressive disorder in the number of symptoms present with 5 or more symptoms necessary for a diagnosis of major depressive disorder. Both disorders require either depressed mood or loss of interest or pleasure in normal activities to be one of the symptoms and the symptoms need to be present for two weeks or longer.

The choice of treatment methodology for a specific patient depends on the patient's diagnosis, medical and psychiatric history, and preferences, as well as the expertise of the treating clinician. Often, behavioral or psychotherapeutic and pharmacological approaches are compatible and can effectively be combined to maximize therapeutic benefits. Frequently, sleep disorders have been also associated with neurodegenerative diseases, mainly when they are characterized by abnormal accumulation of alpha-synuclein, such as multiple system atrophy (MSA), Parkinson's disease (PD) and Lewy body disease (LBD). For instance, people diagnosed with PD have often presented different kinds of sleep concerns, commonly regard to insomnia (around 70% of the PD population), hypersomnia (more than 50% of the PD population), and REM sleep behavior disorder (RBD) - that may affect around 40% of the PD population and it is associated with increased motor symptoms.