Everyone loves having the time to take a nap, so it can be hard to imagine what would be so bad about having a condition like primary hypersomnia and napping a lot. Unfortunately, primary hypersomnia is a very disruptive condition. The good news is it is very rare.
People who think that they might have it usually are afflicted by another condition. The testing and criteria for it are rigorous. It isn’t nearly as pleasant as it sounds as the person has next to no control over what happens.
What is primary hypersomnia?
Primary hypersomnia is when a person may sleep on a regular and adequate schedule, or even sleep to excess at night (10 plus hours) and then still have a need to take prolonged naps during the day. The naps are unusual.
They are hours long, the person is in such a deep state of sleep that it is difficult to wake them and they do not experience any renewal of energy or wakefulness from the nap.
In primary hypersomnia, the naps are unavoidable. In many ways this makes it similar to narcolepsy and other sleep disorders that cause a person to fall asleep against their will.
This “oversleeping” leads to the same issues that coping with sleep deprivation does, as it is considered to be a type of sleep deprivation itself. Sleep deprivation includes any condition that deprives the body of the process of rest and renewal.
What causes it?
No one really knows what causes this condition and it is not related to other conditions as far as research can tell. There have been some recent clinical studies that suggest there is a neurological sensitivity to GABA processes in the brain.
It isn’t known if this is an actual cause or if it is just common in some people who have primary hypersomnia.
There are also some suggestion that there may be a neural misfire in the process of receiving the waking hormones and the functioning of the circadian rhythm.
Who is at risk?
As no one knows what the specific causes of primary hypersomnia are, it is hard to define a risk group. Even in doing a forensic review of past cases doesn’t reveal a common group typing. It is known that primary hypersomnia is a chronic and long term condition.
If you develop it, it will last for many years, if not a lifetime. It is not always seen as children in adults who develop the condition; there is also no common childhood condition that predates the onset of this hypersomnia in an adult.
What are the symptoms of primary hypersomnia?
The main symptom of primary hypersomnia is that the person is “driven” to take naps during the day. The naps are hours long and do not refresh the person or make them feel less tired. Often, the naps make the person more tired. The quality of sleep during these naps is very unusual too.
The person may remain absolutely motionless and be difficult to wake. It is not uncommon for them to experience lucid dreaming or other very vivid dreams. The experience of sleep paralysis and also of hypnogogic imagery is very common.
Hypnogogic imagery is a series of “visions” or hallucinations that the person has in the moments before they are falling asleep.
They can seem very real and even spiritual in nature. The naps come whether or not the person is maintaining a regular sleep schedule.
At night the person may sleep fine, but more commonly they will sleep for very long periods as well. The main difference between primary hypersomnia and narcolepsy is that narcoleptics can take a short nap and wake up refreshed; someone with primary hypersomnia has great difficulty shortening their naps and never wakes up feeling less tired.
What are the treatments for primary hypersomnia?
There are few treatments that are effective for primary hypersomnia. Many people with it develop their own form of treatment by creating unusual ways to wake themselves up from their prolonged naps.
There is research being done on using certain drugs that affect the GABA receptors but as now there are no specific drugs for this condition.
Some people respond to stimulants, such as those commonly used to treat ADHD. The use of stimulants has to be done with caution as it can cause other side effects.
It should be noted that while this condition is very rare, it is mostly considered a long term condition and not a lifelong one.
The difference is that someone may experience an episode of primary hypersomnia that may last for 10 or 15 years and then it will end.
Researchers have not been able to identify any changes in the person’s brain when this happens. One good thing is that by keeping a good sleep hygiene schedule, people can reduce the effect of the primary hypersomnia on their lives.
How does it impact your life?
Given the enormous amount of time that is spent sleeping, you can imagine that this condition is considered debilitating.
It can severely interrupt a person’s ability to maintain a work schedule, or participate in a family life. One of the treatments that are recommended for someone who is suffering from primary hypersomnia is to have counseling to help them deal with the effects the condition has on their life.
Many people fall into a depression caused by the feelings of helplessness and anger over not being able to control when and how long they sleep.
How do you know if you have it?
The testing involves having a pattern of your sleep history reviewed by a physician. The criteria for being diagnosed with primary hypersomnia includes having a nightly pattern of regular or excessive sleep (8 to 10 hours), followed by a daily pattern of naps that last at least 4 hours.
This pattern has to exist for 6 consecutive months for it to be determined that the person has primary hypersomnia. If you do think that you have it, start to keep a journal of your sleep patterns to aid this review process.