Materiały źródłowe

• #1 Hypersomnia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6139790/

  Adequate alertness is necessary for proper daytime functioning. Impairment of alertness or increase in sleepiness results in suboptimal performance and adversely affects the quality of life. […] Hypersomnia is a state of excessive sleepiness which can result in decreased functioning and affect performance adversely. Hypersomnolence is defined as an inability to stay awake and alert during major waking episodes, resulting in periods of irrepressible need for sleep or unintended lapses into drowsiness or sleep. Excessive daytime sleepiness (EDS) is one of the big public health problems of our time and is estimated to cause almost one-fifth of the motor vehicle accidents in this country. […] Identification of the problem and understanding the underlying etiology is the key to timely treatment and better outcomes.

• #1 Hypersomnia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6139790/

  The state of wakefulness and sleep are controlled by various neuronal systems localized in several brain regions. Hypoactivity of wake-promoting systems, results in activation of sleep-promoting systems and promotion of sleep. In contrast, hyperactivity of wake-promoting systems results in inhibition of sleep promoting systems and promotion of wakefulness. […] Several neurotransmitter and neuromodulators are involved in the regulation of sleep-wakefulness. However, amongst these the two main neurotransmitters/neuromodulators implicated in hypersomnia are hypocretins (also known as orexins) and prostaglandin D2. […] Hypocretins are two neuropeptides (hypocretin-1 and hypocretin-2) discovered in 1998 are important neurochemicals implicated in the pathogenesis of type I narcolepsy. […] Prostaglandin D2 (PGD2) is an endogenous somnogen that deserves a special mention. Its involvement in hypersomnia has been reported in mastocytosis and African sleeping sickness.

• #1 Hypersomnia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6139790/

  The somnogenic effects of PGD2 are believed to be mediated by adenosine. […] Narcolepsy type 1(NT 1) is characterized by a deficiency of hypothalamic hypocretin signaling. […] Narcolepsy with cataplexy is closely associated with HLA subtypes-DR 2/DR B1*1501 and HLA DQB1*0602. This strong association has led to the hypothesis that autoimmunity is a likely etiological mechanism, potentially explaining the selective neural destruction in the hypothalamus. […] Idiopathic hypersomnia(IH) is characterized by excessive daytime sleepiness without REM sleep intrusion not explained by another disorder. […] Hypersomnia can be seen as a complication of head injury in up to 27% people. […] Hypersomnolence affects 16-50% of patients with Parkinson’s disease and can be seen in up to a quarter of patients with Multiple systems atrophy.

• #1 Hypersomnia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6139790/

  Hypersomnolence in Genetic Disorders includes myotonic dystrophy, the most common adult onset form of muscular dystrophy can have hypersomnolence in up to one-third of the patients. […] Hypersomnolence in Inflammatory, Vascular and Neoplastic Processes can also cause somnolence especially when hypothalamus or rostral midbrain is involved. […] The treatment of hypersomnia should be primarily directed at the cause if there is one. Any factor that is adversely affecting the quantity and quality of sleep should be addressed before initiating therapy.

• #2 Excessive Daytime Sleepiness | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0301/p391.html

  Excessive daytime sleepiness is one of the most common sleep-related patient symptoms, and it affects an estimated 20 percent of the population. […] The most common causes of excessive daytime sleepiness are sleep deprivation, obstructive sleep apnea, and sedating medications. […] Excessive daytime sleepiness can occur secondary to sleep deprivation, medication effects, illicit substance use, obstructive sleep apnea (OSA), and other medical and psychiatric conditions. […] Excessive daytime sleepiness is the most common symptom of OSA. […] In patients with OSA, approximately 23 percent of women and 16 percent of men experience excessive daytime sleepiness. […] Many medical conditions can cause secondary excessive daytime sleepiness, including head trauma, stroke, tumors, inflammatory conditions, encephalitis, and genetic and neurodegenerative diseases.

• #2 Excessive Daytime Sleepiness | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0301/p391.html

  Narcolepsy, the most common of the primary hypersomnias, is reported to affect 0.02 to 0.18 percent of the adult population, but may be significantly underdiagnosed. […] Addressing the underlying cause is the mainstay of treatment of excessive daytime sleepiness. […] In OSA, the most dangerous and physiologically disruptive cause of excessive daytime sleepiness, treatment with positive pressure devices (e.g., CPAP) during sleep improves symptoms of daytime sleepiness for most patients.

• #3 Primary Hypersomnia: Practice Essentials, Background, Etiology

  https://emedicine.medscape.com/article/291699-overview

  Evidence suggests that a dopamine system dysfunction may occur in narcolepsy, while a similar malfunction of the norepinephrine system may occur in idiopathic hypersomnia. Decreased CSF histamine levels have been reported in primary hypersomnia, as well as in narcolepsy, but not in non-CNS hypersomnias, suggesting that histamine may be an indicator of a central (versus a peripheral) origin for hypersomnias. […] A major advance in the understanding of the pathology of narcolepsy, a disorder closely related to primary hypersomnia, was made after the discovery of narcolepsy-associated genes in animals; ie, genes involved in the pathology of the hypocretin/orexin ligand and its receptor. Low CSF concentrations of hypocretin-1 and hypocretin-2 in HLA DQB1*0602 were also found in primary hypersomnia, and a generalized defect in hcrt-2 transmission may be present in this disorder.

• #4 Idiopathic Hypersomnia | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/sleep/idiopathic-hypersomnia.html

  Excessive daytime sleepiness […] Hypersomnia means excessive sleep. Patients with idiopathic hypersomnia sleep a reasonable amount at night (at least six hours) but have difficulty waking up and always feel tired and sleepy. […] Excessive sleepiness may be due to: […] A brain abnormality of unknown cause. For example, some people with idiopathic hypersomnia have low levels of the brain chemical histamine. […] Diagnosing hypersomnia is challenging. Much of the diagnosis process involves ruling out other conditions. […] Treatment for hypersomnia is highly personalized, tailored to your specific needs and the severity of your condition.

• #5 Hypersomnolence: Symptoms, causes, diagnosis, and treatment

  https://www.medicalnewstoday.com/articles/318677

  Hypersomnolence, or excessive daytime sleepiness, can occur even after a person has 7 hours or more of quality sleep. […] Researchers are still working to identify what interactions in the brain cause hypersomnolance. It is possible that people have an increase in brain chemicals that are known to cause sleepiness. This increase can act much like a sleeping pill. […] Although researchers have not yet identified the specific substance or molecule that may be involved in hypersomnolence, they believe it interacts with a substance called y-aminobutyric acid (GABA), which is responsible for promoting sleep in the brain. Sedative medications used in surgery work on the same GABA substance to keep a person asleep during surgery.

• #6 Pathophysiology Idiopathic Hypersomnolence – Thoracic and Sleep Group Queensland

  https://thoracicandsleep.com.au/medical-newsletter/pathophysiology-idiopathic-hypersomnolence/

  The absence of physiological biomarkers in IH present another diagnostic barrier. […] research is focussing on GABAergic mechanisms and histamine neurotransmission in the brain. […] Pilot research observed that IH patients presented with decreased CSF levels of histamine, a wake-active monoamine which demonstrates a central mechanism of hypersomnolence; reduced concentrations are known to impair histamine neurotransmission potentially promoting diurnal sleepiness. […] thus validating the effectiveness of decreasing GABA neurotransmission indicating its possible role in contributing to excessive sleepiness in IH patients (Nishino, 2017).

• #7 Excessive Daytime Sleepiness, Hypersomnia, and Narcolepsy – Together by St. Jude™

  https://together.stjude.org/en-us/treatment-tests-procedures/symptoms-side-effects/sleep-disorders/daytime-sleepiness-hypersomnia-narcolepsy.html

  Excessive daytime sleepiness, or EDS, is a condition that causes a person to feel very sleepy during the day. […] Hypersomnia and narcolepsy are sleep disorders that cause excessive daytime sleepiness. […] Hypersomnia is a sleep disorder that causes a person to be very sleepy during day. This is called excessive daytime sleepiness or EDS. […] A sleep study is used to evaluate whether excessive daytime sleepiness is due to hypersomnia or narcolepsy. […] The causes of narcolepsy are not fully understood. Narcolepsy can sometimes run in families but often develops without a known cause. […] Damage to the hypothalamus, a brain structure that helps regulate sleep, can increase risk for narcolepsy. Some types of narcolepsy involve a change in the neurotransmitter hypocretin, a chemical signal produced in the hypothalamus. […] In narcolepsy, patients fall asleep quickly and enter REM sleep, a specific part of the normal sleep cycle.

• #8 Idiopathic hypersomnia | MedLink Neurology

  https://www.medlink.com/articles/idiopathic-hypersomnia

  These findings are concordant with the observations of von Economo during the encephalitis lethargica epidemic, which highlighted that patients suffering from excessive sleepiness often had lesions at the junction of the posterior hypothalamus and midbrain. […] Additionally, therapeutic measures for idiopathic hypersomnia, such as stimulants and modafinil/armodafinil, typically act on catecholamine (dopamine, norepinephrine) signaling mechanisms, indicating that there may be some contribution of these neurochemical pathways in the pathogenesis of idiopathic hypersomnia. […] Other aspects that have been evaluated as possibly contributing to the pathogenesis of idiopathic hypersomnia are histamine signaling, melatonin secretion abnormalities, immunologic and inflammatory processes, somnogens, and genetic factors.

• #8 Idiopathic hypersomnia | MedLink Neurology

  https://www.medlink.com/articles/idiopathic-hypersomnia

  Some studies indicate that idiopathic hypersomnia may have an immunological or inflammatory component, similar to narcolepsy type 1. […] These findings suggest that IL-6 and TNF are possible mediators of excessive daytime sleepiness in humans. […] In sum, despite several intriguing findings spanning the domains of CNS neurotransmitters, immunology, and genetics, the pathophysiology underlying idiopathic hypersomnia remains nebulous.

• #8 Idiopathic hypersomnia | MedLink Neurology

  https://www.medlink.com/articles/idiopathic-hypersomnia

  The exact cause of idiopathic hypersomnia remains unknown. […] There are limited data regarding the neurobiology and pathogenesis/pathophysiology of idiopathic hypersomnia, and there is no existing animal model for more detailed study. […] Many neurochemical studies regarding the disorder have been inconclusive. […] These findings suggest the possibility of gene-environment interactions that can contribute to disease in a fashion similar to narcolepsy with hypocretin deficiency. […] From a structural perspective, the destruction of noradrenergic neurons of the rostral third of the locus coeruleus complex or of the noradrenergic bundle at the level of the isthmus in the cat leads to hypersomnia with a proportional increase of non-REM sleep and REM sleep, resembling idiopathic hypersomnia.

• #9 Narcolepsy – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/narcolepsy/symptoms-causes/syc-20375497

  Extreme daytime sleepiness. Daytime sleepiness is the first symptom to appear, and the sleepiness makes it hard to focus and function. People with narcolepsy feel less alert and focused during the day. They also fall asleep without warning. Sleep can happen anywhere and at any time. It may happen when they are bored or while doing a task. For example, people with narcolepsy can suddenly fall asleep while working or talking with friends. It can be especially dangerous to fall asleep while driving. Sleep may last only a few minutes or up to a half-hour. After waking, people with narcolepsy feel refreshed but get sleepy again. […] The exact cause of narcolepsy is not known. People with type 1 narcolepsy have low levels of hypocretin (hi-poe-KREE-tin), also called orexin. Hypocretin is a chemical in the brain that helps control being awake and entering REM sleep.

• #9 Narcolepsy – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/narcolepsy/symptoms-causes/syc-20375497

  Hypocretin levels are low in people who have cataplexy. Exactly what causes the loss of hypocretin-producing cells in the brain isn’t known. But experts suspect it’s due to an autoimmune reaction. An autoimmune reaction is when the body’s immune system destroys its own cells. […] In narcolepsy, you may suddenly enter REM sleep after going through minimal NREM sleep. This can happen both at night and during the day. Cataplexy, sleep paralysis and hallucinations are similar to changes that occur in REM sleep. But in narcolepsy, these symptoms happen while you’re awake or sleepy.

• #10 Idiopathic Hypersomnia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK585065/

  Idiopathic hypersomnia (IH) is a central disorder of hypersomnolence, with the primary complaint being the irresistible need to sleep and waking up non-refreshed despite the prolonged duration of sleep. […] Idiopathic hypersomnia is considered a disorder of neurological origin, classified as a central disorder of hypersomnolence; others include narcolepsy, type 1 and type 2, and Kleine-Levin syndrome. The condition’s pathophysiology is poorly understood, making diagnosing and managing to challenge for clinicians. […] The etiology of IH is unclear. Triggers include Abrupt change in sleep-wake habits, overexertion, general anesthesia, Viral illness, and mild head trauma. Rare genetic predisposition was recently suggested to play a role in the pathogenesis of IH. […] Specifically, it was found that subgroups of IH are associated with reduced signaling of orexin via variant in the cleavage site of prepro-orexin.

• #10 Idiopathic Hypersomnia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK585065/

  Furthermore, dysregulation of micro RNA (miRNAs) has been reported to play a role in the etiology of central hypersomnias, including IH. […] Neurochemical studies are inconclusive. The main pathophysiologic feature of central hypersomnias is a defect in the arousal CNS system rather than hyperactivity of sleep centers. […] Impairment in the neurotransmission of orexin (a neuropeptide produced mainly by neurons in the lateral hypothalamus) is the hallmark pathology in narcolepsy with cataplexy (narcolepsy type 1), possibly due to an autoimmune process. However, the pathophysiology of the other central hypersomnias like IH remains unknown.

• #11 What is the evidence for the efficacy of treatments for idiopathic hypersomnia and their proposed mechanism of action? – The ENT Voice & Snoring Clinic

  https://www.entvoicesnoring.com/what-is-the-evidence-for-the-efficacy-of-treatments-for-idiopathic-hypersomnia-and-their-proposed-mechanism-of-action/

  In 2012, Rye et al showed that cerebrospinal fluid (CSF) from subjects with hypersomnias of unknown cause stimulated in vitro GABAergic transmission relative to the stimulation obtained with CSF from control subjects. They proposed a new possible pathophysiological pathway in the generation of excessive daytime sleepiness. […] Nonetheless, this pathway was evaluated clinically with drugs that inhibit or enhance GABA transmission.

• #12 List of 7 Idiopathic Hypersomnia Medications Compared

  https://www.drugs.com/condition/idiopathic-hypersomnia.html

  Idiopathic hypersomnia is a debilitating neurologic sleep disorder characterized by chronic excessive daytime sleepiness, making it difficult to stay awake and alert during the day. […] The cause of idiopathic hypersomnia is not known but may be related to the presence of a substance that interacts with gamma-aminobutyric acid (GABA) in the cerebrospinal fluid, thereby enhancing the sleep promoting effects of GABA. Other possible causes of idiopathic hypersomnia include autonomic nervous system dysfunction, circadian system dysregulation, and dysfunction of energy metabolism.

• #13 Idiopathic Hypersomnia (Hypersomnolence Disorder) – PsychDB

  https://www.psychdb.com/sleep/3-hypersomnolence-disorder

  Hypersomnolence can be increased temporarily by psychological stress and alcohol use, but they have not been documented as environmental precipitating factors. […] Viral infections have been reported to have preceded or accompanied hypersomnolence in about 10% of cases. HIV pneumonia, infectious mononucleosis, and Guillain-Barre syndrome, can also evolve into hypersomnolence within months after the infection. […] Hypersomnolence can also appear within 6-18 months following a head trauma.

• #14 Hypersomnia – Wikipedia

  https://en.wikipedia.org/wiki/Hypersomnia

  When specific treatments of the known condition do not fully suppress excessive daytime sleepiness, additional causes of hypersomnia should be sought. […] Hypersomnia can also be a symptom of other sleep disorders, like sleep apnea. […] Hypersomnia can also develop within months after viral infections such as Whipple’s disease, mononucleosis, HIV, and Guillain-Barr syndrome. […] Mood disorders, like depression, anxiety disorder and bipolar disorder, can also be associated with hypersomnia. […] In some cases, hypersomnia can be caused by a brain injury.

• #15 Hypersomnia secondary to severe acute respiratory syndrome coronavirus-2 infection

  https://www.e-acn.org/journal/view.php?number=662

  Excessive daytime sleepiness (EDS), with or without an excessive need for sleep, is a primary reason for patients seeking consultation at the sleep unit. EDS is observed in ~5% of the general population. Common causes of EDS include obstructive sleep apnea, sleep deprivation, effects of medication, psychiatric disease (especially depression), and circadian rhythm disorders. Coronavirus disease 2019 (COVID-19) infection is a rare cause of EDS. We present a case of mild COVID-19 infection as an unusual cause of hypersomnolence. […] Hypersomnia due to a medical disorder encompasses various clinical scenarios with diverse etiologies characterized by chronic EDS and/or ENS. The World Health Organization (WHO) defines post-coronavirus disease 2019 (COVID-19) or long COVID as a complex syndrome with typical symptoms such as fatigue, shortness of breath, and cognitive disorders.

• #15 Hypersomnia secondary to severe acute respiratory syndrome coronavirus-2 infection

  https://www.e-acn.org/journal/view.php?number=662

  EDS can occur secondary to sleep apnea, sleep deprivation, medication or substance use, restless legs syndrome, periodic limb movement disorder, and medical or psychiatric disorders. It is less commonly caused by narcolepsy or idiopathic hypersomnia. […] Our patient was young and had no sleep disorders, EDS, or ENS before the COVID-19 infection, suggesting a causal association between hypersomnolence and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. […] Mechanisms potentially contributing to post-COVID pathophysiology include 1) direct viral damage; 2) immune system dysregulation and chronic inflammation; 3) expected sequelae of postcritical illness; and 4) persistent brainstem dysfunction. […] The olfactory pathway is the most likely route via which the causative virus can disseminate to the central nervous system (CNS).

• #15 Hypersomnia secondary to severe acute respiratory syndrome coronavirus-2 infection

  https://www.e-acn.org/journal/view.php?number=662

  Some of these brainstem nuclei are involved in sleep-wakefulness regulation, such as the dorsal raphe nucleus, locus coeruleus, pedunculopontine tegmental nucleus, periaqueductal gray substance, sublaterodorsal nucleus, and laterodorsal tegmental nucleus. […] Further studies are needed to understand the pathological mechanism, clinical course, prognosis, and management of hypersomnia related to COVID-19 infection.

• #16 Sleep and Hypersomnia

  https://www.webmd.com/sleep-disorders/sleep-disorders-hypersomnia

  Hypersomnia, which refers to either excessive daytime sleepiness or excessive time spent sleeping, is a condition that makes it hard to stay awake during the day. […] When you have narcolepsy type 1, a daytime nap is usually short and helps you feel more refreshed, which isnt true for other types of hypersomnia. […] Doctors think these episodes are related to a malfunction of the hypothalamus, the part of the brain that controls appetite, and thalamus, the part of the brain that controls sleep. […] This type of hypersomnia is caused by something else. […] Some health conditions that can cause hypersomnia are: […] You may also have hypersomnia as you go through withdrawal from a stimulant drug, such as an ADHD medication. […] There are several potential causes of hypersomnia, including:

• #16 Sleep and Hypersomnia

  https://www.webmd.com/sleep-disorders/sleep-disorders-hypersomnia

  If you are diagnosed with hypersomnia, your doctor can prescribe various drugs to treat it, including stimulants, antidepressants, as well as several newer medications (for example, Provigil, Wakix, Xyrem, and Xywav). […] Certain medications can promote alertness and help you stay awake during the day. […] For some types of hypersomnia, especially those tied to a mood disorder such as depression, your doctor may prescribe an antidepressant such as Prozac or Wellbutrin. […] Other drugs have become recent options for treating hypersomnia, including: […] If you are diagnosed with sleep apnea, your doctor may prescribe a treatment known as continuous positive airway pressure, or CPAP. […] Hypersomnia is a condition that keeps you from staying awake during the day, even if youve gotten enough sleep at night.

• #17 Sleep Disorders

  https://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/neurology/sleep-disorders/

  Excessive daytime sleepiness refers to the inability to stay alert during the major awake period of the day, resulting in falling asleep at inappropriate times. […] The most common cause of excessive daytime sleepiness seen in sleep disorders clinics is OSA. Narcolepsy and the other hypersomnias of central origin are less common. […] Narcolepsy is a rare hypersomnia of central origin affecting 0.02% to 0.18% of Western populations, with onset usually in adolescence or young adulthood (in those aged 15 to 25 years). It is characterized by excessive daytime sleepiness, cataplexy, often irresistible sleep attacks, sleep paralysis (transient inability to move or speak), and hypnagogic or hypnopompic hallucinations (usually vivid audiovisual phenomena that occur upon falling to sleep or waking).

• #17 Sleep Disorders

  https://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/neurology/sleep-disorders/

  Idiopathic hypersomnia is characterized by excessive daytime sleepiness that occurs at a young age, usually before the age of 25 years, and is distinguished from narcolepsy by the absence of cataplexy and other narcolepsy-associated phenomena (eg, sleep paralysis and hypnagogic hallucinations). […] In addition to insomnia, this group of disorders, which includes shift work sleep disorder, jet lag disorders, and advanced sleep phase disorder can also manifest with excessive daytime sleepiness. […] Chronic partial sleep deprivation and OSA are the most commonly encountered causes of excessive daytime sleepiness in practice. […] Wake-promoting agents that have been used in sleep disorders causing excessive daytime sleepiness include modafinil, methylphenidate, amphetamines, and caffeine. Modafinil and armodafinil can be used to enhance alertness in OSA, narcolepsy, and shift-work disorder. […] Positive airway pressure (PAP) is the mainstay of treatment for OSA. This can take the form of continuous positive airway pressure (CPAP), autotitrating positive airway pressure (autoPAP), or bilevel positive airway pressure (BiPAP).

• #18 Excessive daytime sleepiness in sleep disorders – Slater – Journal of Thoracic Disease

  https://jtd.amegroups.org/article/view/568/html

  Excessive daytime sleepiness is a significant public health problem, with prevalence in the community estimated to be as high as 18%. […] There is continuing discussion of the mechanisms by which these disorders cause daytime symptoms, with intermittent nocturnal hypoxia, sleep fragmentation and autonomic dysregulation identified as important factors. […] The factors determining EDS in OSA are not well understood; the severity of OSA measured by AHI does not correlate well with the presence or degree of daytime sleepiness. […] However, nasal continuous positive airway pressure (CPAP) to correct INH in OSA, has proved to be an effective treatment for EDS, especially for those with a high AHI or severe sleepiness. […] The consistent association between nocturnal hypoxaemia and EDS suggests that there may be a linking pathogenic mechanism.

• #18 Excessive daytime sleepiness in sleep disorders – Slater – Journal of Thoracic Disease

  https://jtd.amegroups.org/article/view/568/html

  Autonomic arousals during sleep have been discussed as another cause of EDS in patients with sleep-disordered breathing. […] This evidence suggests that lower oxygenation and increased sympathetic cardiac tone during sleep are key factors contributing to EDS in patients with sleep-disordered breathing. […] Metabolic disruption and chronic inflammation in obesity may be more relevant to EDS than the mechanical effects of excess weight. […] Vgontzas and colleagues have suggested that daytime sleepiness in obesity is a manifestation of a metabolic abnormality leading to hyperarousal at night and hypoarousal during the day. […] The importance of factors other than sleep disordered breathing could also explain why CPAP therapy sometimes fails to correct EDS, especially in those with mild OSA.

• #18 Excessive daytime sleepiness in sleep disorders – Slater – Journal of Thoracic Disease

  https://jtd.amegroups.org/article/view/568/html

  Daytime sleepiness has been shown to correlate with increased depression tendency scores in the general public. […] The prevalence of EDS also changes with age, with a number of studies finding increased EDS in the very young and very old. […] Additionally, both sleep efficiency and sleepiness become less common in middle age, suggesting that EDS in older people is not solely due to less efficient sleep, but may also hint at changes in the everyday routines that working life demands.

• #19 Causes of Excessive Daytime Sleepiness

  https://www.healthline.com/health/sleep/factors-contribute-excessive-daytime-sleepiness

  According to a 2021 review, as many as 58% of people with untreated obstructive sleep apnea experience excessive daytime sleepiness. […] Along with central disorders of hypersomnolence, other neurological conditions can affect your sleep function. This impaired sleep can lead to EDS. […] Sleep disorders like hypersomnia and insomnia are common symptoms of major depressive disorder (MDD). […] A 2019 study suggests as many as 50.8% of people with major depression may experience EDS. […] Experiencing sleep disorders with ME/CFS may lead to excessive daytime sleepiness. […] Excessive daytime sleepiness can be a side effect of many types of medications, including antidepressants, anxiety medications, antihistamines, blood pressure medications, antipsychotics, prescription pain medications, and antiepileptic drugs.

• #19 Causes of Excessive Daytime Sleepiness

  https://www.healthline.com/health/sleep/factors-contribute-excessive-daytime-sleepiness

  EDS can also be a side effect of lifestyle factors that cause you to lose sleep. Even if you dont meet the criteria for a sleep disorder, regularly missing sleep can lead to excessive sleepiness during the day. […] EDS can also be caused by physical and psychological conditions that affect sleep and lifestyle factors, like chronic stress or shift work.

• #20 Hypersomnia in Depression: Causes, Effects, and Solutions

  https://enticare.com/2024/12/09/hypersomnia-in-depression/

  Hypersomnia, also known as excessive daytime sleepiness (EDS), refers to excessive sleep or an overwhelming need to sleep during the day. […] Hypersomnia is not just a sleep disorder; it can also serve as a warning sign of an underlying mental health issue. Many people suffering from depression experience hypersomnia as a core symptom, leading to prolonged sleep durations and excessive daytime fatigue. […] Depression affects neurotransmitters in the brain that regulate sleep patterns, including serotonin and dopamine. The result can be either insomnia (difficulty falling asleep) or hypersomnia (sleeping too much). […] When hypersomnia and depression occur together, they can create a vicious cycle. Excessive sleep worsens feelings of lethargy and hopelessness, which fuels depression. […] The presence of comorbidities like depression, anxiety, and substance abuse is not uncommon among those with hypersomnia.

• #20 Hypersomnia in Depression: Causes, Effects, and Solutions

  https://enticare.com/2024/12/09/hypersomnia-in-depression/

  Research indicates that approximately 30% of individuals with hypersomnia also experience depression, while 20% struggle with anxiety. […] For those suffering from both hypersomnia and depression, treatment must address both issues simultaneously. Ignoring one condition may cause treatment to fail, so recognizing the relationship between the two is vital for recovery. […] CBT is one of the most effective treatments for both depression and hypersomnia. […] Several medications can treat both hypersomnia and depression. Antidepressants can balance neurotransmitters, improving mood and sleep regulation. […] One of the most effective ways to prevent hypersomnia is to understand your personal sleep needs. […] Stress is a significant contributor to both depression and hypersomnia. […] Hypersomnia and depression are complex conditions that can dramatically impact your quality of life, but you don’t have to suffer in silence. Early diagnosis and effective treatment can break the cycle of excessive sleep and depression, improving both mental and physical well-being. […] Hypersomnia is a multifaceted sleep disorder that can profoundly affect an individual’s quality of life, social interactions, and performance in work or school settings.

• #21 Hypersomnia: Causes, Symptoms, Treatment, and Management

  https://www.everydayhealth.com/sleep/excessive-daytime-sleepiness-facts/

  More often, hypersomnia is caused by another health issue, Bazil says. In this case it’s called secondary hypersomnia, and the potential causes include depression, obesity, epilepsy, neurological disorders (such as multiple sclerosis), substance abuse, restless leg syndrome, upper airway resistance syndrome, and sleep deprivation (also called insufficient sleep syndrome). […] According to both Bazil and Dr. Kapur, the top cause of excessive daytime sleepiness they see in their clinical practice isnt an underlying disorder or condition but rather lack of adequate sleep duration. […] Apart from poor sleep, the following conditions can cause hypersomnia: Sleep disorders, such as obstructive sleep apnea (OSA), narcolepsy, or Kleine-Levin syndrome; Other medical conditions, including multiple sclerosis, depression, encephalitis, epilepsy, or obesity; Alcohol and recreational drug use; Certain medications, such as prescription high blood pressure medications, steroids, decongestants, antidepressants, and diet pills; A genetic predisposition.

• #22 Idiopathic hypersomnia – Hypersomnia Foundation

  https://www.hypersomniafoundation.org/ih/

  Having IH can greatly affect daily life: […] Waking up is usually very hard, especially for people who have IH with long sleep. They often need multiple alarms and morning rituals to wake up for school or work. […] The amount and timing of needed sleep can limit daily activities. […] IH can cause problems with thinking, working, and socializing. People with IH may have trouble doing their jobs, staying in school, having romantic relationships, and fully engaging with their friends and loved ones. […] These effects are especially true for people who aren’t taking medicines that work well. But even with medicines, people who have IH may struggle with these activities. […] Doctors will usually: […] Ask about your symptoms and medical history, sometimes using questionnaires […] Confirm from your history that you’ve had daily EDS for at least 3 months

• #23 Hypersomnia — Sleep and Brain

  https://www.sleepandbrain.com/hypersomnia

  Although behavioral approaches are frequently helpful, some people with hypersomnia, especially those with narcolepsy, also receive treatment with medications. Some of the medicines we commonly prescribe for narcolepsy include: Modafinil and Armodafinil. These two FDA-approved wakefulness-promoting drugs are chemically similar and are typically the first therapy for excessive daytime sleepiness.

• #24 Idiopathic hypersomnia Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/idiopathic-hypersomnia

  Your provider will likely prescribe stimulant medicines such as amphetamine, methylphenidate, or modafinil. These medicines may not work as well for this condition as they do for narcolepsy. […] Other medicines for idiopathic hypersomnia, which are also commonly used for narcolepsy, include sodium oxybate (or oxybate salts) and newer wake-promoting agents such as pitolisant and solriamfetol.

• #25 Hypersomnia and depressive symptoms: methodological and clinical aspects | BMC Medicine | Full Text

  https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-11-78

  The associations between depressive symptoms and hypersomnia are complex and often bidirectional. […] Hypersomnia in mood disorders, rather than a medical condition per se, is more a subjective sleep complaint than an objective finding. […] The mechanisms by which EDS contributes to the development of depressive symptoms remain unclear. […] The proposed DSM-5 criteria for sleep-wake disorders nosology planned for publication this year included major changes regarding hypersomnia with elimination of the diagnosis of primary hypersomnia in favor of hypersomnia disorder, with concurrent specification of clinically comorbid conditions. […] The complaint of EDS is rarely corroborated by the MSLT results, particularly in the context of associated mood disorders. […] Taken together, there is no objective evidence supporting the view that patients with mood disorder have either abnormal mean sleep latency on the MSLT or objective extended nocturnal sleep. However, these patients spent a substantial amount of time in bed, acknowledged as resting more than sleeping (called clinophilia), with major distress and impacts on the natural course of mood disorders. […] Further interventional studies are needed to explore whether the management of sleep complaints improves mood symptoms in hypersomnia disorders and whether the management of mood complaints improves sleep symptoms in mood disorders.

• #26 Clinical Approach Hypersomnia of Central Origin and Differential Diagnosis – Turkish Journal of Sleep Medicine

  https://jtsm.org/articles/clinical-approach-hypersomnia-of-central-origin-and-differential-diagnosis/doi/jtsm.galenos.2022.07279

  Hypersomnia and excessive daytime sleepiness are commonly encountered by physicians dealing with sleep medicine. […] Hypersomnia is used as a comprehensive definition for excessive daytime sleepiness and/or excessive need for sleep or increased amount of sleep. […] Hypersomnia can be either a symptom of neurological and metabolic diseases, especially sleep disorders, or develop due to substance, drug use, and trauma. […] It is crucial to examine this symptom, which causes a significant deterioration in the quality of life of people, and to diagnose and treat the diseases causing it. […] This review article plans to address the epidemiological, pathophysiological, clinical aspects of sleep disorders that cause hypersomnia, treatment and emphasize the critical points in the differential diagnosis.

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