HomeSleep HealthThe Definitive Hypersomnia Guide: When Too Much Sleep Isn’t Enough

The Definitive Hypersomnia Guide: When Too Much Sleep Isn’t Enough

By - Last Updated: July 17th, 2019

Imagine what it would be like if you slept for more than 12 hours a night and still feel tired the next day? Maybe you try to alleviate your exhaustion with a nap, but even a mid-day snooze doesn’t seem to help.

It sounds miserable, doesn’t it? Sadly, this is the norm for people with hypersomnia.

I myself have suffered on and off from hypersomnia for years which has forced me to undergo two sleep studies and countless treatments.

Explaining the disorder to people who get by fine with 8 hours of shut-eye can be particularly difficult. Sometimes I compare my hypersomnia to being dehydrated but no amount of water will quench my thirst.

Hypersomnia isn’t like other sleep disorders. It’s difficult to classify and it’s even harder to diagnose.

What is Hypersomnia?

Most adults need 7 to 9 hours of high-quality sleep per night to function properly. If you have hypersomnia you’ll find yourself needing considerably more.

Hypersomnia is a sleep disorder that causes an abnormal increase in your total sleep need. Hypersomnia is considered the opposite of insomnia (hyposomnia) and other sleep disorders that cause a reduction in your total sleep.

Hypersomnolence

Not only does hypersomnia increase your total sleep but it also results in excessive daytime sleepiness, termed hypersomnolence, which can cause a strong urge to nap.

If you have hypersomnia, you might find that you sleep for an abnormally long time when given the opportunity to stay in bed. You may even find it impossible to feel well-rested no matter how much sleep you get.

Primary Hypersomnia vs Secondary Hypersomnia

It’s important to understand out that not all hypersomnias are considered true sleep disorders. In medicine, the word ‘hypersomnia’ is a blanket term for any condition that abnormally increases sleep and hypersomnolence.

Hypersomnia is divided into two categories:

  1. Primary Hypersomnia: Primary hypersomnia is a legitimate sleep disorder that occurs due to neurological dysfunction in the areas of your brain that control sleep.

    Primary hypersomnia is subdivided into 4 unique sleep disorders:
    1. Idiopathic Hypersomnia
    2. Kleine-Levin Syndrome
    3. Narcolepsy Type 1
    4. Narcolepsy Type 2

  2. Secondary Hypersomnia: Secondary hypersomnia is not a true sleep disorder. Increased sleep in secondary hypersomnia is caused by another factor such as a disease, illness, injury, or substance.

How Common is Hypersomnia?

Compared to sleep disorders such as insomnia and sleep apnea, hypersomnia is relatively rare.

Scientists calculate that approximately 4-6% of the world’s population suffers from conditions that increase sleepiness. Sleep disorders that fall under primary hypersomnia make up less than 1% of this estimate.

Symptoms of Hypersomnia

There are many common symptoms that are present in both primary and secondary hypersomnia. These symptoms include:

  • Excessive Sleep. You may sleep more than the average 7-9 hours per day, with many sleeping greater than 12 hours.
  • Daytime Sleepiness. Hypersomnia causes abnormal sleepiness during the day in spite of getting plenty of sleep at night. You may have a strong urge to take frequent naps.
  • Inappropriate Sleeping. Hypersomnia makes it much easier to nod off. You may find yourself falling asleep at work or during other activities where sleep would not normally occur.
  • Difficulty Waking. You might find it extremely difficult to wake up even with the aid of multiple alarms.
  • Sleep Inertia. Sleep inertia, also called sleep drunkenness, occurs when your brain has difficulty transitioning from the asleep to the awake state. This causes you to feel mentally and physically impaired and is comparable to being drunk.
  • Excessive Napping. Hypersomnia increases your urge to nap. You may find you need several long naps throughout the day, although they’re seldom refreshing.
  • Cognitive Dysfunction. Hypersomnia can affect your cognitive function and you may experience problems with your attention, learning, and memory.

What Causes Primary Hypersomnia?

Primary hypersomnia is a legitimate sleep disorder that occurs due to neurological dysfunction in the areas of your brain that control sleep and wakefulness.

Sleep disorders that fall under primary hypersomnia include:

  1. Idiopathic Hypersomnia
  2. Kleine-Levin Syndrome
  3. Narcolepsy Type 1 and 2

1. Idiopathic Hypersomnia (Idiopathic Hypersomnolence)

Unlike other hypersomnia disorders such as narcolepsy, there is no clear neurological cause for idiopathic hypersomnia (IH).

If you have IH, you’ll require more sleep usual. Despite increased nighttime sleep, you may feel unrested and sleepy during the day.

You may also need to nap often throughout the day, although this seldom alleviates your sleepiness. Sleep inertia upon waking that lasts over an hour is also common with IH.

Because IH has no clear cause, it can be extremely difficult to diagnose.

Fortunately, researchers have started to explore what triggers the disorder and how it might be treated. Many scientists believe that the area of the brain that regulates sleep and wakefulness is dysfunctional in people with IH.

2. Kleine-Levin Syndrome (KLS)

Kleine-Levin syndrome (KLS), sometimes called ‘sleeping beauty syndrome, is an extremely rare hypersomnia disorder that is characterized by episodes of excessive sleep, often up to 20 hours a day. Symptoms of KLS normally first appear during adolescence.

KLS causes episodes of extreme sleepiness that come on abruptly, often following flu-like symptoms. Unlike other hypersomnias such as idiopathic hypersomnia and narcolepsy, KLS episodes aren’t consistent and typically last a few days to a few weeks.

When an episode is over, you’ll return to normal. It’s not uncommon to have no memory of their episode.

During episodes of KLS, you may ‘wake’ for a few hours each day to eat and use the bathroom, however, you’re never fully awake, which results in drastic changes in your normal behaviour.

Behavioral changes in KLS include:

  • Excessive food intake
  • Irritability
  • Apathy
  • Depression
  • Child-like or infantile behavior
  • Aggression
  • Disorientation and confusion
  • Visual and auditory hallucinations
  • Impulsivity
  • Uninhibited sex drive

The cause of KLS is not totally understood but scientists believe it may be due to dysfunction the parts of your brain that regulate appetite and sleep.

3. Narcolepsy Type 1 and 2

Narcolepsy is a chronic hypersomnia sleep disorder that affects your brain’s ability to control sleep-wake cycles.

Narcolepsy makes you feel extremely sleepy throughout the day and often results in ‘sleep attacks’, in which you unwillingly fall asleep during your normal activities.

Other common symptoms associated with Narcolepsy:

The Difference Between Narcolepsy Type 1 and Type 2

There are two types of narcolepsy: Type 1 and Type 2

Type 1 narcolepsy is also referred to as ‘Narcolepsy With Cataplexy’. Cataplexy is a condition that causes sudden muscle weakness causing you to go limp and unable to move. Cataplexy is often brought on by extreme emotions such as fear or laughter.

Type 2 narcolepsy, also referred to as ‘narcolepsy without cataplexy’ has the same symptoms as type 1, however, you don’t suffer from episodes of cataplexy.

What Causes Narcolepsy?

Unlike other hypersomnia disorders, the cause of narcolepsy is well understood.

Scientist discovered that narcolepsy is caused by a lack of a brain chemical called orexin, also known as hypocretin. Orexin plays an essential role in maintaining wakefulness and regulating transitions between sleep and wake.

Patients with narcolepsy first develop an autoimmune disorder which causes their own immune system attack and destroys the cells in the brain that create orexin.

Without the production of orexin, the brain can’t maintain an awake state during the day and a sleeping state during the night.

How Narcolepsy Affects Your Sleep Cycle

Not only does narcolepsy dysregulate the sleep-wake balance, but it also affects your brain’s ability to transition through each sleep stage.

Your sleep cycle is divided into different stages:

  1. Non-rapid eye movement sleep (NREM) is composed of 3 stages, varying from light to deep sleep.
  2. Rapid eye movement (REM) sleep is a single-stage when dreaming occurs and eyes move in response to dreaming.
Four stages of sleep NERM and REM sleep with sleeping man

When falling asleep, you first enter stage 1, the lightest stage of NREM. During this time, you feel relaxed and your mind will wander. You’re still semi-aware of your surroundings and are easy to wake.

Your brain will continue to move through NREM until it enters into stage 3, deep sleep, also called Slow Wave Sleep (SWS). During SWS, your brain has very low activity and you’re completely unconscious to the outside world. At this point, you’re extremely difficult to wake.

Once NREM has finished, stage 4, REM sleep begins. During this time your brain is active and you may experience dreaming. You’ll also experience paralysis to keep you from acting out your dreams.

One full sleep cycle takes 90 minutes to complete and will repeat throughout the night.

Narcolepsy causes you to enter the REM too soon after you fall asleep. Sleep scientists call this having a ‘reduced REM latency’. You’ll also spend an abnormally long time in the REM stage.

This reduces the total amount of refreshing deep NREM sleep you receive and lead to feeling unrested the next morning.

Scientists also believe that REM sleep intrudes on wake states, resulting in the symptoms of cataplexy.

What Causes Secondary Hypersomnia?

Secondary hypersomnia is not a true sleep disorder.

Increased sleep and daytime sleepiness in secondary hypersomnia are caused by other non-sleep related factors such as health conditions, disease or illness, head injury, hormones, psychiatric disorders, or medications.

Health Conditions that Cause Secondary Hypersomnia

A wide variety of medical conditions can lead to secondary hypersomnia symptoms. These conditions include:

  • Sleep Apnea. Sleep apnea occurs when breathing repeatedly stops during sleep. This leads to frequent awakenings, making you feel excessively sleepy the next day.
  • Parkinson’s Disease (PD). Medical professionals estimate that between 60% and 90% of PD patients suffer from one or all of the following sleep disruptions that can lead to hypersomnia symptoms:
  • Renal Disease. Severe decrease in kidney function can also lead to a buildup of waste products in your body, causing tiredness and fatigue. Renal disease can also trigger anemia, which causes weakness and fatigue.
  • Chronic Fatigue Syndrome (CFS) CFS, also known as systemic exertion intolerance disease (SEID) or myalgic encephalomyelitis (ME), is highly associated with hypersomnia.

    CSF causes extreme fatigue and tiredness that worsens with activity and doesn’t improve with rest. The cause of CFS is unknown, although many scientists believe it’s triggered by a viral infection.
  • Autoimmune Disease. Autoimmunity occurs when your own immune system mistakenly attacks your cells and tissues.

    The American Autoimmune Disease Related Diseases Association (AARDA) found that 98% of people with autoimmune disease suffer from profound and debilitating fatigue and hypersomnia.
  • Cancer. Cancer-related fatigue is a common symptom and generally occurs due to sleep disturbance caused by both the disease itself and the treatments.

Illnesses that Cause Secondary Hypersomnia

Secondary hypersomnia is a common symptom when you’re suffering from an illness caused by infectious disease. Not only does infection place stress on your body leading to fatigue, but scientists also believe that sleep helps your immune system work more efficiently.

Additionally, some viruses are associated with a condition called ‘post-viral fatigue’, which is a lasting feeling of extreme sleepiness after a viral illness. Scientists don’t fully understand what causes post-viral fatigue but it can lead to many symptoms of secondary hypersomnia.

Infections commonly associated with secondary hypersomnia symptoms include:

  • Cold and Flu
  • Malaria
  • Tuberculosis (TB)
  • Infectious mononucleosis
  • Cytomegalovirus (CMV)
  • HIV
  • Hepatitis
  • African trypanosomiasis
  • Epstein-Barr virus
  • Human herpesvirus 6
  • Enterovirus
  • Rubella
  • West Nile virus
  • Ross River virus

Traumatic Brain Injury and Secondary Hypersomnia

Scientists estimate that 30%–70% of people with traumatic brain injury (TBI) develop sleep disturbances. Sleep disorder such as insomnia and hypersomnia (primary and secondary) are the most commonly reported sleep complaints following TBI.

Hypersomnia can result when areas of the brain that control the maintenance of wakefulness are injured.

Additionally, TBI is linked to the development of the primary hypersomnia disorder, narcolepsy. Although rare, TBI can also trigger Kleine–Levin syndrome.

Hormones and Secondary Hypersomnia

Hormones play a large role in sleep regulation. Any changes your hormones can, therefore, increase sleepiness. Below is a list of hormone conditions that can lead to secondary hypersomnia symptoms:

  • Premenstrual syndrome in women. Normal rising and falling hormones levels during the menstrual cycle can make a woman feel excessively tired. This is especially prominent at the end of the cycle when the sleep-promoting hormone, progesterone, peaks.
  • Low testosterone in men. A reduction in male testosterone can directly affect sleep quality and duration. It can also contribute to the development of sleep breathing disorders like sleep apnea.
  • Medications that alter hormones. Any medication that changes your hormone levels can influence the way you sleep. Common hormonal medications include the contraceptive pill, testosterone replacement medications, and androgen blockers.
  • Pregnancy. Increased sleepiness during early pregnancy is extremely common and is usually a result of normal hormonal changes in the first trimester.
  • Endocrine disorders. The endocrine system is responsible for creating all of your body’s hormones. Disorders of this system such as hypothyroidism, polycystic ovarian syndrome, and hypopituitarism can lead to hypersomnia symptoms.

Psychiatric Disorders and Secondary Hypersomnia

Secondary hypersomnia is extremely common in some mental health disorders.

Secondary hypersomnia can lead to the development of new mental illness or exasperate existing disorders. On the other hand, having a mental illness increases your risk of developing secondary hypersomnia.

Hypersomnia has a particularly strong link to mood disorders such as major depressive disorder (MDD), bipolar disorder, and seasonal affective disorder. Excessive daytime sleepiness is considered a diagnostic symptom of depression.

Medications that Cause Secondary Hypersomnia

There are many prescription and over the counter drugs that can cause excessive sleepiness. These include:

  • Allergy Medications (Antihistamines). Common allergy medications that cause drowsiness include diphenhydramine, brompheniramine, hydroxyzine meclizine. Some of these antihistamines are used as gentle sleeping pills.
  • Tricyclics Antidepressants. Tricyclics when first used can lead to sleepiness. Tricyclic antidepressants include amitriptyline, doxepin, imipramine, and trimipramine.
  • Anxiety Medications. Several anxiety medications have a sedative effect. These medications include benzodiazepines, alprazolam, clonazepam, diazepam, and lorazepam.
  • Blood Pressure Medications. These medications work by slowing down your heart which can cause fatigue and sleepiness. Common blood pressure medications include atenolol, metoprolol tartrate, metoprolol succinate, and propranolol hydrochloride.
  • Cancer treatment. It’s well known that cancer treatments can make you feel extremely fatigued and tired. Cancer treatments include chemotherapy, radiation therapy, surgery, bone marrow transplantation and biological therapy.
  • Anti-nausea Medications. Drugs that control nausea act like a sedative and can make you very drowsy. These drugs include diphenhydramine, dimenhydrinate, and meclizine.
  • Muscle relaxants. Most muscles target your nervous system and can make you tired. Common muscle relaxants are carisoprodol and cyclobenzaprine.
  • Opioid Pain Medications. At lower doses, opioids may make you feel sleepy. Common opioids include morphine, oxymorphone, oxycodone, and fentanyl.
  • Seizure and Epilepsy Medications. Because seizure medications work in the central nervous system, most cause some degree of drowsiness. Seizure medications include benzodiazepines, carbamazepine, phenobarbital, phenytoin, topiramate, and valproic acid.

Hypersomnia Diagnosis

Nobody likes going to the doctor so getting a diagnosis for your hypersomnia may seem like an irritating process.

It’s important to remember that it’s a step in the right direction to getting the treatment your body so desperately needs.

Diagnosis starts with an evaluation by your doctor to determine if you have primary or secondary hypersomnia.

During the exam, your doctor will attempt to identify any medical or psychological illness that may be contributing to your hypersomnia.

You may be asked about chronic snoring and recent weight gain, which might suggest another sleep disorder such as sleep apnea.

You will be asked questions to see whether you’re suffering from depression or other mental health conditions that may be increasing your urge to sleep.

If your physician believes your hypersomnia is secondary, they may opt to focus on treating the condition that is causing your sleepiness.

If no specific reason for your sleepiness can be identified, your doctor might suspect you have primary hypersomnia and will refer you to see a qualified sleep specialist.

Diagnosis of primary hypersomnia starts with an evaluation of your sleep by a trained sleep specialist.

There are various methods your specialist may use for assessment.

These commonly include:

  1. Sleep Diary
  2. Epworth Sleepiness Scale
  3. Actigraphy
  4. In-Clinic Sleep Study
  5. Multiple Sleep Latency Test

1. Sleep Diary

Your specialist may ask you to keep a sleep diary to better determine if a sleep study should be prescribed. Over the course of at least two weeks you might keep a record of the following information:

  • What time you went to bed.
  • The amount of time it took you to fall asleep.
  • What time you got out of bed in the morning.
  • The number of times you awoke during the night.
  • How refreshing you perceived your sleep to be.
  • A list of factors which may have disturbed your sleep (noise, temperature, pain, illness).
  • The number of caffeinated beverages you consumed during the day and the time of consumption.
  • The number of alcoholic beverages you consumed during the day and the time of consumption.
  • The medication you used during the day.
  • The time you spent exercising.
  • The activities you performed immediately prior to bed.

2. Epworth Sleepiness Scale

To get to the bottom of how severe your hypersomnia is, your doctor may score you with the Epworth Sleepiness Scale (ESS). The ESS is a scientifically validated questionnaire that is used to evaluate daytime sleepiness.

The ESS asks you to rate your likelihood of falling asleep while engaged in eight different activities. These activities might include watching television, reading a book, attending a meeting, or driving.

A high ESS score indicates your average sleep propensity (ASP), or ‘daytime sleepiness’. A higher ASP often indicates that you are suffering from a sleep disorder such as hypersomnia.

3. Actigraphy

Before sending you to complete an in-hospital sleep evaluation, your doctor may instead decide to use a less invasive method of monitoring your sleep. A simple way of achieving this is by having you wear an actigraph.  

Actigraphy is a test to assess your sleep and wake patterns over time. A small device called an actimetry sensor, is worn like a wristwatch.

The device determines whether you’re awake or sleeping by your movement. It can therefore not only determine when you fall asleep but also how long you slept, and whether you woke up during the night.

Unlike polysomnography, the method used during an in-clinic sleep study, actigraphy allows you to move around and go about your normal routine.

Actigraphy is also more affordable than polysomnography so it’s particularly useful for collecting sleep data over a long period of time.

Because actigraphy can record data for weeks or even months, the data is more relevant than the result of polysomnography in assessing your total night and daytime sleep.

4. In-Clinic Sleep Study for Hypersomnia

A sleep study, called polysomnography, takes place in a specialized sleep clinic.

During your study, a trained technician will track your brain activity, breathing, blood oxygen levels, and heart rate. Specialized sensors will also test the movement of your body and legs to help determine if you’re restless.

The data collected during your sleep provides detailed information on your sleep quality and can point out the presence of sleep disorders, like hypersomnia.

5. Daytime Sleep Study: Multiple Sleep Latency Test

When you’re tested for a hypersomnia disorder, you’ll usually stay in the clinic for an extra day to undergo a daytime sleep study, called a multiple sleep latency test (MSLT).

The MSLT is the standard tool used to diagnose narcolepsy and idiopathic hypersomnia. It assesses how long on average it takes you to fall asleep.

Under normal circumstances, it takes 8 minutes or more to enter stage 1 of sleep. People with hypersomnia typically fall asleep in 5 minutes or less.

Treatment for Hypersomnia

Once you’re formally diagnosed with hypersomnia, your doctor will create a tailored treatment plan. Treated is largely dependent on whether you have primary or secondary hypersomnia and the severity of your symptoms.

Below is a list of common hypersomnia treatments.

Treatment for Primary Hypersomnia

Primary hypersomnias are caused by dysfunction of the sleep control centres in the brain.

Non-medicinal treatments such as cognitive behavioral therapy (CBT) can be helpful for learning skills to cope with their disorder, however, doctors usually recommend starting with medications that help reduce daytime sleepiness.

Medications for Primary Hypersomnia

There are several medications that are known to be effective in patients with primary hypersomnia.

These medications are normally prescribed to patients with narcolepsy but can also be used to treat idiopathic hypersomnia (IP) and occasionally Kleine-Levin syndrome.

Below is a list of medications prescribed for primary hypersomnia:

  • Stimulant Medications. Stimulants include dextroamphetamine and methylphenidate.
  • Non-stimulant Wake-Promoting Medications. Non-stimulant medications common include modafinil and armodafinil.
  • Deep Sleep-Promoting Medications: While it may seem counterintuitive, medications that promote deeper sleep are helpful for individuals with idiopathic hypersomnia and narcolepsy. One of these medications is Sodium Oxybate.

Treatment for Secondary Hypersomnia

Secondary hypersomnia is not a true sleep disorder. Increased sleep in secondary hypersomnia is caused by another condition such as a disease, illness, injury, or substance.

Medications used for primary hypersomnia are almost never used for the treatment of secondary hypersomnia. Doctors instead focus on treating the primary issue leading to excessive sleepiness, whether it be a mental or physical problem.

For instance, if you’re experiencing daytime sleepiness because you’re suffering from a hormone disorder, doctors will focus their treatment on balancing your hormones. Or, if you’re on a medication that makes you feel drowsy, your doctor may adjust your dosage or try a different drug.

Unlike primary hypersomnia, various non-medicinal treatments may be helpful. Below is a list of treatments commonly used to address secondary hypersomnia:

Behavioral and Lifestyle Changes for Hypersomnia

Hypersomnia isn’t always caused by a secondary medical condition. Sometimes daytime sleepiness is completely self-inflicted by bad habits and a poor sleeping environment.

The first action an individual with hypersomnia can take is to address their personal sleep habits. These habits, termed ‘sleep hygiene‘ by professionals, is a variety of practices necessary to have good nighttime sleep.

The following is a list of good sleep hygiene practices.

1. Adhere to a Strict Sleep Schedule

In order to keep your internal clock working properly, it’s important to go to bed and wake up at the same time every day.

Even though it’s tempting to sleep in on weekends, you should try your best to maintain a routine. This will train your brain to get into a rhythm which will help you fall asleep faster and get better quality sleep.

2. Avoid Caffeine Before Bedtime

Not consuming caffeine before bed may seem obvious but it’s easy to trip yourself up by drinking a small cup of tea or eating a few bars of chocolate.

It’s important to avoid anything containing caffeine at least 6 hours before bedtime.

3. Avoid Electronic Devices Before Bedtime

A few hours before you go to bed your brain starts producing the hormone melatonin. Melatonin signals to the brain that it’s time for sleep and makes you feel tired.

Melatonin is only created at night when our eyes receive less light input. Sunlight and other types of bright light directly inhibit the release of melatonin.

Electronic devices that emit artificial blue light, such as mobile phones and computers, mimic sunlight and inhibit the production of melatonin. This stimulates your brain to stay awake and alert. So it’s important to avoid using these devices too close to bedtime.

4. Remove Your Alarm From Your Line of Sight

You should move the position of your alarm clock so it’s not visible while you sleep. You may find yourself constantly checking the time and stressing about not getting enough sleep. Stress can quickly turn into anxiety, which can make it even more difficult to fall asleep.

5. Start a Pre-sleep Routine

Your brain is excellent at learning new routines and habits. Creating a strict bedtime routine can, therefore, signal to your body that it’s time to settle down.

Common pre-sleep routines include:

  • Taking a warm bath
  • Having a glass of non-caffeinated tea
  • Reading a book
  • Listening to peaceful music

6. Create a Bedroom Environment Conducive for Sleep

Try to create a bedroom environment that is relaxing and favorable for sleep.

It’s important to block as much light pollution as possible. Using high-quality blinds or curtain will keep your room dark. Also, avoid using fluorescent light bulbs and decorating with bright colors.

Avoid keeping a TV and other electronics in your room. The bed itself should be supportive but comfortable, with bedding that doesn’t cause overheating. Make sure your pillow offers proper head and neck support so you don’t experience muscle pain during the night.

Finally, your brain goes through a cooling process before it can sleep so scientists recommend keeping the room temperature at 65°F or 18°C.

7. Only Use Your Bed for Sleep and Romance

To get proper sleep, it’s best that you only use your bed for sleep and romance. Your brain quickly makes associations between your actions and your environment. Thus, it’s difficult to relax if your brain links your bedroom to more stimulating activities.

Therapy and Mental Health Management for Hypersomnia

Many with secondary hypersomnia benefit greatly from seeing a mental health care professional in order to help better manage their symptoms.

Cognitive Behavioral Therapy (CBT) is a program structured to help you identify and replace thoughts and behaviors that cause or worsen sleep with habits that promote sound sleep.

Most medical professionals agree that CBT is a better approach to poor sleep than sleeping pills because it helps you overcome the underlying causes of your sleep problems.

According to the Mayo Clinic, there are several techniques your therapist may use to address your insomnia.

  • Stimulus Control Therapy. The goal of stimulus control therapy is to reduce the anxiety you feel when you go to bed. The therapist will create a set of instructions designed to help you associate the bedroom with sleep and establish a strict sleep schedule. 
  • Sleep Restriction. Sleep restriction aims to eliminate mid-sleep awakenings. It doesn’t restrict actual sleep time but instead initially restricts the time spent in bed.
  • Sleep Hygiene. Improving sleep hygiene involves making minor changes to habits and behaviors that influence sleep, such as watching tv before bed, consuming caffeine late in the day, or not maintaining a strict sleep schedule. 
  • Relaxation Training. Your therapist may suggest relaxation techniques to help calm you before sleep. Meditation is often included in relaxation training. 
  • Paradoxical Intention. Paradoxical intention is a technique that requires you to actively avoid trying to fall asleep. Worrying about getting enough sleep causes anxiety that inhibits sleep onset. If you stop trying to fall asleep and instead stay awake for as long as possible, your anxiety is reduced and sleep may occur more easily.
  • Biofeedback. Biofeedback uses sensors placed on your body to track muscle tension or brain rhythms. This allows you to gauge your tension level or activity, allowing you to develop strategies to reduce this tension. Learning to control these activities can help you fall asleep.

Living with Hypersomnia

Living with hypersomnia means you might have to make major or minor lifestyle changes to help you better deal with the disorder.

Lifestyle Changes for Hypersomnia

There are many achievable changes you can make in your life to help reduce the severity of your hypersomnia. These changes include:

  • Reduce Drugs and Alcohol. Restricting the intake of drugs and alcohol can help you reduce your symptoms of hypersomnia. Alcohol and some drugs lead to the sedation effects that cause increased sleepiness.
  • Better Sleep Hygiene. Maintaining a strict sleep schedule and adhering to good sleep hygiene will help you achieve better rest. Anything that negatively impacts your sleep or circadian rhythm will make your hypersomnia worse.
  • Medication. You may need to start taking medication to help you stay awake during the day. These include various stimulants.
  • Adjust Your Schedule. You may need to adjust your work, social, or school schedule to accommodate your disorder. This may mean scheduling work or classes at times of the day when you’re less likely to feel sleepy. Some individuals with primary hypersomnia go into professions that are flexible and allow them to work later in the day.
  • Exercise. Research has shown that exercise helps reduce daytime sleepiness associated with hypersomnia.
  • Eat Healthier. Certain food can make your fatigue and sleepiness worse. These include foods with high fat and sugar content. A healthy diet will not only help your body produce energy more efficiently but will also help to prevent nutritional deficiencies associated with hypersomnia.