Hypersomnia, always sleep

Hypersomnia, or always being sleepy during daylight hours, is often the reflection of nocturnal sleep deprivation, in terms of quantity and quality. There are different types and symptoms of hypersomnia, but also numerous natural remedies to cure it. Let's find out better.

Symptoms of hypersomnia

Depending on the type of hypersomnia, the symptoms fluctuate from drowsiness on isolated occasions to cognitive difficulties, motor difficulties, chronic sleepiness, fatigue, difficulty waking up, morning headaches. Generally those who are always asleep have reduced sleep times compared to the norm, even just 5 minutes. Physiologically, those with hypersomnia do not enter the phases of rapid eye movements (REM). Hypersomnias are divided into:

psychophysiological hypersomnia
hypersomnia associated with psychiatric disorders
hypersomnia associated with the use of drugs
hypersomnia associated with impaired sleep-induced breathing
hypersomnia associated with restless legs syndrome
narcolepsy
idiopathic hypersomnia
hypersomnia associated with diseases, intoxications and unfavorable environmental conditions
periodic hypersomnia
insufficient sleep hypersomnia
drunkenness of sleep (confusional awakenings)
pseudohypersomnia: the long dormitories
subjective hypersomnia and without corresponding polysomnographic findings.

The diagnosis

To define a "hypersonnic" subject it is necessary to carry out an assessment of sleepiness, starting from an analysis of the waking condition: subjective drowsiness reflects a need or simply a desire to sleep, often confused with asthenia, and is closely connected to the mood and its sudden changes. The objective drowsiness refers instead to the evaluation of the waking condition through methods as much measurable and standardizable as possible:

Study of Behavioral Indexes
Study of Electrophysiological indexes
Study of Performance Indexes.

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Behavioral Indices of Hypersomnia

MSLT (Multiple Sleep Latency Test): this test is performed in the laboratory and instrumentally measures the time it takes for the subject to fall asleep, in conditions suitable for sleep (every two hours from 10.00 to 18.00).
MWT (Maintenance of Wakefulness Test): this test is also carried out in the laboratory and involves measuring the sleep resistance times. It is indicative to test the effectiveness of therapies aimed at combating sleepiness.

Electrophysiological indexes

PSG dynamic outpatient 24h: this polysomnographic test is performed at the subject's home and serves to examine the physiology of sleep and the shape and quality of wakefulness.

Performance Indices

These are standardized subjective tests that assess sleepiness levels, completing the objective picture outlined by the MSLT.

ESS (Epworth Scale): defines a "graduated" scale of average sleepiness, of propensity to sleep in eight typical situations of everyday life and is structured as follows:
Scores Scale: 0 "I never fall asleep"; 1 "I have some chances to fall asleep"; 2 "I have a good chance of falling asleep"; 3 "I have a high chance of falling asleep".
Question: "What are your chances of falling asleep or falling asleep in the following situations, regardless of feeling tired?"
- Sitting while I read
- Watching on TV
- Sitting, idle, in a public place (at the theater, in a conference)
- Passenger in the car, for an hour without stopping
- Lying down to rest in the afternoon, when I get the chance
- Sitting while I talk to someone
- Sitting after lunch, without having drunk alcohol
- By car, stopped for a few minutes in traffic
Rating score: 0-10 normal; 11-15 moderate drowsiness; 16-24 marked somnolence (according to the interpretation of the results by Dr. Murray Johns, inventor of the Scala). The Stanford study group applied more restricted ranges: up to 6 points optimal sleepiness situation; 7-8 acceptable result; over 9 points potentially dangerous condition.

Who to contact

In Italy there are real Sleep Centers, where doctors and researchers on the subject can help for those who experience serious problems related to sleep and related disorders. The Italian Narcolettici and Ipersonni Association (AIN), for example, promotes initiatives aimed at disseminating useful information for those who experience the hardships of phenomena that are so limiting in the social sphere, in the workplace, at school, in the family, to map this kind of pathologies and related treatments and to enact the research. He has also compiled a set of recommendations (of which an excerpt is reproduced below) in order to involve people with pathologies such as narcolepsy and hypersomnia to share experiences, therapies, results to implement knowledge about it.

Decalogue of Councils promoted by AIN Italian Narcolettici and Ipersonni Association

"Don't fight yourself: sleep is a part of you [...]. Accepting it and learning to know it is the only way you have to manage it in the best way and thus be able to build the existence you desire.
Do not shut yourself up: if you learn to know yourself without judging yourself, you will be able to build a life according to your needs, without having to give up friends, work, cultural interests, solidarity, physical activity.
Careful not to lose your autonomy: [...] do not allow the creation of hyper-protective situations.
Keep control of your life: don't get replaced in obligations and in any other type of activity, but when you need it do not hesitate to ask for help [...].
Watch out for accidents: the symptoms of narcolepsy can cause accidents [...] so don't exceed your possibilities, [...] follow the advice of your specialist doctor.
You must be responsible: so never challenge yourself! Never put yourself or others in danger.
Live your life as you see fit: remember that Narcolepsy affects every type of category, ethnicity, race and sex. [...] So don't feel different.
Spread the knowledge of your disease: in the appropriate situations it tells you which pathology you suffer and the symptoms. [...] Try to ensure that for other narcoleptics the period between the onset of the first symptoms and the definitive diagnosis is as short as possible.
Take care of yourself: face the disease following the advice of your doctor, the therapies that it indicates to you, accepting the disease does not mean neglecting yourself and passively enduring it. Accepting the disease is the first step in dealing with it
We are very few in Italy to be diagnosed, around 3000. Another 22, 000 narcoleptic people do not know they are, [...]. The more we are and the more we count, the more we will be able to fight to obtain the rights we are entitled to, new treatments and research funding ".