- Last edited on June 7, 2023
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sleep:3-hypersomnolence-disorder [on April 21, 2020] |
sleep:3-hypersomnolence-disorder [on June 7, 2023] psychdb [Hypersomnolence Disorder] |
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| - | ====== Hypersomnolence Disorder ====== | + | ====== Idiopathic Hypersomnia (Hypersomnolence Disorder) ====== |
| + | {{INLINETOC}} | ||
| ===== Primer ===== | ===== Primer ===== | ||
| - | **Hypersomnolence Disorder** is a broad diagnosis and includes symptoms of excessive quantity of sleep, deteriorated quality of wakefulness, and sleep inertia. Individuals with this disorder fall asleep quickly and have a high sleep efficiency (>90%). They may have difficulty waking up in the morning, sometimes appearing confused, combative, or ataxic. This prolonged impairment of alertness during the sleep-wake transition is often referred to as sleep inertia (or sleep drunkenness). | + | **Hypersomnolence Disorder** (DSM-5), or **Idiopathic Hypersomnia** (ICSD-3), is a broad diagnosis and includes symptoms of excessive quantity of sleep, deteriorated quality of wakefulness, and sleep inertia. Individuals with this disorder fall asleep quickly and have a high sleep efficiency (>90%). They may have difficulty waking up in the morning, sometimes appearing confused, combative, or ataxic. This prolonged impairment of alertness during the sleep-wake transition is often referred to as sleep inertia (or sleep drunkenness). |
| == Prevalence == | == Prevalence == | ||
| Approximately 5%-10% of individuals who consult in sleep disorders clinics with complaints of daytime sleepiness are diagnosed as having hypersomnolence disorder. It is estimated that about 1% of the European and U.S. general population has episodes of sleep inertia. Hypersomnolence occurs with relatively equal frequency in males and females. | Approximately 5%-10% of individuals who consult in sleep disorders clinics with complaints of daytime sleepiness are diagnosed as having hypersomnolence disorder. It is estimated that about 1% of the European and U.S. general population has episodes of sleep inertia. Hypersomnolence occurs with relatively equal frequency in males and females. | ||
| - | ===== Diagnostic Criteria ===== | + | ===== DSM-5 Diagnostic Criteria ===== |
| - | <WRAP group> | + | |
| - | <WRAP half column> | + | |
| == Criterion A == | == Criterion A == | ||
| Self-reported excessive sleepiness (hypersomnolence) despite a main sleep period lasting at least ''7'' hours, with at least ''1'' of the following symptoms: | Self-reported excessive sleepiness (hypersomnolence) despite a main sleep period lasting at least ''7'' hours, with at least ''1'' of the following symptoms: | ||
| Line 21: | Line 20: | ||
| == Criterion C == | == Criterion C == | ||
| The hypersomnolence is accompanied by significant distress or impairment in cognitive, social, occupational, or other important areas of functioning. | The hypersomnolence is accompanied by significant distress or impairment in cognitive, social, occupational, or other important areas of functioning. | ||
| - | </WRAP> | ||
| - | <WRAP half column> | ||
| == Criterion D == | == Criterion D == | ||
| Line 53: | Line 50: | ||
| </panel> | </panel> | ||
| </accordion> | </accordion> | ||
| - | </WRAP> | + | |
| - | </WRAP> | + | ==== Sign and Symptoms ==== |
| + | * Individuals often report constant sleepiness and prolonged naps. The naps are not refreshing. There can often be sleep inertia lasting 2-3 hours in the morning, and individuals may be aggressive in the mornings. | ||
| ===== Pathophysiology ===== | ===== Pathophysiology ===== | ||
| Line 60: | Line 58: | ||
| * Viral infections have been reported to have preceded or accompanied hyper somnolence in about 10% of cases. HIV pneumonia, infectious mononucleosis, and Guillain-Barré syndrome, can also evolve into hypersomnolence within months after the infection. | * Viral infections have been reported to have preceded or accompanied hyper somnolence in about 10% of cases. HIV pneumonia, infectious mononucleosis, and Guillain-Barré syndrome, can also evolve into hypersomnolence within months after the infection. | ||
| * Hypersomnolence can also appear within 6-18 months follow ing a head trauma. | * Hypersomnolence can also appear within 6-18 months follow ing a head trauma. | ||
| + | |||
| + | ===== Differential Diagnosis ===== | ||
| + | * Normative variation in sleep | ||
| + | * Poor sleep quality and fatigue | ||
| + | * Insufficient sleep time | ||
| + | * Breathing-related sleep disorders | ||
| + | * [[sleep:breathing:1-osa|Obstructive sleep apnea]] | ||
| + | * Circadian rhythm sleep-wake disorders | ||
| + | * [[sleep:4-narcolepsy|Narcolepsy]] | ||
| + | * [[sleep:parasomnias:home|Parasomnias]] | ||
| + | * [[cl:kleine-levin-syndrome|Kleine-Levin syndrome]] | ||
| + | * Other mental disorders | ||
| + | * [[mood:1-depression:home|Major depressive disorder]] | ||
| ===== Investigations ===== | ===== Investigations ===== | ||
| + | |||
| ==== Polysomnography ==== | ==== Polysomnography ==== | ||
| Nocturnal polysomnography will show: | Nocturnal polysomnography will show: | ||
| - | * normal to prolonged sleep duration, short sleep latency | + | * Normal to prolonged sleep duration, short sleep latency |
| - | * normal to increased sleep continuity | + | * Normal to increased sleep continuity |
| - | * distribution of rapid eye movement (REM) sleep is also normal | + | * Distribution of rapid eye movement (REM) sleep is also normal |
| - | Sleep efficiency is mostly greater than 90%. Some individuals with hypersomnolence disorder have increased amounts of slow-wave sleep. The multiple sleep latency test documents sleep tendency, typically indicated by mean sleep latency values of less than 8 minutes. In hypersomnolence disorder, the mean sleep latency is typically less than 10 minutes and frequently 8minutes or less. Sleep-onset REM periods (SOREMPs; i.e., the occurrence of REM sleep within 20 minutes of sleep onset) may be present but occur less than two times in four to five nap opportunities. | + | * Sleep efficiency is mostly greater than 90%. Some individuals with hypersomnolence disorder have increased amounts of slow-wave sleep. The multiple sleep latency test documents sleep tendency, typically indicated by mean sleep latency values of less than 8 minutes. |
| + | * In hypersomnolence disorder, the mean sleep latency is typically less than 10 minutes and frequently 8minutes or less. | ||
| + | * Sleep-onset REM periods (SOREMPs; i.e., the occurrence of REM sleep within 20 minutes of sleep onset) may be present but occur less than two times in four to five nap opportunities. | ||
| ===== Treatment ===== | ===== Treatment ===== | ||
| + | * There are no consistently effective treatments, but [[meds:stimulants:modafinil|modafinil]] can be used as a wakefulness promoting agent. | ||
| - | ===== Differential Diagnosis ===== | ||
| - | * Normative variation in sleep | ||
| - | * Poor sleep quality and fatigue | ||
| - | * Breathing-related sleep disorders | ||
| - | * Circadian rhythm sleep-wake disorders | ||
| - | * Parasomnias | ||
| - | * Other mental disorders | ||
| ===== Resources ===== | ===== Resources ===== | ||