Feature Article

Idiopathic hypersomnia: more than usual sleepiness

Feature Article

Idiopathic hypersomnia: more than usual sleepiness

MONICA HATCH, David Cunnington

Figures

© HIRURG/ISTOCKPHOTO.COM MODEL USED FOR ILLUSTRATIVE PURPOSES ONLY
© HIRURG/ISTOCKPHOTO.COM MODEL USED FOR ILLUSTRATIVE PURPOSES ONLY

Abstract

Idiopathic hypersomnia presents with extreme daytime sleepiness, despite a longer than average duration of nocturnal sleep. Patients frequently sleep through life, can have long diagnostic delays and frequently face social stigma. Accurate diagnosis and treatment, including lifestyle modifications and pharmacological therapies, will help alleviate symptoms and improve quality of life.

Key Points

  • Idiopathic hypersomnia (IH) is characterised by an excessive need for sleep, persistent sleepiness when awake, unrefreshing sleep and naps and sleep inertia on waking.
  • Patients may be young to middle aged, with impairment in day-to-day functioning that has often been present for years and attributed to other factors such as lifestyle or comorbidities.
  • Patients reporting symptoms of IH in whom other causes cannot be identified should be referred for sleep physician assessment.
  • Open-access ambulatory sleep studies are best validated for diagnosing obstructive sleep apnoea (OSA) in individuals assessed to be at high risk of moderate to severe OSA and may be normal in patients with IH.
  • Medical therapy to improve vigilance and wakefulness for patients with diagnosed IH leads to improvements in symptoms, distress and quality of life.