Sleep and Hypersomnia

Medically Reviewed by Zilpah Sheikh, MD on August 13, 2024
7 min read

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 it, you might fall asleep at any time – like at work or while you’re driving. You may have other sleep-related problems, too, including lack of energy and trouble thinking clearly.

According to the National Sleep Foundation, up to 40% of people have some symptoms of hypersomnia from time to time.

Primary hypersomnia

This type of hypersomnia is when you don’t have another medical condition causing your condition. There are four conditions of this type:

  • Narcolepsy type 1 is a type of hypersomnia caused by having low levels of a chemical in the brain and cerebrospinal fluid called hypocretin (orexin). Your brain can’t control when you sleep and when you’re awake the way it should. When you have narcolepsy type 1, a daytime nap is usually short and helps you feel more refreshed, which isn’t true for other types of hypersomnia. This type of narcolepsy is also called narcolepsy with cataplexy, which means it can cause sudden muscle weakness when you feel emotion.
  • Narcolepsy type 2 has milder symptoms than narcolepsy type 1. You have normal levels of hypocretin and don’t have cataplexy.
  • Idiopathic hypersomnia is hypersomnia without a cause that doctors can find. Idiopathic means “no known cause.”
  • Kleine-Levin syndrome is rare, and it happens mostly in teenagers assigned male at birth. It causes extreme bouts of hypersomnia. When you have it, you may sleep as many as 20 hours in a day. Episodes of extreme hypersomnia may last from a few days to a few weeks. 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.

Secondary hypersomnia

This type of hypersomnia is caused by something else. Maybe you deal with excessive sleepiness because of physical or mental health conditions, drugs or other substances, an injury, or a genetic disorder. 

Some health conditions that can cause hypersomnia are: 

  • Parkinson’s disease
  • Obstructive sleep apnea
  • Hypothyroidism
  • Migraines
  • Vitamin deficiencies
  • Peptic ulcers 
  • Epilepsy
  • Encephalitis
  • Multiple sclerosis
  • Obesity
  • Multiple system atrophy
  • Myotonic dystrophy
  • Mood disorders such as depression

Substances that can cause hypersomnia include:

  • Sedatives such as benzodiazepines, barbiturates, melatonin, and sleeping aids
  • Blood pressure medications 
  • Anti-epileptic drugs
  • Parkinson’s disease medications
  • Skeletal muscle relaxants
  • Antipsychotic drugs
  • Opiates (hydrocodone, oxycodone)
  • Cannabis (marijuana)
  • Alcohol 

You may also have hypersomnia as you go through withdrawal from a stimulant drug, such as an ADHD medication.

You can also get hypersomnia from insufficient sleep syndrome, which simply means you don’t practice sleep habits (like not exercising or drinking caffeine within a few hours of bedtime) that allow you to get enough rest.

There are several potential causes of hypersomnia, including:

If you consistently feel drowsy during the day, talk to your doctor. In diagnosing hypersomnia, your doctor will ask you about your sleeping habits, how much sleep you get at night, if you wake up at night, and whether you fall asleep during the day. Your doctor will also want to know if you are having any emotional problems or are taking any drugs that may be interfering with your sleep.

Your doctor may also order some tests, including blood tests, computed tomography (CT) scans, and a sleep test called polysomnography. In some cases, an electroencephalogram (EEG), which measures the electrical activity of the brain, is needed.

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).

If you are taking a medication that causes drowsiness, ask your doctor about changing to one that is less likely to make you sleepy. You may also want to go to bed earlier to try to get more sleep at night, and eliminate alcohol and caffeine.

Stimulants for hypersomnia

Certain medications can promote alertness and help you stay awake during the day. These are pills you take by mouth, typically in the morning. Most commonly, doctors prescribe:

  • Armodafinil (Nuvigil) or modafinil (Alertec, Provigil). These medications work by changing the amounts of certain natural substances in the area of the brain that controls sleep and wakefulness.
  • Psychostimulants. Drugs typically used for ADHD such as amphetamines, dextroamphetamine (Dexedrine Spansule, ProCentra, Zenzedi), or methylphenidate (Concerta, Daytrana, Methylin, Ritalin) can help you stay more alert. They come with more side effects and the risk of dependence, so doctors typically try other options first.

Antidepressants for hypersomnia

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. Antidepressants won’t work for some hypersomnia, such as Kleine-Levin syndrome.

New medications for hypersomnia

Other drugs have become recent options for treating hypersomnia, including:

Calcium, magnesium, potassium, and sodium oxybate (Xywav). In 2021, the FDA approved Xywav as the first drug for idiopathic hypersomnia. This drug dampens your central nervous system and slows down brain activity. You take it by mouth as a liquid. It can also be called lower-sodium oxybate. 

Xyrem. This drug also slows down brain activity, like Xywav, but has only sodium oxybate as an ingredient. If you’re watching your sodium, this may not be a good choice for you. 

Pitolisant (Wakix). Doctors can prescribe this antihistamine drug for excessive daytime sleepiness. Histamines help regulate your sleep-wake cycle. It can also help treat cataplexy for people with narcolepsy type 1.

CPAP for hypersomnia

If you are diagnosed with sleep apnea, your doctor may prescribe a treatment known as continuous positive airway pressure, or CPAP. With CPAP, you wear a mask over your nose while you are sleeping. A machine that delivers a continuous flow of air into the nostrils is hooked up to the mask. The pressure from air flowing into the nostrils helps keep the airways open.

Ways to prevent sleep problems

There are lifestyle changes you can make to promote quality sleep at night. These include: 

Improve your diet. Research shows that certain foods can help boost sleep quality and prevent daytime sleepiness. A Mediterranean diet high in plants, whole grains, and healthy fats can give you what you need. Bump up your protein intake for longer night sleep, and cut back on sugar and saturated fats, which make you sleepy during the day. 

Cut out alcohol and caffeine. Caffeine is a stimulant that can keep you buzzing at bedtime if you eat or drink it in the second part of the day. And even though alcohol is a sedative (sleep promoter), the rest you get when it’s in your system isn’t as good as sober sleep. 

Keep a strict sleep schedule. Better sleep happens when you keep your bedtime and wake time the same every day. 

Get regular exercise. Some people find that a regular workout schedule helps them sleep better at night and less during the day. Make sure not to exercise too close to bedtime; for some people, this increases alertness. 

Hypersomnia is a condition that keeps you from staying awake during the day, even if you’ve gotten enough sleep at night. You may have a condition that causes it, or it may be a condition on its own. Treatments include medications to promote wakefulness and healthy sleep hygiene habits.

Is there a way to fix hypersomnia? 

Depending on the cause of your hypersomnia, your doctor may prescribe certain medications to help you stay awake during the day. There are also lifestyle changes you can make to help you sleep better at night and improve your alertness during the day.

Is hypersomnia a symptom of depression?

It might be. Hypersomnia can be a symptom of certain mood disorders such as major depressive disorder (MDD).

What’s it like living with hypersomnia?

Being sleepy during the day can affect your quality of life, making it hard to work, go to school, and do social activities. It may take a while to find the treatment that works for you, and treatment may come with side effects. Your thinking can also be foggy, and you may be cranky or delirious. 

Should you nap if you have hypersomnia?

Some types of hypersomnia see improved sleepiness with napping, while others don’t. Napping may make some types of hypersomnia worse. The time and length of your naps can also make a difference in how they affect you. 

Which deficiency causes hypersomnia? 

Some vitamin and mineral deficiencies (vitamin D, vitamin B12) may make you feel sleepy during the day.