Hypersomnia is a sleep disorder characterized by excessive daytime sleepiness. Patients may sleep for more than 10 hours at night, but still feel sleepy during the day. What’s more, even if they sleep for a while during the daytime, they do not feel refreshed after they wake up.
Statistics reveal that 5% of the population suffers from hypersomnia at some point in their life. Another interesting fact is that more males than females suffer from this disorder.
In hypersomnia research, case studies play a significant role and often lead to important medical breakthroughs. A case study was undertaken by PD Dr. T.C. Wetter et al. from Max Planck Institute of Psychiatry, Munich, and Department of Sleep Medicine, Psychiatric University Hospital Zurich, Switzerland. In the study, the patient initially exhibited the symptoms of idiopathic hypersomnia. However, the patient was diagnosed as suffering from Lyme disease after a careful diagnostic evaluation. This hypersomnia research finding indicates the importance of including diagnostic tools (e.g., lumbar puncture in this case) in diagnostic procedures. The study is the first report of a patient who seemingly suffered from hypersomnia, but was actually suffering from Lyme disease. Its importance lies in the fact that an inflammatory disease of the central nervous system may mimic hypersomnia symptoms. This is clearly appreciated given the fact that hypersomnia is encountered frequently in clinical practice.
A similar study has been recently reported (Neurol. Sci. (2010) 31:349–352), in which insulinoma manifested as idiopathic hypersomnia. And the study warns: “Clinicians should keep in mind that neuroglycopenia should be considered in the differential diagnosis of patients with hypersomnia.”
Hypersomnia research is also being carried out with regard to medication. Modafinil and sodium oxybate have been found to be effective in the treatment of hypersomnia caused by narcolepsy. These are wake-promoting drugs whose clinical efficacy has found to be adequate. However, when it comes to treatment, it is important to understand the cause of hypersomnia.
Successful hypersomnia treatment necessitates that the underlying causes of hypersomnolence be revealed. In studies conducted by Nishino, Kanbayashi, and their colleagues, it was found that the histamine levels were low in patients suffering from narcolepsy and idiopathic hypersomnia. Histamine is a wake-promoting neurotransmitter. So, these studies have important implications both clinically and scientifically. One implication is that low histamine levels are responsible for the sleepiness associated with narcolepsy and idiopathic hypersomnia. Further, the fact that histamine levels were found to be normal in patients with obstructive sleep apnea may be interpreted to mean that histamine deficiency may be specific to narcolepsy and idiopathic hypersomnia.
As clinical and scientific investigations continue, new hypersomnia breakthroughs will be made to gain new insights in hypersomnolence.
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