Daytime Drowsiness: When to Seek Help for Sleep Disorders.

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If you find it very hard to stay awake during the day, you may wonder if you have a sleep disorder. Narcolepsy may be the first to come to mind. But difficulty staying awake is also a symptom of idiopathic hypersomnia.

These two rare conditions are similar in several ways, but they are not the same thing. Here’s a look at both; their similarities and differences; and how doctors figure out which one you might have.

Idiopathic Hypersomnia vs. Narcolepsy: What’s the Difference?

These two sleep disorders – or, clinically speaking, central disorders of hypersomnolence (CDH) – look a lot alike. Hypersomnolence means sleeping too much. Both conditions make you feel very sleepy or tired during the day even after a full night’s sleep. The need to sleep can strike at any time and make it hard to work or drive, which can be dangerous. 

But there are some subtle differences. 

Cognitive Behavior Therapy (CBT) May Help By:

  • Easing your depression or anxiety
  • Showing you how to organize your day to make the most of your time awake
  • Helping you see IH as a medical condition, not personal failure
  • Teaching you ways to recharge and stay alert


People with idiopathic hypersomnia may sleep a lot at night – often up to 12 or 14 hours – and still find it very hard to wake up in the mornings and after naps. You might wake up feeling confused and disoriented. 

People with narcolepsy, on the other hand, typically sleep the usual 7 to 8 hours during the night, and often find that they wake up refreshed in the mornings and after brief naps. But they soon feel sleepy again. 

Narcolepsy may also come with these other symptoms that idiopathic hypersomnia typically does not:

Sleep-related hallucinations: Visions as you’re falling asleep or waking up, often that someone is in the room with you 

Sleep paralysis: Not being able to move as you’re falling asleep or waking up 

Fragmented sleep: Waking in the night and being unable to get back to sleep. It can be insomnia, vivid dreams, acting out dreams, or sudden leg movements that wake you.

Memory problems: Not being able to remember things that happened or conversations you had because you were half-asleep. You can fall asleep while working, eating, driving, or talking.

Cataplexy: A sudden episode of muscle weakness where your muscles go limp while you’re awake like they do when you're asleep. This only happens in type 1 narcolepsy and usually in response to a strong emotion like surprise or happiness. 


Which One Could You Have?

The American Academy of Sleep Medicine offers self-tests on its website to screen for both of these sleep disorders. 

If you think you may have idiopathic hypersomnia, ask yourself the following questions:

  • Are you very sleepy even though you sleep 8 to 10 hours a night without interruption?
  • Has this happened daily for more than 3 months?
  • Do you feel unrefreshed and sleepy even after naps?

If you think you may have narcolepsy, ask yourself:

  • Do you get sudden urges to sleep during the day even after a full night’s sleep?
  • Do you doze off while working, eating, or speaking with someone?
  • Do you feel alert after a nap, then quickly feel sleepy again?

If you answer “yes” to at least one of these questions, see a sleep specialist for a sleep study. Before you say “No way am I sleeping overnight in a lab,” you should know that many sleep studies take place in your own bed. The doctor sends a monitoring device and instructions home with you. The study will help rule out other conditions that may make you too sleepy, such as sleep apnea.

A sleep specialist will also perform a multiple sleep latency test (MSLT) to measure how sleepy you are during the day. You’ll try to take naps at set times during the day. Falling asleep quickly is a sign that you could have either condition. But doctors can often distinguish between the two by calculating how many sleep-onset rapid eye movement periods (SOREMPs) you have. These are REM sleep periods that happen within 5 minutes of falling asleep. Most people with idiopathic hypersomnia have less than two, but with narcolepsy, you have two or more. 


at’s the Treatment?

While idiopathic hypersomnia and narcolepsy are different conditions, your doctor’s recommendations for treatment of these two disorders may be the same. You may try:

Lifestyle changes. Your doctor might suggest that you avoid alcohol and certain sedating medications, such as benzodiazepines. You might also have to follow certain rules for driving, as you may not always be able to operate a car safely. Scheduled naps are often very helpful for people with narcolepsy and are a mainstay of treatment, but they are not usually helpful for people who have idiopathic hypersomnia. 

Medications. Certain medications may be helpful for both conditions. These include:

  • Modafinil: This is a drug that adjusts levels of certain brain chemicals that control sleep and wakefulness to help prevent you from falling asleep during the day.
  • Oxybates: These central nervous system depressants reduce brain activity to help you sleep better at night and stay awake during the day.

Studies show that up to 3 in 4 people with idiopathic hypersomnia respond to these medications and make good improvement. Researchers are studying other narcolepsy drugs for the treatment of idiopathic hypersomnia, but there’s not enough evidence yet that they work for both.

Regardless of which condition you have, with both narcolepsy and idiopathic hypersomnia, most people get back to a normal life after diagnosis and treatment. 

Please give us a call at 562-505-5600 to see how we can help your healthcare needs.
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