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Typically, the symptoms of IH begin in adolescence or young adulthood, although they can begin at a later age. [44] [15] After onset, hypersomnia often worsens over several years, [15] but it is often stable by the time of diagnosis and appears to be a lifelong condition. [4] Spontaneous remission is only seen in 10–15% of patients. [30] [45]
Hypersomnia can be primary (of central/brain origin), or it can be secondary to any of numerous medical conditions. More than one type of hypersomnia can coexist in a single patient. Even in the presence of a known cause of hypersomnia, the contribution of this cause to the complaint of excessive daytime sleepiness needs to be assessed.
Treatment of excessive daytime sleepiness (EDS) relies on identifying and treating the underlying disorder which may cure the person from the EDS. Drugs like modafinil , [ 22 ] armodafinil , [ 23 ] pitolisant [ 24 ] (Wakix), sodium oxybate (Xyrem) oral solution, have been approved as treatment for EDS symptoms in the United States.
Idiopathic hypersomnia, a primary, neurologic cause of long-sleeping, sharing many similarities with narcolepsy. [83] Insomnia disorder (primary insomnia), chronic difficulty in falling asleep or maintaining sleep when no other cause is found for these symptoms. Insomnia can also be comorbid with or secondary to other disorders.
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Kleine–Levin syndrome (KLS) is a rare neurological disorder characterized by persistent episodic hypersomnia accompanied by cognitive and behavioral changes. These changes may include disinhibition (failure to inhibit actions or words), sometimes manifested through hypersexuality, hyperphagia or emotional lability, and other symptoms, such as derealization.
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