Central Disorders of Hypersomnolence are probably more common than the studies would suggest and are not often recognised. Often a patient will have symptoms of these disorders for many years before the condition is properly diagnosed. GP’s and some Specialists can easily miss the diagnosis as the symptoms are non-specific and patients may otherwise appear to be young and healthy (leading to diagnostic biases). Sometimes patients may have been misdiagnosed as having “depression” or “chronic fatigue syndrome”.
Generally sufferers describe marked tiredness and sleepiness during the day with long sleep needs and/or frequent daytime napping. Because of these symptoms they cannot work or socialise properly and their family time is affected. The diagnosis of these conditions requires a detailed sleep disorders history and assessment. In particular, other possible causes such as obstructive sleep apnoea, sleep deprivation, insomnia, leg movements at night time, medications, sleep phase disturbances, and chronic medical or mental health conditions need to be excluded as causes or contributors. Then further testing is required with overnight and daytime sleep studies.
Narcolepsy and idiopathic hypersomnolence are examples of Central Disorders of Hypersomnolence. Importantly and rewardingly, with the correct diagnosis and treatment, sufferers recover good alertness during the day and are much more functional in their day to day activities. They can drive safely and manage social, work and family commitments well.
Diagnosis and treatment is complex and requires sufferers to see experienced Sleep Physicians who will pick up the symptoms and organise appropriate testing.