Test Your Knowledge

In diagnosing hypersomnia, a physician will typically perform a physical examination and compile a medical history. The physician will pay particular attention to details such as how much sleep the patient gets each night and whether or not excessive napping occurs. It often is helpful if a patient’s sleeping partner can offer details about the patient’s sleep habits, including any abnormalities such as

• Kicking
  
• Pauses in breathing
  
• Sleepwalking
  
• Snoring
  
• Teeth grinding

The physician may also ask about any emotional issues in the patient’s life, whether or not the patient is taking medications or has a medical condition that may be responsible for the patient’s symptoms.

Other questions that a physician may ask include:

• Do you snore, or experience periods where you stop breathing during sleep?
  
• Are you depressed or bored?
  
• Have you taken steps to try to reduce your drowsiness?
  
• Are you experiencing other symptoms?

Various tests may also be performed to evaluate the patient’s general health and identify any existing disorders of the heart, liver or lungs that may be causing the patient’s symptoms. Depending on the patient’s history and symptoms, these may include blood tests, urine tests and imaging tests (e.g., magnetic resonance imaging [MRI]). A neurological examination may also be performed. This type of examination can helps a physician diagnose disorders of the brain, nerves, muscles and spinal cord.

In some cases, a physician may order a sleep study (polysomnography) in which a person’s brain waves and other physiological responses are measured during a typical sleep cycle. During this test, patients are required to stay overnight in a facility while measurements are performed to record muscle movement, heartbeat, eye movement, leg movements and respiration.

Primary hypersomnia may be diagnosed if patients experience excessive sleepiness that occurs regularly (for at least one month) and that impairs social, occupational or other types of functioning. Recurrent primary hypersomnia may be diagnosed if patients experience excessive sleepiness for at least three consecutive days several times a year for at least two years. Primary hypersomnia may be diagnosed as long as the patient’s symptoms are not found to be caused by another type of sleep disorder (e.g., insomnia, narcolepsy), mental or medical disorder, or the result of certain medications or substances. If a likely cause for a patient’s hypersomnia is discovered, a patient may be diagnosed with secondary hypersomnia.