Hypersomnia

· Hypersomnia is a disorder characterized by excessive sleepiness, extended sleep time in a 24-hour cycle, and the inability to achieve the feeling of refreshment that usually comes from sleep. There are two main categories of hypersomnia: primary hypersomnia (also called idiopathic hypersomnia) and recurrent hypersomnia (also called primary recurrent hypersomnia). Both have the same symptoms, but differ in frequency of occurrence.[1] Nota: In the proposed 5th edition of the Diagnostic and Statistical Manual of Mental Disorders, due for publication in May 2013, hypersomnia is reclassified under Sleep-Wake Disorders as Hypersomnolence, of which there are several subtypes.[2] Primary hypersomnia is reclassified as Major somnolence disorder.[3] Idiopathic hypersomnia is not included. As of November 2012, the draft diagnostic criteria for DSM-5 are still in flux and the specific criteria text has been removed from public view on the DSM-5 Development site.[4] Contenido 1 Síntomas 2 Diagnóstico 3 Epidemiología 4 Causas 5 Tratamiento 5.1 Psychological treatment 5.2 Physical treatments 6 Ver también 7 Referencias 8 External links Symptoms According to the U. S. National Institute of Neurological Disorders and Stroke: "Hypersomnia is characterized by recurring episodes of excessive daytime sleepiness (EDS) or prolonged nighttime sleep. Different from feeling tired due to lack of or interrupted sleep at night, persons with hypersomnia are compelled to nap repeatedly during the day, often at inappropriate times such as at work, during a meal, or in conversation. These daytime naps usually provide no relief from symptoms. Patients often have difficulty waking from a long sleep, and may feel disoriented. Other symptoms may include anxiety, increased irritation, decreased energy, inquietud, slow thinking, slow speech, loss of appetite, alucinaciones, and memory difficulty. Some patients lose the ability to function in family, social, ocupacional, or other settings. Hypersomnia may be caused by another sleep disorder (such as narcolepsy or sleep apnea), dysfunction of the autonomic nervous system, or drug or alcohol abuse. In some cases it results from a physical problem, such as a tumor, head trauma, or injury to the central nervous system. Certain medications, or medicine withdrawal, may also cause hypersomnia. Medical conditions including multiple sclerosis, chronic fatigue syndrome, depresión, encephalitis, epilepsia, or obesity may contribute to the disorder. Some people appear to have a genetic predisposition to hypersomnia; in others, there is no known cause. Hypersomnia typically affects adolescents and young adults, although the most common causes of the condition for the two age cohorts differ."[5] Those who suffer from hypersomnia have recurring episodes of excessive daytime sleepiness (EDS), which is different from feeling tired due to lack of or interrupted sleep at night. They are compelled to nap repeatedly during the day, often at inappropriate times such as at work, during a meal, or in conversation. These daytime naps usually provide no relief from symptoms. Typically, hypersomnia is first recognized in adolescence or young adulthood.[5] Patients with hypersomnia often experience prolonged night sleep and have difficulty waking from extended sleep episodes, feeling disoriented upon doing so. This condition is known as sleep inertia or, more descriptively, as sleep drunkenness.[6] Other symptoms may include anxiety, increased irritation, decreased energy, inquietud, slow thinking, slow speech, loss of appetite, alucinaciones, memory difficulty and difficulty regulating body temperature.[7] Some patients lose the ability to function in family, social, occupational or other settings.[8] These symptoms are present in both types of hypersomnia. A sufferer of primary hypersomnia displays these symptoms continually for months or years.[8] Recurrent hypersomnia is characterized by recurring periods of symptoms many times throughout the year mixed with periods of normal sleep-wake cycles. Kleine-Levin syndrome is the most well-known form of recurrent hypersomnia, though it is very rare; sufferers often sleep up to eighteen hours a day and yet do not feel refreshed upon waking. Diagnosis An adult is considered to have hypersomnia if he or she sleeps more than 10 hours per day on a regular basis for at least two weeks, or if he or she is compelled to nap repeatedly during the day. Epidemiology Hypersomnia is an uncommon disorder; fewer than 5% of adults complain of EDS. The disorder usually occurs between ages 15–30 and develops slowly over a period of years.[6] Causes Hypersomnia can be caused by brain damage and disorders such as clinical depression, bipolar disorder, celiac disease, uremia and fibromyalgia. Hypersomnia can also be a symptom of other sleep disorders such as narcolepsy, sleep apnea, restless leg syndrome and periodic limb movement disorder. It may also occur as an adverse effect of taking certain medications (p. ej.. some psychotropics for depression, ansiedad, or bipolar disorder), of withdrawal from some medications, or of drug or alcohol abuse. A genetic predisposition may be a factor.[5] Primary hypersomnia can be caused by hyperactive GABAA receptors in the central nervous system. En este caso, neurotransmission is inhibited and the effect is similar to that of chronic medication with benzodiazepines or alcohol.[9][10] People who are overweight may be more likely to suffer from hypersomnia. This can often exacerbate weight problems as excessive sleeping decreases metabolic energy consumption, making weight loss more difficult. Sin embargo, it is also the case that sleep disorders of this nature provoke or initiate weight gain due to a tendency to attempt to manage low energy levels by eating non-complex carbohydrates. Mononucleosis can cause hypersomnia; one of its major symptoms is fatigue. In children, influenza may do the same. Two people with excessive daytime sleepiness and prolonged nocturnal sleep were treated for their subclinical hypothyroidism, effecting significantly decreased sleep time and daytime sleepiness.[11] En algunos casos, the cause of the hypersomnia cannot be determined; in these cases, it is considered to be idiopathic hypersomnia. Hypersomnia may also occur as a side effect of taking certain medications (i.e some psychotropics for depression, ansiedad, or bipolar disorder).  Treatment Psychological treatment Sleep hygiene Physical treatments From the website of the National Institute of Neurological Disorders and Stroke: "Treatment is symptomatic in nature. estimulantes, such as amphetamine, metilfenidato, and modafinil, may be prescribed. Other drugs used to treat hypersomnia include clonidine, levodopa, bromocriptine, antidepressants, and monoamine oxidase inhibitors. Changes in behavior (for example avoiding night work and social activities that delay bed time) and diet may offer some relief. Patients should avoid alcohol and caffeine."[5] No obstante, treatment for primary (or idiopathic) hypersomnia is far from satisfactory. CNS stimulants tend to be less effective for hypersomnia than they are for narcolepsy and may be less well tolerated.[8] Además, stimulants provide diminished returns when taken for a period of years, let alone a period of decades. The negative side effects of stimulants, such as hypertension, are also of concern. A 2012 study found that flumazenil provides relief for some patients whose CSF contains an unknown "somnogen" that enhances the function of GABAA receptors, making them more susceptible to the sleep-inducing effect of GABA. For one patient, daily administration of flumazenil by sublingual lozenge and topical cream has proven effective.[12] See also Fatigue Kleine-Levin syndrome Reticular Formation (includes info about hypersomnia) Somnolence Narcolepsy Nonorganic hypersomnia References ↑ Hypersomnia— causes, adultos, droga, person, gente, usó, effect, Definition, Descripción, Causes and symptoms, Demografía, Diagnóstico, Tratos, Pronóstico. Minddisorders.com. URL a la que se accede en 2010-08-05. ↑ Sleep-Wake Disorders. DSM-5 Development. Asociación Americana de Psiquiatría. ↑ Hypersomnolence Disorders. DSM-5 Development. Asociación Americana de Psiquiatría. ↑ DSM-5: The Future of Psychiatric Diagnosis. DSM-5 Development. Asociación Americana de Psiquiatría. ↑ Jump up to: 5.0 5.1 5.2 5.3 Institutos Nacionales de Salud (2008). NINDS Hypersomnia Information Page. URL a la que se accede en 2009-01-23. Error de cita: No válido etiqueta; nombre "NINDS" defined multiple times with different content ↑ Jump up to: 6.0 6.1 Sharon L. Schutte-Rodin, MD. Idiopathic Hypersomnia with Long Sleep Time. American Academy of Sleep Medicine. ↑ Vernet, C., Leu-Semenescu, S., Buzare, M.-A. and Arnulf, Yo. (2010). Subjective symptoms in idiopathic hypersomnia: beyond excessive sleepiness. Journal of Sleep Research 19 (4): 525-534. ↑ Jump up to: 8.0 8.1 8.2 Michel Billiard, MD. Idiopathic Hypersomnia. Sleep Disorders I. Gui-de-Chauliac Hospital, Neurology B Department, 34295 Montpellier, Cedex 05, Francia. ↑ Lynn Marie Trotti, MD. Flumazenil for the Treatment of Primary Hypersomnia. Emory University - Georgia Research Alliance. ClinicalTrials.gov. ↑ Lynn Marie Trotti, MD. Clarithromycin for the Treatment of Primary Hypersomnia. Emory University - Georgia Research Alliance. ClinicalTrials.gov. ↑ Successful treatment with levothyroxine for idiopathic hypersomnia patients with subclinical hypothyroidism. General Hospital Psychiatry - Elsevier Inc. URL a la que se accede en 2010-08-05. ↑ D.B. Rye, D.L. Bliwise, K. Parker, L.M. Trotti, P. Saini, J. Fairley, Un. Hombre libre, P.S. García, M.J. Owens, J.C.. Ritchie and A. Jenkins (21 Noviembre 2012). Modulation of Vigilance in the Primary Hypersomnias by Endogenous Enhancement of GABAA Receptors. Sci. Transl. Con. 4 (161): 161ra151. External links hypersomnia at NINDS Merck Home 06-081c Merck Manual 14-173c GPnotebook -483065848 FPnotebook PSY226 eMedicine med/3129 - "Primary Hypersomnia" v·d·e WHO ICD-10 mental and behavioural disorders (F· 290–319) Neurological/symptomatic Dementia (Alzheimer's disease, demencia multiinfarto, Pick's disease, enfermedad de Creutzfeldt-Jakob, Huntington's disease, enfermedad de Parkinson, complejo de demencia por sida, Demencia frontotemporal) · Delirio· Post-concussion syndrome Psychoactive substance alcohol (embriaguez, dependencia al alcohol, Delirium tremens, Korsakoff's syndrome, abuso de alcohol) · opiods (dependencia de opiáceos) · sedative/hypnotic (abstinencia de benzodiacepinas) · cocaine (dependencia de la cocaína) · general (Intoxicación, Abuso de drogas, Dependencia física, Retiro) Psychotic disorder Schizophrenia (esquizofrenia desorganizada) · Schizotypal personality disorder· Delusional disorder· Folie à deux· Schizoaffective disorder Mood (afectivo) Mania· Trastorno bipolar· Clinical depression· Cyclothymia· Dysthymia Neurotic, stress-related and somatoform Anxiety disorder (Agorafobia, Trastorno de pánico, Ataque de pánico, Trastorno de ansiedad generalizada, Ansiedad social) · OCD· Reacción al estrés agudo· PTSD· Adjustment disorder· Trastorno de conversión (síndrome de Ganser) · Somatoform disorder (Trastorno de somatización, Desórden dismórfico del cuerpo, hipocondriasis, nosofobia, Da Costa's syndrome, psicoalgia)  · Neurasthenia Physiological/physical behavioural Eating disorder (anorexia nerviosa, bulimia nerviosa) · Sleep disorder (disomnia, insomnio, hipersomnia, parasomnia, Noche de terror, pesadilla) · Sexual dysfunction (disfuncion erectil, eyaculación precoz, vaginismo, dispareunia, hipersexualidad) · Postnatal depression Adult personality and behaviour Personality disorder· Passive-aggressive behavior· Kleptomania· Trichotillomania· Voyeurism· Factitious disorder· Munchausen syndrome· Ego-dystonic sexual orientation Mental retardation Mental retardation Psychological development (trastorno del desarrollo) Específico: discurso y lenguaje (trastorno del lenguaje expresivo, afasia, afasia expresiva, Afasia receptiva, Síndrome de Landau-Kleffner, ceceo) · Scholastic skills (dislexia, disgrafia, síndrome de Gerstmann) · Función motora (dispraxia del desarrollo) Penetrante: Autism· Rett syndrome· Asperger syndrome Behavioural and emotional, childhood and adolescence onset ADHD· Conduct disorder· Oppositional defiant disorder· Separation anxiety disorder· Selective mutism· Reactive attachment disorder· Tic disorder· Tourette syndrome· Discurso (stuttering· cluttering) Plantilla REDIRECT:CNS diseases of the nervous system v·d·e Articles on sleep Sleep stages Rapid eye movement sleep· Non-rapid eye movement sleep· Slow-wave sleep· Beta wave sleep· Delta wave sleep· Gamma wave sleep· Theta wave sleep Sleep disorders Advanced sleep phase syndrome· Automatic behavior· Circadian rhythm sleep disorder· Delayed sleep phase syndrome· Dyssomnia· Hypersomnia· Insomnio· Narcolepsia· Night terror· Nocturia· Nocturnal myoclonus· Non-24-hour sleep-wake syndrome· Ondine's curse· Parasomnia· Sleep apnea· La privación del sueño· Sleepeating· Sleeping sickness· Sleeptalking· Sleepwalking Benign phenomena Consciousness states·Sueño· Dream content· Exploding head syndrome· False awakening· Hypnagogia· Hypnic jerk· Lucid dream· Nightmare· Nocturnal emission· Parálisis del sueño· Somnolence· Other Sleep-related Topics Chronotype· Electrosleep treatment· Hypnotic drugs· Napping· Jet lag· Lullaby· Polyphasic sleep· Segmented sleep· Siesta· Sleep and learning· Deuda de sueño· Sleep inertia· Sleep onset· Sleep treatment· Sleep wake cycle· Snoring v·d·e Mood disorder (F30–F39, 296) History Emil Kraepelin· Karl Leonhard· John Cade· Mogens Schou· Frederick K. Goodwin· Kay Redfield Jamison Symptoms Hallucination· Delusion· Emotional dysregulation (Anhedonia, Dysphoria, Suicidal ideation) · sleep disorder (Hypersomnia, Insomnio) · Psicosis· Racing thoughts Spectrum Bipolar disorder (Bipolar I, Bipolar II, Bipolar NOS) · Cyclothymia· Dysthymia· Major depressive disorder· Schizoaffective disorder Mania· Mixed state· Hypomania· Major depressive episode· Rapid cycling Treatment Anticonvulsants Carbamazepine· Gabapentin· Lamotrigine· Oxcarbazepine· Topiramate· Valproic acid (Sodium valproate, Valproate semisodium) Other mood stabilizers Lithium pharmacology (Lithium carbonate, Lithium citrate, Lithium sulfate) · Antipsychotics Non-pharmaceutical Clinical psychology· Electroconvulsive therapy· Involuntary commitment· Light therapy· Psychotherapy· Transcranial magnetic stimulation· Cognitive behavioral therapy Related Affective spectrum· List of people affected by bipolar disorder· Bipolar disorder in children·Libro:Bipolar Disorder {| clase="navbox plegable nowraplinks" estilo="margen:auto; " [. v]·[. d]·[. e] M: PSO/PSI mepr dsrd (o, p, metro, p, un, d, s), sysi/epon, spvo proc (eval/thrp), droga (N5A/5B/5C/6A/6B/6D) |}