Idiopathic Hypersomnia and Depression

Medically Reviewed by Neha Pathak, MD on March 22, 2024
5 min read

If you have idiopathic hypersomnia (IH), you know it can affect your physical health. But it can also affect your mental health. About 30% of people diagnosed with IH also have depression.

A dual diagnosis of idiopathic hypersomnia and depression can be tricky, since some of the symptoms overlap. But there are important differences when it comes to symptoms, diagnosis, and treatment. Here’s a closer look at both, and how they relate to one another. 

“Idiopathic” means a condition that has no known cause. So it’s hard to know if your IH makes you feel depressed or vice versa. IH impacts every part of your life. It may:

  • Interfere with your relationships 
  • Make it hard to be productive in your work 
  • Affect your ability to enjoy hobbies and other activities 
  • Curb your independence by limiting your ability to drive

IH can also be hard for others in your life to understand. Some people may think you’re lazy, or that you can “fix” it by going to bed earlier or taking a medication or supplement. All of these things can have a serious and lasting effect on your mood.

It’s important to remember that you can have hypersomnia as a symptom of depression. That means that you sleep a lot, because you feel down. Some studies suggest that up to almost 60% of people with depression get hypersomnia. But this is different from a formal diagnosis of idiopathic hypersomnia combined with depression.

If you’re depressed, you may find that you sleep more than normal. But if you have idiopathic hypersomnia, the signs will go beyond that. You may:

  • Constantly feel sleepy, even with long naps during the day
  • Need at least 10 hours of sleep each night
  • Feel very groggy and out of it when you wake up. This is also known as “sleep drunkenness” or “sleep inertia.”
  • Have mood changes
  • Get headaches

If your doctor thinks you may have IH, they’ll send you to a sleep specialist. They’ll do tests such as a sleep study to rule out other sleep disorders like sleep apnea. If you have IH, you’ll fall asleep quickly – generally in less than 8 minutes – and your overall sleep patterns will look very different from those of someone who doesn’t have the condition.

If you are diagnosed with IH, it’s important to watch for symptoms of depression, such as:

  • Sadness
  • Hopelessness
  • Crankiness
  • Loss of interest in hobbies or favorite activities
  • Lack of energy
  • Trouble concentrating
  • Changes in appetite that lead to weight gain or loss
  • Thoughts of suicide

It’s normal to have some of the above depression symptoms from time to time. But if you have any of them for more than 2 weeks, you should see your doctor to get checked for depression. They will most likely start with a screening test like the Beck Depression Inventory (BDI), which has you respond to 21 questions. It takes about 10 minutes to do.

If you are diagnosed with idiopathic hypersomnia, your doctor may recommend treatment with one of several types of medications that promote wakefulness, including:

  • Armodafinil (Nuvigil)
  • Modafinil (Provigil)
  • Pitolisant (Wakix)
  • Solriamfetol (Sunosi)

Your doctor may also prescribe a psychostimulant, such as: 

  • Amphetamine 
  • Dexmethylphenidate (Focalin) 
  • Dextroamphetamine (Dexedrine, ProCentra, Zenzedi), 
  • Methylphenidate (Concerta, Daytrana, Methylin, Ritalin)

Other meds include: 

  • Baclofen (Baclodol, Lioresal) 
  • Clarithromycin (Biaxin) 
  • Flumazenil (Romazicon),
  • Levothyroxine (Synthroid)
  • Sodium oxybate (Xyrem, Xywav) 

But if you also have depression or anxiety, adding antidepressants can help. These include:

  • SSRIs (selective serotonin reuptake inhibitors) such as fluoxetine (Prozac) or sertraline (Zoloft)
  • SNRIs (serotonin norepinephrine reuptake inhibitors) like duloxetine (Cymbalta) or venlafaxine (Effexor)
  • NDRIs (norepinephrine/dopamine-reuptake inhibitors) like bupropion (Wellbutrin)
  • NRIs (norepinephrine reuptake inhibitors) such as reboxetine (Davedex)
  • Monoamine oxidase (MAO) inhibitors such as selegiline (Emsam)
  • TCAs (tricyclic antidepressants) such as protriptyline (Vivactil)

If you are diagnosed with depression after a diagnosis of IH, speak to your doctor. Some medications that are prescribed to treat IH, like flumazenil, can also cause mood changes. You may need to switch to a different drug.

The following tips can help you manage both your IH and your depression:

Try talk therapy. The most popular option is cognitive behavior therapy (CBT). A therapist will work with you to change negative thinking patterns and emotional responses like frustration or anger. They’ll also show you ways to improve your confidence and ability to manage your feelings. A specific type of CBT, CTB-H, is designed for people with hypersomnias. One small study found that 40% of people who tried it for 6 weeks had far fewer depressive symptoms than they did before. 

Meditate. Since it helps your brain rest, it may help you feel less sleepy. It will also make you more mindful, which may make it easier for you to deal with stress. Some small studies have shown that people with depression who take part in a regular meditation program have fewer depression symptoms, compared to people who don’t meditate. You can try a free online program or download an app that can help you get started.

Exercise. It can help you feel more alert to balance out some of the symptoms of idiopathic hypersomnia. You can also use it as a way to stay awake for important tasks: for example, taking a Zoom call while you walk on a treadmill. Exercise has also been shown to help boost mood.

Eat a healthy diet. The right foods can help you feel more energized, and also help to ease feelings of depression. Foods that are high in sugar can make you sleepier. Several studies have also found a link between sugar intake and depression symptoms. Instead, choose a diet that’s rich in whole, unprocessed foods like fruits, veggies, and nuts. 

Seek out support. IH is something not too many people know much about. It can help your outlook if you meet other people who “get” it. You can find a list of online support groups through the Hypersomnia Alliance