It can be hard to get a diagnosis of idiopathic hypersomnia (IH). It’s easy to confuse it with other sleep disorders, such as narcolepsy. But even with a proper diagnosis, there are challenges. People with IH may also be more at risk of having other conditions, such as depression or sleep apnea. Conditions that happen together are known as comorbidities.
Here are five common conditions that often happen along with IH:
Sleep Apnea and IH
About half of people with IH also have sleep apnea, which can make you sleepy during the day by waking you many times overnight. That’s why you should have a sleep study done if your doctor suspects any sort of a sleep disorder. This is a test that records your brain waves, your blood oxygen levels, your heart rate and breathing, and eye and leg movements during sleep. It also checks for sleep apnea. You may be able to do a sleep study for apnea at home.
If your sleep study shows that you have sleep apnea, your medical provider will usually recommend a breathing device like a continuous positive airway pressure (CPAP) machine. It provides constant air pressure through your upper airways to keep them open while you sleep. They may also recommend lifestyle changes such as:
- Regular exercise
- Weight loss
- Limiting alcohol and caffeine
- Quitting smoking
- Sleeping on your side to help keep your airways open as you sleep
Heart Disease and Idiopathic Hypersomnia
People with IH are more likely to have things that raise their chances of getting heart disease. Other research has shown that people with IH have a significantly higher risk of having a heart attack or stroke.
Excessive daytime sleepiness in general is linked with higher levels of inflammation in your body. It’s thought that this inflammation raises levels of certain markers of heart disease, such as C-reactive protein. This can raise your blood pressure and cause cholesterol to build up in your arteries.
If you do have any risk factors for heart disease, it’s very important that you speak to your sleep doctor. You’ll need to avoid certain medications prescribed to treat IH, such as the antibiotic clarithromycin. It’s linked to heart attacks and strokes that can happen years after you’ve taken it. It’s also important that you follow certain healthy lifestyle strategies, including:
- Eating a healthy diet that focuses on whole foods
- Getting regular exercise
- Controlling your blood pressure
- Practicing relaxation techniques such as meditation
- Not smoking or vaping
- Limiting alcohol intake – if you don’t drink, don’t start
- Managing stress
These can help address both your IH and your risk of heart disease.
Headaches and IH
Almost a quarter of people with IH report that they often get headaches or migraine attacks. As with many conditions that go along with IH, it’s not clear why that is. There may be differences in sleep patterns that contribute to both. Another theory is that people with IH have low levels of histamine, a chemical that plays an important role in our bodies’ sleep-wake cycle and also plays a role in migraine attacks.
If you do have frequent headaches, talk to your doctor. Treating these two conditions together can be tricky. Certain medications prescribed to treat IH may make them worse. There are also certain treatments for migraine that can make you more sleepy, so talk to your doctor about the best way to manage your meds if you have both conditions.
Diabetes and IH
People with sleep disorders may have a higher risk of getting diabetes. When your sleep is disrupted, it makes it harder for your body to control your blood glucose levels.
About 20% of people with IH either have diabetes or take medication for diabetes or obesity. This may be because they already have yet another condition that raises their risk, such as sleep apnea.
If you have IH, talk to your doctor about getting screened for type 2 diabetes. It’s also important to treat and manage any diabetes risk factors you may have that you can control. If you don’t get regular physical activity, talk to your doctor about starting an exercise program. If you’re overweight or have obesity, take steps to get to a healthy weight. If you lose about 7% of your body weight through exercise and a healthy diet, you can cut your chances of having diabetes by about 60%.
Mental Health Conditions and IH
Sleep and mood disorders often happen together and may directly affect each other. About 30% of people with IH have anxiety, 31% have depression, and another 32% have a mood disorder such as bipolar disorder. It’s not clear why this is. It may be that depression and anxiety stem in part from the stress of living with IH. It may also be due in part to brain changes that happen with IH that make you more prone to these mood conditions.
Similarly, about 15% of people with mood disorders, such as major depressive disorder, bipolar disorder, and seasonal affective disorder, have some form of hypersomnia.
Researchers aren’t completely sure why sleep and mood disorders affect each other. One theory is that sleep issues affect how the neurotransmitter serotonin acts in the body, which can cause depression. Problems with sleep also disturb the body’s circadian rhythms, or sleep-wake cycle – another risk factor for depression.
Some medications used to treat anxiety and depression are also used to treat idiopathic hypersomnia. But other medications that treat anxiety, like benzodiazepines, can make you sleepy. These drugs are only used in cases of severe hypersomnia. They’re highly addictive, so you can only use them at the lowest possible dose for 4 weeks at the most. Your doctor can talk to you about other options.
When you have IH, it’s a good idea for your doctor to screen you every 1 to 2 years for a mood disorder such as depression.
