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Pediatric hypersomnia (excessive daytime sleepiness)
Hypersomnia (hy·per·som·nia), or hypersomnolence (hy·per·som·no·lence), is excessive daytime sleepiness (EDS).
What is pediatric hypersomnia (excessive daytime sleepiness)?
While many daytime sleep disorders result from a lack of nighttime sleep, people with hypersomnia may sleep 10 or more hours each night. The condition is rare in children.
What are the different types of pediatric hypersomnia (excessive daytime sleepiness)?
- Primary hypersomnia - This type of disorder is also known as idiopathic hypersomnia and has not identifiable cause.
- Secondary hypersomnia - This is the result of another cause, such as lack of sleep or medical problems, including sleep apnea.
What are the signs and symptoms of pediatric hypersomnia (excessive daytime sleepiness)?
The main symptom of hypersomnia in children is excessive drowsiness, often after sleeping for 10 or more hours at night.
Other symptoms of hypersomnia include:
- Awaking confused or disoriented
- Need for daytime naps (that don't relieve the sleepiness)
- Need for naps at inconvenient times (such as during school)
- Trouble waking from long sleeps
Less common symptoms may include:
- Anxiety or irritation
- Loss of appetite
- Restlessness
- Slow speech, or trouble thinking
How is pediatric hypersomnia (excessive daytime sleepiness) diagnosed?
While excessive daytime sleepiness is common in adolescents and adults, it is rare in children. Idiopathic hypersomnia is more unusual still—affecting less than one percent of the population.
Your child's doctor will perform a physical exam to rule out medical conditions that may be behind her excessive sleepiness. The physician may want older kids to keep a sleep diary for a week or more before recommending a sleep test.
- Multiple sleep latency test (MSLT) - An MSLT measures the speed at which your child enters a deep sleep over several two-hour periods. Kids with hypersomnia usually fall asleep quickly (in less than 10 minutes). A multiple sleep latency test is one of the best ways to detect hypersomnia in children.
- Sleep study (polysomnography) - A sleep study can rule out other sleep disorders that may be behind the excessive daytime sleepiness. If the first test is normal, your child may need to come back for a second polysomnogram. If the sleep specialist still can't find another cause, he may diagnose hypersomnia.
Learn more about sleep studies.
What are the causes of pediatric hypersomnia (excessive daytime sleepiness)?
- Primary hypersomnia has no identifiable cause.
- Secondary hypersomnia in children can be caused by infections, kidney problems or disorders such as myotonic dystrophy.
Research
Research is ongoing, but idiopathic hypersomnia may be the result of problems with the brain's sleep-wake cycle. It may also be caused by atypical depression.
How is pediatric hypersomnia (excessive daytime sleepiness) treated?
If your child has a medical condition causing her excessive daytime sleepiness, they will need to be treated for that first.
Primary and secondary hypersomnia
- Avoiding caffeinated beverages before bedtime
- Using blackout shades
- Avoiding naps during the day or, alternately, encouraging scheduled naps to regulate sleep patterns
Secondary hypersomnia medications are most often used to treat a secondary hypersomnia.
- Stimulants are amphetamine derivatives that can prevent your child from napping during the day. Stimulants usually prescribed include dextroamphetamine and methylphenidate (Ritalin™). Stimulants may have harmful side effects, such as aggressiveness, dependence and heart problems.
- Wake-inducing medications - Medications such as modafinil and armodafinil may influence brain chemistry and stimulate wakefulness. They are not stimulants. Side effects of modafinil and armodafinil include headache and a potentially life-threatening rash.
- Sodium oxybate is a drug that your child takes at bedtime (and again during the night). It promotes deep sleep, which can reduce excessive daytime sleepiness in some patients.
Idiopathic hypersomnia
It is important to note there are currently no approved treatments for idiopathic (unknown cause) hypersomnia. However, behavioral changes can be an effective way to treat idiopathic hypersomnia. Your child should have a regular sleep schedule and a comfortable bed and pillows in a quiet room.
Pediatric hypersomnia (excessive daytime sleepiness) doctors and providers
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Elisa Basora Rovira, MD Pediatric Pulmonologist and Sleep Medicine -
Michelle Caraballo, MD Pediatric Pulmonologist and Sleep Medicine -
Tanya Martinez-Fernandez, MD Pediatric Pulmonologist/Sleep Medicine -
S. Kamal Naqvi, MD Pediatric Pulmonologist/Sleep Medicine -
Anna Wani, MD Pediatric Sleep Medicine Specialist -
W. David Brown, PhD Pediatric Psychologist - Sleep Medicine -
Annie Kincaid, APRN, FNP Nurse Practitioner - Pulmonology -
Rachel Rosen, APRN, PNP-PC Nurse Practitioner - Sleep Disorders
Frequently Asked Questions
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How common is hypersomnia?
Hypersomnia is extremely rare in children. Only one percent of the population has idiopathic hypersomnia and most of them are adolescents and adults..
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How can I tell if my child has hypersomnia?
Kids with hypersomnia will often sleep more than 10 hours at night and nap another 4 to 8 hours during the day (if possible). They may also be extremely difficult to wake. Your child may nap in inconvenient or unacceptable places (such as school).
Other symptoms of hypersomnia may include anxiety, irritation, loss of appetite and slow thinking or speech.
If your child has had symptoms for more than three uninterrupted months without an identifiable cause, see a doctor.
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What is the prognosis for children with hypersomnia?
Because medications can have potentially life-threatening side effects, it is important for parents to monitor their child’s sleeping habits.
Kids who have regular sleeping schedules, avoid caffeine before bedtime and sleep in a comfortable environment have better outcomes than those kids who don’t.