Disorders Cure

oi-Amritha K


on July 14, 2021

Called ‘Kumbhakarna’ by his neighbours, 42-year-old Purkharam, a resident of Bhadwa village in Rajasthan, sleeps 300 days a year, says reports [1]. While most people sleep approximately 6.5 to 8 hours daily in a single period, Purkharam sleeps for 25 days at a stretch.

Purkharam, who runs a local business in the area, is able to operate his small shop just five days a month and was first diagnosed with the rare syndrome 23 years ago. The symptoms became worse as years passed, where 7 to 8 days of sleep eventually became nearly 20 to 25 days.

This rare condition, termed HPA Axis hypersomnia, has impacted his wellbeing and lifestyle. Despite treatment, his body was fatigued most times and had severe headaches as other associated symptoms [2]. Purkharam’s daily chores, such as bathing and eating, are all done with the help of his family members when he’s asleep.

What Is Axis Hypersomnia?

HPA Axis hypersomnia is an extremely rare sleep disorder that causes the affected person to sleep for long hours, negatively impacting their overall health and life quality [3]. Axis hypersomnia is a type of hypersomnia that occurs due to the fluctuation in the brain Protein known as the TNF-alpha, which is generally associated with the disorders related to excessive sleepiness, such as sleep apnoea, narcolepsy, and idiopathic hypersomnia [4].

As axis hypersomnia falls under the classification of hypersomnia, the symptoms, causes and treatment options are primarily the same.

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What Is Hypersomnia?

Hypersomnia is a condition that causes one to feel excessive sleepiness during the day and is also called excessive daytime sleepiness (EDS). Hypersomnia can be a primary condition or a secondary condition; that is, it can develop on its own or can be a result of another medical condition.

Axis hypersomnia is classified as primary hypersomnia, where there are no other underlying medical conditions. Secondary hypersomnia is due to other medical conditions. These can include sleep apnoea, Parkinson’s disease, kidney failure, and chronic fatigue syndrome.

Hypersomnia is completely different from feeling tired due to lack of or interrupted sleep at night. One may often have difficulty waking from a long sleep and feel disoriented [5].

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What Causes Hypersomnia?

  • Primary hypersomnia is caused by problems in the brain systems that control sleep and waking functions.
  • Secondary hypersomnia is caused by conditions that cause fatigue or insufficient sleep, such as sleep apnoea.
  • Some medications can cause hypersomnia.
  • Frequent drug and alcohol use may trigger sleepiness during the day.
  • Other less common causes are low thyroid function and head injury.

What Are The Symptoms Of Hypersomnia?

Apart from excessive fatigue and constant sleepiness, other symptoms associated with hypersomnia are as follows [6]:

  • Anxiety
  • Increased irritation
  • Decreased energy
  • Restlessness
  • Slow thinking and slow speech
  • Loss of appetite
  • Hallucinations
  • Memory difficulty

What Are The Risk Factors For Hypersomnia?

People with the following conditions are most at risk for hypersomnia:

  • Sleep apnoea
  • Kidney conditions
  • Heart conditions
  • Brain conditions
  • Atypical depression (your depressed mood can brighten in response to positive events)
  • Low thyroid function [7]

How Is Hypersomnia Diagnosed?

The doctor will begin by reviewing your symptoms and medical history. The following tests may be prescribed:

  • Epworth Sleepiness Scale (you rate your sleepiness to determine the severity of the condition)
  • Multiple sleep latency tests (you take a monitored nap during the day, and the test measures the types of sleep you experience)
  • Polysomnogram (you stay at a sleep centre overnight, where your brain activity, eye movements, heart rate, oxygen levels, and breathing function will be monitored)
  • Sleep diary (where you will be asked to record sleep and awake times through the night to track sleeping patterns)

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What Is The Treatment For Hypersomnia?

Treatments for this condition can vary, depending on the cause of hypersomnia. In some cases, medicines used for treating narcolepsy can treat hypersomnia [8]. Another important step of treatment for hypersomnia is lifestyle changes. Your doctor will recommend a regular sleeping schedule, avoiding certain activities that may cause tiredness, especially around bedtime.

Another important thing for people with hypersomnia is that they should not consume alcohol, drugs or even coffee. A high-nutrition diet may be recommended to maintain energy levels naturally.

On A Final Note…

Axis hypersomnia or hypersomnia is not a life-threatening condition. But it can severely affect the health and living quality of an individual. For some people, hypersomnia can be managed through lifestyle changes and treatment, but for some, it can be life-long trouble.

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Story first published: Wednesday, July 14, 2021, 8:30 [IST]

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