The diseases concerned - Identification of the pathology - Treatment strategy
The diseases concerned
Excessive sleepiness is a symptom found in several diseases called hypersomnias.
Hypersomnia encompasses prolonged sleep at night and a complaint of excessive sleepiness during the day. Hypersomnia accounts for a significant proportion of patients consulting for a sleep disorder.
Hypersomnia includes sleep apnoea syndrome, chronic sleep failure, narcolepsy, idiopathic hypersomnia, recurrent hypersomnia and some other neurological, psychiatric and endocrine causes.
Identification of the pathology
Hypersomnias are most often unrecognised, undiagnosed and misunderstood by the family. Only a careful questioning of the patient and/or the spouse can identify some of these disorders.
In particular, the number and duration of daytime sleep bouts, whether they are refreshing (restorative) or not, and the quality of the previous night's sleep should be specified.
There are many situations that can cause excessive daytime sleepiness.
Before making a more in-depth etiological diagnosis, which is sometimes difficult, it is first necessary to confirm the reality of hypersomnia.
The identification of these different hypersomnias from a clinical and polysomnographic point of view makes it possible to specify the type of disorder, its severity and thus to envisage an adapted therapeutic management.
Finally, one should not underestimate the existence of certain differential diagnoses such as delayed phase syndrome, chronic fatigue syndrome and distinguish from "long sleepers" in chronic sleep deprivation.