Is there anything to do to help with post-traumatic hypersomnia — sleeping too much?
First, you need to make sure that excessive sleepiness or hypersomnia is, in fact, a result of TBI before deciding on appropriate treatment.
There are many reasons that people can be excessively sleepy and post-traumatic hypersomnia is really a diagnosis of exclusion; that is, one needs to make sure that all other conditions are adequately assessed for and ruled out before assigning a diagnosis of post-traumatic neurogenic hypersomnia. Endocrine problems such as hypothyroidism can also result in fatigue and excessive sleepiness. Medication-related side effects can produce hypersomnia. Non-restorative sleep patterns like obstructive sleep apnea or restless leg syndrome can produce hypersomnia. Depression and anxiety can also be causes.
If the hypersomnia is a direct result of the TBI, then the traditional treatments tend to be pharmacologic and include the use of more naturopathic “medicines” such as caffeine, Guarana, or Gotu cola. When stronger pharmacologic agents are necessary, then stimulant-type medication such as amantadine, armodafinil, atomoxetine, or controlled substances such as psychostimulants are often prescribed.
Nathan Zasler, MD is CEO and medical director for Concussion Care Centre of Virginia, Ltd. as well as CEO and medical director for Tree of Life Services, Inc. He is board certified in physical medicine and rehabilitation and fellowship trained in brain injury.